Artificial insemination is a simple assisted reproduction technique, imitating the natural conditions of fertilization. it consists of the introduction of a sample of semen, previously examined and prepared in the laboratory, into the uterine cavity.
How DOES IT HAPPEN?
Who is it for?
- Couples with mild or moderate sterility problems, with a short time of sterility and woman under 38.
- Single women who want to have a pregnancy and who meet the requirements for this technique.
- Lesbian couples who choose this option and who are suitable for it.
- Heterosexual couples who must use donor sperm due to an insufficient sperm count or being a carrier of a genetic disease not detectable in a PGD.
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 egg, 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 egg happenened or, of course, about the quality of a possible embryo.
- Is it possible to do artificial insemination in a natural cycle?
Yes, it is possible to do in a natural cycle. in this case, medication is not administered to stimulate the ovaries and we are simply doing ultrasounds to control ovulation. however, the possibility of pregnancy with this method will be lower than if we perform 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 normally seeing the growth of between 1 and 3 follicles. as long as there is more than one egg, there will be a risk of having a multiple pregnancy, although the possibility following these guidelines is around 8% of twins. if the patient does not want to take this risk under any circumstances, it is possible to do artificial insemination with a very low dose so that a single follicle grows, or even in a natural cycle, although it must be assumed that this will decrease the chances of pregnancy.
- What requirements must be met in order to attempt artificial insemination?
In general, this technique is reserved for young women, maximum 37 years old. in the case of same-sex couples or single women, who are going to use donor sperm, it may be reasonable to try until 38 or 39 years.
Apart from this, it is necessary to check that the woman has a good ovarian reserve, to rule out pathologies such as endometriosis and in many cases to check that there is tubal patency (by means of hysterosalpingogram or hysterosonogram).
In case of artificial insemination with partner sperm, it is recommended to attempt only in cases of couples with a short time of sterility and in which the man has a motile sperm count (rem) above 5 million / ml.
- What are hysterosalpingography and hysterosonography?
both tests mainly assess whether the fallopian tubes are patent, so that eggs and sperm can travel through them to meet and fertilize.
The main difference between one and the other is that hysterosalpingogram is done using x-ray and hysterosonogram is done using ultrasound. in both, a liquid is introduced through the cervix and it is a matter of looking at the morphology of the uterine cavity and if this liquid travels through the tubes, showing that they are patent.
In recent years, a specific contrast has been developed for ultrasound, so that it can be easily seen if this contrast passes through the tubes. this technique is called hycosy and is currently the most recommended.