Timing of IUI – what matters?

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Timing of IUI what matters?

• Dr Sheetal jindal

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Important points

• IUI is simple, cost effective procedure for
  treating mild male factor subfertility,
  idiopathic infertility
• Success rates quoted varies 5-15
• Rationale behind IUI - to increase gamete
  density at the site of fertilization even when
  sperm or cervical mucus abnormalities are present
• Most important factor for success - semen
  preparation
• Also, right patient selection optimal ovarian
  stimulation

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• In order to improve the quality and outcome
  of IUI procedures, there is a need for simple,
  inexpensive, reliable and safe sperm preparation
  techniques that isolate and select sperm cells
  with intact functional and genetic properties,
  including normal morphology, minimal DNA damage
  and intact cell membranes with functional binding
  properties

World Health Organization, 2010
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Basic questions?
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What are indications for IUI Vs intercourse or
expectant management in infertile couples when
should treatment be initiated ?

•  In couples with unexplained infertility with
  prognosis of becoming pregnant without assistance
  within the next 12 months (estimate gt30), IUI
  could be postponed for at least 6 months
• If prognosis of getting pregnant is lt 30, TMSC
  gt10 million- IUI
• If semen parameters poor Success with IUI ?
• IUI review and
  systematic assessment of the evidence that
  supports global recommendations 
• Ben
  Cohlen, Aartjan Bijkerk, Sheryl Van der
  Poel, Willem Ombelet 
• Human Reproduction
  Update, Volume 24, Issue 3, May-June 2018
•  

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When to do ovarian stimulation with IUI?

• 1 In unexplained infertility, OS with IUI
  improves LBR
• IUI alone does not seem to improve LBR
  significantly in natural cycles odds ratio (OR)
  1.60, 95 CI 0.922.78
• 
  
   Bhattacharya et al. (2008)
• Mild male factor subfertiity, TMSC gt 10 million,
  OS improves CPR
• TMSC lt 10 million, no improvement
• Lower cut offs below which IUI to be withheld
  post wash lt 1million
• Rationale OS causes multifollicular growth
• Improves CPR (15 Vs 8.4) with 2 or more
  follicles

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Factors which optimise IUI success
IUI Optimizing results, minimizing complications
Fertility science and research june, 2021
Pikee Saxena1, Archana Mishra2
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OPTIMAL METHOD OF TIMING IUI one of the most
important factor

• Issues with timing
• Methods LH kit testing in NC
• Follicular monitoring by ultrasound along with
  HCG administration

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Timing of insemination after hcg