If the cause of infertility is unknown, or the quality of the spouse’s sperm does not meet the necessary standards, and also if it is not possible to have sexual intercourse to achieve conception, it is recommended to do insemination.
To find out whether the husband's seminal fluid is suitable for insemination, a trial processing of the biomaterial is carried out. After this, the specialist gives an opinion on which sperm should be used for the manipulation. If the spouse's seminal fluid is considered unsuitable for artificial insemination, then donor sperm can be used or IVF with ICSI can be resorted to.
AI is also provided to single women who want to give birth to a child after they undergo the necessary examinations.
Indications and contraindications for artificial insemination
The question of whether the procedure is worthwhile is decided by the attending physician individually after a comprehensive examination of the patient.
Artificial insemination in Moscow is prescribed to women if the following factors are present:
Unsatisfactory quality of partner's sperm. There are quite a few reasons, the result of which is the worst side the quality, quantity of seminal fluid or sperm motility changes (previous infectious diseases, poor environment, increased stress and constant stress). All this leads to the fact that sperm cannot reach the egg and die in the woman’s genital tract;
The husband has cancer, the course of treatment of which includes chemotherapy. It is known that this technique has an extremely negative impact on the quality of seminal fluid, reducing the reproductive function of men. Therefore, in this case, it is better to donate sperm in advance, before starting treatment. The semen will be frozen and can be used in the future.
Vaginismus. This is the name for involuntary contraction of the vaginal muscles, as a result of which sexual intercourse becomes impossible, as it causes pain in the woman. With this pathology, it first makes sense to work with a competent psychologist who will help identify the essence of the problem and find ways to solve it. If this does not help, then you can resort to intrauterine insemination to achieve conception.
Immunological infertility. In this case, the woman’s body perceives sperm as foreign agents and begins to actively produce antibodies that destroy male reproductive cells, preventing them from fertilizing the egg. Such antibodies are found in cervical mucus. This barrier can be overcome using intrauterine insemination.
Erectile dysfunction and ejaculation disorders. In this case, IUI is the most reliable and effective way solving the problem. In all of these cases, insemination in Moscow is carried out with the husband’s sperm. But there are cases when the partner’s seminal fluid, for various reasons, cannot be used for IUI. In this case, the procedure is performed using donor sperm.
Intrauterine insemination is contraindicated if a woman:
- diagnosed with advanced endometriosis;
- absent ovaries or uterus;
- There are no fallopian tubes or there is obstruction.
In these cases, the results of artificial insemination are highly likely to be negative. Therefore, there is no point in carrying it out.
When choosing a medical institution for the procedure, you should take into account the equipment of the clinic, the experience of the specialists working in it and the authority of the medical institution.
If such a procedure requires donor sperm, then the specialists of the AltraVita clinic will offer a number of candidates from the donor catalog. This is where the largest sperm bank in our country is located.
Analyzes before AI
Before the procedure, both partners are required to undergo a series of tests.
The woman is prescribed the following tests:
- blood test for hormones;
- detection of antibodies to the rubella virus (this virus poses a threat to the life of the unborn child during pregnancy and can also cause the development of birth defects);
- analysis for tumor markers;
- STD testing;
- determination of the concentration of sex hormones in the blood;
- Ultrasound of the fallopian tubes (to determine their patency) and the uterus.
A man undergoes an STD test and a spermogram, the results of which determine the quality of his seminal fluid and its suitability for use during IUI.
Preparing for artificial insemination
Depending on the reasons that interfere with conception naturally, drug therapy aimed at stimulating ovulation can be carried out in parallel with artificial insemination. In this case, the effectiveness of IUI will be much higher, since not one, but several follicles will mature. However, this sharply increases the risk of developing multiple pregnancy.
It is important to correctly calculate the time when intrauterine insemination will be most effective. For this purpose, an ultrasound is performed 8 days after the start of menstruation. When the follicle reaches the desired size, hCG is injected, and 12–40 hours later IUI is performed.
In addition, preparation for insemination involves diagnosing the cause of infertility. The procedure is performed only for those women who have a normal menstrual cycle, ovulation occurs monthly, the internal genital organs have a normal structure, and the fallopian tubes are completely passable.
Carrying out AI
Pre-prepared and treated seminal fluid is drawn into a special syringe. It is attached to a plastic catheter, which is inserted into the cervical canal and uterus. After installing the catheter, the slow injection of sperm begins. Patients who have undergone insemination leave good reviews. Women note that the manipulation is practically painless and takes little time. After the procedure, there is no need for a stay in an inpatient department or special rehabilitation measures - the patient can lead a normal lifestyle.
The cost of this manipulation may vary. This depends primarily on whether the husband's or donor's sperm will be used. IUI prices at the AltraVita clinic are indicated at the beginning of this page.
Intrauterine (artificial) insemination is one of the modern assisted reproductive technologies used to achieve pregnancy in couples diagnosed with infertility, during which the man's sperm is introduced into the woman's uterus or her cervical canal.
Indications for a procedure such as intrauterine insemination with the husband's sperm on the part of a man are:
Subfertile sperm (when the fertilizing ability of sperm is reduced or, more simply, male infertility);
Ejaculatory-sexual disorders.
A woman may also have indications for this procedure:
Cervical factor infertility (in which changes in the properties of the cervical mucus are observed, preventing the penetration of a sufficient number of sperm into the uterine cavity);
Vaginismus (when the pubococcygeus muscle involuntarily contracts, making any vaginal penetration impossible);
Increasing the chances of pregnancy in female infertility.
Before the procedure, the couple must undergo full examination. Artificial insemination, reviews of which can be read on the Internet, is carried out on the days of a woman’s ovulation, which the gynecologist determines in advance. This technology can be used as part of the patient’s natural cycle, however, practice shows that in most cases it is preceded by hormonal stimulation of superovulation, which somewhat increases the effectiveness of this procedure.
The man is asked to donate sperm 1-3 hours before insemination, although it is also possible to use thawed sperm that has been cryopreserved in liquid nitrogen in advance. Currently, before introducing sperm into the uterus, women are required to undergo a processing process, which consists of separating sperm from seminal fluid, for which two or three times reprecipitation of sperm is carried out with dilution of the sperm with a physiological medium in a centrifuge. Previously, it was also possible to use native (unprocessed) sperm, however, without pre-treatment there is a likely risk of developing anaphylactic shock, in addition, thanks to the pre-treatment of sperm, the number of motile sperm increases, and “inferior” ones are eliminated and a sterile nutrient medium enriched with a complex of minerals is introduced into the uterus substances and proteins and containing sperm.
The insemination procedure itself is absolutely painless; sperm is injected into the uterus through a special plastic catheter, to which a syringe with sperm is attached. Further, fertilization occurs naturally, i.e. the sperm independently reach the egg through the fallopian tubes. Intrauterine insemination lasts only a few minutes.
Unfortunately, there are a number of contraindications for women to undergo this procedure: - defects and pathologies of the development of the uterus, which make pregnancy impossible; - tumors and tumor-like neoplasms of the ovary; - acute inflammatory diseases; - malignant formations; - mental, as well as somatic diseases that are a contraindication for pregnancy.
In some cases, after insemination, patients are prescribed progesterone medications to support the luteal phase. This appointment is not mandatory, however, practice shows that taking progesterone drugs is still desirable, since luteal phase deficiency is often detected.
Unfortunately, artificial insemination, reviews of which are further proof, is not a panacea for infertility. As studies show, its successes are quite modest: pregnancy occurs in only 8-12% with a single use of this technique, i.e. much less often than with natural fertilization. The chances of each couple in this case differ significantly and can be 3-40% depending on many factors, such as the duration of infertility, the woman’s age, concomitant diseases, etc. The main conditions for pregnancy using artificial insemination are normal patency of the fallopian tubes and good sperm count. In many clinics, confirmation of tubal patency is a prerequisite for the procedure, since the lack of information not only significantly reduces the effectiveness of insemination, but also increases the risk of ectopic pregnancy. The research method can be any: hysterosalpingography, transvaginal or classical laparoscopy, hydrosonography.
Couples are most likely to become pregnant if:
Woman under 30 years of age;
Before insemination, mild stimulation of ovarian ovulation was performed;
All spermogram parameters are within normal limits.
Also, an important success factor is the professionalism of doctors, so if the question arises about intrauterine insemination, you should seriously consider the choice of the clinic where the procedure will be performed, as well as the choice of a specialist.
On average, treatment with this method covers 3-5 cycles, as a rule, in 87% of patients pregnancy occurs in the first three cycles of artificial insemination, the chances of each subsequent attempt do not exceed only 6%, so if after 3-4 attempts pregnancy still does not comes, the couple is recommended to have more complex methods of assisted reproductive technologies - IVF or ICSI, which have now moved from the category of medical sensations to the category of conventional medical procedures, confirming once again that infertility is not a death sentence.
This method was first used back in 1784 - an Italian doctor performed artificial insemination on a dog, as a result of which it gave birth to three absolutely healthy puppies. Intrauterine insemination for a woman was first performed 6 years later, in 1790, by a Scottish doctor.
It should be remembered that the reproductive age, unfortunately, is limited, so you should not waste precious time, measured by nature, and at the first suspicion of infertility, contact a specialist who will help determine the cause of non-pregnancy and prescribe appropriate treatment.
Intrauterine insemination is a reproductive technology in which sperm is taken from a man and placed in a woman's uterus. There is no sexual contact. This method has been practiced in our country since 2003. We will talk about its features and the process itself in this article.
Intrauterine insemination is used to achieve pregnancy, which for certain reasons cannot occur. The procedure itself is the artificial insemination of a woman with sperm. There is no classical sexual intercourse.
Insemination can be carried out using either fresh or frozen biomaterial. The sperm is injected directly into the uterine cavity, bypassing the vagina itself and the cervical canal.
Intrauterine insemination is performed without anesthesia. It does not have serious negative effects on a woman’s body. A woman's hospitalization is not required for insemination.
Types of intrauterine insemination
Depending on the biological material used, it may be:
- Insemination with husband's sperm.
- Insemination with donor sperm.
If intrauterine insemination with donor sperm is used, it is pre-frozen or ready-made frozen material is used. It is stored in special cassettes for about six months. This period allows us to identify some diseases in sperm that were not identified during the test.
If the material is used, the patient's husband must give his written consent to the procedure.
The insemination process itself can:
- Accompanied by hormonal stimulation.
- Not accompanied by hormonal stimulation (with a natural cycle).
Hormone stimulation is not prescribed to young women who have a regular cycle and are ovulating. Hormones increase the number of follicles, but lead to hormonal imbalance and multiple pregnancies. Hormone therapy makes the IUI procedure much more expensive.
Sperm can be injected:
- In the vagina.
- There are marks in the neck.
- Into the uterine cavity.
The last method is the most effective.
Indications
Intrauterine insemination is prescribed to couples of a certain group. It is mainly used when a woman is infertile. For IUI, two participants in the procedure must be examined.
The intrauterine insemination method is used in the following cases:
- Insufficient sperm activity in a man. Here, sperm cannot reach the egg and die while still in the vagina. Pathology may have following reasons: serious infections, heavy stress, unhealthy environment and constant stress.
- Erectile dysfunction or ejaculation disorder. The phenomenon can be observed quite often. As a result of this pathology, a man suffers from absolute or temporary impotence. If the man cannot be cured, then intrauterine insemination will give the couple a chance to have a child.
- Oncology in a man. If a man has undergone chemotherapy, his sperm quality decreases significantly. Experts advise submitting biological material for freezing before irradiation.
- High viscosity of plasma in sperm.
- Abnormal phenomena in the development of the penis.
- Immunological incompatibility. It is observed in very rare cases. Incompatibility refers to the presence of antibodies in a woman to sperm. The immune system extinguishes viable cells before they reach the egg.
- Female vaginismus. Vaginismus refers to contractile actions of the vaginal muscles. It leads to the inability to perform sexual intercourse or to severe pain in a woman. In this case, not only intrauterine insemination, but also the advice of a psychologist can help the couple. A specialist will help identify where the problem is coming from and teach a woman to relax during sexual intercourse.
- Lack of ovulation in a woman. In this case, the woman is in long-term infertility. The second partner usually has good sperm counts.
- Infertility, the cause of which cannot be determined.
- A woman is allergic to sperm.
Insemination is done if a woman does not have a regular sexual partner. Here, of course, biological material from a donor is used. His sperm is also used in cases of impaired sperm motility in the husband, unhealthy ejaculation, and also if geneticists have given the couple an unfavorable prognosis.
Contraindications
IUI has its contraindications:
- Complete obstruction of the fallopian tubes. In this case, it will not be possible to physically deliver sperm to the right place.
- You cannot become pregnant artificially or naturally if a woman has cancer.
- The size of the patient’s uterus is up to 35 mm.
- The patient has pathologies of the cervix or cervical canal.
- A woman is sick with sexually transmitted infections.
- A woman has fibroids or polyps.
- The woman has a premenstrual state (here we should talk about temporary contraindications).
How is intrauterine insemination performed?
There are several conditions for the IUI procedure:
- The first condition: the woman must be ovulating.
- The second condition: the man must have a sufficient amount of sperm. At the same time, sperm must have good and healthy mobility. This condition is assessed using a spermogram.
The procedure is carried out in a natural or hormone-stimulated cycle. However, partners are initially examined to identify health abnormalities.
The woman undergoes the following tests:
- Hormone analysis.
- Test for rubella. This disease causes a threat to the life of the fetus, various deformities, and pathologies. Therefore, the possibility of rubella must be excluded before pregnancy.
- Analysis for the identification of harmful viruses: ureaplasma, herpes, trichomonas, chlamydia, mycoplasma, .
- Analysis to detect cancer cells.
- Photo of the fallopian tubes and uterus. The doctor assesses the condition of the organs, in particular the patency of the fallopian tubes.
A man passes:
- Analysis for the presence of sexually transmitted infections.
- Spermogram procedure. It shows sperm count, consistency, sperm volume, sperm shape and evaluates sperm motility.
Doctors try to correct detected deviations using tests. Next, treatment and re-diagnosis are carried out. Only after this the specialist decides on the need for an IUI procedure. The question of which biomaterial will be used is also immediately resolved: husband or.
Stages of insemination
Intrauterine insemination can be divided into the following stages:
- Stimulation of ovulation in a woman (not in all cases).
- Carrying out folliculometry and laboratory monitoring of the onset of ovulation.
- Collection of biological material (sperm) or defrosting frozen donor material. This stage is carried out during the periovulatory period.
- Preparation of sperm for insemination.
- The process of introducing sperm itself. This is carried out using a syringe. The sperm is injected with a catheter through the cervical canal into the uterine cavity.
The IUI procedure itself is quick. The woman does not feel pain. The doctor gains access to the uterus using a vaginal speculum. There is no need to dilate the cervix, since the catheter used has a small diameter and easily penetrates through the cervical canal, dilated during the ovulation period. But sometimes there are cases when it is necessary to use expanders.
Visualization with the help of devices of the location of the catheter tip is not necessary. The doctor is guided by his professional feelings. After the tip of the catheter enters the uterine cavity, it presses on the syringe. After the entire amount has been administered, the syringe and catheter are carefully removed. After the procedure, the woman must lie on her back for half an hour. At this time, she may show signs of anaphylaxis and a vasovagal reaction. In this case, the doctor takes emergency measures.
Preparation of biomaterial (sperm)
Due to the fact that spermatozoa bypass the vagina, where they often die due to the acidic environment, even not very fast spermatozoa have the opportunity to participate in the fertilization process. Their high concentration in the uterus significantly increases the chance of conception.
There are no special requirements for sperm collection from a man. But it is advisable to take her to a medical facility to avoid unwanted transportation.
Before sperm are implanted into a woman’s body, they undergo preliminary preparation. This takes about three hours. The doctor selects more viable sperm for further procedure. Sperm is examined for quality indicators, which are specified in WHO standards. After the work has been done, the collected viable material is left alone for 30 minutes. The procedure is necessary. During this time it should naturally liquefy.
Several methods are used to prepare sperm. With any method, there should be one outcome. Seminal plasma should be removed as much as possible from the sperm (this is necessary to prevent an undesirable reaction). It should not contain immature, dead or poorly motile sperm. In addition, antigenic proteins, bacteria, leukocytes and prostaglandins are removed. The result is a material of excellent quality and high concentration.
There is a special kit for home insemination. The sperm is drawn into a sterile syringe and inserted through a catheter into the vagina. As a result, a large amount of sperm is produced near the cervix. This procedure is considered more of a vaginal procedure, therefore the chance of getting pregnant is less than in a clinic. After administration, the woman must maintain a horizontal position for 30 minutes.
In addition to insertion items, the kit includes a pregnancy test. It can be performed on the 11th day after insemination. If the test gives “not pregnant”, then the determination is repeated after 7 days.
Complications
Intrauterine insemination almost always occurs without complications. But there is a probable risk of their occurrence. Complications may be the following:
- Infection of the uterus and pelvic organs.
- Pain in the lower abdomen.
- Vasovagal reaction.
- Allergic reaction.
Complications can occur after pregnancy. These include: multiple pregnancy, pregnancy outside the uterus and spontaneous miscarriage.
Efficiency of IUI
The chance of success, according to WHO, is 12%. The effectiveness increases slightly if you perform repeated intrauterine insemination in the same cycle. It is very important to perform IUI very close to the time of ovulation. Doctors are using all possible methods to find out the day of its onset.
The effectiveness is also influenced by the type of infertility, the age of the woman and man, and the parameters of the sperm used. In addition, the condition of the fallopian tubes and endometrium is very important.
The intrauterine insemination procedure can be repeated up to four times. It does not have a negative effect on a woman’s body. If after many attempts there is no result, then they resort to IVF.
The diagnosis of infertility is not a death sentence and very often it can be overcome by performing a simple and relatively inexpensive procedure - artificial insemination, as one of the methods of artificial insemination.
Carrying out the intrauterine insemination procedure increases the likelihood of natural conception, since male sperm are previously carefully selected and divided into groups of the most active ones. They, together with female eggs, are fed with special microelements and are also immersed in a favorable, sterile environment for development. In laboratory conditions, protein-enriched sperm is prepared for injection into the uterus, due to which its “path to the goal” is significantly shortened, which means that even low sperm motility cannot interfere with conception.
Thus, after artificial insemination, the likelihood of a long-awaited pregnancy increases. As follows from the results of research at the Institute of Reproductology, pregnancy after insemination occurs in 30% of cases.
Sometimes the procedure is prescribed after laparoscopy, which stimulates ovulation, and in each special case The indications for its implementation are determined by the doctor.
Application of insemination
A man’s satisfactory state of health and regular sex life, unfortunately, do not always guarantee his ability to fertilize. Not only injuries and overheating of the genital organs, but also various infectious diseases can have a detrimental effect on male reproductive function. bad habits. All these reasons directly affect the quality of seminal fluid and sperm motility.
But insemination is recommended not only for male infertility. There are times when after long unsuccessful attempts When a woman becomes pregnant, her cervix begins to produce antibodies to individual components of her partner’s sperm, perceiving it as a foreign substance.
During the insemination procedure, seed material from both the husband and the donor can be used, and the procedure is the same. The only differences are in the indications for fertilization.
Insemination with the husband's sperm is prescribed in the following cases:
- when the seminal fluid is of poor quality and sperm have poor motility;
- the man does not ejaculate or suffers from impotence;
- female vaginismus, which prevents normal sexual intercourse;
- in the presence of antisperm antibodies in the cervical canal of a woman’s uterus.
Donor material for fertilization is used when:
- the woman’s sexual partner has no sperm;
- husband suffers infectious diseases, dangerous for the child;
- there is a risk of genetic abnormalities and hereditary diseases;
- the woman does not have a sexual partner.
Preparing for AI
Just making the decision to undergo artificial insemination is not enough, and partners who dream of conceiving a child should first contact a specialist in the field of intrauterine insemination. The doctor will analyze the situation, take a family history, and prescribe an examination plan.
To begin with, venous blood is taken from a man and a woman for HIV, torque infections, hepatitis, as well as a passive hemagglutination reaction (RPHA). After three days of abstinence from sexual intercourse, the expectant father must undergo a spermogram and a test to identify antisperm bodies.
Favorable flora of the genital organs contributes to the proper development of the baby, therefore, during the examination, the woman additionally undergoes a culture in the period from 15 to 24 days menstrual cycle. Infections such as papillomavirus, ureplasma, group B streptococcus can interfere with the full gestation of the fetus. These diseases are usually asymptomatic, so the importance of these studies in preparation for the procedure is especially high.
The sperm is also prepared before insemination. The laboratory assistant liquefies the seminal fluid and cleans it of cellular debris and proteins. Then, under a microscope, the most motile and morphologically suitable sperm are selected to be used in the fertilization process.
Intrauterine insemination with the sperm of a partner or donor is carried out during ovulation, at the moment a mature and ready-to-conceive egg leaves the ovary. If a woman has problems with ovulation, then doctors additionally stimulate the ovaries through hormone therapy. Preliminary stimulation increases the effectiveness of the procedure and also allows you to calculate the exact time of ovulation.
Insemination: how the manipulation works
The chronology of insemination consists of the following sequence:
- After the partners come to the fertility doctor’s office at the appointed time, the doctor’s first step is to prepare the sperm for use. A cell specialist selects the fraction of the most viable sperm and adds all the necessary substances to them. Centrifugation, enrichment and semen separation usually takes about 45 minutes.
- After manipulating the sperm, it must be administered within the next few hours.
- At the same time, the gynecologist must confirm the occurrence of ovulation by performing folliculometry. If the egg does not leave the ovary, folliculometry is repeated again one day after insemination.
- The doctor places the purified sperm into a syringe with a long catheter. His fertility specialist carefully inserts it into the woman’s cervical canal and leaves all the selected sperm there.
- If the procedure is performed correctly, then the sperm closest to the entrance to the fallopian tubes penetrate inside without barriers and fertilize the egg.
This is the process of intrauterine insemination with sperm. It is absolutely painless, and all instruments used are sterile and disposable.
The completion of the manipulations is the attachment of a special cap to the cervix. This is necessary to ensure that the introduced liquid does not leak out. After 8 hours, you can remove the cap yourself. Sexual intercourse is not prohibited, but on the contrary, it is recommended.
2 weeks after AI, a woman must undergo a blood test from a vein to determine the hormone human chorionic gonadotropin.
If pregnancy occurs, your doctor will most likely recommend homeopathic maintenance therapy. If conception does not occur, then, if the partners wish, another fertilization cycle will be scheduled. There is no need to worry about the fact that you were unable to get pregnant the first time, since there are biological reserves of eggs and fertilization cannot take place in every AI cycle. However, the effectiveness of artificial insemination increases from time to time.
Many fertility centers have a discount system, according to which the price is reduced for subsequent cycles of artificial insemination. If the AI's attempts are unsuccessful, the discount also applies to IVF.
Pregnancy after AI
The first sign of pregnancy after the intrauterine insemination procedure is a woman’s delayed menstruation. If the development of the embryo has begun, the gynecologist may prescribe maintenance therapy to the expectant mother.
The probability of conception after the first cycle in this case is 15%, but if this does not happen, then it is advisable to continue treatment up to 4 cycles. It is impossible to stimulate the ovaries more than 4 times, and as an alternative method, doctors may recommend using the IVF method.
If the patient’s age does not exceed 30 years, she is healthy, and the partner’s sperm good quality, then the chances of fertilization increase.
Advantages and disadvantages of insemination
Advantages of the artificial insemination procedure:
- naturalness of manipulation;
- genetic connection between parents and child in the event of pregnancy;
- low cost of reproductive procedures.
Disadvantages of insemination:
- additional hormone therapy can cause hyperstimulation of the ovaries, in which they enlarge and release a lot of fluid into the abdominal cavity. This leads to an increase in overall body weight and a feeling of bloating;
- If a catheter is inserted incorrectly into the uterine cavity, the likelihood of infection increases.
Contraindications to insemination:
- oncological diseases;
- infertility due to pathological changes in the uterus as a result of malformations or acquired diseases;
- diseases for which pregnancy is contraindicated;
- structural changes in the endometrium.
Helpful Tips:
- The priority area of activity of a reproductologist is the use of sperm from the patient’s sexual partner. Therefore, if a man’s seminal fluid contains even the smallest amount of viable sperm, the doctor will do everything possible to effectively carry out insemination.
- The more active cells in the sperm, the more likely it is that the AI procedure will be completed successful conception. If the mobility of cells capable of fertilization is low, the doctor may choose a method of hormonal stimulation of ovulation.
- For insemination, only fresh, not pre-frozen biological material from a man is taken. Additional freezing can impair the properties of sperm, slow down sperm motility and even suppress them.
- For the procedure to be successful, a woman must have at least one healthy fallopian tube and there must be no serious contraindications to its procedure.
Intrauterine insemination at home
If you decide to carry out this manipulation at home, then you need to be well prepared for it. First of all, buy all the necessary tools:
- syringe without needle;
- catheter;
- tests to determine ovulation.
Insemination at home should be carried out at a time when the egg is in a mature state and is ready to meet the sperm. Therefore, if you plan everything regardless of the menstrual cycle, then all your efforts will be in vain.
The first cycle of artificial insemination should be done independently two days before ovulation and then repeated every 48 hours. Place your partner’s sperm in a separate sterile container, but remember that no more than 2 hours should pass from the moment of ejaculation to insemination.
Before the procedure, relax and set your thoughts in a positive way.
The chronology of artificial insemination at home consists of the following stages:
- Draw some semen into the syringe and insert a catheter.
- When inserting a syringe into the vagina, you should not use lubricant, as it can damage the sperm.
- Once the catheter is completely immersed, gently press the plunger and release the contents of the syringe.
- For comfort, place pillows under your pelvis so that it is elevated during insemination.
You should remain in this position for a while so that the seminal fluid does not leak out. After a few hours, it is recommended to experience an orgasm. In this case, the walls of the uterus shrink, which in itself promotes the advancement of sperm.
The results of the procedure can be found out after some time using a pregnancy test.
In conclusion, I would like to note the importance of the age of the expectant mother when carrying out this type of fertilization. The quality of eggs decreases after 35 years, so fertility doctors recommend using the traditional IVF method at this age.
Artificial insemination. Video
Among the methods of overcoming infertility, artificial insemination stands out - a procedure that, unlike, allows one to achieve pregnancy with virtually no intervention in the woman’s body. This medical manipulation gives a real chance to become parents to many couples who in the recent past were considered infertile. How is artificial insemination performed and reviews about the procedure?
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A non-invasive procedure called insemination involves the introduction of a man's sperm into a woman's uterus using a special catheter and syringe.
Initially, doctors practiced various ways introduction of sperm into the body of the expectant mother. Insemination could be:
- intracervical;
- in the area of the fallopian tubes;
- into the peritoneum;
- intrauterine.
The last method was recognized as the most effective - it is used today in most cases.
But first the couple needs to get tested. An approximate list is presented in the table:
| No. | For a man | For woman |
| 1 | Spermogram | Vaginal smear for flora, for the presence of urogenital infections |
| 2 | Blood test for Rh factor | |
| 3 | Antibodies to hepatitis, HIV | Antibodies to hepatitis, HIV |
| 4 | Antibodies to cytomegalovirus | Antibodies to cytomegalovirus, herpes simplex virus |
| 5 | Urethral smear for urogenital infections | Coagulogram (test for blood clotting - after all, the procedure is still considered an intervention, although non-invasive, and complications are not excluded) |
| 6 | Pelvic ultrasound | |
| 7 | Checking the patency of the fallopian tubes |
Important: good patency of pipes - necessary condition to carry out manipulation. If one of them is clogged with adhesions or fluid, there is a high risk of complications - ectopic pregnancy. If both tubes are completely obstructed, insemination does not make sense: the egg will not meet the sperm.
The procedure is performed only if the woman has spontaneous (or hormone-stimulated) ovulation. In order to track the moment of ovulation, starting from the 8th-9th day of the cycle, the reproductive specialist performs folliculometry, observing the dominant follicle and choosing the time to administer a small dose of hCG. 24-36 hours after the hCG injection, the largest follicle bursts - the egg goes “on the hunt”. It is very important not to be late here.
This procedure, unfortunately, is not a panacea. Pregnancy with artificial insemination is possible if:
- the man has subfertile sperm (i.e. there are few viable sperm or many of them have defects);
- the man has been diagnosed with ejaculatory-sexual disorders;
- a woman’s body actively produces sperm, which immediately kill sperm in the vagina, preventing them from reaching the egg;
- the partner experiences vaginismus (involuntary contraction of the vaginal muscles, making normal sexual intercourse impossible).
The procedure helps to get rid of infertility also in cases where its causes could not be established. Good effectiveness is observed with so-called psychological infertility, when a woman’s body destroys sperm after normal sexual intercourse due to some internal problems that have “gone” to the subconscious level.
Note! Insemination will not allow you to acquire heirs if:
- no ovulation;
- pipes are missing or impassable;
- woman's age is more than 39−40 years;
- early ovarian exhaustion or menopause is observed; all eggs mature with defects.
After the necessary preliminary examinations have been carried out, the woman is prescribed a course of drugs - gonadotropins - to stimulate ovulation.
If there are no hormonal problems, the ovaries are working normally, the doctor simply tracks the day of the supposed rupture of the dominant follicle. An hCG injection is prescribed about a day before insemination, so that the follicle does not develop into a cyst and “releases” the egg.
Most often, the procedure is performed on days 12–14 of the cycle (at this time the periovulatory phase occurs). A couple of hours before the manipulation, the woman comes to the clinic, where she undergoes a control ultrasound, and sperm is collected from her husband.
Next, the husband is released, and the wife must come to the moment when the sperm is processed. The sperm is put through a centrifuge to purify it. If unprocessed sperm enters the uterus, it can cause severe allergic reactions, including anaphylactic shock.
Having prepared the sperm for artificial insemination, the doctor invites the woman to the operating room. You need to change into a disposable robe and cap, and replace your shoes with shoe covers.
The patient is located in a gynecological chair. Under ultrasound control, the doctor inserts a catheter into the uterus, at one end of which a syringe with sperm is attached. The infusion is made slowly to avoid reflex contraction of the uterine muscles. Then the catheter is removed, the woman remains in the chair for another 10 minutes, and after artificial insemination she rests in the room for half an hour.
Then you can go home or to work, and after 14 days do a test or donate blood for hCG.
The manipulation itself takes about 5 minutes. It is completely painless and does not require anesthesia, since the catheter is thin. The only “but”: those patients whose neck is very narrow or tortuous may need intramuscular injection of painkillers: no-shpa or ketorol. They will relax the muscles and facilitate the process of inserting the catheter.
To support the luteal phase, doctors prescribe medications with progesterone. Usually these are Utrozhestan or Duphaston capsules. They are inserted into the vagina to make the endometrium “lush” and to support the corpus luteum, without the normal functioning of which the embryo will not be established.
Price of the procedure
The price for artificial insemination is about 12-15 thousand rubles (this does not include hormones to stimulate ovulation and tests). For tests, you will have to add another 8 thousand for the wife and 3-4 thousand for the husband. Compared to the costs of IVF, this is very little.
The procedure is simple and rarely causes complications, since the intervention in the woman’s body is minimal. However, many are depressing statistics: according to research, only 11-15% of women who decide to carry it out succeed in becoming pregnant through insemination. The chances of having a child with IVF reach 45% (if the spouses are young and relatively healthy).
But the procedure can be repeated several times without interruption, as soon as the new egg matures, and the cost of artificial insemination is low. It is believed that it is advisable to perform insemination 3 times - after this, the effectiveness drops sharply.
