Intra-Uterine Insemination (IUI) Malaysia

It is a medical method of directly introducing sperm into the uterine cavity.

Intra-Uterine Insemination (IUI) is a medical method of directly introducing sperm into the uterine cavity. Sperm is processed and selected for motility in a concentrated amount to be placed intra uterine. Couples seeking families and with a history of infertility has shown to benefit from fertility treatments such as IUI. It is a useful technique for those seeking pregnancy with sexual dysfunction, cervical factor or male/female factor infertility. The theory behind IUI is that by inseminating a high concentration of sperm into the uterus can increase the likelihood of fertility and conception. This article will focus on the indication, preparation, procedure and outcomes of those seeking intra-uterine insemination for couples trying to achieve pregnancy.

IUI is beneficial for couples in which sexual dysfunction is present. Many men and women face sexual incompatibility or anomalies that render them infertile. Women with cervical dysfunctions, vagismus or men suffering from ejaculatory dysfunction are reasons for infertility. Couples with discordant venereal diseases/ STDs also benefit from fertility treatments. IUI allows the seamen to bypass cervical dysfunctions or factors that prevent insemination as well as increasing the amount of sperm to enter the uterine cavity opposed to males suffering from infertility. IUI Malaysia has been showed as a positive adjunctive procedure for fertility besides intercourse alone. IUI is usually tried prior to IVF due to being less invasive and cost effective. Seamen is collected usually post ejaculation after 2-3 of abstinence. The sperm is collected in a sterile container to ensure no contamination when entering the uterus. Semen is then separated into sperm from prostaglandin secretions or seminal fluid as it may cause uterine cramping or reactions when directly placed in the uterus. A small sample of the sperm is measured and observed on the microscope to ensure motility and physical acuity. The amount of motile sperm post wash and separation usually warrants a range of 10 million to ensure successful insemination.

In addition to preparing the sperm, proper timing and cycles of ovulation must be calculated to ensure fertility. The most effective and natural method is to time the normal moment of ovulation via at home ovulation kits or going to your local OB GYN, known as unstimulated cycling. These unstimulated cycles provide a natural cycle that was shown to be better for fertilization. LH hormone levels are increased during ovulation and once the LH surge is documented, intrauterine insemination is performed the following day. This observation and monitoring of ovulation allows for an uninterrupted fertilization process with higher pregnancy success. The other option for couples who have irregular ovulation, hormonal imbalances or unexplained infertility is stimulated cycling. Controlling the timing of ovulation by hyper stimulation artificially does this. Hormone ovulation inducing medications include clomiphene or injectable gonadotropins. The ovaries are hyper stimulated with clomiphene for 5 days during their natural day 5 cycle. The urine is then tested for LH until a surge is seen. One the LH surge is recorded; IUI is followed the next day. Other options are to monitor the follicles via ultrasound, though this requires extra costs and clinic or hospital monitoring. This is usually performed for women whose LH surge or LH monitoring is missed. Older women tend to benefit from gonadotrophin injections as it stimulated ovarian reserves. This is given day 2 of the woman’s natural cycle and the LH surge is followed after.

Once ovulation is calculated and reached, the actual procedure of intra-uterine insemination is performed. Equipment needed includes the prepared sperm, a speculum for examining, sterile syringe usually 1cc and an insemination catheter. The patient prepares for the produce by lying on an exam table, undressed from the waist down with her feet in the stirrups. The syringe aspirates the processed sperm, usually up to 0.5ml and attached to the insemination catheter. The speculum is inserted for proper visualization of the cervix. The catheter is then inserted through the cervical os, into the uterus about 6.5 cm deep. The sperm is then injected and the catheter is withdrawn after. Sperm should have reached the fallopian tubes after a few minutes and the patient is asked to lay in a supine position. The patient may notice increased cramping, discharge or light bleeding which is all-normal due to insertion through the OS. Intercourse is allowed after and a urine or serum pregnancy test is done 2 weeks later. Usually one to two cycles of IUI is needed for pregnancy, after 3 or more, chances of fertilization decreases.

Intra-uterine insemination in Malaysia is a great and less invasive procedure for those wanting to get pregnant. Those with mild factor infertility, unexplained infertility and organ dysfunctions will benefit from IUI compared to those who try naturally. The process is a cost effective and follows the woman’s natural cycle. More information can be obtained from the patient’s OB GYN or Fertility specialist and can be a life changing even if pregnancy becomes successful. Feel free to consult us at our fertility centre in Petaling Jaya, Selangor.

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