Standard IUI is the most common method of assisted reproduction and a first choice method. According to the latest international data, the number of cycles treated with IUI is double to that with IVF. Interest in IUI was renewed in the last 15 years when sperm preparation techniques for IVF were further developed. IUI is a relatively quick and painless method performed in the doctor’s office without any anaesthesia. According to the World Health Organization (WHO) and the latest scientific literature, sperm insemination should firstly be performed 4 to 6 times before moving on to IVF.
Intrauterine insemination is a procedure used for couples with unexplained infertility, ovulation dysfunction, mild or moderate endometriosis, mild male infertility, women with cervical mucus problem, as well as infertility due to immunological factor. Intrauterine insemination with ovulation induction gives better results, often reaching twice the rate of spontaneous pregnancy. Besides, the amount of hormones (gonadotrophins) administered for 4 days is much smaller to that administered for IVF. Finally, the fertilization of the egg will be achieved naturally, in a natural environment. Insemination is usually performed 24 – 36 hours after the hCG administration. The husband will then produce a sperm specimen, which will be prepared for IUI. The sperm preparation procedure enables the collection of motile spermatozoa and the removal of prostagladins, inflammatory factors and antigenic proteins found in raw sperm. Another advantage of the sperm preparation is the removal of dead, damaged and abnormal spermatozoa, leukocytes and immature germ cells, bacteria, other cells such as white blood cells and cellular debris. An important factor of the qualitative improvement is the decrease of free oxygen radicals and the prevention of lymphocin and cytocin production. Thus, sperm preparation results in its better fertilizing ability in vivo and vitro.
The insemination is performed with a soft catheter, which is passed through the cervix and into the uterus where the 0,5ml of the prepared sperm is deposited. Insemination is followed by oral administration of progesterone for 14 days for the support of the luteal phase. Pregnancy is confirmed by blood test 14 days after insemination.