This slide has been prepared for educational purpose using various standard medical books. This is prepared by medical student and if any mistakes are there please comment.
2. Introduction
• Procedure to bypass endocervical canal which is abnormal
• Place increased concentration of motile sperm as close to fallopian
tube
• May be either
• Artificial insemination husband
• Artificial insemination donor
• Husband’s semen commonly used
3. Indication
• Hostile cervical mucus
• Cervical stenosis
• Oligospermia or asthenospermia
• Immune factor(male and female)
• Male factor-impotency or anatomical defect but normal ejaculation
can be obtained
• Unexplained infertility
4. Technique
• Methods to extract sperm from seminal plasma
• Washing
• Swim up
• Density gradient centrifugation
• Swim method-allow most motile sperm to swim up into supernatant
• Compared to washing, swim method has no dead sperm and cellular
debris
• About 0.3 ml washed or concentrated sperm injected through flexible
polyethylene catheter within uterine cavity around time of ovulation
5. • Density gradient centrifugation recovers most higly motile as well as
morphogically normal sperm
• Processed motile sperm count for insemination should be at least 1
million
• Best result if motile sperm >10 million
• Normal sperm survive in female reproductive tract can fertilize at
least 3 days
• Procedure can be repeated 2-3 times over period 2-3 days
• To increase sperm mortility, pentoxyphylline(phosphodiesterase
inhibitor) can be used
6. Timing of IUI
• Not so vital; sperm can survive in cervical canal for 1-2 days
• Controlled ovarian hyperstimulation is required
7. • Cumulative conception rate after 12 insemination cycle is 75-80%
• Best result obtained in treatment of cervical factor and unexplained
infertility and in stimulated cycle
• IUI with superovulation gives higher result
8. Artificial Insemination Donor
• Semen of donor is used
• Indication
• Untreatable azoospermia, astenospermia
• Genetic disease
• Rh-negative donor insemination- for women with Rh-sensitization
• Donor is healthy and of same ethnic group as husband
• Donor serologically and bacteriologically free from venereal disease
• Recipient and donor must be matched for blood group and Rh typing
9. • Fresh or frozen semen is used
• Sperm used when it is kept sequestered for at least 180 days
• Legal, psychological and religious aspect should be counseled before
its application
10. Result of technique
• Total of 3-6 cycle may have to be utilized to get success
• Success rate 50-60%
11. Reference
• Dutta’s Gyanecology, 6th ed. Chapter 16. Infertility. P:266-270
• William’s Gynae, 2ed. Reproductive endocrinology, infertility and the
menopause.
• Shaw’s Textbook of gyanecology, 15th ed. The pathology of
conception. Chapter 17. P:197-220.