Artificial Insemination

Artificial insemination

Supporting insemination is a form of infertility treatment and can be performed by introducing suitably prepared sperm into the female genital tract during ovulation. There are several options for supporting insemination: vaginal, intracervical, intrauterine, intratubal, intrafollicular, intracavitary (in the abdominal cavity), perfusion of sperm in the fallopian tubes.

The most common form of supporting insemination is intrauterine insemination (IUI).
IUI is a form of infertility treatment and can be performed by introducing a properly prepared sperm into the uterus during ovulation.

The procedure can be performed as in a natural menstrual cycle, and by using the inductors of superovulation.

During IUI with the sperm of donor, we use only cryopreserved sperm. It is acceptable to use donor sperm obtained from other institutions with donor sperm banks.

It is permitted to use only frozen / thawed donor sperm after receiving repeated (6 months after the date of sperm delivery) negative test results for HIV, syphilis,and hepatitis. Using frozen / thawed sperm allows:

  • implementation of measures to prevent transmission of HIV, syphilis, hepatitis and other infections;
  • exclude the possibility of the donor and recipient meeting.

Indications for IUI sperm of a husband:

For a man:
  • subfertile sperm;
  • ejaculatory-sexual disorders;
  • retrograde ejaculation;
  • hypospadias;
  • parvisemia (small volume of ejaculate);
  • Seed high viscosity fluid;
  • sperm antibodies;
  • cryopreserved sperm;
  • unsuccessful attempts of intracervical insemination;
  • state after chemotherapy or vasectomy.
For a woman:
  • unexplained infertility;
  • cervical factor infertility;
  • chronic endocervicitis;
  • manipulation of the cervix in history (cone biopsy, amputation, cautery, diathermy, cryotherapy);
  • sperm antibodies;
  • ovulatory dysfunction amenable to treatment;
  • allergy to semen;
  • vaginismus.

Indications for IUI with donor sperm:

For a man:
  • infertility;
  • ejaculatory-sexual disorders;
  • adverse health genetic prognosis.
For a woman:
  • absence of a sexual partner.

Contraindications for IUI:

For a woman:
  • age over 40 years;
  • physical and mental illness, which are contraindicated in pregnancy;
  • malformations and pathology of the uterus, in which it is impossible to childbearing;
  • tumors and ovarian tumor formation;
  • malignancies at any site;
  • tubal;
  • infection of the genital tract;
  • vaginal bleeding of unknown etiology;
  • surgery in the pelvic cavity in history;
  • multiple unsuccessful attempts to IUI (4 or more);
  • ovarian hyperstimulation syndrome following treatment with gonadotropins in history;
  • luteinization of follicle not ovulated in two consecutive cycles;
  • acute inflammatory diseases of any localization.

Possible complications during IUI:

  • allergic reactions associated with the administration of drugs to stimulate ovulation;
  • shock-like reaction with the introduction of sperm into the uterus;
  • toning the uterus;
  • ovarian hyperstimulation syndrome;
  • acute exacerbation of chronic inflammation or inflammation of the female genitalia;
  • the occurrence of multiple and/or ectopic pregnancies.

Generalized possibility of pregnancy after one attempt of insemination is 12-15%. The possibility of success of insemination significantly depends on a number of prognostic factors: the duration of infertility, a woman’s age, sperm parameters, indications, and the number of previous attempts insemination.

Recommendations

It is recommended no more than 3-4 insemination attempts. This is due to the fact that 87% of patients in whom pregnancy is due to insemination, they are pregnant in the first 3 cycles of insemination. In the remaining cases, the women’s risk of pregnancy during further inseminations does not exceed 6% per attempt. While the net result of the first three cycles is 39.2%, and 6 cycles does not exceed 48.5%. Therefore, the ineffectiveness of attempts 3-4 insemination is necessary to move forward to the in vitroprocedure.

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