The least invasive technique in Assisted Reproduction Medicine. It consists of the introduction of a semen sample, previously analyzed and prepared, into the uterine cavity. Artificial insemination reduces the distance that the sperm must travel to reach the ovule, thus increasing the potential for fertilization. It does not require the removal of the ovule, unlike IVF.
How it will be?
Who is it for?
- Couples with mild or moderate sterility problems.
- Lone women who want to have a pregnancy.
- Couples in which the male has an insufficient sperm count or is a carrier of an undetectable genetic disease in a PGD analysis.
Artificial insemination can be done, according to each case, either in a spontaneous ovulation cycle with previous ultrasound monitoring, or by stimulating ovulation to mature more than one ovum, by ultrasound control and drugs (gonadotropins) subcutaneously for a period of about 12 days.
In practice, its main drawback is that it only gives us data on the response of the ovaries to stimulation and on the quality of semen on the day of insemination. Once the semen has been introduced into the uterine cavity, we have no parameters to know whether or not fertilization of the ovum occurs or, of course, about the quality of a possible embryo.
In most cases in which after three cycles of AI pregnancy has not been achieved, it is advisable to proceed to IVF.
- Is it possible to do artificial insemination on a natural cycle?
Yes, it is possible to do it on a natural cycle. In this case, no medication is given to stimulate the ovaries and we are simply doing ultrasounds to control ovulation. However, the possibility of a pregnancy with this method will be lower than if we do an ovarian stimulation, so it is only recommended in women with a very good prognosis.
- What are the risks of having a twin pregnancy with artificial insemination?
In artificial insemination, the ovary is stimulated so that we usually grow between 1 and 3 eggs. Whenever there is more than one egg, there will be a risk of having a multiple pregnancy, although the possibility of a twin pregnancy following these guidelines is around 8%. If the patient does not want to run this risk under any circumstances, it is possible to perform artificial insemination with a very low dose so that a single follicle grows, or even on a natural cycle, although we must assume that this will reduce the chances of a pregnancy.
- What requirements must be met in order to attempt artificial insemination?
In general, it is recommended to reserve this technique for young women, up to 37 years old. In the case of lesbian or unmarried women, who are going to use donor semen, it may be reasonable to try at 38 or 39 years old.Apart from this it is necessary to verify that the woman has a good ovarian reserve, rule out pathologies such as endometriosis and in many cases check that there is tubal permeability (by hysterosalpingography or hysterosonography).In the case of artificial insemination with semen from the couple it is recommended to try it only in cases of couples that have been sterile for a short period of time and in which the male has a mobile sperm count (REM) above 5 million / ml.
- What are hysterosalpingography and hysterosonography?
Both tests serve us mainly to assess whether the fallopian tubes are permeable, so that ovules and sperm can travel through them to meet and fertilize.The main difference between one and the other is that hysterosalpingography is done using x-rays and hysterosonography using ultrasound. In both of them a liquid is introduced through the cervix and it is used to check the morphology of the uterine cavity and to see if this fluid passes through the tubes, showing that they are permeable.In recent years a specific contrast for ultrasound has been developed, so that it can easily be seen if this contrast passes through the tubes. This technique is called HyCoSy and is currently the most recommended.
he success rates shown correspond to those of our headquarters in Marbella. The percentages presented in this section have been divided as follows:
Beta-hCG positive: hormone produced by the body once the embryo is implanted in the uterus. Calculated after 10/12 days after embryo transfer.
Clinical Pregnancy: Calculated in the 5 week gestation by means of ultrasound. Its presence is a sign of implantation of the embryo in the endometrium.
SEF (Spanish Fertility Society). The rates shown here correspond to the last report published by the agency in 2016.