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10 Tips of success of IUIdr. sharda jain

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10 Tips of success of IUIdr. sharda jain

  1. 1. 10 secrets of success of IUI Dr. Sharda Jain Programme Director
  2. 2. 1 Secret st 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 Understand The Case (H & W) • • • • Age – women & men Ovarian response (Poor /High/ Normal) Endometrial Response AMH
  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 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%
  7. 7. 3rd secret Individualised Ovarian Stimulation Protocol • Typical PR 4 / 8 / 12 / 20 • GT • Antagonist in IUI protocol
  8. 8. 4th secret Poor Endometrial Thickness • CC – neg. effect on ET – EV ? • Delay trigger • GT • Scratching of Endometrium • ↑ Endo Vascularity (Aspirin/ Viagra / Sidnafil)
  9. 9. 5th secret Follicle Monitoring Do it your self Modify Dose / ET / Follicle size / HCG Trigger - GT - EV
  10. 10. 6th secret Do Right Thing at Right Time 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
  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 Lab 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
  13. 13. 8th secret Success lies in looking into details of techniques • • • • • • • Full Bladder Cx mucus aspiration Targets time - 90 minutes Load – when ready No free space Rest 10 mints Emergency trey Easy IUI
  14. 14. 9th secret Luteal support • Progesterone • Vaginal progesterone (↑ PR) is the BEST
  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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