Artificial  Insemination

Dra. Maria Zweig MD

 

Artificial insemination is a procedure where the man’s ejaculate is processed; washed, concentrated and the most motile sperm selected, and injected into the woman’s reproductive system.

 

This procedure is often selected when there is a male –factor identified in a couple’s fertility problem. There are two types of insemination:

  • ICI – intra cervical placement of the insemination
  • IUI – intra uterine placement of the insemination, the more common type offered.

 

When is it used?

A normal count of sperm in a semen analysis is around 70 million per ejaculate. Less than 20 million, the woman will normally need help to get pregnant.

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      • If it is between 10 – 20 million an artificial insemination will be offered.
      • If motility is low, and they are not strong enough to swim to where fertilization will occur an IUI will be recommended.

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Think of an artificial insemination as providing a short cut to sperm to reach their target – the fertilization of an ovum.

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      • It may also be an alternative when the woman has endometriosis and has not been able to conceive without assistance.
      • If all test are normal and the cause of fertility remains unknown this is a first step we recommend. We over stimulate ovulation, to give more targets to sperm. We inseminate to give give sperm a shortcut to the ovum.

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If the count is less than 10 million an in – vitro fertilization will be recommended.

If in – vitro is not selected or an artificial insemination has not been successful a sperm bank is also an option. There are large banks that offer cryo – preserved specimens ready for insemination. Donors are tested for sexually transmitted diseases in the manner that blood donations are also screened and are considered safe. Donors are listed and available as to their ethnicity, physical characteristics, education etc.

 

What can you expect with an artificial insemination?

The procedure it self is relatively simple for the woman. Often medication (fertility drugs) are given to the woman to ensure ovulation (egg production), an injection is given to encourage ovulation for the date of the insemination. On the day of the procedure the specimen will be processed, this takes about an hour, then the sperm are placed in a thin tube called a catheter and introduced through the vagina and cervix into the uterus. The insemination takes about the same time it takes to do a pap test, and then you stay lying down for about a half hour while everything is working. Some women have cramping during the procedure and light bleeding afterward.

 

The whole procedure takes a couple of hours and there is no down – time, the woman can resume her usual activities immediately after the procedure.

 Success Rates

Success rates for artificial insemination vary depending on a number of factors and the initial reason for the fertility problem but it will range around 20 – 30% per cycle.

Factors that lessen the chance of getting pregnant with the procedure include:

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      • Woman’s age over 40
      • Lower end of acceptable for insemination sperm count or motility
      • Severe endometriosis
      • If the fallopian tubes are very damaged by disease even if they’re not completely blocked.

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The procedure is safe with little health risk for the woman. I have personally seen many women achieve pregnancy with the aid of an artificial insemination. Once the patient is pregnant, the insemination per say, does not increase risk during the pregnancy or afterwards in the child’s life.