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Intrauterine insemination (IUI)
( Intrauterine insemination, IUI )
Testicular Sperm Extraction
( Testicular Sperm Extraction, TESE )
IVF
( In Vitro fertilization )
ICSI
(Intra Cytoplasmic Sperm Injection)
Oocyte/Sperm/ Embryo Cryopreservation
( Oocyte/Sperm/
Embryo Cryopreservation )
Pre-implantation Genetic Testing
( Pre-implantation Genetic Testing,
PGT )
Artificial Insemination (AI) or Intra-Uterine Insemination (IUI)
(Artificial Insemination, AI or Intra-Uterine Insemination, IUI)
Artificial Insemination (AI) or Intra-Uterine Insemination (IUI) is a process of sperm injection using a onemillimeter silicone tube or smaller inserted through a cervical opening into the uterus. The strong sperm will fertilize the egg in a uterine tube.
AI is a primary process for infertility treatment. Seminal fluid must be prepared or washed with a special washing liquid every time as it would select strong sperms with perfect physical quality, i.e., normal shape and movement, and adjust quality seminal fluid density for fertilization. Washing or seminal fluid preparation will separate other cells that affect the fertilization of sperms, i.e., white blood cells, red blood cells, and other contaminated bacteria in seminal fluid. Different seminal fluid preparations result in different outcomes depending on the purpose and seminal fluid quality.
The prepared seminal fluid is injected via the cervix into a woman's uterus. It is a short version of the natural process in which the sperm swims through the cervix after natural sexual intercourse. After injecting sperms through the cervix into the uterus, the strong sperms with appropriate density and amount (obtained from the preparation process) will swim through the uterus into both fallopian tubes and naturally fertilize the egg that is going to travel through the fallopian tubes. After fertilization, an embryo will move along the fallopian tubes to the uterus and embeds in the appropriate endometrial tissue.
IUI is the process injecting seminal fluid that has been prepared into the uterus to create pregnancy without having natural sexual intercourse. The technique is firstly selected to treat infertility when one of the couple or both of them have the following abnormalities:
Infertile couple that suits AI or IUI
- Have regular sperm density, but the number of motile sperms with the normal shape is low.
- Have less sperm density, but the number of motile sperms with the normal shape is normal.
- Have less amount of seminal fluid per one ejaculation.
- Male has a disorder of genital organ or cannot have sexual intercourse, but seminal fluid can still be collected, i.e., Hypospadias, Impotence, and Erectile Dysfunction (ED).
- Male has a disorder of genital organ or cannot have sexual intercourse, e.g., Cervical Stenosis and Vaginismus.
- Couple with unknown causes of infertility after the preliminary examination.
Three required qualities of a couple suitable for AI or IUI
- A woman has ovulation
- No block fallopian tubes, at least on one side, in a woman.
- A man's sperm density and motility must meet the range.
Steps of AI
- The preliminary examination results confirm that a man and a woman are qualified to receive AI treatment.
- See the doctor during the first three days of the menstruation period to receive the fertility agent appropriately. Most women take Clomiphene Citrate or Aromatase Inhibitor for five days consecutively.
- Get an ultrasound check to measure the egg size and endometrial thickness to estimate the ovulation day.
- If the ultrasound results show the appropriate egg size, the ovulation day can be estimated, or a woman receives the ovulation stimulation. The day for seminal fluid injection into the uterus is determined.
- On the injection day, a man who stops ejaculating for 3-5 days prior to the injection day collects seminal fluid with the masturbation method and contains it in a barrel. The lab will wash sperms to select the most appropriate sperms.
- The prepared seminal fluid is injected through a woman’s cervix with the sterilization method, which takes about 15 minutes. After the process completes, rest as appropriate.
- After having a seminal fluid injection, the woman can resume her daily routine.
- After two weeks, in case of no menstruation, take a urine pregnancy test or consult with the doctor to evaluate pregnancy.
Pregnancy Rate
The pregnancy rate from IA or IUI is 10-15% per treatment cycle. If the IA method has proceeded for 3-6 months consecutively, and pregnancy is still negative, consider other alternative treatments.