Artificial Insemination Artificial Insemination is an assisted reproduction technique that consists of inserting laboratory-treated spermatozoa into the woman’s uterus or cervical canal. What is Artificial Insemination? When is it indicated? Phases of Artificial Insemination Gravida Results What is Artificial Insemination? Artificial insemination is an assisted reproduction technique that consists in inserting spermatozoids, previously treated in the laboratory, into the woman’s uterine cavity to achieve gestation. This tries to shorten the distance separating the spermatozoids from the egg and therefore helps them both to meet. It is a simple, pain-free procedure, and it is suitable for women with permeable tubes and correct ovary function. View more If the spermatozoids come from the partner, the technique is called artificial insemination by husband/partner (AIH). Alternatively, the technique can be carried out with donor semen (AID). In this case, the simple comes from a legally authorised sperm bank and is in optimum conditions in terms of the quantity and quality of the spermatozoids. The procedure is simple, painless and has significant success rates. When is it recommended? AIH Male symptoms Decrease in the number or mobility of spermatozoa and/or anomalies therein (minor or moderate oligozoospermia / astenozoospermia / teratozoospermia). Difficulty with sperm penetrating the uterine cavity (anomalies that prevent coitus and/or make ejaculation difficult). Female symptoms Anatomical or functional alternations in the uterus, particularly the cervix (cervical or uterine factor). Alterations in the menstrual cycle (ovulatory dysfunction). Endometriosis Sterility with unknown origins Namely, couples for whom the cause of sterility has not been determined after the basic sterility study has been conducted. AID LGTBI partners Women without partner. Male symptoms: Absence of spermatozoa in the semen (azoospermia), whenever it is not possible to recover them from the testicles and/or epididymis. Severe drop in the number or mobility of the spermatozoa present in the semen (severe oligozoospermia and/or astenozoospermia), at times after the failure of in vitro fertilisation. Different chromosomal or genetic alterations with no possibility of pre-implantation genetic diagnosis. Risk of transmission of other types of pathologies, such as infectious diseases. Requirements for Artificial inseminations Artificial inseminations can be performed provided that the fundamental requirements below are met: Fallopian tube There is at least one permeable fallopian tube Motile sperm Suitable motile sperm count (for AIH) Cycles No more than 6 previous insemination cycles have been done Phases of the Artificial Insemination Hormone control and stimulation Artificial insemination can be done during a natural cycle or after an ovarian stimulation process (OS). The pregnancy rate is significantly higher in stimulated than spontaneous cycles. OS is done by using drugs whose action is similar to that of hormones that women produce called gonadotropins. The purpose of this treatment is to obtain the development of one or more follicles. An egg will then mature inside this follicle. Medication At present, the most commonly employed drug formats are injections that are applied subcutaneously, and which offer patients both independence and comfort.. The dose of gonadotropin and its start date may vary depending on the case. The ovarian stimulation process is regularly monitored through vaginal ultrasounds that report on the number and size of developing follicles, as well as the endometrial thickness. At time these data are complemented by hormonal determinations. After optimal follicular development is attained, a drug will be administered (the hCG hormone), whose action is similar to the luteinizing hormone (LH) that will trigger ovulation. Then the date and time for the insemination will be scheduled. It is extremely important to respect the instructions provided by the Centre with regard to the time of administration. Andrology Laboratory On the day scheduled for insemination, the andrology laboratory will proceed to sperm capacitation, using either the couple’s semen sample (AIH) or the semen sample from the sperm bank (AID), with the aim of selecting the sperm of the highest quality. The aim of capacitation techniques is to eliminate the seminal plasma from the ejaculate and select the sperm with the best motility for insemination, eliminating immotile sperm. Insemination Later, during the appointment with the gynaecologist, these sperm will be inserted into the woman’s uterus, using a thin flexible catheter. The process is completely painless and requires neither anaesthesia nor hospitalisation. The aim of this procedure is to deposit the sperm as close as possible to the ovulation site. This helps avoid the obstacles that the ‘hostile’ environment of the vagina produces to fight sperm concentration and motility. After insemination, the woman can carry on with her normal daily routine. Lastly, hormone treatment may be recommended to support the luteal phase, with the aim of favouring gestation. Results in Artificial Insemination The objective of all fertility treatments is to obtain pregnancy, so that their effectiveness is evaluated by conception rates. According to different records (including the Spanish Fertility Society), the pregnancy rate for AIH ranges from 12% to 18% per cycle realized, and is 20.5% for AID. The pregnancy rate by patient increases to 30 to 42% after 6 cycles. This depends largely on the woman’s age, the cause of sterility and the number of years it has evolved. The initial quality of the semen is also a determining factor in the final result, as the artificial insemination will be executed with a greater or lesser number of recovered motile spermatozoa. 17.0% AIH < 40 years old 6.3% AIH > 40 years old 21.3% AID < 40 years old 9.5% AID > 40 years old Other Assisted Reproduction Techniques In Vitro Fertilization View more ROPA Method View more Culture to blastocyst View more
