Assisted Reproductive Technologies in Bangladesh



Intrauterine insemination (IUI) is the deliberate introduction of semen into a woman's uterus for the purpose of achieving a pregnancy through fertilization by means other than ejaculation. It is the medical alternative to sexual intercourse, or natural insemination. Washed sperm, spermatozoa that have been removed from most other components of the seminal fluids, can be injected directly into a woman's uterus in this process. If the semen is not washed it may elicit uterine cramping, expelling the semen and causing pain, due to content of prostaglandin.

The most recent studies of artificial insemination suggest that the best results are achieved when insemination coincides with ovulation induced by fertility drugs. However, it is important that doctors undertaking this ovarian stimulation monitor their drug treatment to ensure there are not too many follicles developing in the ovary. A lot of follicles will produce too many eggs and increase the risk of multiple pregnancies, so the usual aim is to increase no more than three eggs. This far fewer than for IVF but ensures that the risks of multiple pregnancies are minimized. The early stages of treatment are therefore similar to steps 1 – 2 in IVF (but without the use of GnRH drugs). Only at the time of ovulation does the procedure change.

Steps in IUI:

Drug treatment to encourage two or more eggs to mature.

  • Usually gonadotrophins to stimulate the growth of follicles and cause ovulation.
  • When the largest follicle has reached a diameter of around 18 millimeters, a final injection (of hCG) is given; IUI is usually performed 38 hours later.

Throughout the drug phase, treatment is monitored, to measure the growth of follicles, individualize drug doses, and prevent serious side effects.

  • By trans-vaginal ultrasound scanning (two or three) times during a treatment cycle).
  • Sometimes by measuring hormones in a blood sample.

Sperm, either provided on the morning of ovulation or from a frozen sample, is prepared (washed) and inserted later that day directly into the uterus.

Pregnancy testing, monitoring.

Because fertilization takes place in the natural environment (i.e. in the fallopian tubes), the female partner’s tube must be open.

The success rates from IUI following ovarian stimulation are between 10 and 15 percent per cycle, but can reach 50 percent per cycle after several attempts in one year. It is important that the female’s fallopian tubes are healthy. Doctors might try four cycles of IUI and if unsuccessful, then recommended other method like IVF.

In case where the male partner has severe sperm disorders frozen sperm from an anonymous donor may be used. This is known as Donor Insemination or DI. All sperm donors must be screened for genetic diseases. Recent successes with sperm injection techniques like ICSI mean that anonymous sperm donation is now much less frequently used and only in cases where no sperm is produced.

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intrauterine insemination - male infertility treatment Kolkata


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