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

2. 1st Secret
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. Understand The Case (H & W)
2nd secret
Understand The Case (H & W)
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 %
Sperm survival (24 hours) - ↑ 80%

7. Individualised Ovarian Stimulation Protocol
3rd secret
Individualised Ovarian Stimulation Protocol
Typical PR / 8 / 12 / 20
G T
Antagonist in IUI protocol

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

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

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

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

12. Lab secret 7th secret Labeling Preparation in doctor’s office must
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. Success lies in looking into details of techniques
8th secret
Success lies in looking into details of techniques
Full Bladder
Cx mucus aspiration
Targets time 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