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Artificial insemination

What does it involve?

Artificial insemination involves depositing a semen sample, previously prepared in the laboratory, in the uterine cavity using a fine cannula. This technique is performed at the moment of ovulation to encourage union between egg and spermatozoon and thus increase the chances of fertilisation.

In physiological conditions, a structure known as a follicle that contains an egg grows every month in each of the ovaries alternately. During ovulation, the ovary releases this egg, which is collected by the Fallopian tube, where, if possible, spermatozoa arrive to fertilise it and then implant it in the uterine cavity.

Depending on the origin of the semen sample, it is necessary to differentiate:

A. Artificial insemination with partner (AIH)

A. Artificial insemination with partner (AIH)

STAGES OF AIH

  1. Hormonal stimulation and ultrasound scans

    Prior to artificial insemination, the ovaries must be stimulated by hormonal treatment (FSH) in order to encourage the growth of several follicles and the ovulation of different eggs. This method is used to increase the technique’s effectiveness. It is, however, necessary to control this cycle precisely, to evaluate the sensitivity of the ovary to medication, to avoid high responses that could increase the risk of multiple pregnancies and to adapt the ovulation induction protocol to each response.

    The assisted reproduction specialist gynaecologist is therefore in charge of all check-ups and supervision of the entire process.

    Once the moment of ovulation has been determined, insemination is scheduled. At that moment, the couple will provide the laboratory with a semen sample so it may be processed to yield the spermatozoa required for insemination.

  2. Preparation of the semen sample. Sperm capacitation

    Prior to insemination, the semen sample must be prepared in the laboratory using different semen preparation techniques.

    On the same day as the insemination, the couple should provide the laboratory with the sample approximately 90 minutes before the scheduled time of insemination. According to WHO recommendations, a 2- to 7-day period of abstinence from sexual relations should be observed.

    This sample is processed in the laboratory to select the best quality and most motile spermatozoa and to separate them from the other components of the semen: seminal plasma, immotile or low-motility sperm, other cells, etc.

    The ultimate objective is to attain the best spermatozoa and prompt the physiological changes (sperm capacitation) necessary to encourage fertilisation of the egg.

  3. Insemination

    It is a fast, simple and painless technique.

    It involves introducing the processed semen sample into a fine cannula. The gynaecologist deposits it in the patient’s uterus through the cervical canal.

    After a few minutes’ rest, the patient may leave the centre and resume life as normal.

 

WHEN IS ARTIFICIAL INSEMINATION WITH PARTNER RECOMMENDABLE (AIH)?

ADVISABLE

Artificial insemination is a simple technique, recommendable in cases of:

  • Alterations in semen parameters
  • Ovulatory dysfunction
  • Endometriosis
  • Cervical factor infertility
  • Immunological factor infertility
  • Sterility of unknown origin
  • Incapacity to deposit the semen inside the vagina normally
INADVISABLE

There are any cases in which AIH is not advisable:

  • In women of advanced age
  • Low motile sperm retrieval (under 3 million post-MSC)
  • Impermeable Fallopian tubes
  • High response to ovarian stimulation
B. Artificial insemination with donor sperm (AID)

B. Artificial insemination with donor sperm (AID)

Sperm bank

The entire process is similar to AIH. In this case, however, a donor’s semen sample must be used.

Before starting treatment, the couple should have an interview with a biologist to determine the most suitable donor.

This is a simple, efficient technique as the semen sample is in optimal conditions of quality and quantity of spermatozoa and always comes from a healthy donor. The sperm sample simply requires thawing and subsequent processing in the laboratory. The rest of the sperm capacitation process is identical to that of AIH.

WHEN IS ARTIFICIAL INSEMINATION WITH DONOR SPERM ADVISABLE (AID)?

ADVISABLE

Artificial insemination with donor sperm (AID) is advisable:

  • when the man suffers from hereditary diseases
  • incapacity of the testicles to produce sperm (azoospermia)
  • severe male factor infertility
  • for women with no male partner.