IUI A to Z TYPICAL PREGNANCY RATE PER

IUI A to Z

TYPICAL PREGNANCY RATE PER CYCLE WITH VARIOUS TREATMENT OPTIONS In Infertility Method Pregnancy Rate (%) Intercourse (Timed) 4 (Follicle Monitoring) IUI 6 ---do---- CC+IUI 8 FSH / HMG 7. 7 CC / FSH /IUI 9 -12 3 FSH/ HMG/IUI 17 – 20 % 5 In vitro fertilization 20 to maximum 30 1 2

Effect of Etiology on Success Rate with IUI Infertility Etiology Pregnancy Rate (Maximum) Unexplained 22. 6% Mild male factor 18. 8% Anovulation 12. 4% Endometriosis 6. 5% Tubal Factor 6. 5% Combined factors 9. 7%

Endometriosis, Tubal factor, severe male factor and combined factor should proceed earlier to higher level ART

Our IUI Experience (2009 - 2011) N = 369 = 23. 57% (two cycles) (world over success rate 10 to 15% only) • Idiopathic - 30% - (2 cycles) • PCOD – 30% - (r FSH) (2 cycles) • Cervical Factor 20% • Endometriosis – 15% • After treatment for TB 15% • Immunological cause TNF ↑ (treated ) 5 %

Male Infertility • 5 - 20 millions 15% • Less then 5 million Nil • AID – 46% (2 cycles)

Success rates according to AGE (Success rate in 1 st 2 cycles) • • Less then 30 – 28 % Less then 35 – 22% 35 - 39 years - 8 % 40 + Nil

PREREQUISITES • • • Age < 40 yrs Spont. / Induced ovulation One patent FT >10 million pre wash semen count >5 million post wash semen count Easy access to uterine cavity

INTRAUTERINE INSEMINATION (IUI): Steps 1. Patients selection & workup 2. Ovarian stimulation 3. Semen wash 4. Insemination technique 5. Luteal support

What is the difference between IUI & Artificial Insemination

EJACULATORY FAILURE • • Severe hypospadias Retro grade ejaculation Paraplegics Impotence & erectile dysfunction

Super ovulation V/s Control Ovarian Hyperstimulation • Stimulation • Monitoring • Follicle growth & release of multiple eggs

How Many Eggs ?

Office visits 4 - 6

Complication of IUI Stimulation , Technique & others - Infection -Rare - Multiple Pregnancy - OHSS

Can we have sex in Rx cycle ?

IUI is a simple procedure Easy Nurses

IUI Preparation in Doctor’s office

↑ 37 yrs – married to 10 yrs what should be done ?