(English) Intrauterine insemination

Evaluation of female partner

  1. Physical parameters

    Anthropometric

    • weight (kg);
    • height (m);
    • body mass index (BMI);
    • normal range : (BMI 19-25);
    • waist girth (cm);
    • hip girth (cm);
    • W:H ratio ;
    • normal value for W:H ratio ‹0.85;
    • normal value for waist girth ‹90cm.
  2. Clinical parameters

    Transvaginal sonography

    • Evaluation of uterus , uterine cavity and endometrial response;
    • Measurement of ovarian volume , antral follicle count (AFC) to differentiate PCOS from non-PCOS;
    • HSG: in case of women with infertility period of

    Diagnostic laparoscopy and hysteroscopy:

    • if infertility period is > 5years for evaluation of cervical , uterine , tubal and ovarian factors (irrespective of male factor status);
  3. Endocrinological parameters

    Baseline hormones

    • Women (below 35 years ) with menstrual aberrations : serum LH , FSH , TSH , PRL , Estradiol , Testosterone , SHBG , Insulin and GTT ;
    • Women > 35 years with / without menstrual aberrations : serum Antimullerian hormone (AMH) for evaluation of ovarian reserve along with the above mentioned endocrine parameters ;

    D21 Hormone

    • Serum progesterone to rule out ovulatory dysfunction and luteal phase defect.

Evaluation of male factor

  1. Clinical parameters

    Medical history

    • Hair distribution score to evaluate secondary sexual characters;
    • Physical examination of tests , epididymis and vas deferens;
    • measurement of volume of tests in case of azoospermia;
  2. Laboratory parameters
    • Semen analysis as per WHO criteria;
    • Normospermia;
    • Astheno / necrospermia <25%
  3. Grade 3 and 4
    • Teratozoospermia <30% normal morphology ;
    • Oligospermia (Moderate)5 million – 10 million / ml ;
    • Severe oligozoospermia < 5 million / ml;
    • Azoospermia (Obstructive /nonobstructive) (No motile/nonmotile sperm)
  4. Investigations
    • No futher investigations unless indicated;
    • Antisperm antibody test;
    • Check for DM/hypertension;
    • Sperm function tests (SFR) Check for varicocele
    • Vasogram , thermogram , Doppler study for varicocele ;
    • Testicular biopsy / FNAT , Endocrine evaluation : FSH , AMH / Inhibin B

Indications of intrauterine insemination

IUI with the partner sperm
  1. Female factor:
    • Anatomic defects of vagina or cervix;
    • Hostile cervical mucus;
    • Sexual dysfunction;
    • Mild to moderate endometriosis;
    • Endocrine anomalies;
    • Chronic anovulatory menstrual cycle;
  2. Male factor
    • Anatomic defect of penis e.g. hypospadias ;
    • Sexual / ejaculatory dysfunction ;
    • Retrograde ejaculation ;
    • Semen volume in excess or deficit ;
    • Immunological factors ;
    • Male subfertility : mild oligozoospermia , asthenozoospermia or teratozoospermia;
  3. Other factors
    • Idiopatic poor post coital test (PCT);
    • Combined subfertility factors;
    • Unexplained infertility;

IUI with donor sperm

Male factors

  • Azoospermia (non-obstructive ) ;
  • Severe oligozoospermia ;
  • Severe Astheno / necrospermia ;
  • Failure in at least six IUI cycles with oligozoospermia ;
  • Sterility due to disease or vasectomy , orchidectomy , chemical or radiation exposure ;
  • Sexual / ejaculatory dysfunction ;
  • Genetic considerations (hemophilia , Huntington’s chorea) ;
  • Rh-incompatibility.

Cabinet Ginecologic

Cabinet Ginecologie / Ecografie 2D, 3D, 4D, Doppler Color
Videocolposcopie / Planificare familiala

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