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Technicians liquefy the sperm at room temperature for 30 minutes and add a harmless chemical to separate out the most active sperm. They use a centrifuge to collect the best sperm. Those are placed in a thin tube called a catheter and put through your vagina and cervix into the uterus. Artificial insemination is short and relatively painless. Many women describe it as similar to a Pap smear. The patient may have cramping during the procedure and light bleeding afterward. The patient is usually required to lie down for about 15 to 45 minutes to give the sperm a chance to get to work. After that, the patient can get back to their usual activities. In some cases, before the procedure, some patients will be put on fertility drugs, such as clomiphene citrate (Clomid). This helps the body ovulate multiple eggs. How do you get the semen (sperm) sample from the male partner? The most common and preferred way is via masturbation and the male partner ejaculates into a provided container (cup) made of special material that is not toxic to sperm. In some instances the male partner is unable to do so in the lab and can produce the sperm at home with the aid of the wife (sample must reach lab within 30 minutes of production). depending on woman’s age (lower in older women) and cause of infertility such as endometriosis. Does IUI ever fail? Judging from the success rate, failure is more likely than success but because of the relative low cost of IUI many fertility experts will recommend 3-6 cycles in patients meeting the criteria for IUI. How does IUI compare to IVF? IUI is relatively cheaper than IVF, as a cycle on average costs about KShs. 30,000/= per cycle with a success rate of about 15%. IVF costs more than 10 times i.e. KShs. 400,000/= per cycle and success rates range from about 30%-50% again depending on woman’s age and cause of infertility. In older women success rates can be improved with the use of donor eggs (for IVF). Also there are more procedures, medications involved in an IVF cycle, and complications are more in an IVF cycle as compared to IVF however it is worthwhile to attempt IUI in well, chosen clients. As indicated previously some patients cannot undergo IUI. Which complications arise from IUI? There are also special condoms but this is not recommended. In cases of ejaculatory failure there is an electrical machine that can help stimulate an ejaculation but I am not aware of its use in Kenya. In men who have retrograde ejaculation i.e. they ejaculate backwards into the bladder and not outside, sperm can be collected from urine samples. Although generally painless, IUI is still a medical procedure. Most side effects are relatively minor, and may involve symptoms like mild abdominal pain or spotting for a few days after the washed sperm is introduced into the womb. However, there are certain complications it’s worth being aware of if you’re considering IUI. What is the success rate for IUI? Effects of fertility drugs Success rates vary, but is limited to about 15% and this can be cumulative over 6 cycles. Success rates are also lowered In some IUI procedures, ovulation- inducing medications may be prescribed. Most patients will not experience any side effects from these, though they have been known to cause symptoms including stomach ache, mood swings, insomnia and headaches. Moreover, these medicines can increase the likelihood of complications such as multiple births (twins, triplets or more) and ovarian hyper-stimulation syndrome. This is an effect of the fertility drug rather than the IUI itself, though it is worth discussing with the doctor. Infection Since it involves placing a catheter inside the body, IUI carries a slight risk of introducing bacteria and causing an infection. The odds of a pelvic infection are low, at only 1 in 800. However, if you do start to feel unwell after an IUI procedure, get to a doctor as soon as possible. What risks are there for the baby? Although a certain percentage of IUI babies may be born with a defect or disability, that’s true of babies in the general population too. Even if an IUI baby has a disability, this can usually be more credibly attributed to other risk factors like advanced maternal age, or a multiple pregnancy. You can rest easy knowing there’s no evidence of a direct link between IUI and harm to the baby. However, if you’re concerned, talk to your clinician about other possible risk factors in your case and how to avoid them. With so many remarks I hope again the article has been useful to all of you and hoping to converse with you more in future on Gyn Chronicles. Dr. Maureen Owiti is a practicing Obstetrician Gynaecologist and fertility consultant based in Nairobi. You can commune with her on this or related matters via email at: [email protected].