Assisted Reproduction
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Artificial insemination
What is artificial insemination?
Artificial Insemination is a simple technique. It basically consists of placing a sperm, previously prepared in the laboratory, into the uterine cavity at the time close to ovulation. For artificial insemination to be a viable option, it is necessary for the woman to have at least one penetrable fallopian tube.
Types of Artificial Insemination:
Depending on the source of semen for insemination, two different types of artificial insemination may be used:
- Homologous artificial insemination (within the relationship) is undertaken using sperm from the partner.
- Heterogonous artificial insemination (donor) is undertaken with sperm from an anonymous donor.
In what cases is artificial insemination required?
The specialist will assess each case and after examining the couple, will decide which technique is best for the insemination. It is usually suggested for problems such as:
- Sterility of unknown origin, i.e. those cases where a comprehensive study of the sterile couple has been made and can not conclusively determine the cause of it
- Ovulatory disturbances: where the woman does not ovulate normally (which happens more often in those who suffer from polycystic ovary syndrome) or defects in the cervical mucus, making it a hostile environment for sperm
- Mild semen abnormalities: slight defects in the semen. For example, the concentration or mobility is not adequate (oligozoospermia or asthenozoospermia) or, although this is less common, genital abnormality in preventing intercourse and / or difficulty ejaculating.
Procedure:
To increase the success rate the number of eggs in the female genital tract are increased by stimulating the ovaries with drugs that induce multiple ovulations (ovarian stimulation). Follicular monitoring (ultrasound) allows doctors to pinpoint the time of ovulation and therefore identify the optimum days for insemination.
In homologous insemination, the semen sample is obtained on the same day that the insemination takes place. The couple are recommended to abstain from sexual intercourse for 3 days beforehand in order to maximise the quality of the semen sample and to increase the quantity. A series of sperm washes with special solutions are used to remove cellular debris, bacteria, white blood cells, dead sperm and seminal secretions or slow sperm, while at the same time, they concentrate on the most fertile spermatozoa , in a volume of 0.5 ml. This lasts up to 2 hours and must be started within 30 minutes after obtaining the sample.
When the sample is ready for insemination it is placed into a special catheter attached to a syringe. The patient has a sterile vaginal speculum applied to locate the cervix (as in a routine vaginal examination), the catheter is introduced into the uterus and the semen is deposited (intrauterine insemination). If the case warrants it, the sperm can also be place inside the cervix (intracervical insemination). Then the catheter is slowly removed.
Complications:
Artificial insemination rarely causes complications. Some side effects could be:
- colicky pains
- Brief bleeding that will subside a few hours after insemination
- Nausea and vomiting
- Pelvic infection in the case of hydrosalpinx or a history of active cervical / vaginal infection
Results:
- The probability of success in these cases is around 15-25%. As it is a relatively simple technique, the process can be repeated several times without problems.
