Priyasree Jayasimhan1, Hema Sreedharan Nair2, Jayashree Vijaya Vaman3
BACKGROUND
IUI is one of the simple techniques of assisted reproductive technique for treating infertility by artificial insemination. It has the advantage of positioning good quality sperm with increased count prepared by special semen washing technique into the uterine cavity, so that factors like decreased sperm count, poor sperm motility, impenetrable or absent cervical mucus or antisperm antibodies can be overcome. Sperm preparation method includes wash and swim-up technique using Percoll gradient. IUI is done by simple method and does not require the elaborate setup, investment and personnel like the other procedures of ART.
The aims and objectives-
1. Factors associated with effectiveness of IUI among couples with primary infertility.
2. Factors studied include- Age of female partner, duration of infertility, menstrual regularity, menstrual flow, ovarian stimulation protocol, timing of IUI, endometrial thickness, number of cycles of IUI, luteal support, semen analysis findings.
MATERIALS AND METHODS
This is a case comparative study conducted in a tertiary hospital during three year period in which the forty women who conceived were considered as “study group” and another forty non-conceived women selected at random were taken as “control group.”
RESULTS
Factors like age of female showed statistical significance- when the age of female increased from 20-24 years to 30 years and above, the rate of conception reduced from 50% to 9%. Other factors like menstrual regularity, menstrual flow timing of IUI and number of cycles of IUI yielded no significant association with conception rates. Regarding the mode of ovarian induction, 90% of conceived group was given controlled superovulation using clomiphene citrate and gonadotrophins and 39% had ovulation triggered by HCG, which were statistically significant. In the conceived group, the mean endometrial thickness was 9.3 mm contrary to 7.8 mm in the non-conceived group. Minimum duration of infertility has got an increased conception rate- 3.8 years in conceived group against 5.1 years in non-conceived group. Regarding semen parameters, active motile sperms showed a positive correlation with the success rate.
CONCLUSION
IUI entails superovulation, timed administration of HCG, sperm preparation and sperm insemination into the uterine cavity. It is an effective, invasive, relatively simple and economical method of treatment of infertility. IUI is proved most beneficial to young women with patent fallopian tubes, no ovulatory disorders, mild-to-moderate degree of endometriosis and no severe degree of male factor infertility.
