Human Artificial Insemination

A fertility doctor will go over artificial insemination options with you after an exam.
By Amy Hoover

Using human artificial insemination techniques to get pregnant is less invasive and potentially less costly than other forms of infertility treatments.

Candidates for Artificial Insemination

A couple who has been trying to get pregnantwithout success will often be referred to a fertility doctor who can discuss the option of artificial insemination. Persons who may be good candidates for an artificial insemination procedure include those with these conception problems:

Men with low sperm count Men with ejaculation problems or sexual dysfunction Women with forms of endometriosis Women with cervical mucus issues Unexplained infertility problems

Couples who experience male infertility may choose to use donor sperm in their artificial insemination process. Donor sperm can also be used if a woman does not have a partner, although some clinics may not treat single women. Before undergoing the artificial insemination procedure, most couples will be required to have full screenings. This may include blood tests, hormone tests, sperm sample tests, and ovulation tests. Depending on the woman's ovulation, she may need fertility drugs in conjunction with artificial insemination to produce a stimulated cycle.
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Artificial Insemination Techniques

Although artificial insemination has come to be synonymous with intrauterine insemination (IUI), it also refers to several other ways of becoming pregnant using assisted techniques. While some of these insemination methods may not be widely used, they are available and might be worth looking into depending on your particular fertility problems.

Intrauterine Insemination (IUI)

Intrauterine insemination is one of the first treatments doctors will use after a fertility problem occurs. This technique is the most commonly used of all the human artificial insemination procedures done today. It involves washing and preparing sperm before using a catheter to place the sperm into the womb at the time of ovulation. Procedural methods may vary slightly from doctor to doctor. Higher success rates have been found with this technique that other artificial techniques, although rates vary widely depending on the fertility problems, drugs used/not used, and maternal age. Success rates tend to be in the range of 10 to 20 percent.

Other Insemination Techniques

Besides IUI, the procedure can also be done by:

Intracervical insemination: Semen is placed into the cervix. Intrafallopian (or intratubal) insemination: A technique that uses a catheter to place semen into fallopian tubes.

Intravaginal insemination: Placing semen into the vagina before ovulation using a safe syringe; this insemination is typical of a home insemination.

Intraperitoneal insemination: Injection of semen using a needle through the top of the vagina into the peritoneal area.

All artificial insemination techniques require close monitoring of the woman's ovulation cycles so that insemination can be performed between 24 and 48 hours before ovulation occurs. Cycles can be monitored by a doctor through blood tests and ultrasounds (common for women on fertility drugs) or by women at home using ovulation prediction kits. Approximately two weeks after the procedure is performed, the woman will take a pregnancy test. If it is positive, she will then be schedule for an ultrasound to check for pregnancy viability and multiple embryos.

Risks of Human Artificial Insemination

As with any medical procedure, artificial insemination carries risk. Two of the biggest worries may be that of failure and of being inseminated using the "wrong" sperm. Considering the high cost of infertility treatments, you should choose one that has the least chance of failure according to your

fertility problem. To avoid semen mix-ups, screen your doctors and clinic carefully, asking how semen is labeled and stored. Instances of multiples in pregnancy go up when fertility drugs are used in conjunction with artificial insemination techniques. Carrying several babies at a time comes with risks not only to the mother, but to the unborn children as well. Various fertility drugs also have side effects and risks that should be discussed with a doctor before undergoing treatment, including that of ovarian hyperstimulation syndrome (OHSS). If OHSS or other unwanted side effects occur while using fertility drugs, let your doctor know immediately before you continue your treatments. Mild pain or discomfort may be felt during the insemination procedure, but it does not pose a high risk for the woman being inseminated.

Human artificial insemination is one of the least invasive forms of infertility treatments available. While it can be performed on a woman with natural cycles, the success rates do rise if fertility drugs are also used. Few risks are associated with the actual procedure itself, and the cost can be significantly less than that of in vitro fertilization.

Fertility treatment: Intrauterine insemination (IUI)

Written for BabyCentre UK Approved by the BabyCenter Medical Advisory Board

Who might benefit? How it's done How long will treatment last? Success rate What are the advantages? What are the disadvantages?

Intrauterine insemination (IUI) has a long history and is much less "hi-tech" than some other methods of assisted conception.

In IUI, warmed prepared sperm is introduced into the woman's uterus (womb) at around the time of ovulation, with the aim of getting the sperm nearer to the egg.

The procedure is often combined with fertility drugs.

Who might benefit?

IUI can help couples where the man has a low sperm count or poor motility (the ability of the sperm to move), as long as there are sufficient levels of healthy, motile sperm to make the treatment worthwhile. If not, IVF or ICSI will be more suitable. Different clinics use different criteria to decide whether the quality of sperm is sufficient for IUI.

Because sperm is placed directly inside the woman, IUI can also help couples who are unable to have intercourse because of disability, injury, or difficulties such as premature ejaculation.

It is also recommended for women with mild endometriosis, and is often used as the first line of assisted conception treatment for couples with "unexplained infertility".

Women without a male partner may also want to have IUI, as using sperm donated through a clinic has a number of advantages over self-insemination at home. Read our article on donor insemination to find out more. Not all clinics treat women who do not have a partner; use the the HFEA website to find out more about clinics near you.

How it's done

Depending on your particular fertility problem you may or may not be advised to usefertility drugs alongside the IUI treatment. If fertility drugs are used it is called a "stimulated cycle" because the drugs stimulate ovulation. If drugs are not used it is called an "unstimulated cycle" or "natural cycle".

Stimulating ovulation is not recommended alongside IUI if its only your partner that has the fertility problem, or if the reason for infertility is unexplained. This is because there is a much greater risk of a multiple pregnancy in these cases.

While many couples with fertility problems think that twins or more would be a great way to start a family, the reality is that multiple pregnancies increase your risk of miscarriage and other pregnancy complications. (Read more about risks associated with multiple pregnancies.)

In unstimulated cycles, IUI is timed to take place at the time of natural ovulation. You may be asked to detect ovulation using an ovulation predictor kit, or your doctor may track your cycle using blood and urine tests. IUI is

usually done between about day 12 and day 15 of a natural menstrual cycle, but the exact day will depend on your particular cycle and when ovulation is detected.

If your fertility specialist has offered you IUI during a stimulated cycle, you'll probably be given fertility drugs in the form of an injection and nasal spray. You'll start taking the drug near the beginning of your menstrual cycle to stimulate your ovaries to develop several mature eggs for fertilisation. (You normally release only one egg a month.) Your doctor will use ultrasound to detect ovulation and make sure that insemination is carried out at the optimum time. You may ovulate naturally, or be given an injection of the hormone hCG (human chorionic gonadotrophin) to bring this on.

Once you ovulate, your partner produces a sperm sample, which is "washed" to extract the best quality, most mobile sperm. Using a catheter (tube) through your cervix, doctors then put this sperm directly into your uterus near a fallopian tube (the passage the egg travels along from an ovary to your uterus). This is IUI.

If you have unexplained infertility, the sperm may be inserted within a larger volume of fluid than usual so it can wash up into the fallopian tubes more easily. This technique takes a few minutes more than standard IUI and is known as "fallopian sperm perfusion". It has been shown to increase the chances of success in cases of unexplained fertility.

You rest for a short time afterwards and then carry on life as normal. You'll be able to take a pregnancy test in about two weeks.

How long will treatment last?

The insemination itself is straightforward and takes only a short time but, if you are having a stimulated cycle, you'll be on fertility drugs before you ovulate.

Success rate
Success rates depend on the causes of you and your partner's infertility and your age. You're more likely to conceive if you're trying to solve a cervical mucus problem than a sperm quality problem. The success rate for IUI with fertility drugs is about 15 per cent per cycle.

What are the advantages?

This procedure can be an effective solution for men with a low sperm count or poor sperm motility, where the sperm can't make the long journey to the egg. It's also a useful technique for couples who have problems because the man's

sperm can't get through the woman's cervical mucus, perhaps because of an immune reaction. It can only work for couples where the woman has no fallopian tube blockages.

Donor sperm can be used in cases where the man is producing no sperm at all, or where a woman wants to have a baby on her own or within a same-sex relationship. In the latter case, the advantages of going to a clinic for IUI with donor sperm include proper screening of the donated sperm for infections such as HIV and hepatitis. The legal rights and responsibilities of the father if the baby is conceived using fresh sperm do not apply if frozen donated sperm is used.

What are the disadvantages?

Because timing of the insemination is so crucial, your partner must be able to produce a sperm sample by masturbating into a cup at your doctor's office or clinic. The procedure can also be uncomfortable for some women if it proves difficult to insert the catheter and also because IUI can cause cramps similar to period pains.

With stimulated cycles there is also a risk of developing the potentially dangerous condition known as ovarian hyperstimulation syndrome (OHSS). This happens when your ovaries respond too well to the fertility drugs used to induce ovulation. The ovaries rapidly swell up to several times their normal size and can leak fluid into the abdominal cavity, making you gain weight and feel full and bloated.

It is vital that you seek medical help if you think you are experiencing hyperstimulation. You may need to stay in hospital while your ovaries settle down, and your doctor will probably advise cancelling your IUI treatment for this cycle as the risks of conceiving a multiple pregnancy are too great. Read our article for more information on the warning signs of OHSS.

Artificial Insemination Precautions Issued by the FDA

Artificial insemination is the introduction of sperm into the reproductive tract of a woman, by means other than sexual intercourse, with the express intention of fertilizing her. In humans, it is known as assisted reproductive technology, and is resorted to in cases of infertility and when a woman without a male partner wishes to have a child through a donor sperm. The sperm donor becomes the genetic or biological father of the child and the woman the genetic and gestational mother.

The process is to take freshly ejaculated sperm, thaw it out and place it in the cervix or uterus. Generally a woman undergoing this treatment is prepared for it, a process that takes about 4 to 6 weeks before the proposed insemination. Furthermore it is done at a time when her biological functions are suitably receptive. When sperm is collected by a sperm bank, the donor is first tested for transmissible diseases. The sperm is then frozen and quarantined and then suitably treated to increase the density and motility, and facilitate conception, before use. Every care is taken to ensure that the donor sperm if free from disease or other infections. Nonetheless, the Public Health Service has recommended certain added precautions to prevent the transmission of the AIDS virus through donated sperm. Since 1985, the new guidelines are that all prospective donors should be screened for the presence of AIDS anti-virus in the blood on two occasions - the first at time of donation and the second test after a lapse of at least six months. The rationale behind this is that an infected person may initially test negative because adequate antibodies might not have had time to develop on the first occasion to show up in a blood test. Six months later the virus would have progressed sufficiently to be easily detected. In the intervening period, the sperm is kept frozen.

Advantages & Disadvantages of Artificial Insemination

For many same-sex couples, AI is one way to build a family.

In human artificial insemination (AI), sperm is placed through nonsexual means into a woman's reproductive system to impregnate her. Once envisioned as a tool of eugenics and coercive population control, in 2011 AI is largely considered one possible way to voluntarily build a family. Before undertaking AI, carefully weigh the advantages and disadvantages, which often are specific to your own family situation.

1. Procedure Risks and Benefits

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AI procedures vary according to the condition of the sperm--fresh or frozen, treated and concentrated or not--and the site where it is placed in the woman's reproductive tract. Insemination can occur high in the woman's vagina or within her cervix, uterus or fallopian tubes. She might take medications so she ovulates more than one egg. Discuss the risks and benefits of each procedure with your fertility specialist. You can guard against many risks by selecting a doctor, fertility clinic or sperm bank that complies with professional and legal standards, such as taking detailed medical histories of sperm donors and screening them for HIV and other infectious diseases.

Reasons
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People undertake AI to conceive, bear and raise children they cannot or choose not to by other means, whether they are infertile heterosexual couples, female same-sex couples or single women.

Some single men or same-sex male couples also seek fatherhood through AI, often with their own sperm, of a surrogate mother. Families created or expanded by AI still face the stigma that they are somehow "abnormal" or "unnatural." At the same time, AI opens up reproductive choices that many people did not have before.

Donor-Related Considerations
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Prospective parents need to honestly weigh for themselves the probable long-term pros and cons of each donor scenario. The donor can be known, such as the prospective mother's husband or a friend. He might be an anonymous or "willing to be known" donor to a sperm bank. Many prospective parents work with sperm banks because the donors generally cannot seek legal parental rights, such as visitation. Others are comfortable with, for example, a donor who plays an uncle-like role in the child's life. Whatever boundaries the parents and/or the law draw, however much or little contact he has with the child, the donor will be a lifelong presence within any AI-created family. Even when happy about their upbringings, most AI-conceived people are curious about their biological fathers.

Other Social and Legal Issues

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Aside from donor issues, the AI-created family may face an uncertain status, even before conception. In the U.S. and elsewhere, health plans, public or private, may not cover infertility treatments or the reproductive plans of LGBT (lesbian-gay-bisexual-transgendered) people. Some physicians, sperm banks and fertility clinics still discourage anyone but infertile male-female married couples from AI. In many jurisdictions, the parental rights of any nonbiological parent may be unclear or tenuous, especially if legal adoption is not possible. Consultation with a knowledgeable family lawyer may be in order. At the same time, families built through "alternative" means such as AI can be loving and resilient as any other.

How To Understand the Disadvantages of Artificial Insemination

By Staff Writer

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Artificial insemination is a process wherein sperm is directly inserted into the reproductive tract of a female using a special device. This is to impregnate the female via a method other than actual sexual intercourse. This method is beneficial to people who suffers from disability, injury or other sexual problems such as premature ejaculation. This process was first developed in the dairy cattle industry. It is primarily used on cows. The cows are inserted with the sperm of a bull to improve milk production. Artificial insemination is used in animals to transmit desirable traits of one male to many females. It is also used to overcome breeding problems. It is commonly used in the cases of sheep, pigs, canines, and honeybees. Although it has a long history of success in cattle and pigs, artificial insemination has only recently been practiced in breeding horses in North America. Artificial insemination is done by placing a freshly ejaculated sperm, which can be produced by the male partner through masturbation. It can also come from a sperm sample which has been frozen and thawed, such as those donated to sperm banks. In either case, the sperm will them be inserted in the uterus by artificial means. A sperm donor usually provides the sperm if the womans partner has a low sperm count. Artificial insemination can be done with a range of techniques. There are different ways to place the sperm into the reproductive tract. These methods include intracervical, intravaginal, intrauterine, intrafallopian and intraperitoneal insemination.

The Side Effects After Human Artificial Insemination

By an eHow Contributor

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The Side Effects After Human Artificial Insemination

Artificial insemination, as stated in Comhaire and Mamoud (2003), has been associated with several dangerous side effects such as congenital abnormalities, impaired development and retinoblastoma in the child. Aside from these issues some couples experience emotional problems in dealing with the social stigma tied to non-coital insemination.

1. Birth Defects
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In a study that analyzed rates of birth defects between naturally conceived children and those conceived though artificial means, Hansen et al (2002) found that children conceived through the latter means were at much higher risk. For example, babies conceived through artificial insemination had an 8.6% chance of having a birth defect compared to 4.2% of naturally conceived babies.

Most likely defects

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Of the seven types of defects that the researchers showcased in their study, only two reached significance as being more prevalent in artificial insemination births. These were cardiovascular, at 1.3%, and musculoskeletal, at 3.3%. In naturally conceived babies, these were at .6% and 1.1%, respectively. The researchers submitted that some of the likely causes of the higher rate of defects could be owed to the advanced age of infertile couples, the underlying cause of the infertility and the medications prescribed during the insemination process.

Multiple Births
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In another study that tested the possible defects associated with assisted conception, Wennerholm et al (2000) found that the majority of cases of abnormalities could not be directly correlated with the practice of artificial insemination alone. Instead, these cases were linked to those that are typically related to prematurity and multiple births, conceived through non-coital or coital means. It must be taken into account, however, that both prematurity and multiple births are more common in cases of assisted conception.

Neurological Effects
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In an investigation that examined children conceived through in vitro fertilization in terms of mental health postpartum, Stromberg et al (2002) observed that cases of cerebral palsy were more common in instances of low gestation age, multiple births and low birth weight as a result of assisted conception. For singleton births, there were no significant effects observed.

Psychological Toll

Another side effect of artificial insemination is of a psychological nature. Clinical psychoanalyst Annie Reed Henderson (2008) says the emotional stress that couples experience during assisted fertilization procedures can result in serious consequences for the relationship. In cases of artificial insemination from a donor, only the female partner can claim a biological association with the child, leaving the male parent to learn how to psychologically cope with this reality. Henderson states that the majority of emotional trauma induced by the sometimes long and drawn-out fertilization procedures could be assuaged by professional psychological counseling.

Artificial Insemination Process

The artificial insemination process has proved to be a boon for many couples who desire to have children, but are unable to conceive naturally. The artificial insemination procedure may require a lot of consideration before you can opt for it, but is surely is an effective option. Read on for more information on the artificial insemination process.

Infertility and the inability to have children could be quite distressing for couples longing to start a family. The artificial insemination process could be a possible solution to most types of infertility problems. The first successful IVF treatment took place in 1981 and since then many infertile couples have been resorting to this procedure as a possible solution to their infertility problem. However, before deciding to opt for the artificial insemination procedure, there are a lot of points to be considered by the couple, especially regarding the length of the procedure and the time and commitment required for its success. Read more on artificial insemination procedure. Process of Artificial Insemination The process of artificial insemination involves preparing and placing sperms directly into the cervical canal or the reproductive tract of the female and does not involve sexual intercourse. Artificial insemination is useful in treating infertility caused due to a low sperm count, problems in the cervical mucus or sperms that are not active. You will need to consult a gynecologist to determine if artificial insemination is the right procedure to treat your infertility problems. Once it is determined that you can go ahead with the procedure, certain medical tests would be conducted for the couple as a part of the preparation for the artificial insemination process. It would be advisable to determine the artificial insemination cost and the time schedule required prior to the commencement of the procedure. Read more on human artificial insemination.

How does Artificial Insemination Work? There are several artificial insemination steps involved in this fertility treatment procedure. Once all the tests have been conducted, the doctor will be able to recommend which artificial insemination method should be opted for. There are three different methods of artificial insemination, the intrauterine insemination (IUI), the intracervical insemination (ICI) and the intratubal insemination. Of these, the IUI and the ICI are the most common methods of artificial insemination, which are easy and safe as well. The intratubal insemination method is comparatively rare due to its low success rates. The following will brief you about theartificial insemination steps. Step# 1: Based on the medical reports, the doctor may or may not advice the female partner to take fertility medication that stimulates production and maturation of eggs. This fertility medication needs to be taken just before the commencement of the menstrual cycle. Step# 2: The woman's ovulation cycle is determined, using body basal temperature and ultrasound and, the hormone levels are closely monitored. Step# 3: A sperm sample is obtained from the male partner, which is 'washed' and concentrated. This needs to be done so that the mucus and non-motile sperms are removed which will increase the possibility of fertilization. Step# 4: At the beginning of ovulation, the sperm is inserted into the woman's reproductive tract, using a catheter in the IUI method or a needle less syringe in the ICI method. Both these methods are painless, but the ICI is a quicker method. If the egg is fertilized, that is, if pregnancy occurs, it can be detected 2 weeks later. The number of artificial insemination cycles that you would need to undergo would depend upon the cause and extent of the infertility problem. Consuming fertility medication during the artificial insemination process will increase your chances of getting pregnant. In case of failure of this process, the stimulated artificial insemination process can be opted for.