Intrauterine Insemination (IUI) in Dr. Shterev Hospital - accents

- Intrauterine insemination is a fast and not painful procedure that is held in a special manipulation room in the IVF Sector of Dr. Shterev Hospital.

- The procedure doesn‘t take much time – about 5-10 minutes, including the preparation. The patient lies, and a specialist injects the treated sperm in the uterus by dint of a particular, very plastic and thin sterilized catheter. Then the catheter has to be fixed, and the patient should lie about 30-40 minutes.

- "Every year we help hundreds of couples to get their beloved baby with Intrauterine insemination procedure", Ivaylo Tsanov, biologist, Dr. Shterev Hospital.

Intrauterine Insemination (IUI) in Dr. Shterev Hospital

Step 1 | Drafting a protocol for Intrauterine insemination

Step 2 | Tests regarding Regulation 28 for Assisted Reproduction

Female patient: HIV, Syphilis, Hepatitis B, Hepatitis C, microbiology of the vaginal discharge, cervical smear (PAP smear)

Male patient: HIV, Syphilis, Hepatitis B, Hepatitis C, microbiology of the semen

Step 3 | Signing an informed consent for proceeding Intrauterine insemination

Step 4 | Cycle tracking
o Ultrasonography in defined days during the menstrual cycle;
o LH and Estradiol hormones test.
Usually, the following rules are followed: if there is a need for hormonal stimulation use, the patient should visit the clinic between 2nd and 3rd day of her menstrual cycle. If there is no need for hormonal stimulation, the days for attending the clinic are between the 9th and 11th day in a 28-day menstrual cycle.

Step 5 | Ovulation timing
Once a developing egg follicle reaches a certain size – diameter of 18 -20 mm and the uterine lining is thick enough, the moment for the timing of the ovulation is considered as good. An hCG (Human chorionic gonadotropin) injection is prescribed. Such are Pregnyl, Ovitrelle or Choriomon.
This hormone surge is what triggers ovulation about 24 to 36 hours later, after increasing the levels of LH. When the cycles are stimulated, the procedure usually is set to be done in 40 hours after the hCG injection.

Step 6 | Intrauterine insemination material preparation
o Intrauterine insemination with partner's sperm (IUI-H)
It is mandatory for the partner to respect sexual restraint 3-5 days before the Intrauterine insemination procedure and to avoid drinking alcohol. He shouldn't use antibiotics and antiallergic medicines.

Two hours before the procedure the partner gives some material – fresh ejaculate. Semen preparation techniques are used to separate sperm, which has the best appearance and movement from the centrifuged, any debris, round cells, non-motile and poor quality sperm. Then the sample stays for a while in the incubator. The treated semen receive an etiquette with the name and surname of the patient, insemination type and the catheter type. Unique identity number is put on the sample.

In case of no presence of the husband/partner, there is an option frozen sperm to be used.

o Intrauterine insemination with a donor's sperm (IUI-D)
When a donor's sperm is used for intrauterine insemination, the patient should be informed in advance with the available donors in the sperm bank. Dr. Shterev Hospital uses Cryos International – a Danish specified sperm bank, which is approved by the Bulgarian Executive Agency for Transplantation and fully complies with Bulgarian legislation Regulation No 28 for Medically Assisted Reproduction, 20th of June, 2007.

All donors are tested for transmissive deceases and had passed through genetic screening. Regarding Bulgarian regulations, donors stay anonymous.

The patient receives in advance a catalog with potential donors with information about the race, nationality, eye color, hair type, height and weight, job and blood type included.
Some of the donors have extended profiles with child pictures of the donors and additional information about his genealogy. Sometimes the donors write an essay about: "Why I became a donor" where his handwriting may be seen. Usually, the patient chooses and arrange top three wished options. The reason is that because of the significant amount of procedures in the hospital, the first donor material may be sold out.

Step 7 | Intrauterine insemination
Intrauterine insemination is non-traumatic and easy and fast to be proceeded procedure. It is held in a special manipulation room (on the 3rd floor). The patient is lying on an exam table and put her legs into stirrups, and a speculum will be inserted into her vagina. First, a wash is done. Just before the real insertion of the sperm, the biologist informs the patient and the doctor with the data on the etiquette to ensure the safety of the sample.

The procedure takes just 5-10 minutes, including the preparation. The doctor inserts a long, thin, flexible tube (catheter) into the patient's vagina through her cervical opening and into the uterus. Then the doctor pushes the sperm sample through the tube into the uterus and fixes the catheter. The patient should remain to lie for 30-40 minute.

After the insemination, the doctor may prescribe medicines for luteal support until the pregnancy test. There is no special regime to be abided after such a procedure. In case of any problems, we recommend resting and avoiding excessive loads.
Sometimes the insemination should be proceeded in two consecutive days, when:
o more than one follicle, one ovulated, and one – to be ovulated
o with low biological survival period of sperm cells.

Step 8 | Pregnancy test
The pregnancy test should be done 14 days after the intrauterine insemination procedure.

YOU CAN SEE A LIST OF OUR REPRODUCTIVE SPECIALISTS HERE.

SIGN YOUR MEDICAL APPOINTMENT VIA PHONE CALL TO +359 2 920 09 01 OR VIA OUR WEBSITE.

Video: Intrauterine Insemination

Watch our exclusive cartoon video about the assisted reproduction technique Intrauterine Insemination. You will learn when this procedure is applicable, what is the preparation for it, and what are the implementation steps from the beginning to the pregnancy test.

Intrauterine Insemination (IUI) - resume