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Artificial Insemination

It is one of the techniques used in Assisted Reproduction programs. It consists of placing sperm treated in the lab inside the uterine cavity following mild ovarian stimulation and ovulation induction.

ivf spain

Steps

The steps in this process involve ovarian stimulation, semen preparation and the placement of the treated sample into the uterus. These steps are common to both artificial insemination with husband’s sperm and donor sperm.

Ovarian stimulation ivf spain

In most of the cases, a woman will physiologically experiment the growth of an egg which is released into the fallopian tubes for it to be fertilized on the fourteenth day of the menstrual cycle.

In Artificial Insemination the aim is a mild, controlled stimulation of the ovaries to increase the chances of pregnancy. This ovarian stimulation induces the growth of the follicles (ovarian structures containing the eggs) by the use of medication to make them grow.

It is important to limit the quantity of mature eggs to 2-3 in order to reduce the risk of multiple pregnancy while keeping a success rate reasonable for the technique.

The gynecologist specialized in assisted reproduction leads the whole process of ovarian monitorization including ultrasound scans and hormonal tests for a thorough and individualized follow-up to enhance the efficiency of each cycle.

Sperm preparation

On the same day the insemination is to take place, a sperm sample should be obtained to be processed in the Andrology Lab. A sperm capacitation test is carried out to separate and concentrate in a 0,4-0,5 ml volume the sperm in the sample that present best quality for their later insertion in the uterus.

Insemination

It is a painless procedure not requiring anesthesia performed in the gynecology office with a duration of 30 minutes. It consists of the insertion of a catheter through the cervix into the uterus and the placement inside of the capacitated sperm sample.

Insemination is performed right before the egg is released from the ovary and pulled by the fallopian tubes. This process takes place 38-40 hours after ovulation induction (administration of the human chorionic hormone (HCG)).

Types of insemination

Depending on the origin of the sperm sample used for insemination, there are two types of techniques:

  • Sperm sample from the partner (HAI).
  • Sperm sample from the partner (HAI).
Sperm sample from the partner (HAI)

In this type of insemination the semen sample is provided by the partner. We advise that a maximum of 4-6 cycles is done in a consecutive fashion as the cumulative probabilities of pregnancy are increased.

    Indications
  • Inability to deposit the semen inside the vagina (hipospadias, retrograde ejaculation, erectile dysfunction, vaginismus)
  • Mild or moderate male factor (when MSR Test allows for the recovery of more than 5 million spermatozoa with good motility)
  • Ovulatory dysfunction (anovulation, polycystic ovaries -routinely corrected with hormonal treatment).
  • Cervical factor (alterations in the cervical mucus)
  • Endometriosis (mild level, grade I and II).
  • Sterility of unknown origin (couples where all the tests performed come back normal, but pregnancy is not chieved).
Sperm sample from the partner (HAI)

In this type of insemination the semen sample is produced by an anonymous donor and is provided by a Semen Bank.

Semen Banks are medical centers authorized by the Health Administration to perform donor selection, study of seminal quality, freezing and distribution of the semen samples to Assisted Reproduction Centers. Donor selection involves a thorough study including seminal and health controls to avoid the transmission of hereditary and infectious diseases. The assignation of a sperm donor to a recipient woman or couple is based on the maximum phenotypical similarity (race, type of skin, eye colour and hair colour and texture) and immunologic similarity (blood group and Rh) between them.

    Indications
  • Azoospermia (absence of sperm either in the ejaculate or in the testicle)
  • Hereditary genetic diseases of male origin, non susceptible to Preimplantation genetic diagnosis
  • Altered FISH
  • Single mothers
  • Female couples