1. 10 secrets of success of IUI
Dr. Sharda Jain
Programme Director

2. 1 Secret
st
Right choice based on facts
(Actiology)

3. Good Result : - Unexplained I
: - Cervical Factor I
: - Anovulatory I
: - Donar IUI
Poor Results
:- severe male infertility
tubal factor/
pelvic adhesions
severe endometriosis

4. 2nd secret
Understand The Case (H & W)
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Age – women & men
Ovarian response (Poor /High/ Normal)
Endometrial Response
AMH

5. Good Responders :- young
:- Good Crop of
Preovulatory follicles
:- Good ET (> 7 mm)
:-
Good PMS count
Poor Responders
:- Older self / partner,
:- ↑ duration infertility (> 5 yrs)
:- Poor OR
:- Poor ET
:- Poor Sperm Quality

6. Male
Male age - < 35 yrs
> 45 yrs
>10 million prewash count
5-10 million Post Wash Count
Normal morphology – 14% (Krugers)
DNA fragmentation - 30 %
Sperm survival (24 hours) - ↑ 80%

7. 3rd secret
Individualised Ovarian Stimulation Protocol
• Typical PR
4 / 8 / 12 / 20
• GT
• Antagonist in IUI protocol

8. 4th secret
Poor Endometrial Thickness
• CC – neg. effect on ET – EV ?
• Delay trigger
• GT
• Scratching of Endometrium
• ↑ Endo Vascularity
(Aspirin/ Viagra / Sidnafil)

9. 5th secret
Follicle Monitoring
Do it your self
Modify Dose / ET / Follicle size / HCG Trigger
- GT
- EV

10. 6th secret
Do Right Thing at Right Time
Trigger when
GT – 17-18 mm
CC -24 -25 mm
Doppler – Perifollicular perfusion 50 – 70 %
RI < 5
PSV > 11
S/C HCG – (BMI)
Agonist trigger - OHSS

11. Timing of IUI – 38 hours
Single
– No Male Factor
Double IUI
– Male factor, PSV > 20
1st 16 - 18 hrs
2nd 36 – 38 hrs
+ LH surge - Give HCG trigger immediately
- IUI 24 hrs

12. 7th secret
Lab secret
• Labeling
• Abstinance (<3 V/S > 10 days)
• Semen collection
• Semen preparation
One size does not fit all
• High quality Consumables & media
Preparation in doctor’s office must

13. 8th secret
Success lies in looking into details of techniques
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Full Bladder
Cx mucus aspiration
Targets time - 90 minutes
Load – when ready
No free space
Rest 10 mints
Emergency trey
Easy IUI

14. 9th secret
Luteal support
• Progesterone
• Vaginal progesterone (↑ PR) is the BEST

15. 10th secret
Counseling / Knowing when to stop
3 cycles of IUI = 1 IVF

16. Final secret
All that we are
• Integrity of Team
• Right documentation
• Analysis of Result what works

17. Thanks