IUI A to Z

MethodPregnancy Rate (%) Intercourse (Timed)4 (Follicle Monitoring) 1 IUI6 ---do---- CC6 ---do---- CC+IUI8 2 FSH / HMG7.7 CC / FSH /IUI FSH/ HMG/IUI17 – 20 % 5 In vitro fertilization20 to maximum 30 TYPICAL PREGNANCY RATE PER CYCLE WITH VARIOUS TREATMENT OPTIONS In Infertility

Effect of Etiology on Success Rate with IUI Infertility EtiologyPregnancy Rate (Maximum) Unexplained22.6% Mild male factor18.8% Anovulation12.4% Endometriosis6.5% Tubal Factor6.5% Combined factors9.7%

Endometriosis,Tubal factor, severe male factor and combined factor should proceed earlier to higher level ART

Our IUI Experience ( ) N = 369 = 23.57% (two cycles) (world over success rate 10 to 15% only) Idiopathic - 30% - (2 cycles) PCOD – 30% - (r FSH) (2 cycles) Cervical Factor 20% Endometriosis – 15% After treatment for TB 15% Immunological cause TNF ↑ (treated ) 5 %

Male Infertility millions 15% Less then 5 million Nil AID – 46% (2 cycles)

Success rates according to AGE (Success rate in 1st 2 cycles) Less then 30 – 28 % Less then 35 – 22% years - 8 % 40 + Nil

PREREQUISITES Age < 40 yrs Spont. / Induced ovulation One patent FT >10 million pre wash semen count >5 million post wash semen count Easy access to uterine cavity

INTRAUTERINE INSEMINATION (IUI): Steps 1.Patients selection & workup 2.Ovarian stimulation 3.Semen wash 4.Insemination technique 5.Luteal support

What is the difference between IUI & Artificial Insemination

EJACULATORY FA ILURE Severe hypospadias Retro grade ejaculation Paraplegics Impotence & erectile dysfunction

Super ovulation V/s Control Ovarian Hyperstimulation Stimulation Monitoring Follicle growth & release of multiple eggs

How Many Eggs ?

Office visits 4 - 6

Complication of IUI Stimulation, Technique & others - Infection -Rare - Multiple Pregnancy - OHSS

Can we have sex in R x cycle ?

IUI is a simple procedure Easy Nurses

IUI Preparation in Doctor’s office

↑ 37 yrs – married to 10 yrs what should be done ?