IUI is a fertility treatment where the sperm is placed in the uterus for fertilization.
The purpose of IUI is to increase the number of sperms that reaches the egg and thus increase
the chance of fertilization.
This process gives a headstart to the sperm but it still demands the sperm to reach and fertilise an egg.
This is an inexpensive method to treat infertility compared to IVF.
When to opt for IUI?
1. Commonly IUI is opted when the sperm count is low and decreased sperm mobility.
However, it is also selected to treat infertility in the following conditions-
2. Unexplained Infertility
3. Cervical mucus problems
4. Ejaculation dysfunction
The procedure : Before IUI, ovulation stimulating medicines are given. Follicular monitoring is done.
24 – 36 hours after ovulation. IUI is performed.
The collected Semen is washed in the laboratory, sperms are separated from the seminal fluids and placed in
the uterus using a catheter. This increases the number and quality of sperm in the uterus and thus
increasing the chance of conceiving.
IUI takes only a few minutes involving least discomfort and then the patient needs to look for
symptoms of pregnancy.
The success rate of IUI depends on various factors like women’s age, reason of infertility and the medication
used to treat infertility in the past.
IUI performed each month may give 20% higher chance of conceiving per cycle.
As you see IUI is less invasive and inexpensive as compared to IVF, the success rate is lower too in
comparison to IVF.
Women who have had severe fallopian tube disease, history of pelvic infection and moderate to severe
endometriosis are not recommended to go for IUI.
IN VITRO FERTILIZATION (IVF)
Fertilisation (Combining oocyte and sperm) outside human body is In Vitro Fertilisation
When is IVF opted?
IVF is used to treat infertility in the following patients-
Blocked/Damaged Fallopian tubes
Decreased Sperm Count
Ovulation disorders
Premature Ovarian Failure
Uterine Fibroids
Removed Fallopian Tubes
Genetic disorders
Unexplained Infertility
INTRA CYTOPLASMIC SPERM INJECTION (ICSI)
Intracytoplasmic Sperm Injection is performed as an additional part of an IVF treatment cycle where a single
sperm is injected into each egg to assist fertilisation using very fine micro-manipulation equipment.
In most cases, ICSI can be used to overcome severe male infertility.
Intracytoplasmic sperm injection is recommended for couples who have been diagnosed with male fertility issues
such as low sperm count, low sperm morphology or motility, anti-sperm antibodies or have previously had a vasectomy
or unsuccessful vasectomy reversal.
We can also use this technique for couples who have experienced poor or no fertilisation rates using
standard IVF.
There are five main steps to the ICSI procedure:
A sperm sample is taken from your partner’s semen or surgically extracted from his testes or epididymis.
Your eggs are surgically extracted from your ovaries.
Using a tiny hollow needle, one sperm is carefully injected into an egg.
After injection, the fertilized egg is observed for growth and development.
Once normal growth is observed, the embryo will be implanted into your uterus where it has a chance to
implant and grow.
Some fertility clinics choose to use fresh sperm that have just been extracted, while others prefer to do
the ICSI procedure with frozen sperm. There appears to be no difference in pregnancy rates between those
who use fresh or frozen sperm during the ICSI process.
ICSI and male infertility
The ICSI procedure can help you achieve IVF pregnancy success even when male infertility problems are an issue.
If your male partner has experienced any of the following problems, talk to your doctor about ICSI:
Absence of sperm in the semen, possibly caused by a blockage.
Low sperm count, poor sperm quality and/or abnormal sperm shape and movement.
Sperm unable to penetrate through the outer layer of your egg or production of antisperm antibodies.
EMBRYO FREEZING
Embryo freezing is done when there are more embryos developed than required for transfer into the uterus.
These embryos are frozen in liquid nitrogen and can be utilized in future.
Embryos are also frozen if the endometrial thickness (lining of the uterus) is less than 8mm. In this case
endometrial thickness is developed in next cycles and frozen embryos are utilized.
When frozen embryos are utilized; patient does not have to take injections for stimulation.
Success rate for fresh embryo transfer and frozen embryo transfer is almost same.
OOCYTE FREEZING
Oocyte literally means egg. Oocyte freezing is a procedure to preserve the eggs.As the age increases the number
of eggs that a woman can produce is decreased. The quality of the eggs is also hampered. The quality of the Oocyte
decreases once the woman reaches age 35.With her biological clock ticking, egg freezing is very good option for
women to preserve the fertility. When she is ready to conceive, she can use her own frozen eggs for IVF/ICSI-ET.
Women may choose to freeze their eggs for many reasons. If a woman is undergoing cancer treatment,
the radiation and the chemotherapy may affect her ovaries and kill the existing eggs. In this scenario,
by egg freezing she can prevent effects of cancer and conceive later after the treatment. Women might wish to
delay to have kids for having a demanding career.If a woman doesn’t want to freeze embryo after an IVF cycle,
she can always go for egg freezing.
SPERM FREEZING
Semen freezing (commonly called sperm banking) is a process in which sperm cells are preserved. Semen can be
used successfully for a long time after freezing them. Sperm can be used in future for many purposes like assisted
reproductive technology or they can also be donated.
We ask our patients to produce a fresh sample of semen. It is then checked for sperm count, sperm motility,
their shape. A cryoprotectant (a substance which reduces damage to the biological cells after freezing) is
added to the sperms and stored in vials. These vials are then frozen to -196 ℃ in liquid nitrogen tanks.
All the biological and biochemical processes are stopped at such a low temperature.
Sperms are normally stored for a maximum of 10 years in the sperm bank.
Whenever the patient and his partner want to conceive, the sperms can be used to perform artificial
reproductive techniques like IUI, IVF, and ICSI treatment.
EMBRYO DONATION
Embryo Donation – If a couple cannot produce both oocytes and sperms then the embryo donation method can be
used. A patient who has produced extra embryos may donate some to another couple. Consents of both the couples
are taken for this procedure.
By utilizing donor sperm and donor eggs, the subsequent developing embryos give a high rate of achievement.
After the sperm are utilized to treat the eggs, embryos are cultured (developed) to day 5 or 6, otherwise
called the blastocyst stage.
The embryos are then exchanged to patients that have been planned to have an
exchange that is synchronized to the egg donor’s cycle. Any outstanding embryos are then put away with a
very effective freezing technique known as vitrification.
There is a great possibility of twins happening therefore of the embryo transfer methodology. Since age
does not influence a lady’s capacity to get pregnant with donated embryo, the odds of pregnancy stay high.
In our Experience, we have found that a normal uterus and high quality embryo result in very high success
rate.
Since the planned mother conceives the pregnancy and the embryos originate from an unknown donor,
there are no lawful difficulties to parental rights. Ladies bringing forth a child will have their name
put on the infant’s birth certificate and will have the chance to name the father of the infant with the
end goal of the birth certificate.
OOCYTE SHARING PROGRAMME
In some patients the ovarian function is very much reduced so that they cannot produce eggs themselves
(ovarian failure). These patients can achieve pregnancy if the oocytes of another patient are used to produce
the embryo. The written consent of both the patients (oocyte donor and oocyte recipient) is required for
this procedure.
DONOR SPERM
For infertile patients with azoospermia ,donor sperms can be used with their consent. The samples are taken
from sperm banks. The donors undergo various tests like HIV, VDRL, Australia Antigen to prevent risk of
infection. The samples are frozen for 6 months after which the donors undergo the tests once more. If they
are negative then their frozen samples are used to achieve pregnancy. Matching donor samples can be selected
with respect to height, complexion, hair colour etc. and complete confidentiality is maintained.