Artificial insemination (AI) is a simple technique and usually the first choice for women who have difficulty getting pregnant naturally or single women. It is considered the most widely used assisted reproduction method.
The main objective is to help the sperm reach the egg, in a time close to ovulation. The sperm is processed to obtain the best and most motile spermatozoa and to remove the seminal fluid. After this, the sample is deposited in the female reproductive tract, generally inside the uterine cavity.
Although the first reported pregnancy is from the 18th century, this treatment became more popular during the seventies. Obviously, the technique has been developed since then and so the results have increased. The first approach was to perform the sperm deposit in the cervix, the opening from the vagina to the uterus. This is known as paracervical insemination. Although this method is generally successful, currently the most used is intrauterine insemination, since it increases the chances of getting pregnant.
Artificial insemination is a cost-effective treatment if it is well indicated. It is much cheaper than the complex, technology demanding in vitro fertilisation (IVF). If we include medication in the comparison, cost of an AI versus IVF can be a five times lower.
There are some criteria to be met if we want AI to be successful. First, we need a valid sperm sample. Slight alterations such as moderate motility problems can be solved, but the total amount of highly motile spermatozoa once the sample has been treated should be higher than 5 million.
We also need a mature egg to be ovulated right before the insemination. Usually medication is used to mildly stimulate the ovaries to produce one or two mature eggs. Another drug, called HCG is used to determine the ovulation time. It is possible to perform AI without any medication, but the results can be lower so you should ask your doctor about this option.
In addition, for the spermatozoa and the egg to meet at least one of the fallopian tubes must be permeable. To check for this, a hysterosalpingogram should be performed. This technique consists of a series of x-ray of the cervix, uterine cavity, and fallopian tubes right after a radiopaque liquid is introduced in the cervix.
When the specialist has detected using ultrasound that the follicles have a minimum diameter, it triggers ovulation injecting the chorionic gonadotropin (HCG). 36 hours after, the ovulation will occur, and so the IA is performed around that time. The process of introducing the sperm sample contained in a plastic catheter inside the uterus is easy and not painful.
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