Bypass (Vaginal acidity + cervical mucus hostility)
Deposition of a well prepared sperms as close as possible to the oocytes (Short distance)
Non invasive (like pap smear).
Antenatal & perinatal complications (like pregnancies from normal S I)
1.Multiple pregnancy (>IVF) number of follicles will grow or rupture can not precisely controlled.
2. Infection Iatrogenic infertility.
3. Psychological (guilt- anger- loss of self esteem)
Indications for IUI
Ejaculatory failure (Hypospadius- Vaginismus- Impotence- retrograde ej.)
Cervical factor (mucus hostility-poor mucus)
Male subfertility (Mild, moderate)
Immunological (Male sperm a.bs- female antisperm a.b)
Husband is away from wife for long time (work abroad)
Ovulatory (?! Induction + timed sexual I).
Combined non tubal infertility factors.
HIV negative women with processed semen of HIV +ve husband.
Cancer-husband: cryopreservation of semen prior to chemo, radiotherapy or orchidectomy.
Is IUI and /or COH cost effective for male subfertility compared with IVF? And for how many cycles?
What is the threshold level for numbers of motile spermatozoa after sperm preparation beyond which treatment outcome is no longer improved? Or what is the minimum number of motile sperms below which IUI is no longer effective