Intrauterine Inseminisation (Insemination Within Uterus)

What is intrauterine insemination?

Intrauterine inseminisation / insemination is a fertility procedure where ‘washed’ sperms are concentrated and placed directly inside the woman’s uterus on the day after ovum has been released for the purpose of fertilization. Following introduction of sperm inside the uterine cavity, the health sperm cells travels to the fallopian tube and fertilizes the egg cell ultimately leading to pregnancy. There are several reasons why  intrauterine insemination is recommended. The procedure is scheduled by either coordinating with the normal menstrual cycle or with the administration of drugs which promote ovulation.

Reasons for intrauterine insemination

There are number of factors which contribute to infertility in women and men. These can be discussed as :

  • Mild male factor infertility: In this condition semen analysis of the male partner shows below average concentration of sperm, weak movement of the sperm and/or abnormal size and shape of the sperm. Through intrauterine insemination, these problems can be overcome as in this procedure highly motile and normal sperm are separated from the inferior quality sperm.
  • Cervical factor infertility: Under usual circumstances seminal fluid is ejaculated inside the vaginal canal and the sperm travel to the fallopian opening after traversing the cervical canal and uterine cavity. Cervical fluid is produced by the cells surrounding the cervical canal at the time of ovulation. The principal function of the cervical fluid is to provide an ideal environment so that the sperm enters the vaginal canal and ultimately reaches the fallopian tubes. In some women this cervical fluid is very thick in consistency thereby hindering the sperms’ journey through the uterine cavity.
  • Semen allergy: Some women may be allergic to the proteins present in their partner’s semen resulting in redness, burning sensation and swelling at sites where the semen has come in contact with tissue. A condom can protect from these unwanted reactions but it will also prevent conception. Therefore intrauterine insemination may be considered in these sensitive women as an alternative. The semen proteins are then removed prior to insemination of the sperm into the uterine cavity.
  • Unexplained fertility: In couples suffering from infertility and with no apparent cause behind it intrauterine inseminisation is performed as it may assist with conception for unknown reasons.
  • Donor sperm: In women who conceive with the donor sperm, intrauterine inseminisation is the procedure to introduce the donated sperm into the uterus.

Procedure

Before the actual procedure, the semen sample provided by the male partner is “washed” to concentrate the healthy sperm. If necessary drugs that stimulate ovulation may be administered. The woman about to undergo intrauterine insemination is monitored for signs of ovulation by transvaginal sonography or by urine ovulation kit.

The procedure itself does not require any sedation or painkillers. It is performed by a fertility doctor (gynecologist specializing in fertility treatments or related medical professionals) or a specially trained nurse. At first the vaginal speculum is placed and then a thin catheter attached with a vial containing the sample of sperm is introduced inside the uterus and the sperm sample is pushed inside the uterus. Usually the whole procedure takes 15 to 20 minutes and the woman can resume normal activities soon thereafter.

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