Intrauterine insemination involves the insertion of sperm into the uterus of the woman through the vagina. This is done by controlling the ovulation cycles of a woman and understanding the right time of the ovulation for sperm insertion. After the first IUI was performed in the year 1884, IUI has been widely used to treat women wishing to have children. The following is the step-by-step protocol of the artificial insemination procedure.
• STEP 1 – Controlled ovarian stimulation: This step involves the introduction of hormonal injections into the women’s body to induce the ovaries to produce more than one follicle. Hormonal interventions can last up to 8 to 12 days where gonadotropins are administered in regular but small doses. These hormonal doses are given in a controlled way to avoid multiple pregnancy probabilities. The growth and development of follicles are monitored through ultrasound and blood tests (estradiol test). Monitoring enables regulating the dosage of hormonal medications.
• STEP 2 – Monitoring the ovarian stimulation cycle: Maturation of follicles is monitored through the ultrasound imaging procedure and estradiol analysis. Estradiol analysis is the detection of estrogen levels that are produced by the antral follicles of the ovaries during the ovulation period. When the follicles reach the size of around 16 to 18 mm, and the estrogen levels are between 150-200 units, an ovulation triggering shot (hCG shot) is administered. A single shot allows the release of eggs from the mature follicles. The egg, once released, resumes its journey into the fallopian tube and awaits the arrival of the sperm for fertilization. Sperm insemination is generally performed within 36 hours of the trigger shot administration.
• STEP 3 – Semen collection and processing: The semen sample is collected on the very day of insemination. The semen samples are obtained through ejaculation.
The sperm is later washed through a special technique. This technique focuses on concentrating high-quality sperms from the semen sample thus increasing the success chances.
• STEP 4 – Insemination: Insemination is generally performed 36 hrs after the hCG shot administration where the specialists insert a hollow injectable tube called a cannula into the uterus via the vagina. The cannula allows safe placement of the sperms inside the uterine cavity. The whole procedure is usually painless and guided by an ultrasound.
• STEP 5 – Pregnancy test: Once the fertilization occurs in the fallopian tube, the embryo moves to the uterus for implantation. Almost after 14-15 days of insemination, a pregnancy test will be performed to confirm IUI success and pregnancy commencement.