Can IUI Help with Unexplained Infertility?

When faced with a diagnosis of unexplained infertility—where all standard fertility tests come back normal—Intrauterine Insemination (IUI) is often the first-line and least invasive treatment recommended.

 

IUI is considered an effective first step because, while the exact cause of infertility remains unknown, the procedure directly addresses potential minor issues that standard tests cannot detect, such as subtle problems with sperm transport through the cervix or minor timing errors in natural conception. By concentrating the highest quality sperm and delivering them directly into the uterus, IUI maximises the chance of fertilisation near the egg.

 

Understanding what happens during an IUI fertility treatment and its expected success rates can help you and your partner decide if this approach is right for your unique journey.

 

The Role of IUI in Unexplained Infertility

 

Unexplained infertility typically accounts for about 15% to 25% of all fertility cases. A couple is given this diagnosis after a comprehensive workup confirms:

 

1. Regular Ovulation: The woman is releasing an egg consistently.
    
2. Patent Fallopian Tubes: Tubes are open, confirmed by a test like an HSG.
    
3. Normal Ovarian Reserve: Egg supply is adequate for her age.
    
4. Normal Semen Analysis: Sperm count, motility, and morphology fall within established normal parameters.
    
5. Normal Uterus: No significant fibroids or polyps are obstructing the cavity.

 

Since all visible mechanics are sound, the problem often lies in the "unseen" elements: sperm-egg interaction, cervical mucus hostility, minor timing discrepancies, or subtle defects in egg quality.

 

IUI's mechanism of action for unexplained infertility:

 

1. Bypassing the Cervix: It eliminates the need for sperm to navigate potentially hostile or thick cervical mucus, which can trap or destroy a significant number of sperm.
    

2. Increased Concentration: The sperm washing process concentrates the most motile and morphologically sound sperm into a tiny volume, ensuring a high density of the best sperm is placed close to the fallopian tubes.
    

3. Perfect Timing: IUI is almost always combined with ovulation induction (fertility drugs like Clomid or Letrozole) and precise cycle monitoring, ensuring the procedure is performed at the exact moment the egg is released.
    

By optimising these three factors, IUI significantly increases the chances of sperm meeting and fertilising the egg compared to timed intercourse alone.

 

This Is What Happens During an IUI Fertility Treatment: A Step-by-Step Guide

 

Intrauterine Insemination is a simple, low-risk procedure, generally performed in an IUI Clinic in Kenya on an outpatient basis.
 

Step 1: Ovarian Stimulation and Monitoring

The IUI cycle typically begins with the woman taking oral fertility medications (like Clomiphene Citrate or Letrozole) for about five days, starting early in the menstrual cycle. The purpose of these drugs is to encourage the ovaries to mature one or two high-quality follicles (eggs) rather than the usual single egg.

 

Monitoring: The fertility specialist will use transvaginal ultrasounds and sometimes blood tests to track the growth of the follicles and the thickness of the uterine lining (endometrium). This monitoring is critical for determining the precise timing of the insemination.

 

Step 2: The Trigger Shot (Timing)

 

Once one or two follicles reach the optimal size (usually 18mm or larger), an injection of Human Chorionic Gonadotropin (hCG)—often called the "trigger shot"—is administered. This injection mimics the body's natural luteinizing hormone (LH) surge, causing the final maturation and release of the egg(s) approximately 36 to 40 hours later. The IUI procedure is then scheduled to take place about 24 to 36 hours after the trigger shot.

 

Step 3: Sperm Preparation (Washing)

 

On the morning of the procedure, the male partner provides a semen sample. If donor sperm is used, the frozen vial is thawed. The sample is taken to the andrology lab for processing, often called sperm washing.

 

1. This process separates the highly motile, structurally normal sperm from the seminal fluid, non-motile sperm, and cellular debris.
    
2. The final product is a small, highly concentrated, purified suspension of the best sperm, prepared specifically for injection into the uterus.

 

Step 4: The Insemination Procedure

 

The IUI itself is a quick (5 to 10 minutes), non-surgical procedure performed in the clinic:

 

1. The woman lies on an examination table, similar to a Pap smear.
    

2. The doctor inserts a speculum to gently visualise the cervix.
    

3. A very thin, flexible catheter is passed through the cervix and into the main cavity of the uterus.
    

4. The prepared, washed sperm sample is gently injected through the catheter.
    

5. The catheter and speculum are removed.

 

Most women experience little to no pain, perhaps only mild cramping similar to menstrual discomfort. You may be advised to lie down briefly before resuming normal daily activities.

 

Advantages and Disadvantages of IUI for Unexplained Infertility

 

When considering IUI Treatment, especially for a diagnosis where the problem isn't clearly visible, weighing the pros and cons is important.

 

Advantages

 

 

Disadvantages

 

 

IUI Success Rates in Kenya and When to Move to IVF

 

Success rates for IUI Treatment depend primarily on the woman's age and the quality of the sperm. For couples with unexplained infertility:

 

1. Age Under 35: Success rates per cycle (with ovarian stimulation) are generally in the range of 15% to 20%.
    

2. Age 35-39: Success rates per cycle decline to approximately 10% to 15%.
    

3. Age 40+: Success rates drop significantly, often making IVF the recommended initial treatment.

 

The Cumulative Effect: The chances of success are cumulative. Studies show that 90-95% of successful IUI cycles occur within the first three to four attempts. After the fourth failed IUI cycle, the chance of success in subsequent IUI cycles drops dramatically, making the transition to IVF the most cost- and time-effective next step.

 

Top 10 IUI Clinics in Kenya

 

Choosing a reputable IUI Clinic in Kenya with a strong andrology lab for sperm washing is paramount to success. Here are some of the most recognised centres providing quality IUI Treatment:

 

1. Fertility Point
    

2. Nairobi IVF Centre
    

3. Harley Street Fertility Centre Kenya (HSFC KE)
    

4. Victoria IVF & Fertility Centre
    

5. Mediheal Diagnostic & Fertility Centre
    

6. The Nairobi Fertility Centre
    

7. Aga Khan University Hospital Fertility Clinic
    

8. LifeBridge Fertility Clinic
    

9. Footsteps to Fertility Centre
    

10. Vinsfertility IVF Centre

 

Summary: Making an Informed Decision

 

For couples with unexplained infertility, IUI Treatment represents a sensible, effective, and minimally invasive bridge between trying naturally and pursuing IVF. It addresses the likely, though undetectable, issues of poor sperm transport and imprecise timing by concentrating the best sperm and delivering them at the moment of ovulation.

 

If you meet the criteria—younger age, open tubes, and adequate sperm quality—choosing IUI for three to four cycles is a medically recommended strategy. The commitment of a specialised Fertility Clinic like Fertility Point to personalised monitoring and optimal timing ensures you get the best chance of success from every cycle of IUI.