Insemination is a painless procedure consisting of placing of purified, selected and concentrated sperm directly into the uterus via a catheter. It is executed in a most preferred time of administration of sperm – ovulation.
Insemination is the first step of the treatment of patients belonging to the group of reduced fertility, with the aim of increasing the chances of fertilization of oocytes.
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How to prepare for insemination?
Patients before insemination are requested to take the following tests:
- HTLV – 1 ( human T-lymphotropic virus type 1) – should be made by the patients, who come from high-incidence areas or whose sexual partners or parents originate from those areas (North and South America, Caribbean);
- Trypanosoma cruzi – after the patient’s travel to the countries of Central or South America, to two weeks after returning from a trip or up to 40 days after blood transfusions made in the countries of Central or South America;
- Malaria – after the patient’s travel to tropical countries, where there is malaria (please make sure that there is a risk in a given region using, for example, the website of Military Medical Institute:
- A quick test for malaria – up to 40 days after returning from a trip, if there are no symptoms, and a year after returning from a trip, if there were episodes of fever.
- Smear – up to 40 days after returning from a trip, if you have episodes of fever.
Before the first visit, you can make already a part of these tests. During the first visit you will be referred to the other examination and the doctor will present a treatment plan.
The validity of laboratory tests (virological, Toxoplasmosis, Rubella, Chlamydia) is 3 months.
Artificial insemination can be carried out both during the natural cycle or after prior hormonal therapy, which stimulates the maturation of ovarian follicles. In the treatment, clomiphene is used (in treatment of ovulation disorders, it blocks the effects of estrogen) or gonadotropin (stimulates functioning of ovaries). The doctor monitors the cycle with ultrasound and when the ovarian follicles reach the appropriate size during ovulation, insemination is performed. The procedure does not require anesthesia, although some patients complain about discomfort and a light bleeding resulting from the placement of a catheter in the cervix. It takes a few minutes. After surgery sometimes light spotting may appear, and after several days – gentle abdominal and chest pain felt like before menstruation.
The insemination procedure is minimally invasive and uncomplicated. The side effects can be associated rather with previous hormonal stimulation, which may have an impact on the physical and mental condition of a woman.
It should be also taken into account that after the insemination, there is the risk of multiple pregnancy. Particularly if, as a result of stimulation, more than one follicle matures.
After the surgery:
You should allow yourself to relax and unwind. A woman should avoid the sauna and solarium, as well as the sun, vigorous exercise, drugs and stress. Healthy eating and standardized rhythm of sleep and wakefulness is important.
The efficiency of artificial insemination:
The efficiency of artificial insemination with husband semen is about 10%, depending on the semen parameters, woman’s age, the amount of mature follicles and additional factors affecting male and female fertility. The first failure should not, however, suggest that there is no chance of conceiving as a result of subsequent insemination. Efficiency can be assessed properly after minimum 3 treatments. After 4 unsuccessful inseminations it is worth considering continuing the treatment, because this is the first 3-4 treatments which offer the highest chances of pregnancy. Later efficiency decreases and according to the European Association for Infertility, when the sixth attempt fails, you should talk to your doctor about other ways to become pregnant.
The efficiency of artificial insemination with donor semen is higher and amounts to 25%.
Preparation of semen:
- Partner’s semen insemination (AIH)
Before insemination semen from the partner is properly prepared in the laboratory. This is mainly aimed at the removal of plasma seed, bacteria, leukocytes and other cells of dead sperm and at sperm condensation of the best parameters. The number of spermazoons in the sample is, however, significantly smaller, so the initial concentration of sperm in the ejaculate should be taken into account. The most effective method to prepare a density gradient centrifugation and / or a swim-up.
- Donor’s semen insemination (AID)
The donor’s semen is an important alternative for couples in whom the problem is caused by a male factor or with genetic risk from the partner.