Chapter 24

Intrauterine Insemination (IUI)

Sometimes nature needs help to start a pregnancy, and the doctor can do this by giving the sperm a piggyback ride through a fine tube into the body. This procedure is called intrauterine insemination (IUI) or artificial insemination with husband's sperm (AIH), and effectively, the doctor is giving Nature a helping hand by increasing the chances of the egg and sperm meeting.

IUI is useful when:

The woman has a cervical mucus problem. For example, it may be scanty or hostile to the sperm. With an intrauterine insemination, the sperm bypass the cervix and enter the uterine cavity directly.
The man has antibodies to his own sperm. The "good" sperm which have not been affected by the antibodies are separated in the laboratory and used for IUI.
If the man cannot ejaculate into his partner's vagina. This is usually because of psychologic problems such as impotence (inability to get and maintain an erection) and vaginismus (an involuntary spasm of the vaginal muscles so that vaginal penetration is not possible); or anatomic problems of the penis, such as uncorrected hypospadias or if he is paraplegic.
The man suffers from retrograde ejaculation in which the semen goes backward into the bladder instead of coming out of the penis.
For unexplained infertility, since the technique of IUI increases the chances of the egg and sperm meeting.
As an inexpensive alternative to GIFT, IUI is a reasonable first choice (especially for younger couples) since it is so much cheaper and less intrusive.
If the husband is away from the wife for long stretches of time (for example, husbands who work on ships or work abroad), his sperm can be frozen and stored in a sperm bank and used to inseminate his wife even in his absence.
For male factor infertility, though this is a controversial area, especially for the common problem of oligospermia (a low sperm count). What is the rationale behind using IUI for treating this problem? Remember that infertility is a problem of the couple's, not just the oligospermic male's. Whether a given couple will conceive or not depends on the sum of their fertility potentials. Therefore, the fertility potential of the wife is improved by superovulating her, so that instead of producing 1 egg per cycle, she produces 2-4 eggs per cycle. In addition, the husband's sperms are processed in the laboratory, and the best sperm are used for IUI. This increases the chances of the best sperm being able to reach and fertilize the egg.

Credits: How to Have a Baby: Overcoming Infertility