Part 5: Treatment for infertility

Tapasya and her husband have undergone investigations to find out why they are having problems conceiving. His sperm count was less than 20 million per millilitre, even on a repeat test.  Their gynaecologist has suggested that they undergo intrauterine insemination.

What is intrauterine insemination (IUI)?

Intrauterine insemination (IUI) is a treatment for infertility that is used when the sperm count is more than 10 million but less than 20 million per millilitre. It may also be used in couples that have unexplained infertility. In this situation, all the investigations seem to be normal but the couple still has trouble conceiving.

The woman is given medication to stimulate ovulation. Using ultrasound scanning, the growth of the egg is tracked. When the follicle (in which the egg is growing) reaches an optimum size, she is given an injection to help the release of the egg from the ovary. On the appropriate days, the husband’s sperms are then placed inside the uterus. The sperms are separated from the seminal fluid in a special manner so that only the most active sperm will be placed inside the uterus.

Intrauterine insemination is an outpatient procedure. You will be usually asked to wait for 15-30 minutes before you go home. The success rate of the procedure varies between 10-25 percent.

What next?

Sometimes there are conditions where natural conception cannot occur. The woman’s fallopian tubes might be blocked. The husband’s sperm counts might be very low. Occasionally, all factors may be normal but conception is just not occurring. Your infertility specialist will advise you on the need for further treatment, which is called assisted reproductive technology.

What is assisted reproductive technology (ART)?

All fertility treatment in which both eggs and sperm are handled, are called assisted reproductive technology. In general, ART procedures involve removing eggs from a woman’s ovaries and combining them with sperm in the laboratory. This results in the formation of an embryo (in-vitro fertilisation or IVF). This embryo is then transferred into the woman’s uterus (embryo transfer or ET). Since the fertilisation occurs in the laboratory, these procedures have been termed ‘test tube baby technology’ by lay people.