Intrauterine insemination (IUI) is a procedure commonly done in fertility clinics around the world. The sperm is placed inside the uterus, close to the fallopian tubes, to increase the chances of conception. This article, Dr. Mohit Saraogi discusses certain things that patients can incorporate so that they can have the highest chance for an IUI pregnancy. Dr. Mohit Saraogi, one of the best IVF specialists in Mumbai, and has over a decade of experience in the field.
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What Are The Fertility Tests Done Before IUI?
The first thing the doctor does is to make sure that they know their patient’s fertility diagnosis before treatment.
So, talk to your doctor about these five things. If you are looking for doctors to undergo the IUI procedure or you need an opinion, then it is suggested that you get in contact with medical aggregators like ClinicSpots. ClinicSpots will provide you with all the necessary information like the Infertility Specialists near you, the procedures they perform and infertility centres in prime metropolitan cities like Mumbai, Delhi Bangalore and so on.
These are five simple steps that you can take to figure out what’s going on with you to make sure that IUI is the right treatment plan.
1. The Tubes:
They do a hysterosalpingogram to make sure the tubes are open. If one tube is blocked and one tube is open, you can still do IUI but you want to make sure you’re monitored because the cycles that you’re ovulating from the block side are probably cycles you don’t want to do IUI in and when you ovulate it’s not like you ovulate every even month on the left side or odd month on the right. It’s literally a flip of a coin. So without monitoring with a pelvic ultrasound, you would have no way of knowing about the follicular scan or follicle check.
2. The Uterus:
An ultrasound of the uterus is needed. Without a pelvic ultrasound to look at the uterus the doctor wouldn’t know if you have cysts on your ovaries, a polyp in your uterus or a fibroid in your uterus. That could block the pathway for an embryo to implant. So get the uterine ultrasound done before you consider IUI treatment.
3. Sperm Count:
For obvious reasons, the doctor would want to look at sperm count. There is so many things that you can do to get sperm to swim even faster and better. Lifestyle factors, vitamins, supplements so unless you check the sperm count you wouldn’t know what you could do on your own to increase your chances of pregnancy.
The thing is doctors want everyone to get pregnant on their own without their help but certainly know that’s not possible. But if they equip people with this information the treatment might be more successful. So that’s why they find that checking the sperm is really helpful. Often they hear things like the patients were diagnosed with unexplained infertility. They knew the sperm was slow but they said it was unexplained.
4. The Hormones:
TSH prolactin is a hormone that if not balanced can cause problems with fertility. So before you start your IUI treatment make sure you do a preconception panel including things like rubella, varicella, and a blood type. How many people know what your blood type is? Well there’s a reason why you want to know before pregnancy and that’s because if you’re Rh negative then there is a shot you will need if you have any spotting in your pregnancy.
5. Genetic Profile:
Making sure that the egg and sperm are genetically compatible is super important and that’s why the doctor likes to do preconception genetic testing before they start an IUI cycle.
So these are the elements of fertility diagnosis so that you can start your IUI cycle and feel like this is the right treatment for you.
What Are The Goals You Need To Set For The Treatment?
One of the questions the doctor asks the patients is, how many kids do they want and look at their age and their fertility factors and then talk about what they have to do to plan for their future. So if for example, they want two kids and they are starting IUI at 41 then they need to rethink that and talk to their doctor about what can they do to give them the highest chance of having the family size that they want.
The doctor wants you to reach your goals and have the family size that you want. Some patients ovulate regularly and they are introduced to ovulation pills. There is a reason for that. Every month you only ovulate one egg but a lot of people have the potential to ovulate more eggs. So the doctor want you to ovulate maybe two eggs and by taking the fertility pills for example you’ll ovulate 1.5 and the reason for that is some months it might be 2 and sometimes it might be 1.
There are certainly some protocols if you add injectables or you do a straight injectable IUI cycle then you’ll automatically for the most part ovulate two or more eggs if that’s your potential.
So talk to your doctor about what the goals are with treatment, what your pregnancy rate is and how many cycles they expect you to do before you change the path to pregnancy. Meaning at what point you are going to say, this probably isn’t working for us and we should change course.
How To Go About IUI?
- First thing that happens is your period starts. Once your period starts the doctor asks the patients to email them because that means their work is not done and they need to look at the notes from their personalized fertility care plan that they have developed together and then the doctor formulate the calendar based on all the things that was discussed above.
- On cycle day number three, you will start medications. The drug can totally mess with your brain. A lot of patients deal with depression and anxiety just because of the fertility problems they are having so adding a medication that makes them feel a little bit more on edge isn’t something that the doctor wants to do.
The side effects of the medication are patients feel slight nausea, a slight headache when you first start taking it and maybe some lower leg cramps. The medications is in your system for about two days or so and those side effects should go right away and if you’re having a lot of side effects you can consult the doctor and there are certain things that you can do to lessen the side effects. For example, rather than taking three tablets, go down to two and even go down to one. If you definitely don’t want to ovulate two eggs and have a chance for twins.
- The other thing that you can do is play around with the dosing, alternate three two three two three or take it three times a day morning noon and night. The doctor asks the patients to take the medication at night; the reason is you don’t feel nauseous when you’re asleep so this can sometimes help. There is a reason also why we start the medication on cycle day number three. The reason is our body picks the egg it is going to oscillate by day five so if you start earlier there is a higher chance that you can rescue an extra egg. You can ovulate an extra one and hopefully there are two chances for the sperm to hit one egg in one cycle so in some cases that can increase a person’s chance for pregnancy.
- A lot of people think that they should abstain from sexual intercourse as soon as their period starts in their I UI cycle. They should abstain from sex. However, some doctors recommend intercourse or sexual relations and the reason is ejaculation is a good thing.
On this topic, Dr. Saraogi says that on the IUI day, strong healthy sperm cells are required, not a whole bunch of dead swimmers and that’s what happens if you wait too long on your IUI day. But there is going to be a time where the doctor may tell you no more sex because it is time for IUI planning.
However, IUI is not like IVF. The doctors have to rely on nature in order for the egg and sperm cell to come together and the embryo to travel down the fallopian tube for approximately five days before it sticks and grows in the lining of the uterus. So timing is important. Once the doctor has determined that it is time to do IUI planning that’s when they talk about the trigger shot. This is a small injection in the skin of your tummy.
Typically, it is timed approximately 36 hours before the IUI and again this timing is individualized based on the thickness of the lining, the size of the follicles, the sperm quality as well because sometimes the doctor plans a double IUI. It means for example if the doctor gives a patient a trigger shot at 11 pm then they will do one IUI at 10:45 the next day and one IUI on the day after at 11 am. So that’s why the trigger shot are timed in such a way.
The doctor recommends sex after the IUI but is not required unless of course the sperm count is on the lower side. The doctors start progesterone. Progesterone is a hormone that can promote implantation. But it can affect people who have problem with their mood and depression. Progesterone can totally mess with your mood so there are two ways of taking it, first is just pop the pill orally that’s how the pill was actually made or you can take the capsule and put it in your vagina Patients report that when you place a medication vaginally you have less side effects.
Do not check for a pregnancy test within eight days from the trigger shot because the trigger shot can still be in your system for up to ten days but for the most part it is out of your system by seven days.
