Artificial insemination is a low-complexity assisted reproduction technique that consists of depositing sperm with a catheter at the bottom of the uterus (during natural intercourse, sperm are deposited only at the entrance of the uterus).
This is done in the woman in her ovulatory period with the aim of achieving pregnancy. There is homologous insemination (IAH) or conjugal insemination when it is with sperm from your partner and donor insemination (DAI) when it is with donated sperm (sperm bank).
It is often confused with In Vitro Fertilization, which is a completely different technique.
In what cases is Artificial Insemination practiced?
Couples who benefit from artificial insemination are those with a diagnosis of infertility due to factors such as:
Impossibility of depositing semen in the vagina either by premature ejaculation.
Vaginismus.
Erectile dysfunction, alterations in sperm number or motility (mild oligoastenoteratozoospermia).
Problems with the cervix (narrowing/stricture).
Mild endometriosis.
Infertility of unknown origin.
Couples in which one of them is positive for HIV/AIDS.
In some of these cases, the first treatment option is psychotherapy or medical treatment and insemination is a complementary treatment
What is required to do an insemination?
The couple requires that the semen has at least 5 million motile spermatozoa, after the sperm capacitation, and that the woman has at least one permeable fallopian tube (proven either laparoscopically or X-rays).
Tests for AIDS, hepatitis B and hepatitis C should also be done.
What is the Process like?
Initially, you should go to an appointment with the gynecologist for a complete check-up (hormonal review, and ultrasound). The man must have a spermogram).
The treatment cycle begins with Controlled Ovarian Stimulation: in the first 5 days of the start of the menstrual period, ovulation-inducing medications such as clomiphene citrate or gonadotropins are started with the aim of allowing the development of several follicles. An ultrasound follow-up is carried out a few days later. This stimulation process lasts approximately 9 days (depending on the response of each patient) and is accompanied by ultrasound follow-up on average 2 or 3 times before making the decision of when the follicles are ready and which days the insemination is scheduled.
When the stimulation is completed, a medication (hCG) is added whose function is to complete the maturation of the oocytes and allow the follicle to rupture so that it is captured by the fallopian tube. After 24 to 36 hours of applying this medication, insemination will be performed.
Intrauterine insemination: On the scheduled day, the man takes the semen sample (taken by masturbation) to the laboratory to be processed (where the sperm are separated in a better way and with better mobility). This can take anywhere from 2 to 3 hours. Then the woman is placed in a gynecological position (similar to the cytology position) and the already trained sample is introduced through an intrauterine catheter.
After insemination, a few minutes of rest is recommended, approximately 15 minutes.
The following 2 weeks, progesterone (a hormone necessary for the initiation and maintenance of pregnancy) is administered either orally, vaginally or intramuscularly.
The blood pregnancy test that is performed on average 15 days after the procedure.
Are there risks when performing Artificial Insemination?
Multiple pregnancy: Due to the medication that is used to stimulate the ovary, there may be ovulation of several oocytes resulting in a multiple pregnancy. Multiple pregnancy involves an increased risk for the mother and babies.
Ovarian Hyper-Stimulation: Due to the ovulation of several follicles, there can be a condition of enlarged ovaries and fluid retention.
Pelvic infection: Inserting the insemination catheter could encourage the rise of microorganisms from the vagina to the uterus and fallopian tubes. This is a very rare complication
What are the odds of success?
The probability of pregnancy per cycle and the number of cycles to be performed depends on the diagnosis, age, sperm quality and the number of follicles developed.
Overall, the pregnancy rate per insemination cycle oscillates around 15%
Regarding the number of cycles performed, it is very important to highlight that of the total number of patients who are going to achieve pregnancy with AHI, 90% will do so in their first 3-4 cycles (cumulative rate of approx 60%)
When artificial insemination is not successful, other more complex and more efficient assisted reproduction techniques should be considered, such as In vitro fertilization.
InSer Group
