Artificial Insemination

What does it consist of?

This treatment consists of introducing a conveniently prepared seminal sample into the uterus at a time close to ovulation.

Types of Insemination

Conjugal artificial insemination (CAI): Artificial insemination using the partner’s semen sample.

Donor artificial insemination (DAI): This is the same technique but using a donor’s sperm sample.

Who is CAI recommended in?

The cause of sterility of each couple should be treated individually but, in general, the main reasons for using CAI are:

  1. Sterility of unknown cause.

  2. Mild alterations in the seminogram. The seminal sample is prepared in the laboratory so as to obtain a sufficient number of spermatozoids with good mobility.

  3. Failure of other treatments (such as ovulation induction) in cases of male or female sterility, if the woman has at least one permeable (not obstructed) fallopian tube.

 

Who is DAI recommended in?

  1. Women without a male partner.

  2. Absence of spermatozoids in the ejaculation which cannot be solved with other techniques.

  3. Males carrying determined hereditary diseases which may be transmitted to the descendents.

What does artificial insemination consist of?

In both CAI and DAI, the first part consists of stimulating the ovulation to increase the possibilities of treatment success. The medication has to be injected but may be easily administered by the patient herself. The treatment normally lasts between 5 to 12 days and the patients will undergo between one and four medical controls (a hormone blood test and an echography) until the ovary is prepared for ovulation. At this time, ovulation will be provoked so that the exit of the ovule from the ovary coincides with the day on which the insemination will be carried out.

In the case of CAI, the same day of the insemination the couple obtains a seminal sample which is prepared in the andrology laboratory with the aim of selecting the best spermatozoidswhich are, in general, those with the greatest mobility and normal morphology.

Once the sample from the couple (CAI) or the semen donor (DAI) is prepared, the insemination itself is performed: A vaginal speculum is placed (the same as in a gynaecologic check up) and a very fine cannula is introduced into the uterus where the seminal sample is injected through the cannula. The technique is painless and a rest period afterwards is not required.

Secondary effects and risks

During the first hours after the insemination, the woman may have mild abdominal discomfort and may notice the appearance of a slight vaginal secretion which, on occasions, may be stained with blood. The appearance of complications is rare with the regimen schedule of ovarian stimulation used in our center.

The development of an ovarian hyperstimulation syndrome (important retention of fluids, generally in the abdomen) secondary to the ovulation stimulation is very exceptional.

The risk of multiple pregnancies is less than 10 %.

Possibilities of success

CAI: Even though the possibilities of achieving pregnancy are less than the IVF ones, CAI allows gestations in many couples without the need of other more expensive and complex assisted reproduction techniques. However, if pregnancy is not achieved after three or four CAI, we recommend changing the treatment to cycles of IVF, because after the fourth CAI the possibilities of success are reduced.

DAI: The rate of pregnancies is higher than in CAI treatments since the woman who receives the donor’s seminal does not usually have fertility problems. In general, we recommend up to six DAI before considering a treatment change.