Understanding Assisted Reproductive Technologies: Intrauterine Insemination (IUI), Sperm Donors and Egg Donors
What is Intrauterine Insemination (IUI)?
Intrauterine insemination (IUI) is a kind of an artificial insemination procedure for women who are not able to conceive naturally, or where the partner has low sperm count or low sperm motility. It is also applicable for women whose parterhave male factor infertility and single mother or same sex couples using donor sperm to get pregant. The sperm, after being washed, is placed inside the uterus around the same time as when the ovary releases a mature egg. The hope is that the sperm will travel through the fallopian tube and fertilize the egg, resulting in pregnancy.
Egg donation is the process in which a fertile young woman usually within the age of 18 to 33 years donates her eggs or oocytes for assistive reproductive procedures.
- Egg donation involves a rigorous screening of physical and psychological health, physical tests and screening for sexually transmitted infections.
- The donor’s menstrual cycle is coordinated with the recipient’s cycle to ensure that the recipient is ready to be implanted with the fertilized embryo when the donor eggs are retrieved.
- The process after egg retrieval is similar to IVF procedure, where the donor eggs and the partner sperm are fertilized in a laboratory and the embryo transferred into the recipient’s uterus.
Sperm donation is the process in which healthy men within the age of 18 to 35 (max 40) years donate their sperm for assistive reproductive procedures.
- Sperm donors usually go through a rigorous screening process before they are allowed to donate sperm.
- It involves personal, medical and sexual history screening, physical tests and semen analysis.
- For qualifying participants, their sperm samples are then taken and frozen for 6 months and then thawed to observe their survival rate.
- Once that step is cleared, only then can donors donate their sperm.
When is IUI used?
A woman’s ability to conceive depends on various factors. IUI is one of the first methods employed for couples finding difficulty in conceiving. It is usually carried out in the following conditions:
- Unexplained infertility: When there is no obvious cause of infertility, IUI is the first treatment employed along with ovulation inducing medicines.
- Endometriosis: For infertility related to endometriosis, the first technique often employed is using medications to obtain a good quality egg along with performing IUI.
- Male subfertility: The partner could have below-average sperm concentration, low sperm motility or abnormalities in sperm shape and size. IUI is a helpful procedure as it helps in identifying the high motile and normal sperm from the low quality.
- Cervical factors: The cervix at the end of the vagina provides an opening from vagina to uterus. The cervical mucus released during ovulation provides a suitable environment for sperm to travel and reach the fallopian tubes. If the cervical mucus is too thick, it may inhibit the sperm from passing through. IUI bypasses the cervix and deposits the sperms directly in the uterus, thus solving fertility problems due to this.
- Ovulation factors: IUI can be used for women facing infertility due to absence of ovulation or reduced number of good eggs.
- Donor sperm: For women requiring donor sperm to get pregnant, IUI is the most common technique used for depositing the thawed donor sperm inside the uterus.
How is IUI done?
- The partner’s sperm sample is collected or the donor sperm’s sample is thawed and prepared. The sperm is washed such that the high quality sperm is separated from low quality ones.
- Ovulation is closely monitored, as it is essential that the sperm is injected at the correct time in the cycle. If needed, ovulation inducing medicines are provided to ovulate at the right time.
- The optimal time is determined and IUIs are mostly done one or two days after ovulation detection.
Advantages of IUI
- Since the eggs are not removed from the body, IUI is less invasive for the woman
- It is also much less expensive than other assisted reproductive procedures like IVF, since the egg does not need to be extracted and monitored in the laboratory.
Disadvantages of IUI
Though IUI is successful in helping couples getting pregnant, it does not address other causes of female infertility. It relies on the woman having normal ovulation and no damage in fallopian tubes and the sperm used has some level of motility. If these criteria aren’t met, IUI will not be successful.