Intrauterine insemination (IUI) is the primary infertility treatment for couples who have been unable to conceive for a year. This process does not require a high level of technical knowledge. It only takes a few minutes to complete and causes little pain or discomfort. IUI can be done as an outpatient department (OPD) procedure. Many gynecologists can do this in their offices. It is preferred as a first-line treatment before IVF because it is less expensive and less invasive.

1. IUI Failure: Causes,
Symptoms, and Treatments

2. • Intrauterine insemination (IUI) is the primary infertility treatment for couples who
have been unable to conceive for a year.
• This process does not require a high level of technical knowledge.
• It only takes a few minutes to complete and causes little pain or discomfort.
• IUI can be done as an outpatient department (OPD) procedure.
• Many gynecologists can do this in their offices.
• It is preferred as a first-line treatment before IVF because it is less expensive and
less invasive.

3. What is IUI?
• Artificial insemination, also known as IUI (intrauterine insemination), is a type of
fertility treatment.
• The procedure involves washing, processing, and isolating motile and immotile
sperm from a male semen sample.
• Then, high-motile sperm is inserted through a catheter into the woman's uterus at
ovulation to help in fertilization.
• The goal is to send more sperm into the fallopian tubes, increasing the chances of
fertilization.
• The procedure lasts only a few minutes and is not particularly painful.

4. When is IUI recommended?
• The following are the most common reasons for IUI:
• Low sperm count – After washing the sperm count should be more than 10
million. IUI is usually recommended for men with low sperm counts.
• Low sperm motility – For IUI to be successful, the total motile sperm count after
sperm washout must be at least 10 million.
• Ejaculation problems – IUI may be recommended if a man has erectile
dysfunction.

5. • Unexplained Infertility – In case of unexplained infertility, IUI is also done.
• Hostile Cervical Mucus – Sperm must remain in the cervical mucus for several
days. As a result, if a woman has hostile cervical mucus, it becomes acidic and the
pH changes.
• IUI is not recommended in cases of severe male infertility or when a woman has a
tubal blockage, endometriosis, or a history of pelvic infections.

6. What causes IUI failure?
• The success rate of IUI is low, but it depends on the cause of infertility, the age of
the woman, and how long the couple has been trying to conceive.
• According to studies, the pregnancy rate for each natural cycle is about 4-5% and
the pregnancy rate when the cycle is stimulated with fertility medication is 7-16%.
• The reasons for IUI failure can vary from person to person, depending on their
age, egg quality, and various other factors.

7. • Some of the reasons for IUI failure or unsuccessful IUI are as follows:
• Poor quality eggs
• Symptoms of poor egg quality can be linked to chromosomal problems, making
them one of the causes of failed IUI.
• Age
• As the age increases, the quality of eggs decreases. impaired egg quality affects
the embryo and its implantation. This is one of the primary reasons for IUI failure.
• Quality of sperm
• The sperm's quality is one of the reasons IUI fails because poor-quality sperm
cannot fertilize an egg.

8. • Timing
• After ovulation, the egg remains in the fallopian tube for 12 to 24 hours; If there is no sperm for
fertilization, the egg will disintegrate. So, time must be of the essence.
• the lining of the endometrium
• Another reason IUI may fail is if the endometrial lining is not properly formed, preventing the
fertilized egg from becoming embedded in the cavity.
• Ovulation
• There could be a minor ovulation issue.
• Progesterone
• Progesterone deficiency may also be one of the reasons for failed IUI, as it is initially required to
support a pregnancy.

9. Are there any signs of IUI failure?
• There are no specific symptoms of IUI failure. If the eggs and sperm are of poor
quality, they may have chromosomal abnormalities, resulting in spontaneous
abortion.
• It is the cause of early pregnancy in 85% of cases.
• However, any abnormal vaginal discharge should be avoided and severe cramping
or discomfort should be treated by a doctor immediately.

10. The next step after a failed IUI!
• If a woman has a history of 3-4 failed IUI cycles, low ovarian reserve, and is over
35 years of age, she should consider IVF as the next step after failed IUI.
• Research has shown that IVF (In-Vitro Fertilization) and ICSI (Intracytoplasmic
Sperm Injection) can significantly increase the chances of conception and
overcome IUI Failure in cases of severe male factor infertility.
• It should also be noted that IUI is less expensive than IVF.
• It is advised that after 3-4 failed attempts if the symptoms of IUI pregnancy are
nil, the couple should consult an IVF specialist instead of continuing.