Friday, June 8, 2012

IUTPI: Is It A Better Method Of Intra Uterine Insemination?


My wife and I are trying for a child for almost a year now and a doctor recommended us this new method of intrauterine insemination, IUTPI (IntraUterine TuboPeritoneal Insemination). I would like to ask you if you have heard about it and of course what is your opinion about it?? You can find the link below.

Thank you. G. from Greece


Hello G. from Greece,

The goal of insemination has ALWAYS been to allow the sperm to travel into the tubes. That is because fertilization has to occur in the tubes. The technique that is offered by this Physician is NOT innovative and has not been proven better than current techniques in my opinion. He is using a larger concentration of the injected pellet (1 ml vs 0.3 ml) which certainly increases the availability of the fluid to get into the tube but I would anticipate that it will cause increased discomfort and cramping similar to doing an HSG (hysterosalpingogram). Is that more effective? A No. 0.3 ml is sufficient to get fluid into the tube with minimum discomfort. He also states that he uses a clamp to prevent reflux, which I am sure needs to be done because of the large amount of fluid being injected. Otherwise the majority of it will flow out.

IUI is dependent on many factors, the least of which is getting sperm to the tube. The success of IUI is mainly dependent on timing, the ovulation of more than one eggs so that there is an increased chance of an egg getting into the tube (getting into the tube is not automatic), fertilization of the egg by the sperm, quality of the egg, development of the egg into a good embryo, travel of the embryo into the uterus, hatching and extrusion of the embryo from its shell, attachment of the embryo to the uterine lining and growth of the lining around the embryo (implantation).

How is the IUTPI helping those steps? None that I can see. A standard IUI, if done properly, should give you equal chance of pregnancy because sperm delivery is the same. In my clinic, I have had a consistently 33-43% pregnancy rate per patient using proper technique but that is also dependent on factors such as the woman's age and the cause for her fertility problems.

Thanks for the question.

Good Luck,
Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
Monterey, California, U.S.A.

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