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46 - Intrauterine Insemination

from PART III - ASSISTED REPRODUCTION

Published online by Cambridge University Press:  04 August 2010

By
Norman F. Angell ,
Hany F. Moustafa ,
Botros R. M. B. Rizk ,
Mary George Nawar ,
Christopher B. Rizk ,
Chris A. Huff ,
Ruth Kennedy ,
Scherri B. Holland ,
Julie Hazelton  and
Juan A. Garcia-Velasco
...Show all authors
Edited by
Botros R. M. B. Rizk ,
Juan A. Garcia-Velasco ,
Hassan N. Sallam  and
Antonis Makrigiannakis
Botros R. M. B. Rizk
Affiliation:
University of South Alabama
Juan A. Garcia-Velasco
Affiliation:
Rey Juan Carlos University School of Medicine,
Hassan N. Sallam
Affiliation:
University of Alexandria School of Medicine
Antonis Makrigiannakis
Affiliation:
University of Crete
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Summary

INTRODUCTION

Intrauterine insemination (IUI) is one of the most commonly performed treatments for infertile or hypofertile couples. Although the technique was first reported by Dickinson in 1921 (1), it was not until the 1980s when IUI started to become popular. Over the past twenty-five years, there has been a substantial amount of research evaluating this method. As in much of infertility, methodological problems preclude clear conclusions. In particular, well-planned randomized controlled trials are rare. However, the data available allow us to scientifically treat our patients even if that science is not perfect.

INDICATIONS FOR IUI

General indications for IUI include cervical factor infertility, male infertility, minimal to mild endometriosis, and unexplained infertility (Table 46.1).

Cervical Factor

An abnormal postcoital test is frequently treated by IUI. However, the test is difficult to standardize and the predictability of the test is low. Inadequate cervical mucus is difficult to quantitate, and whether a threshold amount of cervical mucus is necessary for proper function also is unknown. The epidemic of cervical dysplasia secondary to HPV infection has resulted in a great number of cervical operations via cryotherapy, LEEP and cone biopsy, may result in removing significant amount of cervical glands. The impact of these interventions on subsequent fertility is variable.

An abnormal Spinbarkeit test may show either a low amount of cervical mucus or an increase in viscosity of the mucus. Similar to the above, the prediction of the effect of abnormal Spinbarkeit on fertility is uncertain.

Keywords

artificial inseminationcervical factorcontrolled ovarian hyperstimulationendometriosisintrauterine inseminationunexplained infertilityfollicular count
Type
Chapter
Information
Infertility and Assisted Reproduction , pp. 416 - 427
Publisher: Cambridge University Press
Print publication year: 2008

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