Infertility Options
IUI, IUTPI, and FSP. It almost looks like a computer code for some new program, and in some ways, it is.
A Little History
Fertility treatments are constantly improving and developing, promising new and greater ways to take a couple from childless to married with children. Some of the standard procedures are improved, while others are revised and changed entirely. One procedure that has been around for more than 100 years is intrauterine insemination, also called IUI or artificial insemination. Now, mind you, the process wasn't used on humans back in the early 1900s. Farm animals were the targets back then. But, human artificial insemination with the male partner's sperm as a means of addressing infertility began being used in the 1940s. Essential the same method as was used for farm animals, IUI or artificial insemination was a miracle for couples struggling to conceive.
When IUI Won't Work
IUI can be a very effective treatment for some causes of infertility in women who are under 40 years of age. Female age is a significant factor with IUI. Intrauterine insemination has very little chance of working in women over 40 years of age and it has also had reduced effectiveness in younger women who have significantly elevated day 3 FSH levels or other indications of serious reduction in ovarian reserve.
If couples are dealing with tubal blockage IUI should not be used. When IUI is being considered as the treatment of choice, a hysterosalpingogram (HSG) is done to determine the extent of damage or blockage and if the fallopian tubes are blocked, IUI is not performed.
The other instance where IUI is not appropriate is in the case of male fertility issues. If the sperm count, motility and morphology scores are quite low, IUI is not likely to work.
When IUI is the Best Choice
IUI is most commonly used for unexplained infertility and for couples who are affected by mild endometriosis, problems with ovulation, mild male factor infertility and cervical factor infertility. It is a valid initial treatment that should be used as a first endeavor in women who are ovulating on their own. A longer period of trying can be used for women with PCOS and those given drugs to stimulate ovulation.
When IUI is coupled with ovulation induction the results are often better than without induction. The amount of hormones used for IUI is far less than for IVF and fertilization of the egg will occur naturally, in the natural environment. Insemination is performed using a soft catheter that is passed through the cervix and into the uterus where prepared sperm is deposited. Oral progesterone is administered for 14 days in order to support the luteal phase of the cycle and then a pregnancy test is done at 14 days after insemination.
Improving IUI
Going back to our comment about improving on methods, IUI has been improved upon recently. It s a new method of insemination using a much higher dose of inseminate than is used in IUI. It is called IUTPI - Intra Uterine Tubo Peritoneal Insemination. In this method, a large dose of sperm is used in a process called fallopian tube sperm perfusion (FSP), a procedure that places sperm into the woman's fallopian tube, closer to the eggs than IUI, in order to improve the chances of conception.
In theory, directly passage of the sperm through the fallopian tubes increases the concentration of sperm in the portion of the tube where the egg is resting, thus enhancing sperm-egg interaction, fertilization, and ultimately, pregnancy rates. Some studies have shown that pregnancy rates with FSP are two or three times higher than those with IUI. The main technical difference between IUI and FSP is the sperm volume is increased.
When FSP is Best
FSP and IUTPI are recommended for treatment of mild to moderate male infertility, ovulatory dysfunction, unexplained infertility and infertility due to non-immunological mucus insufficiency. This new and improve method of IUI has shown very promising results.
There are many facets to IUI. You can read about them here.
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