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Timing of IUI – what matters | Jindal IVF Chandigarh

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Timing of IUI – what matters | Jindal IVF Chandigarh

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  1. Dr Sheetaljindal Timing of IUI – what matters?

  2. Important points • IUI is simple, cost effective procedure for treating mild male factor subfertility, idiopathic infertility • Success rates quoted varies 5-15% • Rationale behind IUI - to increase gamete density at the site of fertilization even when sperm or cervical mucus abnormalities are present • Most important factor for success - semen preparation • Also, right patient selection & optimal ovarian stimulation

  3. In order to improve the quality and outcome of IUI procedures, there is a need for simple, inexpensive, reliable and safe sperm preparation techniques that isolate and select sperm cells with intact functional and genetic properties, including normal morphology, minimal DNA damage and intact cell membranes with functional binding properties World Health Organization, 2010

  4. Basic questions?

  5. What are indications for IUI Vs intercourse or expectant management in infertile couples & when should treatment be initiated ? • In couples with unexplained infertility with prognosis of becoming pregnant without assistance within the next 12 months (estimate >30%), IUI could be postponed for at least 6 months • If prognosis of getting pregnant is < 30%, TMSC >10 million- IUI • If semen parameters poor – Success with IUI ? IUI: review and systematic assessment of the evidence that supports global recommendations  Ben Cohlen, AartjanBijkerk, Sheryl Van derPoel, Willem Ombelet Human Reproduction Update, Volume 24, Issue 3, May-June 2018

  6. When to do ovarian stimulation with IUI? 1 In unexplained infertility, OS with IUI improves LBR • IUI alone does not seem to improve LBR significantly in natural cycles [odds ratio (OR) = 1.60, 95% CI: 0.92–2.78] Bhattacharya et al. (2008) • Mild male factor subfertiity, TMSC > 10 million, OS improves CPR • TMSC < 10 million, no improvement • Lower cut offs below which IUI to be withheld – post wash < 1million • Rationale – OS causes multifollicular growth • Improves CPR (15 Vs 8.4%) with 2 or more follicles

  7. Factors which optimise IUI success IUI: Optimizing results, minimizing complications Fertility science and research june, 2021 PikeeSaxena1, Archana Mishra2

  8. OPTIMAL METHOD OF TIMING IUI – one of the most important factor • Issues with timing – • Methods – LH kit testing in NC • Follicular monitoring by ultrasound along with HCG administration

  9. Timing of insemination after hcg

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