Most common IUI side effects

Common IUI Side effects:

• Pain/Side-effects of IUI due to improper procedure
• Side-effects of IUI due to HCG shots
• Abdominal cramps
• Infections
• Bleeding after IUI

IUI side effects are closely related to the fertility drugs administered by the doctor. Also some of the discomfort and pain might also be caused due to improper IUI procedure.

In IUI, the male sperms (spermatozoa) are placed in the woman's cervix or uterus. This is accomplished by a catheter, the same instrument that is also used for inserting dye while performing HSG test. See the catheter here: HSG Catheter and pain.

1) Pain/Side-effects of IUI due to improper procedure.

NATURAL CONCEPTION è Prostaglandin is filtered before reaching Uterus

IUI CONCEPTION è Prostaglandin might directly reach Uterus

What prostaglandin can do to you?

àSpotting or some patches of brown and red blood.

àSevere abdominal cramping on either side of abdomen

àInfection

Lifetime of symptoms è First Trimester, if the pregnancy sustains.

If semen is not washed properly it may contain residual compounds like prostaglandin. This is secreted form prostate glands, and contains some quantities of proteolytic enzymes and zinc. In a natural conception, such enzymes are filtered out before they reach the uterus.

In IUI, these residues can cause serious abdominal cramps, spotting or infection. If you are found to be pregnant after IUI, these enzymes will come out in form of mild spotting, within the first trimester, before the placenta develops.

If IUI does not result in pregnancy, the residual will come out naturally through normal menstrual cycle.

Prevention and Treatment:

 è Choose reputed and proven centers for IUI that have good track record.

 è Spotting mild or otherwise, seek medical advice.

2) Side-effects of IUI due to HCG shots

The HCG injections taken to stimulate egg production inside ovaries can cause OHSS (Ovarian hyper stimulation syndrome). This is nothing but swelling in ovaries due to more HCG given than required. (You might have already attained pregnancy while you were on HCG, so it can’t be always measured or predicted the exact dosage of HCG required for attaining a pregnancy, so some women develop OHSS.)

The symptoms of OHSS may be

à Weight gain (more than 3-4 pounds a day)

à Vomiting

àAbdominal cramps and swelling

 àDifficulty in breathing.

What OHSS can do to you?

It will depend on the severity of the symptoms, and in most cases if diagnosed and treated within time, can be kept under control for full duration of pregnancy.

If not diagnosed, the symptoms might aggravate to result in:

èFluid collection in abdomen

èRenal problems resulting in renal failure

èBlood clotting

3) Abdominal cramps

Is this a side effect that happens only when the conception happened due to IUI?

The answer is No.

Even in normal conception, 80 % of women feel cramps during early stages of their pregnancy. Cramping is a natural body reaction to:

àExpanding uterus stretching abdominal vessels making way for the baby to fit in

àImplantation of Egg in uterus

When to take cramping seriously:

àIf the cramping is continuous and persists for more than 24 hours.

àIf the cramping is accompanied by bleeding or spotting.

Whether IUI aggravates cramping?

No 

Most of the women will experience some cramping during and after the procedure. Do not take over the counter medicines to soothe you from the pain. Ask your doctor, as they are more likely to prescribe such pain killers that do not interfere with impending pregnancy.

4) Infections

Symptoms:

àPain or irritation during urination

àSmelly vaginal discharge

These may be due to not maintaining sterile precautions, poorly administered procedure or pre existing infections. The symptoms are generally burning sensation or pain during urinary discharge, or smelly vaginal discharge. Your doctor will generally recommend antibiotics and anti-bacterial solutions for the treatment of the same.

5) Bleeding after IUI

Mild red discharge once-twice a day is considered normal. It should stop by itself in 2-3 days but if you can’t live without your pads on then you must visit the doctor immediately. The doctor will usually look for any sign of injury and ask you to avoid the intercourse.

HSG Procedure , The Need , The Pain & Pregnancy

-> HSG is just another X-Ray procedure.
-> Under HSG , a catheter is inserted through vagina and cervix.
-> The pain under HSG is caused due to the catheter only.

Catheter used for HSG procedure

-> In HSG , the pain caused due to catheter is like a pap smear, followed by another pain which is like menstrual cramps and occurs for 1-2 days in most cases.
-> After HSG , patients may experience delayed periods,  light bleeding or clots which is quite normal.
-> Generally, after HSG , doctors advices not to have intercourse within 24 hours.

-> HSG procedure will determine :
(a) whether the fallopian tubes are blocked ?
(b) Where the blockage is located ? - at junction , uterus , or end of fallopian tubes.

Pregnancy success rates after HSG :
There is an increased chance of pregnancy after an HSG , but it is controversial to say , whether or not a HSG can improve fertility. Some studies show a slightly increased chance of getting pregnant in the 3 months following the test , but the reason is not clear.

Some of the theories surrounding HSG and Pregnancy are :
(a) Dye flushes out the fallopian tubes , clearing partial or minor blocks in some women.
(b) Iodine Dye used in HSG enhances the endometrium ( lining of uterus) in some way making it easier for an embryo to implant successfully.
(c) Dye solution somehow effect the area surrounding the ovaries enhancing ovulation.

Pregnancy during HSG:
(a) Sometimes the women are not aware that they are pregnant and they undergo HSG procedure , which in turn, harms the embryo and can lead to miscarriage .
(b) I am giving details of 3 such cases of unsuspected pregnancy during HSG :
First case : An ectopic pregnancy :
The patient with regular menstrual cycle had undergone HSG . Her report was completely normal. After a week she suffered from abdominal pain , following which her pregnancy test was done. It came positive , but there was nothing found in uterus . They later confirmed it as an ectopic pregnancy , which ultimately led to miscarriage.
Second case : A healthy pregnancy :
A lady in her early thirties had irregular menstrual cycle ranging from 60 to 90 days , was presented for HSG.
She found herself pregnant 2 months after the procedure .She did not have any intercourse after the HSG. The ultrasound scan showed , a healthy foetus. It was concluded that she was pregnant at the time of HSG investigation. She carried her pregnancy till the 39th week and delivered a healthy baby.
Third case : A miscarriage :
Another lady in her early thirties with menstrual cycles in the range of 45-90 days had undergone HSG test. She had the pregnancy test done before HSG , and it cam negative. 2 days later , the pregnancy test came back positive after she complained of getting vaginal bleeding. On further investigation , no fetal pole was seen and the HCG levels declined , so the pregnancy was considered miscarriage and was terminated by oral administration of misoprostol .
-> The safety of pregnancy after HSG is not well known , given the rarity of this occurence, therefore precaution should betaken prior to the procedure . It is advisable to the patient , to have protected coitus for at least 4 weeks before the HSG procdure and to carry out a compulsory pregnancy test before the procedure.If in doubt , a serum HSG should be considered.

Whether HSG causes ectopic pregnancy ?
Some studies reported that there were ectopic pregnancy following the HSG . This could be due to :
(a) A pre-disposing factor of tubal damage in infertility patients
(b) Possibly a 'flushing effect ' of the amniotic sac by the contrast medium ( dye )

Related Posts : 

Pregnancy after HSG-Myth or Reality
HSG Risks and Alternatives

Pregnancy after HSG - Myth or Reality

Considering the good number of questions surrounding HSG and pregnancy, we got a

Questionnaire answered from Dr. Ranga. Please read on to find his opinion and feel free to ask him any questions surrounding the same.

You may also want to read about Getting Pregnant is just the starting of a risky and long journey.

Q1: Will HSG increase my chances of pregnancy?

Fact 1: No, The only reason why we see some cases of pregnancy after HSG procedure is due to the cleaning action of iodine dye. This flow of liquid might clear small obstructions in the fallopian tube, which might increase the chances of more sperm reaching the ovum, and so more chance of achieving pregnancy. But still it is only a chance and won't work out if you have other infertility issues.

Q2: Whether HSG will cause damage to my ovary or fallopian tube?

Fact: The Iodine dye used in HSG is water soluble, and does not react with internal organs. The only purpose of using iodine dye is that it increases the visibility of the X-ray, so that your doctor can easily detect any blockages. Iodine is a radiocontrast agent and is also used in angiography to detect blockages in other arteries related to heart and brain. There is no question of any damage just due to the iodine dye itself.

Flow of Iodine DYE in HSG

Q3: My doctor asked me if I am using Metformin before conducting HSG . Is this a harmful combination?

Fact: It's not harmful. If HSG is done for testing fallopian tubes, there is no correlation between the two. If you are going in for intra-vascular administration, then in some very rare cases (1 in 10000), the iodine dye might abrupt kidney functions. If you use metformin in this situation, your kidneys won't be able to flush the metformin out of your body. This might deposit toxic compounds in the body. Although this is treatable, your health care provider will ask you to avoid taking metformin before coming in for HSG procedure.

Q4: Will HSG Cause ectopic pregnancy?

Fact: Please go through the below case studies regarding correlation between ectopic pregnancy and HSG.

Q5: Having an intercourse immediately after HSG will increase the chances of conception?

Fact: No evidence to suggest this, but will surely cause a lot of discomfort to both the partners due to residual elements present inside the vagina. Intercourse is never advisable until few days after HSG has been conducted.

Q6: Having HSG under anesthesia decreases conception chances?

Fact: At max, it can relieve you of pain during the procedure. That's it. You will still have post procedure symptoms.

Q7: What are the precautions, required to be taken before HSG test.

Fact: Read about HSG precautions , Risk and alternatives.

Related Posts: 

HSG Procedure , The Need , The Pain & Pregnancy

HSG Risks and Alternatives

Getting Pregnant is just the starting of a risky and long journey.

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