1. IUI A to Z

2. MethodPregnancy Rate (%) Intercourse (Timed)4 (Follicle Monitoring) 1 IUI6 ---do---- CC6 ---do---- CC+IUI8 2 FSH / HMG7.7 CC / FSH /IUI9-12 3 FSH/ HMG/IUI17 – 20 % 5 In vitro fertilization20 to maximum 30 TYPICAL PREGNANCY RATE PER CYCLE WITH VARIOUS TREATMENT OPTIONS In Infertility

3. 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%

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

5. Our IUI Experience (2009- 2011) 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 %

6. Male Infertility 5 - 20 millions 15% Less then 5 million Nil AID – 46% (2 cycles)

7. Success rates according to AGE (Success rate in 1st 2 cycles) Less then 30 – 28 % Less then 35 – 22% 35- 39 years - 8 % 40 + Nil

8. 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

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

10. What is the difference between IUI & Artificial Insemination

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

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

13. How Many Eggs ?

14. Office visits 4 - 6

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

16. Can we have sex in R x cycle ?

17. IUI is a simple procedure Easy Nurses

18. IUI Preparation in Doctor’s office

19. ↑ 37 yrs – married to 10 yrs what should be done ?