10 secrets of success of iui dr. sharda Jain

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Dr. Sharda Jain
Programme Director
Lifecare IVF

Published in: Health & Medicine
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10 secrets of success of iui dr. sharda Jain

  1. 1. 10 secrets of success of IUI Dr. Sharda Jain Programme Director
  2. 2. 1st Secret Right choice based on facts (Actiology)
  3. 3. Good Result : - Unexplained I : - Cervical Factor I : - Anovulatory I : - Donar IUI Poor Results :- severe male infertility tubal factor/ pelvic adhesions severe endometriosis
  4. 4. 2nd secret • Age – women & men • Ovarian response (Poor /High/ Normal) • Endometrial Response • AMH Understand The Case (H & W)
  5. 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. 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. 7. 3rd secret • Typical PR 4 / 8 / 12 / 20 • G T • Antagonist in IUI protocol Individualised Ovarian Stimulation Protocol
  8. 8. 4th secret • CC – neg. effect on ET – EV ? • Delay trigger • GT • Scratching of Endometrium • ↑ Endo Vascularity (Aspirin/ Viagra / Sidnafil) Poor Endometrial Thickness
  9. 9. Modify Dose / ET / Follicle size / HCG Trigger - GT - EV 5th secret Follicle Monitoring Do it your self
  10. 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. 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. 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. 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. 14. 9th secret • Progesterone • Vaginal progesterone (↑ PR) is the BEST Luteal support
  15. 15. 10th secret Counseling / Knowing when to stop 3 cycles of IUI = 1 IVF
  16. 16. Final secret All that we are • Integrity of Team • Right documentation • Analysis of Result what works
  17. 17. Thanks

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