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    Getting Pregnant

    How Much Sperm is Needed for an Intrauterine Insemination Procedure?

    Written on 1 August 2022

    Intrauterine insemination (IUI) is a procedure where sperm is artificially inserted into a woman’s uterus to fertilise her egg. This procedure has higher chances of successful fertilisation in cases where a woman cannot get pregnant in a normal way.

    During insemination, the sperm is washed, and high-quality sperm is collected. This high-quality sperm is then inserted into the uterus with the help of a catheter. This makes it easier for the sperm to fertilise the egg and improves the chances of pregnancy.

    Why is insemination needed?

    Here are a few cases where insemination is needed:

    • Cervical problems: Abnormalities in the cervix, such as a change in the pH level of the cervix, can impair or kill sperm, making fertilisation difficult.
    • Low sperm count: After ejaculation, the sperm needs to travel from the vulva to the fallopian tube to fertilise the egg. This process becomes difficult in the case of low sperm count when the number of sperm cells is low.
    • Usage of donor sperm: Donor sperm is used for fertilisation in cases where the man’s sperm cells are not functional or when a single woman wants to conceive.
    • Erectile dysfunction: This is a condition seen in men who cannot produce or maintain an erection long enough for ejaculation to occur.

    How much sperm does an IUI require?

    Having an adequate sperm count and high-quality reproductive cells are essential for a successful IUI procedure. The quantity of motile sperm available for insemination correlates with IUI success rates in male infertility cases.

    As per sperm counts, if motility percentage and morphology scores fall below normal levels, the effectiveness of IUI for male infertility declines. For the IUI to be effective, there must be at least 5 million motile sperm after washing. Processed sperm samples with less than 1 million sperm total motile after a wash are extremely unlikely to result in successful fertilisation. Success rates are significantly lower with samples that include 1 to 5 million motile cells after wash.

    The ‘total motile after wash’ figure is frequently used in fertility clinics. For instance, a sample with a "5 million total motile sperm count post wash" means 5 million swimming sperm are in the sample after laboratory processing.

    Minimum sperm count for IUI

    The sperm motility percentage for an IUI procedure should be over 30%, which is the bare minimum needed for successful fertilisation. This is calculated based on sperm ejaculation. The man is asked to ejaculate in a sample vial, which is then washed and tested in the laboratory.

    If there is a low sperm count in the analysis, it may also indicate biocompatibility issues. Low motility, morphology, and count scores frequently indicate problems with the sperm’s biochemical and molecular capacity to fertilise an egg. However, in the end, what matters is the sperm's capacity to perform appropriately throughout a biochemical process, not the quantity.

    Semen analysis

    Not every man's sperm can be used for intrauterine Insemination. The sperm has to be quality-checked before the process is conducted. One out of every ten men's sperm is infertile.

    Some factors forming the basis of sperm analysis are:

    1. Concentration: This is calculated based on the number of sperms in a unit of semen.
    2. The shape: The sperm has three parts - the head, the neck, and the tail. The head plays a pivotal role. It must be round, as it helps with the penetration of the ovum. The tail is supposed to be long and thin. It moves vigorously to reach the egg. Alterations in shape can lead to infertility.
    3. Movement of sperm: The speed and direction of movement of the sperm are essential criteria for analysis.

    Conclusion

    Intrauterine insemination, or an IUI, is a process where the sperm is placed near the egg to increase the chances of fertilisation. The sperm count is an important part of the IUI, and the procedure can only be carried out when the sperm count and mobility are accurate. The sperm analysis is conducted. Then the sperm is washed. High-quality sperm is collected in high concentrations. This is then injected inside the uterus of the female, around the time of ovulation. It is placed near the fallopian tube. Insemination is done around the time of ovulation to increase the chances of fertilisation.

    References

    https://academic.oup.com/humrep/article/30/5/1110/591132

    https://pubmed.ncbi.nlm.nih.gov/10202879/

    https://healthcare.utah.edu/fertility/treatments/diagnostic-testing/semen-analysis.php

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