Usually the sample is collected through ejaculation by masturbation into a sterile semen collection container in a private room at the clinic. From the time the sample is received, it takes about 1 hour 30 minutes to make the sample ready for insemination. The amount of time may vary depending on the sperm quality, as special techniques may be required.

Ideally, an IUI should be performed within 6 hours before or after ovulation. Timing is based on an HCG injection (given to release the egg) and the IUIs are usually done between 24 and 36 hours later. Typical timing would be to have a single IUI at about 36 hours post-hCG. If two IUIs are scheduled, they are usually spaced at least 12 hours apart between 24 and 48 hours after the HCG. Success rates are higher with two IUIs as compared to a single IUI. The egg is only viable for a maximum of 24 hours after it is released.

Most women consider IUI to be fairly painless - along the same lines as having a pap smear. There can be some cramping afterward, but often what is felt is the pain of the egg being released (ovulation) rather than from the IUI. The catheter usually does not cause pain as it is very thin and flexible and the cervix is already slightly open for ovulation.

Current research indicates that washed sperm can live 24-72 hours; however, it does lose potency after 12-24 hours. Another issue with IUI is that the sperm can keep on swimming beyond the fallopian tube, so the ideal window is really within 6-12 hours of the egg being released; with a larger margin before ovulation than after since the egg's viability is shorter. Sperm can live up to 5 days in fertile mucus, 2-3 days being common, so combining IUI with intercourse may provide better coverage.

We advise patients to lie down on the table for 30-45 minutes after the procedure.

Most people don't need to, but if you had cramping or don't feel well afterward it makes sense to take rest for a day or two. We advise against any heavy work or travelling by buses, rickshaws or scooters as the bumpy ride may reduce chances of conception.

This depends on your individual situation, but it usually should not be less than 3 days and not more than 7 days in order to ensure the best motility and morphology. We advise that you have an intercourse around the 7th or 8th day of your cycle and then abstain.

Usually you can have intercourse any time after an IUI. We suggest waiting 48 hours to resume relations if you had any bleeding during the IUI or if a tentaculum is used.

Once the sperm is injected into the uterus, it does not fall out. There can, however, be increased wetness after the procedure because of the catheter loosening mucus in the cervix and allowing it to flow out.

According to different studies, 3-4 follicles gives one the best chance of getting pregnant, while more follicles beyond that simply increases the risk of multiples.

IUI can help patients taking only tablets containing clomiphene citrate where cervical mucus is a problem, and IUI increases the chance of success in patients on injections no matter what the sperm count. It does make sense to try IUI if you have tried but haven't had success with intercourse. It is important to note that with intercourse, only the best and strongest sperm make it through the cervical mucus and up into the uterus and fallopian tubes. With IUI, more number and better quality of sperms are available for fertilization.

A count above one million (after sperm preparation) appears necessary for success, with a significant reduction in pregnancy rates when the inseminated is count is lower than 5-10 million (in other words, in most cases one should consider 5 million a lower limit for success, 10 million for cost-effective). Higher success rates are with washed counts over 20-30 million, while increasing counts over 50 million did not appear to offer advantage.

It depends on what you can afford and what medication you are taking. One might do 1-2 IUIs on Tablets before moving on to Injections, then do 3-4 cycles on Injections. If one doesn't have success after four good ovulatory cycles on Injections with well-timed IUI, it would be time to consider IVF. Age is also a factor, the higher the age, the more aggressive is the treatment required.

An IUI shouldn't be done at home without medical supervision because the sperms needs to be washed to prevent infection - i.e., separated from the semen. A vaginal insemination can be done at home, but is no more successful than intercourse. Getting semen or air into the uterus could be quite dangerous - perhaps life-threatening.

It doesn't usually happen, but it isn't uncommon. Some women also have light bleeding with ovulation.

Implantation takes place 6-12 days after ovulation - so 6-12 days after a well-timed IUI.

Transvaginal Ultrasonography is done from Day 10 or 11 of the menstrual cycle to note the growth in follicular size and look for signs of ovulation like reduction in size of follicle, fluid in POD etc.

Follicles are usually considered mature once they have achieved a size of about 18 mm. Also, follicles continue to grow until they release, usually at a rate of about 1-2 mm per day. A woman may ovulate more than one follicle in a cycle, but the releases will occur within 24 hours. When HCG is not used, only follicles close in size are likely to release. The use of HCG induces ovulation in about 95 percent of women, and will get most mature follicles to rupture.

The main risks are some discomfort such as cramping, minor injury to the cervix that leads to bleeding or spotting. There are also risks of hyper stimulation associated with the use of ovulation induction medications such as clomiphene citrate (low risk) and gonadotropin therapy (higher risk). Proper technique and adequate monitoring reduce risks.

Most women don't need medication for pain associated with IUI. If there is cramping, it is best to avoid medications such as ibuprofen and naproxen (NSAIDS), but paracetamol is considered safe (but maybe not that helpful for cramps).

No. A tubal ligation is effective birth control because it prevents the sperm and egg from meeting. The process that leads to pregnancy is having an egg released from a follicle in the ovary and then beginning the journey to the uterus through the fallopian tube. Sperm will travel from the vagina, through the cervix, through the uterus, into the tube where fertilization occurs. IUI bypasses the need for the sperm to travel through the cervix, but that's it. It doesn't get the egg to the other side of the obstruction, so fertilization won't take place. The only way to get pregnant after tubal ligation or blocked tubes is by having reversal surgery or an assisted reproduction technology that includes egg retrieval, such as in vitro fertilization (IVF).

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