Insemination

Intrauterine insemination is a simple assisted reproductive technology involving the administration of properly prepared (washed) semen directly into the uterine cavity. It can be performed with the use of semen from:

• partner (AIH),
• donor (AID).

The treatment aims to shorten the distance between the sperm and the egg and thus ease fertilization.

The indications for intrauterine insemination with the sperm of a partner are:

• male factor infertility – reduced sperm parameters, ejaculation disorders, but at least 5 million morphologically normal and motile sperm,
• endometriosis,
• idiopathic infertility,
• inability to have sex,
• cervical factor, abnormal mucus containing antibodies, or preventing sperm migration
• ovulation disorders (also in PCO),
• use of donor sperm due to the male factor of infertility.

Prior testing of tube patency is required.

First, a patient usually undergoes hormonal stimulation to increase the growth of the ovarian follicles with a goal of 2-3 mature follicles. Insemination can be performed during the natural cycle without hormonal stimulation. Oral or injectable medications are introduced to stimulate follicular growth and development. Frequent cycle monitoring visits with a US scan (and sometimes a blood test) are necessary to monitor growing follicles.

When the follicles reach the appropriate stage of maturity (diameter at least 18-20 mm), special medication to trigger ovulation is given to make sure that oocytes are fully matured.

24-36 hours after the trigger, the insemination is performed.

Intrauterine insemination is painless and is similar to a regular vaginal ultrasound. A very tiny catheter is inserted through the vagina and cervix, and properly prepared sperm is injected directly into the uterine cavity. After the procedure, the patient remains lying down on the exam table for about 10 minutes.

The effectiveness of insemination is lower than that of IVF, usually just above 15%.