This slide has been prepared for educational purpose using various standard medical books. This is prepared by medical student and if any mistakes are there please comment.

1. Intrauterine Insemination
Jeetendra Bhandari
Patan Academy of Health sciences- school of medicine
Medical Student

2. Introduction
• Procedure to bypass endocervical canal which is abnormal
• Place increased concentration of motile sperm as close to fallopian
tube
• May be either
• Artificial insemination husband
• Artificial insemination donor
• Husband’s semen commonly used

3. Indication
• Hostile cervical mucus
• Cervical stenosis
• Oligospermia or asthenospermia
• Immune factor(male and female)
• Male factor-impotency or anatomical defect but normal ejaculation
can be obtained
• Unexplained infertility

4. Technique
• Methods to extract sperm from seminal plasma
• Washing
• Swim up
• Density gradient centrifugation
• Swim method-allow most motile sperm to swim up into supernatant
• Compared to washing, swim method has no dead sperm and cellular
debris
• About 0.3 ml washed or concentrated sperm injected through flexible
polyethylene catheter within uterine cavity around time of ovulation

5. • Density gradient centrifugation recovers most higly motile as well as
morphogically normal sperm
• Processed motile sperm count for insemination should be at least 1
million
• Best result if motile sperm >10 million
• Normal sperm survive in female reproductive tract can fertilize at
least 3 days
• Procedure can be repeated 2-3 times over period 2-3 days
• To increase sperm mortility, pentoxyphylline(phosphodiesterase
inhibitor) can be used

6. Timing of IUI
• Not so vital; sperm can survive in cervical canal for 1-2 days
• Controlled ovarian hyperstimulation is required

7. • Cumulative conception rate after 12 insemination cycle is 75-80%
• Best result obtained in treatment of cervical factor and unexplained
infertility and in stimulated cycle
• IUI with superovulation gives higher result

8. Artificial Insemination Donor
• Semen of donor is used
• Indication
• Untreatable azoospermia, astenospermia
• Genetic disease
• Rh-negative donor insemination- for women with Rh-sensitization
• Donor is healthy and of same ethnic group as husband
• Donor serologically and bacteriologically free from venereal disease
• Recipient and donor must be matched for blood group and Rh typing

9. • Fresh or frozen semen is used
• Sperm used when it is kept sequestered for at least 180 days
• Legal, psychological and religious aspect should be counseled before
its application

10. Result of technique
• Total of 3-6 cycle may have to be utilized to get success
• Success rate 50-60%

11. Reference
• Dutta’s Gyanecology, 6th ed. Chapter 16. Infertility. P:266-270
• William’s Gynae, 2ed. Reproductive endocrinology, infertility and the
menopause.
• Shaw’s Textbook of gyanecology, 15th ed. The pathology of
conception. Chapter 17. P:197-220.

12. Thank you!!