Intra-Uterine Insemination

Intra-uterine insemination (IUI) is a widely used fertility treatment for couples with unexplained and male subfertility. Although it is less invasive and less expensive than l other treatment options such as in vitro fertilization, several factors affect its outcome. In addition, IUI remains controversial due to concerns about some of the possible aspects of treatment, including side-effects such multiple pregnancies. This comprehensive evidence-based book from an international IUI expert team explores all of these topics and provides clear guidelines for daily practice. CONTENTS General introduction. Diagnostic work-up before IUI. When to start IUI? Indications for IUI. Immunologic male infertility and IUI. Factors influencing IUI outcome: Female age. Factors influencing IUI outcome: Male age. Factors influencing IUI outcome: Weight. Factors influencing IUI outcome: Semen quality. Factors influencing IUI outcome: Semen preparation techniques. Factors influencing IUI outcome: Time intervals in IUI. Factors influencing IUI outcome: Number of AIH cycles. Factors influencing IUI outcome: Perifollicular flow and endometrial thickness. Factors influencing IUI outcome: Timing and number of inseminations per cycle. Factors influencing IUI outcome: Site of insemination in therapeutic donor insemination. Factors influencing IUI outcome: Immobilization after the insemination. Factors influencing IUI outcome: Ovarian hyperstimulation. Factors influencing IUI outcome: Luteal phase support. Fallopian sperm perfusion. Platelet activating factor, sperm motility and IUI outcome. Oxidative stress and IUI outcome. Cost-effectiveness of IUI. Minimal standards and organization for donor sperm banking. Indications for donor sperm including lesbian couples and single women. Psychological stress in men and woman undergoing IUI: psychological aspects. Risk factors for higher order multiple pregnancies following stimulated IUI. Prevention of multiple pregnancies after stimulated IUI. Perinatal outcome after IUI. IUI associated infection risks and preventative measures. Cancer and semen preservation. Preconception gender selection: Laboratory aspects. Preconception gender selection: ethical evaluation. Factors affecting the success of IUI: Implications for developing countries. SWOT analysis of accessible IUI in developing countries, resource-poor settings and primary care centres. Summary: levels of evidence of all statements. Summary: grade of strength of all recommendations. Edited by Ben Cohlen, Willem Ombelet