Tuesday, May 21, 2024

IUI Treatment

IUI (Intra-Uterine Injection) at North Cyprus IVF Clinic

IUI (Intra Uterine Injection), or what is sometimes referred to as Artificial Insemination (AI) is the least invasive fertility treatment method usually offered to couples as the first treatment option before exploring more invasive and more expensive treatment options.

Artificial insemination is a fertility treatment method where processed sperm sample is directly inserted into the uterus.

The goal of IUI is to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of fertilization.

IUI is a fertility treatment often selected by patients with the following conditions:

-Low sperm count
-Decreased sperm mobility
-Requirement of donor sperm
-A hostile cervical condition, such as cervical mucus that is too thick
-Sexual dysfunction
-Young and fertile couples who would like to select the sex of their unborn baby through the non-invasive MicroSort IUI method.
-Single women who do not have a male partner can opt for an IUI treatment using a sperm donor.

Although IUI still requires the sperm to reach and fertilize the egg on its own, it is important to make sure that the sperm is healthy and motile. IUI provides the sperm an advantage by giving it a head start since it is injected directly into the uterus, but it still has to seek out the egg on its own. The IUI procedure is simple and may be performed even without taking any medication to stimulate the ovaries. However, we encourage women to take hormone supplements to stimulate the ovaries in order to increase egg production because the more eggs there are in the ovaries, the higher the chance of sperm reaching and fertilizing one of them.

During the medication stage, you will be required to have a couple of sonograms in order to track follicle development (a follicle is what contains the egg which will later mature and ovulate). Once the follicles reach a desired level of growth, human Chorionic Gonadotropin (hCG) injection, is administered to stimulate the release of eggs from the follicles after 35 hours. After the eggs have been released, the IUI procedure can be administered.

Prior to the IUI procedure, semen sample is obtained from the male partner through manual stimulation (masturbation). At the moment of ejaculation, the semen sample contains both mature sperm cells (spermatozoa) and secretions of the prostate and the seminal vesicles. During ejaculation, it is essential that the entire ejaculate is collected in the sterile cup provided, so that we can make sure that the fraction of the ejaculate which contains mature sperm cells is captured in the cup. While it may sound as a simple direction to follow, this is in fact one of the most important steps involved in sperm preparation: Proper sperm collection.

Another important factor which contributes to the quality of the sperm sample is the period of abstinence. It is important that there is an abstinence period between 2 to 4 days prior to providing a sperm sample for the IUI procedure in order to maximize the chance of success. Abstinence refers to no ejaculation, therefore, no sex or masturbation is allowed during this period. The abstinence period of 2-4 days is critical. Abstinence periods that are shorter or longer can hurt your chances of success. Sperm samples obtained in shorter abstinence periods are likely to lack the level of motility present in samples that have higher abstinence periods. Therefore, if you do not have an abstinence period before producing your sample, your sample is likely to have a low level of motility, which is detrimental for the process. Similarly, while patients may think that longer abstinence periods will help you gather more sperm cells, this is not the case. When abstinence is too long, the older sperm cells begin to die, meaning, the longer you wait, the lower the amount of live sperm cells you get in the ejaculate!

Once the sperm sample has been collected from the patient after following the guidelines above, it needs to be processed. For the best quality samples (number and motility of sperms) the sperm washing is performed before the IUI procedure. This is a simple procedure which involves washing the semen with a sterile medium containing human albumin. After the sperm washing procedure, the sample is centrifuged for about ten minutes in order to separate live and motile sperm cells from the rest of the sample. Sperm cells with different density and motility will be observed at different levels of the tube. Sperms which possess high level of motility and good morphology will sink to the bottom of the tube after the centrifugation process and will be free of dead sperm cell, leukocytes and debris.

After the sperm sample has been processed to achieve the most optimal parameters possible, the next stage will be to inject the sample into the uterus. For this, a catheter is used to inject the processed sperm directly into the uterus. This process maximizes the number of sperm cells that are placed in the uterus and thus increases the possibility of conception. The next step is to watch for signs and symptoms of pregnancy.

On the plus side, IUI is a non-invasive and a low cost fertility treatment. On the down side, its success rate is considerably lower than IVF treatments where we have the chance to take out the eggs and fertilize them in the lab setting and grow them in an incubator until they are ready for implantation.

With our new MicroSort sperm sorting technologies, we are able to offer gender selection for family balancing through the IUI method. This offers a less invasive method of selecting the gender of your child. However, the accuracy of sperm separation with the MicroSort procedure is not 100%, therefore, MicroSort IUI should be seen as a method of increasing the likelihood of having a child of certain sex over the other rather than a bullet proof method of gender selection.

The following picture shows sperm preparation and injection into the uterus during the IUI procedure:

Step by step IUI procedure

Cost of Artificial Insemination (IUI)

The cost of artificial insemination at North Cyprus IVF Centre is 1,250 Euros. This includes handling and processing the semen sample and the IUI procedure itself. If a sperm donor is used for the IUI procedure, then the total cost of IUI with donor sperm is 2,500 Euros. We do not charge for the consultations and the ultrasound scans we provide at North Cyprus IVF Center prior to your treatment. However, the following will cost you extra:

-Medication which will be used prior to the IUI procedure. Medication protocols used for IUI are very mild, therefore, the cost of your medication is not likely to be very high. It certainly won’t be anywhere near how much medication would cost in an IVF treatment. The precise cost of medication could vary between countries, therefore, there is no uniform price that we can quote you for the medication. Also, the specific dosage can mildly vary from individual to individual, changing the cost across patients.

-Given that majority of our patients come from abroad, we can organize treatments so that the preliminary work can be carried out locally before coming to Cyprus. Preliminary work includes having the required tests done, using the medication and having scans with a local doctor for monitoring the progress prior to your arrival. The total cost of these tests and scans should not exceed 300-400 Euros.

-Infectious disease screening must be carried out at our own facilities as a high level safety precaution. We do our best to keep our laboratory free from pathogens and contaminants, therefore, before handling any samples, we make sure that owners of these samples are very thoroughly checked for infectious diseases so that we don’t put any gametes at health risk. The cost of infectious disease screening is 200 Euros at our clinic for the male and the female partner.

What to Expect from IUI?

It should be kept in mind that while the IUI procedure may be convenient due to its non-invasive nature and lower treatment cost, it is a process that is close to natural conception with respect to how pregnancy is achieved. The beneift of IUI is that, it processes the sperm sample and places it close to where the eggs can be fertilized. While the order of events are similar to natural conception, the process of fertilization is facilitated by additional efforts. While this increases your chances of success beyond natural intercourse, it still does not give you as high of a success chance as IVF/ICSI treatment would.

Success with IUI treatment depends on the age of the female patient as well as the fertility prognosis. If you are relatively young (in 20s and possibly early 30s), IUI may be a treatment option for you. The general success rate with IUI is around 25-30%. Younger couples may accept lower chance of success given that they may have a longer time period at hand to try non-invasive methods a few times. However if you are above the age of 35 and have diminished ovarian reserves, you should consider IVF/ICSI treatment rather than IUI.

For more information including cost of our IUI treatment and medical details, please contact us via our contact form.

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