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Intrauterine Insemination - also known as Artificial Insemination

Reason for Intrauterine Insemination.

  1. Unexplained infertility. This means that all the tests done on the male and female partner are normal. These are tests for ovulation, tubal patency, pelvic ultrasound and semen analysis. This accounts for 12 -15% of infertility.
  2. Low sperm count and low sperm morphology (quality). The average sperm count is 30 million/ml to 50 million/ml. The motility is > 50% and the morphology is > 4%.
    For artificial insemination, the sperm count has to be > than10 million/ml,
    the motility > 30%
  3. Stage 1 /mild endometriosis
  4. At least one patent tube
  5. Donor insemination
  6. Discordant HIV status
  7. Polycystic ovarian syndrome

Procedure:

Most insemination cycles are stimulated cycles in order to improve the pregnancy rates.

The commonest medication to induce ovulation is Clomid / Fertomid (Clomiphene citrate). Some woman with polycystic ovarian syndrome may be resistant to ovulation with Clomid. Letrozole or fertility injections (e.g.) Gonal F or Menopur are given in such cases.

The aim of ovulation induction is to produce 2 mature follicles (eggs).

The medication is started on the 2nd or 3rd day of the period. It is taken for 5 days. For woman that do not get regular periods, they will be given Provera or Duphaston or the contraceptive pill to induce a period.

The response of the ovaries are monitored by transvaginal ultrasound. The first ultrasound is done on cycle day 11-12. The size of a mature follicle is 18 to20 mm. If the follicle is not mature, a repeat ultrasound will be done a few days later.

Once the follicle is mature, you will have a blood test taken to check your hormone profile. Ovitrell or Pregnyl injection is given that evening between 9 pm and 10 pm. The insemination will be done 36- 38 hours later.

On the morning of the insemination, the sperm sample is handed to the laboratory for sperm wash and harvest. It is a procedure where the best quality sperms are selected and suspended in a special sperm medium. This takes 1 ½ hours to do.

The insemination procedure is done in the rooms. It is similar to a Pap Smear. The sperms are injected into the uterus with a small catheter. It is a painless procedure, taking 2-3 min to do. Pregnancy test done 12 days later.

Success Rate

The success rate depends on the age, number of follicles, sperm quality and reasons for insemination. This is generally 18-22 % per cycle

We usually do a total of 4 insemination cycles.

DR RAZAK DHANSAY

Fertility Specialist registered with the Health Professions Council of South Africa. Over 20 years of experience in all aspects of fertility management.

Patient focused fertility care. All treatments individualised and personalised. Holistic approach to fertility management.

CONTACT

Room 101 Library Square, 1 Wilderness Road, Claremont 7708,
Cape Town, South Africa

021 683-7036

086 620-7937