A-IUI / AI (ARTIFICIAL INSEMINATION)

• What is artificial insemination?
• What kinds of artificial insemination are there?
• When is an Artificial Insemination with donor sperm is required?
• How is artificial insemination performed?
• What are the positive pregnancy rates? What are the chances?

WHAT IS ARTIFICIAL INSEMINATION?

Intrauterine Insemination (or IUI) and Artificial Insemination (or AI) are all synonymous terms. Artificial insemination or intrauterine insemination (IUI) involves inserting the male partner’s (or donor’s) prepared semen, taking a sperm specimen and preparing it by a process frequently referred to as "washing" , through the neck of the womb (cervix) and into the uterus, close to the time of ovulation. It is a simpler, less invasive form of fertility treatment.

WHAT KINDS OF ARTIFICIAL INSEMINATION ARE THERE?

IUI treatment can be performed in a couple of different ways.Natural cycle: This option does not involve any medication and works with the woman’s natural menstrual cycle.

Artificial hormone stimulation (or ovulation induction): This option involves the use of medication to stimulate the ovaries and cause or regulate ovulation with either Letrozole or FSH (follicle stimulating hormones) injections.Sperm can either be provided by the partner –Artificial insemination with partner sperm (AIH)/(AIP)– or from a sperm bank –Artificial insemination with donor sperm (AID).The semen sample is then analysed and washed to concentrate the motile sperm. The final prepared sample is used for insemination where it is gently inserted into the uterine cavity using a speculum and a small catheter.

The ideal situation is for women up to 38 years with normal or acceptable ovarian reserve, patent tubes, normal semen quality or with mild-moderate variations, who is been looking for pregnancy for less than 3 years.

WHEN IS AN ARTIFICIAL INSEMINATION WITH DONOR SPERM IS REQUIRED?

In the case of women who have a male partner:

- When significant alterations in sperm quality occur.
- When treatments with other assisted reproduction techniques (In Vitro fertilization by intracytoplasmic sperm injection [ICSI]) have previously failed due to a very severe male factor.
- When the male suffers from genetic diseases that other treatments either have previously failed to address, such as preimplantation genetic diagnosis (PGD), or were not consented to by patients for personal reasons.
- In cases of sexually transmitted diseases where sperm washing tests have been repeatedly positive for infectious diseases such as Hepatitis B, Hepatitis C, syphilis and AIDS.
- In the case of women who do not have a male partner (single women or women who have a female partner).

HOW IS ARTIFICIAL INSEMINATION PERFORMED?

Usually, the first step is to perform ovarian stimulation on day 3 of the menstrual period. Hormones that stimulate ovarian follicle growth are administered, always with an individualized protocol for each case.

Stimulation is monitored through performance ultrasound scans in a period of 8-10 days until an adequate ovarian response is achieved. Subsequently, ovulation is boosted by injecting hCG hormones when ultrasounds confirm the existence of a follicle of 18 to 20 milimetres of size. A date and time for insemination is agreed on (normally 36 hours after administering hCG). Previously, about 2-3 hours earlier, the husband or male partner must have provided a sperm sample that will be capacitated in the laboratory to enhance its quality. In those cases of insemination with donor sperm, samples are thawed for women according to blood type and Rh, as well as each woman’s physical characteristics (phenotype) 

The treatment is short in length, about 12 to 14 days from the beginning of ovarian stimulation.It is a simple technique that does not require anaesthesia, analgesia or taking anxiolytics, and it is not painful.It is practically the same as any routine gynaecological examination:The patient lays down for a few minutes (10-15). Your everyday life will remain exactly the same during treatment and medical examinations.pregnancy test after two weeks if the woman has not got her menstrual period during that time.

WHAT ARE THE POSITIVE PREGNANCY RATES? WHAT ARE THE CHANCES?

Statistically, the chances or the positive pregnancy rates after performing an insemination are : 20-25%.The positive pregnancy rate is exactly the same for the first 3 to 4 inseminations. Chances start to fall at this point. For this reason, it is not recommended to undergo artificial insemination more than 3 or 4 times.