Monday 5 December 2011

Intrauterine insemination

'Washed sperm', that is, spermatozoa which have been removed from most other components of the seminal fluids, can be injected directly into a woman's uterus in a process called intrauterine insemination (IUI). If the semen is not washed it may elicit uterine cramping, expelling the semen and causing pain, due to content of prostaglandins. (Prostaglandins are also the compounds responsible for causing the myometrium to contract and expel the menses from the uterus, during menstruation.) The woman should rest on the table for 15 minutes after an IUI to optimize the pregnancy rate.[4]

To have optimal chances with IUI, the female should be under 30 years of age, and the man should have a TMS of more than 5 million per ml.[5] In practice, donor sperm will satisfy these criteria. A promising cycle is one that offers two follicles measuring more than 16 mm, and estrogen of more than 500 pg/mL on the day of hCG administration.[5] A short period of ejaculatory abstinence before intrauterine insemination is associated with higher pregnancy rates.[6] However, GnRH agonist administration at the time of implantation does not improve pregnancy outcome in intrauterine insemination cycles according to a randomized controlled trial.[7]

It can be used in conjunction with ovarian hyperstimulation. Still, advanced maternal age causes decreased success rates; Women aged 38–39 years appear to have reasonable success during the first two cycles of ovarian hyperstimulation and IUI. However, for women aged ≥40 years, there appears to be no benefit after a single cycle of COH/IUI.[8] It is therefore recommended to consider in vitro fertilization after one failed COH/IUI cycle for women aged ≥40 years.[8]


Source: -en.wikipedia.org/wiki/Artificial_insemination#Intrauterine_insemination

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