Artificial insemination

Artificial Insemination

Artificial insemination is a procedure for transferring sperm into the uterine cavity. Insemination is the simplest but still efficient method of assisted reproductive techniqes (ART).

Insemination may be recommended for treatment of infertility due to: moderate reduction of the sperm quality, cervical factor infertility, unovulation, immune infertility, and "unexplained" (idiopathic) infertility. The prerequisite for insemination is a preserved functioning of uterine tubes.

The generalized pregnancy rates for one insemination treatment cycle average about 15-20%. Whether an insemination will be successful considerably depends on a number of prognostic factors: infertility duration, woman’s age, spermogram readings, and the number of preceding insemination attempts.

It is recommended to undergo not more than 3-4 insemination attempts. For, 87% of patients, who conceive from insemination procedure, become pregnant within 3-4 insemination cycles. The pregnancy rates for those who still can’t conceive and who continues insemination attempts do not exceed 6% per one attempt. While cumulative results from first three cycles total to 39.2%, efficacy of 6 cycles will not exceed 48.5%. For this reason, after 3-4 unsuccessful insemination attempts an IVF treatment should follow.

Prior to insemination itself, the stimulating treatment of the ovary is usually performed. To provide stimulation, the FSH-containing agents and antiestrogens are used. As revealed by the research, FSH-based stimulation proves to be more efficacious. Good results also can be achieved by combining FSH and antiestrogens.

There is an option to perform insemination in a natural cycle (without stimulation); but, such a procedure is 2-3 times less efficient than FSH stimulation preceded insemination.

There is abundant research evidence showing that, while applying the same stimulation routine, insemination is 2 times more efficient than the monitoring procedure aimed at identifying the optimal day for conception.

Fig. 1. Artificial insemination

1. Catheter
2. Spermatozoa

Fig. 2. Intrauterine insemination (IUI)

The sperm for insemination procedure is obtained by masturbation. It undergoes special treatment in a laboratory. Then it is introduced into the uterine cavity using a soft thin catheter (Figure 1). The main advantage of this method is that a considerable number of sperm cells manage to get to the eg.

Artificial insemination donor

The donor sperm insemination is one of the oldest procedures in the medical reproduction. During many centuries it was efficiently used for the couples with male factor infertility. Before development of ICSI, the donor sperm insemination was the only conception chance for the couples with a grave male infertility factor.

At present this anonymous in our clinic procedure is used if there are no spermatozoa available. If the ejaculate contains no spermatozoa at all, in several cases they may be obtained directly from the testis via surgical techniques. If at least a few live spermatozoa are obtained, ICSI procedure can be applied as an alternative to donor insemination, thus ensuring biological paternity even for severe male factor infertility.

Donor insemination is applied in case of severe male hereditary diseases if preimplantation diagnostics is unavailable or impossible.

In Russia, in compliance with the Decree No 67 of the Ministry of Health on the ART application, the sperm donor shall be aged between 20 and 40, and have at least one child. Donors shall undergo a general medical, urinological, genetic and laboratory examination, and psychiatrist consultation. Only frozen/thawed donor sperm is used after the second (6 months after the sperm submission to the sperm’s bank) negative results for HIV, syphilis, and hepatitis B and C.

For procedure details of woman’s treatment prior to insemination see above.

The decision to borrow genetic material, almost half of which is inherited by a child, is very difficult. We encourage you to discuss this issue openly with your partner and not to hesitate to ask the doctor any questions you have.