10 secrets of success of iui dr. sharda Jain

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Dr. Sharda Jain …

Dr. Sharda Jain
Programme Director
Lifecare IVF

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  • 1. 10 secrets of success of IUI Dr. Sharda Jain Programme Director
  • 2. 1st Secret Right choice based on facts (Actiology)
  • 3. Good Result : - Unexplained I : - Cervical Factor I : - Anovulatory I : - Donar IUI Poor Results :- severe male infertility tubal factor/ pelvic adhesions severe endometriosis
  • 4. 2nd secret • Age – women & men • Ovarian response (Poor /High/ Normal) • Endometrial Response • AMH Understand The Case (H & W)
  • 5. Good Responders :- young :- Good Crop of Preovulatory follicles :- Good ET (> 7 mm) :- Good PMS count Poor Responders :- Older self / partner, :- ↑ duration infertility (> 5 yrs) :- Poor OR :- Poor ET :- Poor Sperm Quality
  • 6. Male age - < 35 yrs > 45 yrs >10 million prewash count 5-10 million Post Wash Count Normal morphology – 14% (Krugers) DNA fragmentation - 30 % Sperm survival (24 hours) - ↑ 80% Male
  • 7. 3rd secret • Typical PR 4 / 8 / 12 / 20 • G T • Antagonist in IUI protocol Individualised Ovarian Stimulation Protocol
  • 8. 4th secret • CC – neg. effect on ET – EV ? • Delay trigger • GT • Scratching of Endometrium • ↑ Endo Vascularity (Aspirin/ Viagra / Sidnafil) Poor Endometrial Thickness
  • 9. Modify Dose / ET / Follicle size / HCG Trigger - GT - EV 5th secret Follicle Monitoring Do it your self
  • 10. Trigger when GT – 17-18 mm CC -24 -25 mm Doppler – Perifollicular perfusion 50 – 70 % RI < 5 PSV > 11 S/C HCG – (BMI) Agonist trigger - OHSS 6th secret Do Right Thing at Right Time
  • 11. Timing of IUI – 38 hours Single – No Male Factor Double IUI – Male factor, PSV > 20 1st 16 - 18 hrs 2nd 36 – 38 hrs + LH surge - Give HCG trigger immediately - IUI 24 hrs
  • 12. 7th secret • Labeling • Abstinance (<3 V/S > 10 days) • Semen collection • Semen preparation One size does not fit all • High quality Consumables & media Preparation in doctor’s office must Lab secret
  • 13. 8th secret • Full Bladder • Cx mucus aspiration • Targets time - 90 minutes • Load – when ready • No free space • Rest 10 mints • Emergency trey Easy IUI Success lies in looking into details of techniques
  • 14. 9th secret • Progesterone • Vaginal progesterone (↑ PR) is the BEST Luteal support
  • 15. 10th secret Counseling / Knowing when to stop 3 cycles of IUI = 1 IVF
  • 16. Final secret All that we are • Integrity of Team • Right documentation • Analysis of Result what works
  • 17. Thanks