IUI Failure: Causes, Symptoms And Treatments

Intrauterine insemination (IUI) is the primary infertility treatment preferred by couples who are unable to conceive for over a year. This procedure does not require much technical expertise.

It takes a few minutes to complete the process and does not cause much pain and discomfort. IUI can be performed as a simple OPD (Outpatient Department) procedure. Many of the gynaecologists can do it in their clinic. It is preferred as the first-line treatment before IVF as it is believed to be cost-effective and less invasive.

What Is Intrauterine Insemination (IUI)?

IUI (Intrauterine insemination), also called artificial insemination, is a type of fertility treatment. During the process, a semen sample from a male is washed and processed, and the motile and immotile sperm are separated.

Then, sperm of higher motility are placed inside a woman's uterus through a catheter during ovulation to facilitate fertilisation. The motive is to increase the number of sperm reaching the fallopian tube, thereby increasing the chances of fertilisation. The procedure takes a few minutes and does not cause much discomfort.

When Is IUI Recommended?

The most common reasons for doing IUI are:

A Low Sperm Count

After washing the sperm, the count should be more than 10 million. IUI is usually recommended for men with low sperm counts.

Decreased Sperm Motility

For a successful IUI, the total motile sperm count should at least be 10 million post-washing of the semen.

Ejaculation Problem

IUI can also be recommended when a male has ejaculation dysfunction.

Unexplained Infertility

IUI is also done in cases of unexplained infertility.

Hostile Cervical Mucus

Sperm needs to stay for as sperm needs to stay for a couple of days within the cervical mucus. So, if a woman has hostile cervical mucus, it becomes acidic, and the change in pH can restrict the sperm's survival in the cervix.

IUI is not recommended in severe male infertility cases and when a woman has a tubal blockage, endometriosis, or a previous history of pelvic infections.

Causes of IUI Failure

The success rate of IUI is not that great, though success would depend on the cause of Infertility, the age of the woman, and the time since the couple is trying to conceive.

Studies have shown that the pregnancy rate for each natural cycle is about 4-5%, and when the cycle is stimulated with fertility drugs, the pregnancy rate is 7-16%. The possible reasons why IUI fails depend on person to person, their age, egg quality and a number of other factors.

Reasons for IUI Failure

Here are some of the IUI failure reasons for unsuccessful IUI:

• Poor Quality Eggs Poor egg quality symptoms can be related to chromosomal problems and are thus associated with one of the reasons for failed IUI.
• Age: Increasing maternal age decreases the quality of the egg. The deteriorated egg quality impacts the embryo and its implantation, becoming one of the major reasons why IUI fails.
• The quality of Poor quality sperm will not be able to fertilise an egg, resulting in one of IUI failure reasons.
• Timing after ovulation, the egg stays in the fallopian tube for 12-24 hours. If no sperm are present at that time to fertilise the egg, it will disintegrate. So, the timing should be perfect.
• Endometrial lining Another possible reasons IUI fails might be if the endometrial lining is not proper, and the fertilised egg cannot get embedded in the cavity.
• Ovulation: There might be a mild ovulation problem.
• Progesterone Deficiency in progesterone may also be one of the failed IUI reasons, as it is initially necessary to support a pregnancy.

IUI Failure Symptoms

• No specific symptoms indicate IUI failure.
• If the treatment hasn't worked, it will result in your period.
• Poor egg and sperm quality can cause chromosomal abnormalities, leading to spontaneous abortion.
• Chromosomal abnormalities account for 85% of early pregnancy losses.
• Watch for unusual vaginal discharge.
• Consult a doctor immediately if you are experiencing severe cramping or discomfort.

After IUI Failure Symptoms

• If there are 3-4 failed IUI cycles, low ovarian reserve, and age above 35, consider IVF as the next step.
• IVF and ICSI can significantly increase the chances of conception, especially in cases of severe male infertility.
• While IUI is less expensive than IVF, the cost of multiple tries and medications adds up.
• IUI failure impacts infertility, and the success rate is lower compared to other ART procedures.
• After 3-4 failed IUI attempts, consult an IVF specialist rather than continuing with natural attempts.

Frequently Asked Questions