We opted the topic “Make IUI safe & more productive, because IUI is performed much frequently than IVF. There is no clear data regarding the ratio of IUI & IVF. But there is estimation that 16.4 IUI is performed per IVF. There are two distinct reason behind this high ratio —
Easy to perform.
Cost effective
Under the heading “Make IUI Safe & More Productive” our aim is to discuss and point out small small measures. Which will the improve the success rate of IUI to a good magnitude.
IUI is mainly performed either by Prepared Sperm of Husband / male partner (IUI-H) or Frozen Sperm of Donor (IUI-D). Certainly quality of sperm is a big factor. But in our discussion it is beyond our scope to discuss how to improve the quality of sperm within the human body.
Other than quality of sperm / semen there are certain factors and measures. Which influence the outcome of IUI directly. Since IUI is either in IUI-H or IUI-D form. Therefore our discussion will be under two heading.
IUI-H — Intra Uterine Insemination – By Husband Sperm
In this method husband deposit the semen in a sterile container. Followed by separation of sperm from seminal fluid. Finally healthy sperms are re-dispersed id a uterine friendly medium (HTF Type) followed by insemination.
Below mentions steps / measures make IUI-H safe & more productive.
Proper medical examination, investigation & management of both partner.
Psychological assessment & counseling of both partner.
Abstinence – 2 to 5 days.
Semen collection in morning hour.
Maintenance of temperature of waiting lobby and collection room and laboratory at 25 degree C (+ /- 2).
Set the temperature of incubator at 32 – 34 degree C (not 37 degree C). Here it is worth to mention that inside human body formation, development, maturation & storage of sperm occur at 3 to 4 degree C less temperature than core body temperature (37 degree C). Therefore it is better to prepare the sperm at 33 degree C.
Scan (Ultrasonically) the follicle to determine right time for insemination. Two insemination per cycle give better result than one insemination.
Inseminate immediately.
Keep the patient on O.T. table for 15 minutes following IUI.
In certain instance clinician need to preserve husband sperm (freezing of husband sperm). In those specific situation the steps of IUI – H and IUI-D both are equally important.
IUI-D — Intra Uterine Insemination – By Donor Sperm
Donor sperm are at particular risk of transmitting infection. Therefore proper screening of donors & quarantine is of prime importance in case of IUI-D.
Proper screening & retesting of donors.
Proper method of sperm freezing .
Use proper cryo-preservative medium for sperm freezing. Cryo-preservative medium for sperm with H.S.A. may decrease success rate. As any foreign protein in the uterine cavity may be antigenic for uterine environment as well as sperm. Therefore H.S.A. or any animal or avian based cryo-preservative media should be avoided.
Avoid taking out Frozen Semen Sample from Liquid nitrogen for sorting or choosing any special donor’s sample.
Do not keep frozen embryo and Frozen Semen Sample in same cryocan. Keep the Frozen Semen Sample in a separate cryocan.
Proper training of the person handling the Frozen Semen Sample & Liquid nitrogen. In developing country usually cryocans and Frozen Semen Sample are being handled by a para-medical staff. Who may not have proper training & expertise.
