Using Artificial Insemination as a Means of Conception

Insemination. Artificial insemination, also referred to as AI, is a medical procedure that artificially places sperm into a woman’s uterus, cervix or fallopian tubes. The concept of artificial insemination was originally used for livestock and since then has been adapted to assist in human reproduction. AI is one of several types of fertility options and is the cheapest and less-invasive of the methods.

Reasons People Seek Artificial Insemination

There are many reasons why women may undergo an artificial insemination procedure. While many of these reasons are related to medical issues, some are not. Women choose artificial insemination for the following reasons:

It is often used to impregnate women whose partners have a very low sperm count or weak sperm that have difficult swimming to the cervix.
IA is used for infertility issues dues to cervical factor infertility. Cervical factor infertility means that the cervix is unable to produce enough mucus and allows the sperm to travel to the womb. In some cases, the mucus may contain substances that kill sperm.
Fertility issues caused by endometriosis.
When the male partner is impotent or suffers from infertility that result from medical issues.
In rare cases, some women suffer from a semen allergy that prohibits having direct contact with the sperm.
Women that want a child without a partner may consider artificial insemination.
A couple that is in a same-sex relationship may use artificial insemination to have a child.

The Artificial Insemination Process

One of the first steps in the artificial insemination process is to collect the sperm. The sperm is either collected from a partner or in situations where the male is infertile, or there is no male partner through a sperm bank.

Preparation for Insemination Using Sperm from a Male Partner

When the woman is inseminated using her partner’s sperm, the man is asked to refrain from having sex for a few days before the procedure. Abstaining from sex helps to increase the amount of sperm in the sample. If the couple lives near the fertility clinic, the sample can be collected at home. Sperm collected at home is done using a collection condom or by masturbation. It is important that the sample get back to the fertility clinic within an hour.

The sample can also be collected at the clinic by using an electronic stimulator or by masturbation. The sperm then is washed and concentrated. This activity serves two purposes. It increases the amount of sperm capable of fertilizing the egg by removing any non-mobile sperm. It also eliminates the presence of any genetic defects. The sperm is always washed. Unwashed sperm is only used during certain methods of artificial insemination because makes the procedure painful, causes uterine cramping and the unwashed semen is expelled by the women’s body.

Preparation of Sperm from a Sperm Bank

The sperm acquired through sperm banks goes through a more involved screening process. The screening evaluates both the sperm donor candidates and the sperm. This process makes sure that the women who use donated sperm receive safe sperm from the best possible people. While the exact screening process of sperm donation does depend on the particular sperm bank used, donors tend to go through the following phases:

Application
Interview Appointment
Test Samples
In-depth Screening

The application requirements for each sperm bank are different. Some may require their donors to have a college education or at least be enrolled in college. All sperm donors must be at least 8 years old and younger than forty. Men interested in becoming donors must all be willing to commit six months to a year to the project.
A clean medical history is another application requirement. Applicants need to provide their family’s medical history for at least two generations. The donor must also not have any chronic medical problems.

Interview and Test Samples

After meeting the initial application process criteria, the donors are interview by a member of the staff. The interviewer may question the potential donor about their motivations for becoming a donor. The candidate is also accessed to see if they participate in any at-risk behavior or habits like smoking or drinking.

At this meeting, several samples of sperm are left. The semen is analyzed to check for its viability. The viability analysis determines the sperm count, sperm’s mobility and sperm morphology. The candidate is also checked for the presence of infectious diseases like Hepatitis B and HIV.

In-Depth Screening

If the samples show a high sperm count and are free from disease, it goes through an in-depth screening. This screening involves genetic testing. The chromosome testing is used to detect genetic diseases like cystic fibrosis. The in-depth screening also tests for genetic conditions that are race-specific. For example, donors that are of African-American descent are tested for sickle-cell anemia. Donors of Italian or Asian ancestry are tested for Thalassemia.

If accepted, the donor signs a contract with the sperm bank. Once the contract is signed, the donor is subjected to periodic health screenings. It should be noted that due to the intensive scrutiny of the selection process, 5 percent or less of men interested in becoming sperm donors actually become one. The entire process could take several months.

After the Sperm Samples are Accepted

The semen samples are frozen after they are collected. The freezing process is called cryopreservation. The semen is preserved with a solution that decreases any potential damage that may occur from the freezing and thawing process. More chemicals may be added to separate active sperm and to dilute the semen to produce several vials for multiple inseminations.

These vials are slowly frozen in liquid nitrogen vapor and stored at temperatures of -196 degrees Celsius or -320 degrees Fahrenheit. While chemicals are added to the sperm to prevent damage, it may not fully prevent it from occurring. After thawing the vials, they are tested to meet certain standards. If the samples, once they are thawed, do not met the minimum criteria of 20 million sperm per milliliter with at least 25 percent mobility, the vial is not used. Thawed sperm is only viable for 24 hours. Frozen sperm does not have an expiration date.

Donor Recipients Can Choose Characteristics

Sperm banks allow a parent to choose particular traits they desire. Donor characteristics that can be chosen include medical history, skin tone, race, ethnicity, eye color and hair color. Some sperm banks let donors select other characteristics like IQ.

It is important to keep in mind that genetics is not exactly as simple as choosing a physical trait. Choosing a donor with specific features does not guarantee having a child with those features. Anyone who wants to find out the probability of having a child with particular traits should have a consultation with a genetic counselor.

Artificial Insemination Preparation for Women

Before the artificial insemination process begins, women are screened for any hormonal issues, structural problems with their reproductive systems and infections. This screening can help determine the best artificial insemination treatment.

On day six of a woman’s cycle, a doctor will begin to look for signs of ovulation using an at-home fertility prediction kit, hormone testing or ultrasound follicular monitoring. Hormone testing looks for increases in luteinizing hormones. When these hormones rise, ovulation is about to occur. Ultrasound follicular monitoring is used to check for the presence of mature follicles. These follicles will eventually become eggs. An insemination cycle happens within 24 hours of ovulation. To increase the chances of pregnancy, some women are prescribed fertility drugs. The fertility drugs help to increase the number of eggs available for fertilization.

The Three Types of Artificial Insemination Procedures

Regardless of whether a donor sperm is used or the sperm comes from a partner, the artificial insemination process is the same. Intrauterine, intravaginal and intratubal are the three types of insemination processes offered by fertility clinics and reproductive specialists.

Intrauterine Insemination

Intrauterine insemination (IUI) is one of the most popular forms of artificial insemination. It also has the highest success rate. This procedure is non-invasive and painless. It is also very close to the natural method of reproduction.

During intrauterine insemination the semen is collected at the time of insemination in the clinic or from home. The semen is washed before it is used during intrauterine insemination. A catheter is placed in the vagina and passed through to the uterus. The sperm is then inserted into the catheter for direct placement in the uterus. A sponge cap is inserted into the uterus to prevent the sperm from leaking. The procedure takes around fifteen minutes. Afterwards, patients rest for 30 minutes. Women are then allowed to go on with their regular, daily activities.

This procedure is performed when the woman is ovulating to ensure the highest possible results. The rate of pregnancy is about 5 percent to 20 percent, per cycle. If two procedures are performed during each cycle, the odds increase to about 30 percent. The success rate of IUI insemination also depends on whether fertility drugs are used. Also, women under the age of 35 have greater success rates.

Intrauterine insemination is ideal for the following situations:

Couples who are fertile ad have no problems with their reproductive organs but cannot conceive for unknown reasons.
Male partner has difficulty ejaculating
Can be used during ovulation that occurs either naturally or with the assistance of fertility drugs
Pregnancy by a surrogate
With use of donated sperm

The cost of intrauterine insemination can range from $300 and $800 a session. If x-rays and donated sperm are used, the cost of the procedure can increase. Intrauterine insemination is the least expensive of the three treatment options.

Intravaginal Insemination

Intravaginal insemination is a lesser-used method of artificial insemination. This type of insemination has a lower rate of pregnancy. Intravaginal insemination is often used for the following situations:

Women who do not ovulate regularly.
Men who have sperm with low mobility.
Process should not be used for women who have mucus issues that prevent fertilization.
This procedure can be done at in a doctor’s office, fertility clinic or at home. The procedure is non-invasive and takes about ten minutes. During this process, the sperm swims through the uterus to the fallopian tube.

Timing is important to the success of this method. To improve the rate of success the insemination must occur within 24 hours of peak ovulation. There are two insemination methods. The first is the syringe method; the other is the cervical cap method.

The Syringe Method

The syringe method can be performed at a doctor’s office, clinic or at home. It involves filling a sterile syringe with sperm. For intravaginal insemination, the semen does not need to be washed. The needle-less syringe is then inserted into the woman until it reaches the cervix. The sperm is then released close to the cervix.

The Cervical Cap Method

This is the most common method used for home insemination. The cervical cap is filled with the father or donor sperm. The cap is then folded and placed into the women’s vagina. It is left there for a couple of hours to give the sperm time to travel through the uterus.

The success rate of intravaginal insemination is not high. However, the chances of success are increased with the use of fertility drugs and the use of washed sperm. One cycle can have a success rate of 10 percent. The use of fertility drugs and washed sperm can increase the likelihood of success to 30 percent.

The cost of intravaginal insemination is not high. When done at home the cost includes the cervical cap, sterile syringe, sterile container and sperm, if a donor is used the cost increases. If the procedure is done at a clinic is can cost at least $300 to $400 per cycle.

Intratubal Insemination

Intratubal Insemination is one of the least performed artificial insemination techniques. It is also the most expensive and most invasive of the procedures. During this process, the sperm is placed directly into the women’s fallopian tubes. The placement of the sperm provides the highest chance of fertilization. There are two types of intratubal insemination procedures: intrafallopian insemination and sperm intrafallopian transfer.

Ouch.

Intrafallopian Insemination (IFI)

Intrafallopian insemination is performed by an endocrinologist at a hospital or clinic. A light anesthetic may be used for this procedure. A catheter is inserted into one of the fallopian tubes. The washed sperm is then pushed through the catheter and inserted directly into the fallopian tube.

This method is ideal for the following conditions:

Women with ovulation issues
Women with cervical mucus that prevents pregnancy
Used as a last chance method for couples when other types of artificial insemination have failed

Sperm Intrafallopian Transfer

Sperm intrafallopian transfer (SIFT) is another type of intratubal insemination technique. It does require more time than any other artificial insemination procedure and is invasive. SIFT procedures must take place in a hospital or clinic.

The woman is placed under local or general anesthesia before the procedure. A small incision is made into the abdomen and a laproscopic camera is inserted. The camera is used to help the physician locate the fallopian tubes. Once the tubes are located a catheter is inserted. A syringe filled with sperm is placed into the catheter and the sperm is released into the fallopian tubes.

As previously stated, intratubal insemination is one of the most expensive forms of artificial insemination. It can cost around $1000 per cycle to undergo intrafallopian insemination. Sperm intrafallopian transfer costs even more.

There is some debate as to the success rates of intratubal insemination. Some doctors believe that intratubal insemination is the most successful option of the artificial insemination methods. Other statistics show a success rate of 5 to 30 percent rate per cycle, which is about the same as intrauterine insemination.

Side Effects of Artificial Insemination

There are some side effects attributed to artificial insemination. The side effects depend on the type of procedure and the methods used. While these side effects can occur, they are rare.

Some women may experience mild cramping in their lower abdomen after the procedure. Women have also reported vaginal discharge and light vaginal spotting or bleeding. There is a slight risk of a perforated uterus from the insertion of the catheter.

Other side effects that can occur include infections of the uterus and fallopian tubes. The infection can cause endometriosis and inflammation of the uterine lining. The infections are usually due to the use of an unsterilized catheter for the insemination. It should be noted that while infections are possible, they are highly unlikely. Less than one percent of women have experienced an infection as a result of an artificial insemination procedure.

If women are prescribed fertility drugs in preparation for artificial insemination, they may experience the following side effects:

Multiple births
Ovarian hyper-stimulation
Hormone drug effects like headaches, hot flashes and irritability
There is a risk of disease when using donor sperm. Reputable sperm banks carefully screen and wash the sperm, eliminating the chances of disease transmission. The risk does exist for acquired sperm that has not been screened.

Artificial insemination is a process that uses artificial means to place sperm in the uterus, fallopian tubes or cervix to help women conceive. This process turns the dreams of having a child into a reality for many couples, single women and same-sex couples.

Intrauterine, intravaginal and intratubal methods are three types of artificial insemination methods. Intrauterine is the most popular method due to its lower cost and success rate. Some couples may choose to use partner sperm. However, in certain situations, partner sperm may not be available.

Many people use sperm banks. Sperm banks use an intense process to screen and guarantee the highest quality of sperm. The screening process also makes sure that the sperm is free of disease and any genetic defects. People who choose to use sperm banks can select the type of sperm they would like based on ethnicity, height and other traits.

While artificial insemination does not guarantee pregnancy, it does have success rates of around 30 percent. The success rates do depend on a variety of factors that include the insemination method used. Anyone interested in artificial insemination should seek a consultation with a local fertility specialist.