Intrauterine insemination is the deposition of washed and capacitated sperm into the uterine cavity and remains one of the most popular ART techniques for patients with mild endometriosis, low sperm counts, poor sperm motility, greater percentage of abnormal sperms, sexual dysfunction (faulty technique or inadequate deposition of sperm in the vagina), some cases of one sided tubal block, polycystic ovaries and also those with unexplained infertility.
Also, we need to stimulate the ovaries of the wife to get more eggs, improve the quality of eggs, enhance the lining of the uterus and be able to time the insemination perfectly with injections.
One of the easiest and most cost effective protocols for COHS in IUI is the Clomiphene (CC)-IUI protocol - Tablets of CC are administered in a dose of 50 - 100 mg once daily from day 2 or 3 of menses - Transvaginal USG follicular monitoring being performed daily from day 7 of cycle until the lead follicle (Egg) reaches 17 - 18 mm in mean diameter and endometrium (lining of the uterus) reaches thickness of > 8 mm when 5000-10000 IU of hCG (ovulation trigger injection) is administered and IUI is performed at 36-40 hours post hCG. Luteal phase support is with hCG 1000 IU administered on days 1,4 and 7, assuming day 0 as day of follicular rupture or more recently, with micronized progesterone vaginal capsules 200 mg twice a day.
CC is administered in a dose of 100 mg daily from days 3 - 7 of menses. Inj.hMG 150 IU is then administered from day 7 of the cycle on a daily basis until the lead follicle reaches 17 - 18 mm in mean diameter. hCG 5000-10000 units is administered on that day and IUI performed on 2 days thereafter.
After a baseline scan on day 2 to ensure endometrial shedding and no residual ovarian cysts, Injections of FSH 150 IU are administered Intramuscularly daily. Ultrasound monitoring will start on day 6. If there are more than 3 follicles 12 mm in mean diameter, the same dose is continued. If less than 3 follicles 12 mm in diameter, the dose might be increased to 225 IU per day . The ovulation trigger of hCG 5000