indications and contra indications for iui

20Jun, 2023

Indications and Contra-indications for IUI

The rationale of IUI is to increase the chances of insemination by healthy sperms at the time of ovulation.

The fecundity (probability of achieving live birth in a single menstrual cycle) is around 5% per cycle in a normal menstrual cycle for a couple in the reproductive age without any factors hampering fertility. Fecundity rate in IUI is 8-22% per cycle, depending on several factors of the IUI process.

Advantages of IUI:

  1. Bypassing the vaginal acidity and hostile cervical factors
  2. Deposition of sperms close to the oocyte
  3. Minimally invasive and acceptable to patient
  4. Affordable
  5. Removal of sperm decapacitation factors during sperm preparation
  6. No severe impact on obstetric and neonatal outcomes.

Indications of IUI (ESHRE)

A) Indications for IUI-Male factor

  1. IUI using partner’s fresh sperms - Subnormal sperm parameters, hypospadiasis and other anatomical defects, ejaculatory &/or erectile dysfunction, retrograde or low volume ejaculate, presence of anti-sperm antibodies, semen with high viscosity and HIV discordant couple are some indications in this category.
  2. IUI using partner’s frozen sperms - Absentee partner, fluctuating semen parameters, prior to anti-cancer therapy and partner is on medications affecting semen parameters
  3. Donor sperm indications - Azoospermia, severe seminal abnormalities and genetic disorders in the male partner. There maybe certain conditions where the couple can be offered IVF/ICSI with the partner’s sperm. However, financial constraints can prevent them from opting for such services. Hence these couple may opt for donor sperms IUI which may be cost effective for them. HIV discordant couple, single women and even repeated IVF/ICSI failures are some other indications for donor semen IUI

B) Indications for IUI-Female factors

Anovulation, Vaginismus, cervical hostility, mild or minimal endometriosis and anatomic defects of the vagina are some female factors meriting IUI.

Unexplained infertility and immunological factors are other indications for IUI.

Contraindications for IUI

Active infection, cervicitis, severe male factor abnormalities, bilateral tubal obstruction, moderate or severe endometriosis and cervical atresia are some of the contraindications for IUI.

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