Candidates for IUI:

• If the simple treatment of tablets and natural timings does not work, the couple is advised to take the next step, which is normally IUI (Intrauterine insemination). This involves taking the tablets again for 5 days, followed by regular scans to check the growth of the egg. When the egg is ready as per the scan, an injection is given to release it at a fixed time. At this time, the husband gives a semen sample. This is then processed to select the best sperms to put in the right place (womb) at the right time (egg release time) by a fine catheter. This has a nominal success rate of 15 to 17%. This means that the chances of failure are very high and the treatment has to be done repeatedly sometimes.
• If this is not working, the couple may lose their faith in the doctor and go to another clinic. Unfortunately, the tests may have become old and the doctors may wish to repeat the tests. Now, this clinic may its own different arrangements. The couple is now dealing with new staff and doctors and that must be challenging. Sometimes, couples travel a long distance to undergo the treatment from a particular clinic and this can have a serious impact on their sufferings.

How many attempts of IUI can be done?

• If three to four IUIs do not work, the couple is getting fed up and may take a break to relax a little. If they are not counselled properly at this stage, they may keep doing too many IUIs. In the process, they start taking excessive medications, which can harm them later and reduce the chances of success using advanced treatment. This must be avoided at all costs. It is very important that the couple understands the full process and is doing the treatment with complete knowledge.
• When they are ready to restart their treatment, they are now faced with some difficult choices. The first is to consider one or two more IUIs to keep the treatment simple and the second is to perform a laparoscopy and hysteroscopy and then some more IUIs. Laparoscopy and Hysteroscopy is an operation involving small cuts on the woman’s tummy. A fine telescope is introduced inside the tummy to check if the tubes are open and if there are any other undetected issues. If any problem, such as a tubal block, fibroid, or endometriosis is found, it should be treated at the same sitting. In some center’s, such facilities and skills may not exist for the operative part and that part is performed at a later date again. This leads to a doubling of the effort and should be avoided preferably. In some women, this operation gets performed repeatedly and leads to increased pain sufferings and costs.