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2012年12月13日 星期四

Intrauterine insemination (IUI) and / or ovulation induction






This may be considered when at least one fallopian tube is patent and semen analysis is normal or near normal.


It involves ovarian stimulation with clomiphane citrate and / or follicle stimulating hormone (FSH or human menopausal gonadotropin). The response to these medications is monitored by ultrasound. Ovulation is triggered by human chorionic gonadotropin (HCG) 5,000 IU when not more than four ovarian follicles reach at least 1.6 cm diam. The semen sample is prepared and is then inseminated into the uterine cavity 24-36 hours later.

Occasionally intravaginal or intracervical insemination is performed when IUI is not technically possible or acceptable by the couple.
Insemination may have to be abandoned when more than four matured ovarian follicles are present.
In some cases, couples may request to have insemination only without prior ovarian stimulation or to have ovarian stimulation only followed by natural coitus.






Reference: fertility.com.hk/
The information aims to provide educational purpose only. Anyone reading it should consult obstetricians and gynecologists before considering treatment and should not rely on the information above.

2012年11月10日 星期六

Treatment procedures for infertility problem - IUI, Intrauterine insemination(Part2)

IUI Process
Woman has to take clomiphene or gonadotropins to increase the number of egg development. Your doctor will monitor you closely in order to prevent too many eggs being stimulated. A semen sample will be collected from your partner about an hour or two before you are scheduled for insemination. 

 
The semen is “washed” to separate the sperm from the seminal fluid, which contains substances that can irritate your uterus. Sperm “washing” sperm may also improve the ability of the sperm to fertilize the egg by reducing the distance for the sperm in reaching the egg and increasing the number of sperm entering the uterus.


Your doctor will inject the “washed” sperm directly into your uterus near the uterine entrance of fallopian tube at the time of ovulation. A speculum will be placed inside your vagina and a small catheter will be inserted through your cervix into your uterine cavity when the sperms are injected through the catheter into your uterus.  This procedure will not cause any discomfort and does not require any anesthetics.

 

Success rate

Success rates vary among international studies, ranging from 5-70%, with a mean success rate of about 9%. This can be explained by different protocols adopted in clinics as well as the patients’ condition (age, chronic illnesses, etc.).

 Most pregnancies in reported IUI studies occurred within 3-6 months. It is suggested that couples should opt for IVF after 6 months of IUI treatment failure.

 

Risks / Possible Complications

Bleeding/ spotting
Bleeding or spotting is often reported in IUI treatment, particularly those with a cervical tenaculum used.

Pain
The procedure is a bit uncomfortable. If needed, local anesthesia may be used to eliminate discomfort.

Multiple pregnancy
Multiple pregnancy is a common and major complication of assisted reproductive therapies. It poses both economic and sociological burden to the family.

Congenital defects of fetus
All ART have reported risks of fetal congenital defects

 
Can I go through this procedure more than once?
Yes,
if you do not become pregnant after the first treatment, you can repeat the procedure again in your next few cycles. Obviously, further evaluation may be required if the treatment fails to show an effect after several attempts.

 

NOTE:
Fallopian tube of female should be normal in order to commence IUI.
Avoid sexual intercourse for 2-3 days before IUI therapy.

 

 

 

 
Reference: fertility.com.hk
The information aims to provide educational purpose only. Anyone reading it should consult obstetricians and gynecologists before considering treatment and should not rely on the information above.

 

2012年11月9日 星期五

Treatment procedures for infertility problem - IUI, Intrauterine insemination(Part 1)





According to the Hong Kong Council on Human Reproductive Technology, a

couple may be classified as "infertile" or "sub-infertile" if pregnancy has not occurred after one year of regular unprotected sexual life. In Hong Kong, an estimated one in six couples has difficulty conceiving due to different reasons.

 
There are many reasons for infertility. Problems affecting male fertility include tubal obstruction or damage, semen abnormality or unexplained infertility while those affecting women include ovulation disorders, endometriosis and unexplained infertility. Age may also be one of the other factors affecting fertility.


 A Reproductive Technology (RT) procedure means a medical, surgical, obstetric or other procedures assisting or bringing about human reproduction by artificial means. RT treatment may be considered as one of the options to increase the chance of conception. Apart from RT treatment, other methods such as timed intercourse, drug therapy and surgery may be recommended by medical practitioners. You are strongly advised to consult your doctor for the most appropriate and suitable procedures if you intend to go through infertility treatment. (reference: http://www.chrt.org.hk/english/patients/patients_abo.html)

 

Intrauterine insemination (IUI)
IUI involves the placement of sperm (usually after processing) into the uterine cavity.

IUI is one of the assisted reproductive therapies (ART) that help couples with subfertility issues, particularly those with mild male subfertility and unexplained infertility.

 

Advantages of using IUI
By placing sperm artificially close to the site of fertilization, IUI bypasses many problems that can occur in the vagina or cervix.  It also improves delivery of the sperm to the egg, especially when there is a low sperm count or inactive sperm.  Other benefits include:

  • Minimally invasive
  • Less emotional commitment
  • Quick procedures

 
Disadvantages of using IUI when compared to other assisted reproductive technologies

  • Fertilisation cannot be confirmed
  • Risk of multiple pregnancy
  • Fallopian tubes must be unobstructed

 

 

Reference: fertility.com.hk

The information aims to provide educational purpose only. Anyone reading it should consult obstetricians and gynecologists before considering treatment and should not rely on the information above.