In this section, you will learn what the process of intrauterine insemination (IUI) is and how it is performed.
About IUI
In today’s practice, intrauterine insemination (IUI) is one of the commonly used treatment approaches for infertility. IUI involves the direct delivery of a low volume of concentrated sperm into the uterus during ovulation. With the IUI method, the transportation of more motile sperm to reach the egg is facilitated by bypassing the uterine canal. It can be applied under physician recommendation to selected patient groups due to its less invasive nature and lower cost compared to the IVF method. The success of the IUI method depends on selecting the right patient group, the woman’s age, at least one open fallopian tube, infertility duration of less than 2 years, normal sperm analysis, and sperm morphology are important factors.
Compared to IUI alone, higher pregnancy rates have been found in patients where ovaries are stimulated with hormonal injections before performing IUI. However, the main concern here is the risk of multiple pregnancies. Therefore, nowadays, mild ovarian stimulation aiming for the development of one or two mature follicles is targeted. When there is development of more than two mature follicles, cycle cancellation or conversion of IUI to IVF (in vitro fertilization) is recommended.
Generally, pregnancy rates after IUI are reported to be around 10% – 20% per patient. The highest rates in terms of infertility reasons are observed in patients with anovulation due to polycystic ovary syndrome, patients with mild male factor infertility, and cases of unexplained infertility. However, the lowest pregnancy rates have been reported in patients with endometriosis.
Ovarian stimulation in IUI aims to induce ovulation in patients with polycystic ovary syndrome and to increase the chance of fertilization by promoting the development of multiple eggs in ovulating patients. It is also done to support the endometrial lining with increased steroid levels, thereby increasing the likelihood of embryo implantation.
The Insemination Process
The insemination treatment consists of several steps. Initially, on the 2nd or 3rd day of the menstrual cycle, the patient’s ovaries are checked with transvaginal ultrasound. If deemed necessary, the physician may request some hormonal blood tests. Then, the patient is started on some hormone medications to stimulate the growth of the eggs. The insemination procedure is usually performed during the woman’s natural ovulation period. Initially, on the 2nd or 3rd day of the menstrual cycle, the ovaries are checked with vaginal ultrasound. Then, hormone medications are started to stimulate the growth of the eggs. Follicle development is monitored with ultrasound at intervals of approximately 10-15 days. When the follicle reaches a certain size, triggering is performed. The insemination procedure is performed 36 hours after the triggering injection. The insemination is done with the prepared sperm sample obtained from the partner in a laboratory setting. The prepared sperm sample is injected into the woman’s uterus using a special catheter. This allows the sperm to reach the fallopian tube more quickly, increasing the chance of fertilizing the mature egg.
The insemination procedure is usually performed in outpatient clinic conditions, without requiring anesthesia, and is generally painless and quick. During the procedure, the woman lies comfortably, and the doctor places the sperm into the uterus using a thin catheter. The procedure should be performed with a full bladder to make it technically easier. After the procedure, the woman rests for a while (10-20 minutes) and can then resume her daily activities. The patient returns for a pregnancy test 15 days after the procedure, and the results are evaluated. If pregnancy does not occur, the insemination process can be repeated once more.
What Medications are Used in Insemination?
In most studies comparing the results of oral medications and injectable hormone medications used in insemination treatments, injectable medications have been shown to be superior in terms of pregnancy outcomes. However, it should be kept in mind that injectable hormone medications, by causing more egg development, may increase the risk of OHSS (ovarian hyperstimulation syndrome) and multiple pregnancies. For this reason, much lower doses (37.5-75 IU/day) of hormone medications are used in insemination treatments compared to IVF treatments.
Who is Insemination Applied to?
Insemination is a treatment option used when couples experience difficulty conceiving naturally. It is generally recommended and applied in the following cases:
– Mild male factor infertility
– Women’s ovulation issues (polycystic ovary syndrome)
– Mild to moderate cases of endometriosis
– Unexplained infertility
Insemination can be a source of hope for couples facing these conditions. Since each couple’s situation is different, it is important for the doctor to conduct a detailed evaluation before insemination.
Advantages and Disadvantages of Insemination
Insemination is a treatment option that offers various advantages. Firstly, it provides couples with a chance to conceive naturally. For couples experiencing difficulty conceiving naturally, insemination is a promising option. Additionally, the insemination procedure is low-cost and non-invasive. Being more affordable compared to other reproductive techniques, it offers an economic option for couples. Moreover, since the insemination procedure does not require surgical intervention, it is a non-invasive option.
The main disadvantage of insemination is that even when the most appropriate patient group is selected under the best conditions, success rates cannot be compared to those of IVF (In Vitro Fertilization) (10-20% vs 40-50%).
Risks of Insemination
Like any medical procedure, insemination carries some risks. In this section, you will find the potential risks and side effects of insemination.
The insemination procedure is generally safe, but like any medical intervention, it carries some risks. One of the potential risks that may arise during or after the procedure is the risk of infection. Sperm cells placed into the uterus may be sensitive to infections, which may increase the risk of developing infections in some women.
Additionally, some women may experience mild bleeding or cramping after the insemination procedure. This is usually a temporary condition and resolves spontaneously within a few days. However, if severe pain, heavy bleeding, or other concerning symptoms occur, it is important to consult your doctor immediately.
Additionally, the insemination procedure may increase the risk of multiple pregnancies in some women. Multiple pregnancies, such as triplets or quadruplets, can occur as a result of fertilization of multiple eggs and embryo implantation. While this situation may be a positive outcome for some couples, it can create challenges for others. Therefore, according to the regulations of our Ministry of Health, if more than two mature eggs develop in our insemination procedure, the insemination is either canceled or converted to the IVF method. It is important for couples to discuss this with their doctor in detail before the insemination procedure.
In general, the insemination procedure can be a safe and effective treatment option for most couples. However, since each couple’s situation is different, it is important for them to discuss potential risks and side effects with their doctors in detail.
Frequently Asked Questions about Insemination
In this section, we will address frequently asked questions about insemination and provide answers to these questions. You can find answers to your questions about insemination here.
Insemination is a treatment option for couples experiencing difficulty conceiving naturally. This procedure involves placing sperm cells into the uterus during the woman’s ovulation period. This allows for easier union of sperm cells with the egg and the formation of pregnancy.
The insemination procedure is generally performed during the woman’s natural ovulation period. Initially, on the 2nd or 3rd day of the menstrual cycle, the ovaries are monitored using transvaginal ultrasound. Then, hormone medications are started to stimulate the growth of the eggs. Follicle development is monitored with ultrasound at intervals of about 10-15 days. When the follicle reaches a certain size, a triggering injection is administered. The insemination procedure is performed 36 hours after the trigger injection. The insemination procedure is performed using a sperm sample obtained from the partner, prepared in the laboratory. The prepared sperm sample is injected into the woman’s uterus using a special catheter. This ensures that the sperm reach the fallopian tube more quickly and increases the chance of fertilizing the mature egg. The insemination procedure is generally performed in outpatient conditions, without requiring anesthesia, and is usually painless and quick.
The duration for repeating the insemination procedure may vary depending on the couple’s situation. Insemination can be repeated 2 or 3 times depending on the underlying cause of infertility. However, since each couple’s situation is different, your doctor will determine the most suitable duration for repetition for you.
The insemination procedure is a treatment option that increases the chance of natural conception for couples. However, since each couple’s situation is different, the success rate of insemination can vary. Success rate depends on various factors, so your doctor will provide you with more information on how effective the insemination procedure could be in your case.
The time it takes for pregnancy to occur after the insemination procedure can vary among couples. Since each couple’s situation is different, the time for pregnancy to occur may vary. Your doctor will provide you with more information on when you should perform a pregnancy test after the insemination procedure.
Insemination is performed by a gynecologist. During the procedure, sperm cells are placed directly into the uterus using a special catheter. This procedure is usually performed painlessly and is a comfortable experience for most people. However, since everyone’s pain threshold is different, some individuals may experience mild discomfort. This discomfort may be felt during the insertion of the catheter into the uterus. However, this discomfort is usually short-lived and subsides immediately after the procedure.
It is important to relax to avoid feeling pain during the insemination procedure. Having a full bladder before the procedure is a method that facilitates the procedure. This way, you may feel less discomfort during the procedure.
In summary, the insemination procedure generally does not cause pain. There may be a slight discomfort, but it is usually short-lived and immediately subsides.
Insemination treatment is offered as an option for couples experiencing difficulty conceiving naturally. However, the number of times insemination should be repeated depends on many factors. Since every couple’s situation is different, your doctor will determine the most suitable treatment plan for you.
The number of times insemination should be performed can vary depending on the couple’s age, health condition, medical history, and other factors. Generally, couples are recommended to undergo insemination treatment 2-3 times. This process is planned according to the woman’s ovulation cycle and can be repeated regularly every month.
For insemination to be successful, it’s important for couples to start treatment at the right time and follow up regularly. Your doctor may use methods such as ultrasound and hormone tests to monitor your ovulation cycle. This way, the treatment can be performed at the right time, increasing your chances of success.
If you have concerns about how many times insemination should be done, it’s important to discuss openly with your doctor. A personalized treatment plan will be created for you, and you’ll be able to get more information about the process.
Remember, every couple’s experience is different, and patience is important.
The Insemination process is generally associated with a mild discomfort, but everyone’s pain threshold is different. Usually, minimal or no pain is felt during the Insemination process. Some women may experience mild cramping or a feeling of pressure in the uterus, but this usually subsides quickly.
Insemination treatment varies depending on the couple’s situation and the recommendations of healthcare professionals. In the initial stage, most couples are advised to attempt 2 to a maximum of 3 insemination trials. Your doctor will determine the most suitable treatment plan for you.
By filling out the form, you can make an appointment with Gynecology and Obstetrics Specialist Prof. Dr. Ebru Çöğendez.
IVF treatment prices usually include factors such as tests, medications, laboratory procedures, doctor examinations, etc. during the treatment process.
IVF treatment is applied to couples who are determined by taking certain factors into consideration.
Factors such as age, health status, choice of treatment center and treatment process can affect success rates.
The stages of IVF treatment usually consist of four main stages. The first stage is the preparation stage.
As with any medical intervention, IVF treatment has potential risks and possible complications.
