The woman has a cervical mucus problem - for example, it maybe scanty or maybe hostile to the sperm. With an intrauterine insemination (IUI) the sperm bypass her cervix and enter the uterine cavity directly.
The man has antibodies to his own sperm. The " good" sperm which have not been affected by the antibodies are separated in the laboratory and used for IUI. If the man cannot ejaculate into his partner's vagina. This is usually because of psychologic problems such as impotence (inability to get and maintain an erection) and vaginismus ( an involuntary spasm of the vaginal muscles so that vaginal penetration is not possible); or anatomic problems of the penis, such as uncorrected hypospadias; or if he is paraplegic.
The man suffers from retrograde ejaculation in which the semen goes backward into the bladder instead of coming out of the penis. For unexplained infertility, since the technique of IUI increases the chances of theeggs and sperm meeting. If the husband is away from the wife for long stretches of time (for example, husbands who work on ships or work abroad), his sperm can be frozen and stored in a sperm bank and used to
inseminate his wife even in his absence. It is not useful is men with low sperm counts or poor sperm motility , because their sperm are functionally not competent.
Methods for performing AIH
There are various methods of doing AIH (artificial insemination by husband). The crudest and simplest technique involves simply injecting the entire semen sample into the vagina by a syringe. However, this is a waste of time if used for treating an infertility problem - after all, why go to a doctor to do something which you can do for yourself at home? Remember, a syringe is no better than a penis. It is only useful if the reason for doing AIH is the inability of the husband to ejaculate in the vagina. However, a number of doctors still use it as they do not offer anything better.
A refinement of this technique is that of using a spilt ejaculate. The first squirt of semen which gushes forth during ejaculation is richest in sperm. This is because the sperm "surf" on the wave of the seminal fluid which carries them forward to the outside world. The man masturbates into a 2-part container, so that this first part goes into one container, while the rest goes into another. This is not as difficult as it sounds, and gets easier with practice! The first bottle is saved and the contents used for artificial insemination. This method is suitable for a small proportion of cases (for example, for the uncommon problem of a large volume of semen, which "dilutes " the sperm; or where laboratory facilities for sperm processing are not available).
