UPUMS Nsg.Officer-2024
Obstetrics & Gynaecology
Easy
What amount of washed and concentrated sperm is administered into the uterine cavity during artificial insemination?
Appeared in: UPUMS Nsg.Officer-2024
Explanation
- The standard volume of prepared sperm for Intrauterine Insemination (IUI) is 0.3 to 0.5 mL.
- The uterine cavity is a small potential space, and using a small volume prevents adverse effects like uterine distension, cramping, and backflow of the sample.
- The sperm is 'washed' to remove seminal plasma (which contains prostaglandins that cause uterine contractions) and then 'concentrated' to deliver a high number of motile sperm in this small volume.
Why Other Options Were Wrong
- Option A: A volume of 1 mL is too large to be safely instilled directly into the uterine cavity.
- Option C: A 2 mL volume significantly exceeds the capacity of the non-pregnant uterus for this type of procedure and would cause severe cramping and expulsion of the fluid.
- Option D: A 5 mL volume is similar to a full ejaculate volume. Injecting this amount directly into the uterus would be extremely painful and counterproductive, as the fluid and prostaglandins would cause immediate expulsion.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Intrauterine Insemination (IUI) Procedure as background academic context rather than a clinical decision trigger.
- Sperm washing is a critical step before IUI. It separates healthy, motile sperm from the seminal fluid, which contains prostaglandins. Prostaglandins can cause severe uterine contractions, pain, and even a vasovagal reaction if introduced directly into the uterus.
- The success of IUI depends on delivering a high concentration of motile sperm as close to the site of fertilization (the fallopian tubes) as possible. Using a small, concentrated volume maximizes this delivery.
- What if? If unwashed semen were used for IUI, the prostaglandins in the seminal fluid would cause intense and painful uterine cramping, likely leading to the immediate expulsion of the entire sample, rendering the procedure ineffective and causing significant distress to the patient.
How to Approach the Question
- Identify the key procedure in the question: 'artificial insemination' into the 'uterine cavity', which specifies Intrauterine Insemination (IUI).
- Recall the anatomy and physiology of the uterus. It is a muscular organ with a small internal cavity, not designed to hold large volumes of fluid when non-pregnant.
- Consider the body's reaction to distension of the uterus, which is to contract and expel the contents (cramping).
- Based on this, deduce that the volume of fluid must be very small to avoid triggering this response.
- Evaluate the options: 1 mL, 2 mL, and 5 mL are relatively large volumes in this context. 0.3 mL is a very small volume.
- Select the smallest volume, as it is the most physiologically sound choice for direct instillation into the uterus.
Concept Tested & Keywords
- Concept Tested: Intrauterine Insemination (IUI) Procedure
- Stem keywords: artificial insemination, intrauterine insemination, IUI, washed sperm, concentrated sperm, uterine cavity
- Lead-in keywords: What amount
Question ID
Q7j-9s7umLSOUf5K-Yu9FE
Reference Book
E6 Gynecology Williams p. 48-73
E6 Physiology Guyton 4SAE Part 3 p. 52-54
Practise the full UPUMS Nsg.Officer-2024
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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