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Genetic Counseling for male factor infertility
Ten Secrets for the Success of IUI
(Our Experience)
Intrauterine insemination is the first therapeutic intervention undertaken by Infertility Experts, where conception does not occur on it’s own, in all IVF centres and Infertility clinics.

IUI is a journey not a destination. All the Infertility Specialists at IVF centres in Delhi and India should tread on path of evidence based medicine armed with following secrets in order to provide best results to their couples of infertility.
It is a reasonable that this initial treatment of IUI can be utilised for a maximum of 3-4 cycles as it is relatively simple, effective and inexpensive. 3 IUI cycles are equal to 1 IVF cycle.

The success rate varies from 8-22% and it depends not only on existent male and female factors but also on the expertise and protocols of the IVF specialists and ART centres, quality of drugs, media and consumables used.

What is IUI?
In intrauterine insemination washed and prepared sperms are introduced into the women’’s uterus by using thin flexible catheters, timed with ovulation, with the aim of getting sperms closer to the womb.

TEN SECRETS First Secret: Knowing the right Facts
It is important to understand the right facts and counsel the patient accordingly.
Best results are obtained in patients with unexplained infertility, Cervical Factor infertility, Anovulatory infertility and Donor insemination.
Success rate drops drastically with severe male factor, tubal factors, moderate to severe endometriosis and pelvic adhesions. Earlier the decision is taken about IVF-ICSI, the better!!

Second Secret: Patient Selection.
A complete work up of both husband and wife is essential before embarking on IUI.
Factors which need to be considered are: Age ( Both Husband and Wife), Ovarian reserve, Endometrial response and Semen Factors.
Age is one of the most powerful variable to impact the success of IUI.
Good responders are those who are young with Good AFC count, ET more than 7mm and good post wash sperm count and motility and sperm survival at 24 hrs. (over 80% )

Third Secret: Success Rate
It is imperative that Infertility Clinics/IVF centres display and counsel the couple of the success rate of individual ovarian stimulation protocol. No body should go with idea that it is 100%
Combining ovarian stimulation with IUI improves pregnancy from 6-22%.
With CC and IUI pregnancy rate is 8% and it increases to 18-20% when gonadotrophins and antagonist are used with IUI.

Fourth Secret: Endometrial thickness.
Ideal endometrial thickness at time of IUI is 7-10mm ( triple line).
In case of poor ET, measures like delayed trigger till follicle is 24mm( CC cycle), using gonadotrophins, scratching endometrium and using drugs like estrogen, aspirin, sidnafil , Viagra can be undertaken.

Fifth Secret: Follicle Monitoring
Follicle monitoring should be done by TVS by the same Infertility Expert at the ART/IVF centre only.
It helps to modify the protocol, assess endometrial thickness, follicle growth and time HCG trigger.

Sixth Secret: HCG trigger
Correct timing of HCG Trigger is essential for good results.
Using Doppler with follicle trigger can even help us time the trigger more accurately and precisely.
In a CC cycle, HCG should be given when follicle is 22-24 mm while in a GT cycle at 17-18mm.
IUI is done 38-40 hrs later. IUI done post ovulation only is key to success. Double IUI offers no advantage over Single IUI except in cases of AID and male factor infertility.

Seventh Secret: LAB Secrets
Meticulous semen preparation using appropriate technique according to semen assessment, use of high quality consumables and media, are the main stay of IUI.
It is a must that Semen is prepared in the same office where IUI is being done. Transit time leave motile sperms but no pregnancy rates if IUI specimen is not processed in inhouse.

Eigth Secret: IUI Technique
Expertise, precision and looking into fine details of the technique of IUI improves pregnancy rates…..Experience and adherence to checklists and protocols enhance the efficacy of IUI.

Ninth Secret: Luteal Phase support
Use of vaginal micronized progesterone is ideal and effective when stared from day of IUI to improve implantation rates.
Tenth Secret: Counselling & documentation
Taking the couple into confidence, transparency and frequent communication goes a long way in improving IUI success rates. Even more essential is to know when to stop doing further IUI and move on to IVF.
3 good IUI cycles are equal to 1 IVF cycle.
It is good to remember for time to time, it is good to review patients records, what works with you and what does not work!!.

  • Quality of the Women’s Egg
  • Quality of the Man’s Sperm
  • Receptivity of the Uterus

Are the Three Ultimatums for the IUI Success!!
These secrets of protocols, maintaining evaluation & special techniques should be sincerely and meticulously followed as to have good pregnancy outcome

                                          Dr. Sharda Jain             Dr. Jyoti Agrwal         Dr. Jyoti Bhaskar 
                                             Prog Director                  Director                      Director
     IUI Experience – Updated till June 30th 2013

        Our success rate (2009 - 30th June 2013)

        N = 501 = 22% (for 2 cycles 9-10% per cycle )
  • Idiopathic - 32% - (2 cycles)
  • PCOD – 30% - (r FSH) (2 cycles)
  • Cervical Factor 20% (2 cycle )
  • Endometriosis – 9% (2 cycle )
  • After treatment for TB 13% (2 cycle )
  • Immunological cause TNF ↑ (treated ) 8 % With Lit
  Male infertility
  • 5 - 20 millions 12% (2 cycle )
  • Less then 5 million Nil (2 cycle)
  • AID – 48% (2 cycles)
Success rates according to AGE
(Success rate in 1st 2 cycles)
  • Less then 30 – 28 %
  • Less then 35 – 22%
  • 35- 39 years - 8 %
  • 40 + Nil
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11, Gagan Vihar, (Near Karkari Morh Flyover)
Delhi - 110051.
91-11-22414049, 22058865
Management of Polycystic Ovarian Syndrome Controlled Ovarian Stimulation IUI (Intrauterine Insemination) IVF – Invitro Fertilisation ICSI-Intracytoplasmic Sperm Injection Natural Cycle and Minimal Stimulation IVF Cryopreservation (Sperms,Eggs & Embryos) Donor Programme (Sperms, Eggs, Embryos) Preimplantation Genetic Screening Fertility Enhancing Surgeries Recurrent Miscarriages
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First Meeting Of Life Care IVF on 9th October 2012
Second Meeting Of Life Care IVF on 27th December
Third Meeting Of Life Care IVF on 23rd March
4th Meeting IUI workshop, 12th August 2013
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