Anatomical defects of the reproductive tract, where direct coitus is not possible
Psychological sexual dysfunction – dysparuenia, vaginismus.
Cervical factors i.e. poor sperm-mucus interaction, failed post-coital test, antisperm antibodies.
It has been universally observed that whenever IUI is combined with induction of ovulation or controlled ovarian stimulation, the success rate in the form of pregnancy is improved.
Depositing actively motile sperm free from debris, leucocytes, pus cells, and dead sperm has a significant reproductive advantage in fertilizing the released oocyte from the ovary, in the fallopian tube. During natural intercourse, semen is deposited in the vagina, motile sperm from the semen move towards fallopian tube. Out of around 100 million sperm from a ‘normal’ man deposited in the vagina, only about 1 million sperm find their way to the upper portion of the uterine cavity and only few hundred enter the tube where fertilization occurs. In IUI, 5-10 million motile sperm are deposited at the top of the uterine cavity near the opening of the tubes thus significantly increasing the chances of healthy sperm reaching the mature oocyte.
The risk of infection with IUI is very small if properly done in a good centre having proper facilities for sperm processing .
In 1978, PC Steptoe and RG Edwards successfully ‘created’ human embryo out side the body after fertilizing female gamete – the oocyte using male gamete- the sperm in a test tube. Though the patient underwent this treatment had blocked fallopian tubes, subsequently clinicians found that many other indications can be effectively treated by this innovative treatment modality.
Over the past 30 years, In Vitro Fertilization has seen many changes that include continuous refinement techniques, development of patient selection criteria, and patient preparation.
