10 secrets of success of iui
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10 secrets of success of IUI. Dr. Sharda Jain Programme Director. 1 st Secret. Right choice based on facts (Actiology). Good Result : - Unexplained I : - Cervical Factor I : - Anovulatory I : - Donar IUI.

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10 secrets of success of IUI

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10 secrets of success of iui

10 secrets of success of IUI

Dr. Sharda Jain

Programme Director


1 st secret

1st Secret

Right choice based on facts

(Actiology)


10 secrets of success of iui

Good Result : - Unexplained I

: - Cervical Factor I

: - Anovulatory I

: - Donar IUI

Poor Results :- severe male infertility

tubal factor/

pelvic adhesions

severe endometriosis


2nd secret

2nd secret

  • Age – women & men

  • Ovarian response (Poor /High/ Normal)

  • Endometrial Response

  • AMH

Understand The Case (H & W)


10 secrets of success of iui

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


10 secrets of success of iui

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%


3rd secret

3rd secret

  • Typical PR 4 / 8 / 12 / 20

  • G T

  • Antagonist in IUI protocol

Individualised Ovarian Stimulation Protocol


4th secret

4th secret

Poor Endometrial Thickness

  • CC – neg. effect on ET – EV ?

  • Delay trigger

  • GT

  • Scratchingof Endometrium

  • ↑Endo Vascularity

    (Aspirin/ Viagra / Sidnafil)


10 secrets of success of iui

5th secret

Modify Dose / ET / Follicle size / HCG Trigger

- GT

- EV

Follicle MonitoringDo it your self


10 secrets of success of iui

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


10 secrets of success of iui

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


7th secret

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 officemust


8th secret

8th secret

Success lies in looking into details of techniques

  • Full Bladder

  • Cx mucus aspiration

  • Targets time - 90 minutes

  • Load – when ready

  • No free space

  • Rest 10 mints

  • Emergency trey

Easy IUI


9th secret

9th secret

  • Progesterone

  • Vaginal progesterone (↑ PR) is the BEST

Luteal support


10th secret

10th secret

Counseling / Knowing when to stop

3 cycles of IUI = 1 IVF


Final secret

Final secret

All that we are

  • Integrity of Team

  • Right documentation

  • Analysis of Result what works


Thanks

Thanks


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