Intrauterine Insemination
Superovulation (SO) is the use of fertility drugs to stimulate two to three ovarian eggs and bring them to maturation so chances of conception are increased.
It is usually combined with intrauterine insemination (IUI), the process by which sperm is deposited in a woman’s uterus.
The procedure is done on an outpatient basis.
Fertility drugs are given for 10 days or more to produce between two to three mature follicles. These drugs may be either injections (gonadotrophins) alone or a combination of tablets (Clomiphene) and injections.
Ultrasound scans are done at intervals to determine the number and size of the follicles before another injection (HCG) is given for final maturation and subsequent ovulation of these follicles.
On the day of the insemination, the couple has to bring the husband’s semen sample to the hospital. The semen is prepared and the motile fraction is then placed into the uterus using a fine catheter through the cervix.
The patient is then started on medications to help improve the chances of implantation and thus pregnancy. A blood test (serum progesterone) is taken seven days after the insemination to monitor the effectiveness of these medications.
The patient should return to the clinic 17 days after the insemination for a pregnancy test.
Success rates:
The average success rate is about 12 to 15 per cent per cycle, or 26 per cent per patient after three cycles. The overall success rate varies with the cause of infertility and the age of the female partner. For some conditions, the pregnancy rate can be as high as 36 per cent per patient.
Price
In Singapore, IUI typically costs about $300-400. The cost of SO-IUI cycle is about SGD $1.3-1.5k
Disadvantages
Chance of over response with too many follicles developing.
12% chance of multiple pregnancy occurring, usually a twin pregnancy.
