An overview of intrauterine insemination and ovulation induction

Abstract

(ICI) is to reduce the effect of factors such as vaginal acidity and cervical mucus hostility and to benefit from the deposition of a bolus of prepared motile, morphologically normal sperm as close as possible to the oocytes at the time of ovulation. There continues to be discussion in the literature about whether or not IUI should be complemented by OI-either with the oral medications clomiphene citrate (CC) or tamoxifen (TMX), or with the injectable gonadotropins. Most practitioners are of the opinion that IUI with OI does increase success rates, and many will initially try with CC or TMX, and move on to gonadotropins if there is no success within a few cycles of CC/IUI. The most appropriate time to move on from IUI to IVF is also a matter for debate, but most practitioners agree that the change should be made after no more than 4-6 cycles of IUI (see Chapters 7 and 8). Before proceeding to artificial insemination, couples should undergo a complete assessment, of which a full description is given in Chapters 2 and 3. This includes a thorough medical history, clinical examination and appropriate investigations for any possible causes of a couple's infertility, such as tubal damage, ovulatory disorder or a male factor. It is essential that couples should receive adequate counseling prior to starting treatment, especially when donor sperm is to be used. Couples should also be assured of complete confidentiality, and informed that all sperm donors are now comprehensively screened for genetic and infective conditions. Couples will wish to know how the donor is to be matched to their own characteristics, the cost of treatment, the probability of success, the potential for complications to occur and the likelihood of their occurrence. Medical professionals and couples can now make use of the internet to find a sperm donor that matches their desired physical, educational, religious and even national and ethnic

A Few Words about Sperm Donation

“…Before intending to artificial insemination, couples ought to undergo a completed evaluation [11]. This includes a thoroughgoing medical history, clinical trial or appropriate investigations because someone possible motives on a couple's infertility, such as tubal damage, ovulatory sickness and a male factor.…”

Overview of intra-uterine insemination in a Sri Lankan scenario

“…The use of a "dip stick" LH test kit can predict ovulation in over 80% of cycles 3 . If hCG is administered when the diameter of the leading follicle is 18-20 mm ovulation may be expected to occur 34-40 hours later 4 . The maximum number of times IUI can be performed is still debatable.…”