What is IUI?

IUI stands for Intrauterine insemination or also known as artificial insemination. In this method, semen is washed and placed inside the uterine cavity so once the ovulation occurs or the egg is released the sperm will fertilize the egg. The less travel time in this method helps in increasing the success rate of pregnancy. In IUI the fertilization process occurs inside the human body. The process of artificial insemination is useful in cases of unexplained infertility, mild endometriosis, and oligospermia.

IUI vs IVF (IUI advantages over IVF)

IUI is less invasive, less costly, and is an easier procedure to perform. The final decision to do IVF depends upon. If the age of the couple is slightly more than the doctors recommend the couple to opt for IVF. so lets us learn what is IVF?

IVF stands for In vitro fertilization in which the process of fertilization is outside the human body or outside the uterus. In this method, for 10-12 days hormonal injections are given for egg development and once the eggs are developed, they are retrieved with the help fine needle which is passed with the guidance of ultrasound guidance under anesthesia. Later these sperms are handed over to embryologists which are placed inside an incubator along with washed sperms. Here the fertilization process occurs and embryos are grown. On days 3 and 5 the these grown embryos are transferred inside the uterus and then the pregnancy continues.

The success rate is much higher in comparison to IUI. As the IVF is a completely monitored procedure the cost is comparatively higher.

When do we do IVF?

IVF is performed when there are multiple failures with IUI or the patient is suffering from the blocked fallopian tube or when the egg reserve is poor or also when the sperm count is very low.

The next fertility treatment a couple can opt for is ICSI so let’s learn about ICSI and when is ICSI is performed

What is ICSI?

ICSI stands for Intracytoplasmic Sperm Injection which is actually a part of the IVF procedure. Instead of sperm being mixed with the egg in the laboratory, the best single, healthy sperm is extracted from the sample and injected directly into the egg to fertilize it.

Why ICSI may be advised?

This procedure is performed when there have been fertilization failures or when the patient has a low sperm count or when the sperms have very low motility also when the patient has low egg reserve that’s when the ICSI is done. In cases where there are no sperms in the semen but the doctor has managed to retrieve the sperms with the process of TESA or PESA. In which the sperms are surgically retrieved and later fertilized with an egg.

The final decision of choosing a fertility treatment depends on couple’s emotional and financial status, the physical factors they have in infertility, the eagerness to conceive, and the most important factor that is the age of the couple.

FURTHER READING

What is IVF?

In IVF or In Vitro Fertilization happens outside the body using medical techniques, which is called IVF pregnancy. Therefore it is also called test tube baby because in a way the baby is made outside the body or in the test tube.

How is IVF Done

1. IVF tests & Medical & Physical Evaluation of Couple

The couple has to undergo certain IVF treatment evaluations. These are the blood test before IVF. IVF tests for Females: The female has to undergo several tests such as female hormonal tests, egg count and quality assessment, blood tests such as AMH, prolactin, thyroid & basic tests such as hemoglobin, sugar, etc. ultrasound is done to check the uterus. IVF tests for males: semen analysis or semen examination, sperm count, shape, and motility are checked.

2. Ovarian stimulation

After evaluation, the IVF Treatment starts from day 2-3. In Ovarian stimulation, injections of hormones are given for 9-12 days to make the eggs mature or make the follicles grow. This process involves ultrasound which is done on days 2-3 of the cycle, then after 5 days of stimulation, reassessment is made to check the progress or to make changes in the doses if necessary. Once the eggs are mature, the patient is given a Trigger Injection which is for the maturity of eggs. This is a very important injection.

3. Oocyte retrieval/egg pickup/Ovum Pick

After the 34-36 hours of trigger injection egg pickup is done. This is a daycare procedure. This is done under short general anesthesia and is a pain-free procedure. Egg pick-up is done by means of a fine needle which is passed under the guidance of ultrasound. Follicular fluid contents are removed using gentle suction that brings the egg along in the fluid. Once eggs reach the lab, the embryologist examines them. Mature eggs are transferred into a special culture medium/nutrient media, placed in an incubator.

4. Fertilization

The sperms are taken from the male partner. These sperms are washed and prepared. There are 2 ways these sperms are fertilized

• • IVF– The embryologists put the sperms along with eggs and leave them to their natural process of fertilization.
  • ICSI-Sperms are manually fused with eggs. Helpful in case of low sperm count or motility.

It’s the embryologist’s choice of what procedure to go for based on the case. Once fertilization is done the embryos are placed inside the incubator and throughout the embryos are monitored. The day of pickup is known as Day 0.

5. Embryo transfer

Embryo transfer is performed after fertilization. It is a daycare procedure. Embryo Transfer is done on day 3 or 5. Day 5 embryos (blastocyst embryo) has the best implantation capacity and their success rate is good. On the day of embryo transfer, a silicone tube is placed in the best position inside the uterus, under the guidance of ultrasound, the embryos are inserted. Thereafter the patient is discharged.