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intrauterine insemination (iui)

Medicine Assisted IUI

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Medicine Assisted IUI is a process where a woman is prescribed fertility medications (Oral or Injectable) to stimulate the eggs production, following which her cycle is closely monitored through blood work and ultrasound. Once the eggs mature, an additional hCG medication is given to trigger ovulation, after which the process of intrauterine insemination is carried out.

Medicated intrauterine insemination refers to a process in which medicines are given prior to semen insemination to ensure the growth of the eggs. Drugs are given to stimulate the ovaries which help the eggs in reaching the size required for ovulation. Now, the medicines can be administeredorally or through injections. Stimulating drugs are given prior to the process of IUI. Medicine assisted IUI induces artificial ovulation, trigerring the body to preapare itself for a potential conception in a methodical pattern. Natural IUI cycle does not include usage of drugs and injectables to promote egg’s growth. The cost of IUI with medicines can range from Rs. 12,000 to Rs. 20,000 depending upon the amount of medicine dosage required. Find here the benefits, risks, procedure and all useful information regarding medicine assisted IUI.

Medications and Process of IUI

1. The oral medications that are used to enhance ovulation or to increase the size of eggsincludeclomiphene citrate or commonly known as clomid, aromatase inhibitors (such as letrozole).

2. The injectable used to promote artificial ovulation include gonadotropins such as HMG (Human Menopausal Gonadotropin), FSH (Follicular Stimulating Hormone) or LH (Leutinizing Hormone).

3. The injectable can be found in the market by their commercial names such as Gonal-F, Follistim, Menopar and Bravelle.

4. Studies have found that clomiphene citrate and letrozole have comparable pregnancy rates. But the usage of HMG injectables is found to have double pregnancy rates as compared to clomid.

process of iui

5. Women usually begin taking this fertility medicine early in the menstrual cycle, on the second, third, fourth, or fifth day after they get their periods. Women need to continue these medicines for around a week with regular monitoring of follicle size after every two days.

6. Sometimes, trigger shots such as hCG injections are also given to induce artificial ovulation. Once the hCG trigger shots are administered, the patient is called after 36- 48 hours for semen insemination.

7. Once the semen is transferred to the uterus with the help of catheter, progesterone tablets are prescribed to ensure uterus-lining thickness.

8. After 2 weeks of semen transfer, pregnancy test is taken with the help of pregnancy test strips and blood tests. Pregnancy test kits are not always reliable to test after IUI, because it might result in false positive results because of high hCG trigger shots. Doctors always rely on blood test reports to confirm the pregnancy.

Orally medicated IUI

Orally medicated process involves the use of Clomid or Letrozole to stimulate the ovaries. These drugs are often referred to as gateway reproductive drugs.  After these drugs are given, your cycle will be closely monitored via several ultrasounds to detect how many follicles are maturing and predict the likely time of ovulation.

After the oral treatment, the doctor will administer a trigger shot of human chorionic gonadotropin (hcG). This is the hormone that is produced by the body during pregnancy. It helps in maturation of eggs and also causes ovulation to occur within 36- 40 hours.

Soon after that, the gynecologist will begin watching for the signs of ovulation to know when to schedule the IUI. The IUI is usually scheduled around 36 hours after the shot.A medicated IUI is done when women do not have normal menstrual cycles or are not ovulating regularly.

IUI with injectable medications

In this case, the injectable gonadotropin like follicular stimulating hormone (FSH) is given. Injectable medications are started on day 3 of the cycle after a baseline ultrasound and a blood work up done. These injections are given for a period of six to ten days. During this period, regular blood workup and serial ultrasounds are done to monitor the growth of eggs. Once the egg reaches a certain optimum acceptable size, a trigger shot of hCG is given to cause ovulation.  The procedure of IUI is done after 36-48 hours of the administration of hCG.

IUI with injectable medications

An injectable medication IUI is done only if you fail to conceive after orally medicated IUI. During injectable IUI cycle, there are chances of multiple egg release. Multiple pregnancies chances are more with injectable IUI cycle as compared to orally medicated IUI.

After the IUI procedure is done you will be instructed to take Prometrium (progesterone) vaginally to help you through the early stage of pregnancy. Progesterone is a hormone, which helps in sustaining the pregnancy. If your body does not produce it naturally in a desired quantity, then progesterone supplements can help you to some extent.

Risks associated with Medicine Assisted IUI

Although medicine assisted IUI is successful and effective, but it might also be risky for some. Here are some of the risks of medicine assisted IUI you need to know before you progress with the treatment.

  • Artificial Insemination (AI) ovulation medicines lead to an increased risk of multiples.
  • Oral medications can cause headache, mood swings, ovarian cysts and visual disturbances.
  • With injectable ovulation medicines there are chances of swelling or a rash at the site of administration of the injection. Injectable can also lead to ovarian enlargement, abdominal bloating and most importantly – ovarian hyper stimulation syndrome (OHSS).

Benefits Of Medicine Assisted IUI

IUI is ideal for fertility issueswhen awoman’s fallopian tubesareopen and she responds well to low doses of fertility medications. Injectable or medicated IUI cycle causes super ovulation, which means multiple eggs are released during a cycle.

  • Superovulationcombined with IUIis associated with a three-fold higher chance of pregnancy than no treatment at all and a two-fold higher chance of pregnancy than either natural IUI or superovulation alone. Infertile Couples who used both superovulation and IUI had a 33 percent pregnancy rate, compared with infertile couples who used none of the fertility treatments.  
  • Women who are not ovulating regularly may start the fertility treatment with the medication;with the goal to get their ovaries release one egg each month.
  • You need to takethe medication at the right time for thesuccessful IUI treatment. Medicine assistance is a great help if you have ovulation issues.

If you have decided to opt for an IUI treatment and are presently searching for the best IUI clinicsyou can call us at+91-7899912611. We will help you with the best gynecologists and fertility specialists across India. These experts have decades of experience in the successful accomplishment of pregnancies with IUI procedures.

Dr. Aanchal Agarwal

About The Author

Obstetrician Dr. Aanchal Agarwal
Delhi

Dr. Aanchal Agarwal is an infertility specialist and gynecologist who has graduated MBBS from University of Delhi in 2001 and then pursued DGO from University of Delhi in 2004. Dr. Aanchal specializes in treating patients with IVF, IUI, High-risk pregnancy care and Normal vaginal delivery procedures. Dr. Aanchal Agarwal is at present practicing at BLK Super Speciality Hospital, Pusa Road, Delhi. You can find more information on elawoman.com

SOURCES AND REFERENCES:

  1. Iui or ivf fertility treatments, Elawoman - 2017
  2. How much does iui cost IUI treatment, Elawoman - 2017
  3. Best iui centers in delhi ncr with highest success rates best IUI clinics, Elawoman - 2018

2 Comments

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Shilpa Ahuja

It's necessary to consider the risks of medicine assisted IUI treatment as they seem to cause certain side effects in the body.

June 5, 2018, 11:22 a.m. 5.0

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Santosh Mishra

We are satisfied with our medicine assisted IUI procedure. It was an affordable and result-oriented procedure for us.

May 20, 2018, 9:16 a.m. 4.5

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