IUI is Intra Uterine Insemination.
The pregnancy rate after IUI for the first time is 15 %, increases to 25 % after 3 cycles. The success rate drops after 5th cycle. So we generally recommend 4 cycles in our centres.
1. After trying natural intercourse for 1 year and not conceived
2. When sperm count is less than 15 million
3. When motility is 15 to 30%
4. When there is erectile or ejaculation problem or sexual problems
5. When wife requires gonadotropin injections to increase or induce egg/follicle growth (PCOS)
1. Male Partner: Semen Analysis
2. Female Partner: Tubal patency test ( HSG/ Laparoscopy), Ovarian reserve test( USG & AMH)
1. Needs minimum of three to maximum of six visits to the doctor.
2. First visit will be during menses day 2 or 3 .The baseline scan will be done and medications will be prescribed.
3. Second visit will be on day 9 or 10 to monitor the follicle/ egg growth.
4. Next visit will be mostly on day 13 or 14 , once follicle grows to 20 to 22mm, a trigger injection ( Painless S C ) will be given.
5. About 36 hours later , Husband will be giving semen sample for Processing.
6. Processing will take about 45 to 90 min , then IUI will be done.
Female partner scan is done to confirm rupture of follicles. Then in the same position , the private area is cleaned with saline , a small speculum is inserted and cervix or uterine mouth visualized. Under USG / scan guidance with partially filled urinary bladder, processed semen sample is instilled into uterine cavity. She lies down relaxed in the couch for 20 minutes , then gets back home. It is a comfortable easy procedure. Not painful and infact they usually ask “ Is it over Dr, that’s all ?
1. Male Partner: Semen Analysis
2. Post IUI, a female can undergo normal activity as before. To avoid stressful activities physically or mentally. Can climb stairs
1. It’s better to have normal intercourse before IUI. Just 1 to 2 days before abstinence is better.
2. Post IUI, once or twice intercourse is advisable to increase the success rate. But after 2 days there is no harm in having normal sexual life.
Healthy diet is the gold standard. Avoid junk foods, foods causing acidity or cold.
Post IUI, after 20 days urine pregnancy test can be done.
No, the procedure is not painful at any step, minimal discomfort can be there after ovum or egg pick up, but almost all patients are comfortable after procedure in 5 to 7 days.
No, the injections are given by syringes like insulin syringes/needles, they are very minimally invasive and very comfortable, with highest quality.
The duration of stimulation of eggs is usually 10 days, 12th day the egg collection happens. If the embryo transfer happens in the same cycle, then it happens 3 to 5 days post egg collection. After Embryo transfer 14 days later pregnancy blood test is done. So if fresh Embryo Transfer ( ET ) happens, the duration is 4 weeks. If the patient is not ready or fit for a fresh embryo transfer (ET), then Frozen Embryo Transfer happens after 30 to 45 days. In Frozen embryo transfer, there is no injections and only oral medications are given. Pregnancy tests is done as usual 14 days after FET.
These injections are the same secreted by a woman’s body. They generally don’t cause any major side effects. But dosage has to be carefully be given by expert doctors.
No, not at all. All couples do not get successful in the first embryo transfer. We have seen patients positive after even 7th to 10th embryo transfer. Most of them (9 out of 10 patients- 90%) will become positive within 3 embryo transfers, so persistent trying, without loosing hope is the secret of success
In IVF / ICSI, present modern practice has become very patient friendly. Apart from pregnancy induced changes which any naturally conceived woman will have, IVF conceived patient also feel the same changes. There are no additional major risks due to method of conception.
The child born out of any method of conception has same risk of anomalies or birth defects, which is more related to age of female rather than method of conception. A female delivering after 35 years have more risk of miscarriage and abnormal child than a younger mother irrespective of method of conception. But systematic evaluation will be done post conception to rule out birth defects.
Definitely not. Except for certain rare genetic conditions and PCOS, mostly fertility issues are not transmitted to next generation. The World’s first IVF conceived and born child LOUIS BROWN, conceived naturally and delivered a healthy child this itself proves it.
There is only assistance in the early stage of embryo formation in IUI and IVF, except that there are no changes in the child. Unless you tell to any of your relatives or friends, no body will know the method of conception.
We have many patients coming to us conceived after ICSI first conception. There are two major reasons for this, apart the stress relief. They are uterine and tubal vascularity getting improved after one conception, other being Endometriosis getting subsided with almost 1 year of no menstruation.
As per guidelines 5 cycles of stimulation and Ovum pick up can be done, irrespective of embryo transfer cycles. But most of the patients are decided about the success in 3 stimulation cycles. Alternate options given and pregnancy made possible.
This is a very rare scenario, almost all patients will have an Ovum pick up after injections. But patients very rarely can have suboptimal response after injections. This will be discussed before hand for patients with low AMH or low egg count.
Strictly no injections should be missed even for single day. We have strict monitoring system, so if patient fail to come for injections, call will be given at the earliest to maintain ideal timing.
It is better to avoid intercourse during stimulation as there can be pain after intercourse. But intercourse does not cause any complications during injections. After ovum pick up for 5 days intercourse is avoided. After embryo transfer also intercourse is avoided.
They can have orgasm with clitoral stimulation, this does not cause any complications.
This is a very important step in ICSI cycle, the trigger timing is decided exactly 36 hours before Ovum Pick Up procedure. Hence, the timing has to be maintained and the concerned sister in charge is informed after the receipt of injections.
Ovum Pick Up is done under anesthesia, hence 8 hours of fasting is absolutely necessary. Even water should not be taken for 8 hours before OPU. If thyroid or HT medications are to be taken, this alone can be taken with sips of water as per instructions given by the doctor.
They can resume to have intercourse 5 days after egg collection, provided embryo transfer is not planned. If the embryo transfer is planned then it should be avoided usually till first 3 months of pregnancy.
After Ovum Pick UP, the embryo is grown till - cleavage stage or day 3 / blastocyst or day 5. Day 5 transfer is most often recommended for patients. If fresh transfer is not planned then embryo is grown till day 5 and then frozen in that stage, when frozen embryo transfer is planned the embryo is thawed before 2 to 3 hours of procedure.
Most of the embryo transfers are done without anesthesia, as it is not painful at all, except for the discomfort caused by partially filled urine and the small vaginal speculum. But if the patient is worried, anesthesia can be given for embryo transfer but only with prior intimation and preparation.
The procedure as such takes only 15 minutes. The duration of stay in hospital is 2 hours before and 3 hours after the procedure
DO’s- can take bath daily , can do daily routines by yourselves, can climb stairs slowly, should have healthy food , can have fruits which doesn’t cause cold ( raw papaya and large quantities of pineapple can be avoided) , can have non vegetarian food with less spices, do maintain normal bowel habits , better use western toilet,do drink lots of water, can do walking with intermittent rest, can do routine activities without physical exertion, do read good books, do sleep restful, do have lots of positive attitude. Dont’s - Do not have intercourse, Do not travel in rough roads, Do not sit and stand for long time, intermittent resting is very helpful, do not eat junk foods and spicy foods, avoid foods causing tummy upset, avoid getting cold or allergies, avoid mental stress, avoid negative ideas, do not skip medications
Evidence had clearly showed that embryo transfer under USG or scan guidance has better success rate. Hence for abdominal scan guidance, partially filled bladder is essential. Usually not passing urine for 1 hour is sufficient after drinking water.