Insemination Procedures for Infertility

 

 Artificial Insemination

Treatment Overview

An insemination procedure uses a thin, flexible tube (catheter) to put sperm into the woman’s reproductive tract. For some couples with infertility problems, insemination can improve the chances of pregnancy.

Donor sperm are used if the male partner is sterile, has an extremely low sperm count, or carries a risk of genetic disease. A woman planning to conceive without a male partner can also use donor sperm.

Prior to insemination, the sperm usually are washed and concentrated (placing unwashed sperm directly into the uterus can cause severe cramps). Concentration is accomplished by selectively choosing highly active, healthy sperm that are more capable of fertilizing an egg.

Intrauterine insemination (IUI)

Intrauterine insemination (IUI) is the placing of sperm into a woman’s uterus when she is ovulating. This is achieved with a thin flexible tube (catheter) that is passed into the vagina, through the cervix, and into the uterus.

IUI can use sperm from the male partner or a donor. It is often combined with superovulation medicine to increase the number of available eggs.

Artificial insemination (AI)

Artificial insemination (AI) is another name for intrauterine insemination but can also refer to placing sperm in a woman’s vagina or cervix when she is ovulating. The sperm then travel into the fallopian tubes, where they can fertilize the woman’s egg or eggs.

AI can be done with sperm from the male partner or a donor, and can be combined with superovulation.

What To Expect After Treatment

These techniques are done on an outpatient basis and require only a short recovery time. You may experience cramping during the procedure, especially if sperm are inserted into your uterus. You may be advised to avoid strenuous activities for the remainder of the day.

Why It Is Done

Intrauterine insemination or artificial insemination may be done if:

• Tests have shown no cause for a couple’s infertility (unexplained infertility).
• A man releases semen and sperm into the urinary bladder instead of out the penis (retrograde ejaculation). Sperm are collected, washed, and used for insemination.
• A man’s sperm are absent, low in quantity, or poor in quality. In this case, your doctor may recommend that you try ICSI. ICSI stands for intracytoplasmic sperm injection.
• There is a problem with a woman’s cervix, as from prior surgery, that prevents sperm from traveling through it.
• A woman does not have a male partner.

How Well It Works

Treatment success is strongly influenced by a woman’s age (an aging egg supply decreases pregnancy rate, and miscarriage risk increases with age).

For couples with unexplained infertility, intrauterine insemination can improve the chances of becoming pregnant when combined with superovulation treatment.¹

If a man’s sperm are absent, low in quantity, or poor in quality, intrauterine insemination may slightly improve the chances-by up to 10%-that the female partner will become pregnant.²

Risks

Insemination combined with superovulation increases the risk of multiple pregnancy (conceiving more than one fetus). Multiple pregnancy is high-risk for mother and fetuses. To learn more, see the topic Multiple Pregnancy: Twins or More.

Insemination procedures pose a slight risk of infection.

Some women experience severe cramping during insemination.

There is a slight risk of puncturing the uterus during intrauterine insemination.

There is a slight risk of ovarian hyperstimulation syndrome if superovulation is used together with insemination.

There may be a higher risk of birth defects for babies conceived by certain assisted reproductive techniques. Talk with your doctor about these possible risks.

What To Think About

Insemination procedures are the simplest and least expensive methods of assisted reproduction. No anesthesia or surgery is needed.

Use of donor sperm

If donor sperm are needed, you can choose a known or anonymous donor who is willing to provide sperm.

• Donor sperm from a male who isn’t a sex partner (as from a sperm bank, friend, or relative) must remain frozen for at least 6 months before it can be used. This is done so that the donor can be tested twice over 6 months to ensure that he does not have any number of infectious diseases, including human immunodeficiency virus (HIV).
• Frozen sperm are less effective than fresh sperm.

Complete the special treatment information form (PDF)(What is a PDFdocument?) to help you understand this treatment.

References

Citations

1. Bhattacharya S, et al. (2010). Female infertility, search date October 2009. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
2. Fritz MA, Speroff L (2011). Male infertility. In Clinical Gynecologic Endocrinology and Infertility, 8th ed., pp. 1249-1292. Philadelphia: Lippincott Williams and Wilkins.

Credits