There are two possibilities when talking about artificial insemination: either the woman’s husband’s sperm, previously prepared in the laboratory (artificial insemination by husband, AIH), or a known or anonymous sperm donor, selected and prepared in the laboratory (artificial insemination by donor, AID) can be used.
Indication of partner sperm or AIH:
- Failure in obtaining a gestation performing arranged intercourses.
- Ovulation alteration.
- Anomalous interaction between spermatozoa and cervical mucus: positive antisperm antibody binding.
- Low number, motility and spermatozoa anomalies.
- Difficulties of spermatozoa entering the uterine cavity.
- Ejaculation alterations.
- Unexplained male unfertility
Indication of donor sperm or AID:
- Secretory azoospermia (nor spermatozoa neither sperm cells in testicle).
- Bad sperm quality not allowing AIH (high number of spermatozoa with no motility, anomalous or died ones); those who failed when performing AIH or do not want to follow IVF.
- Genetic or chromosome alterations of the couple.
Before the partner or donor insemination is performed, ovulation will be triggered with an injection of human hormones (FSH y/o HMG). Administration of hCG is performed when the cycle is correct, that is to say, there is a good number of follicles in ovulation stage. One or two inseminations during each cycle can be performed after personal and cycle characteristics. In our Clinic, we perform two inseminations, because a highest number of pregnancies is reached, following published works.
If more than four follicles are developed in ovulation stage, the cycle will be cancelled because of high risk of multiple pregnancy.
Insemination allows best quality spermatozoa (by concentration and training developed in the laboratory) to be placed into the uterine cavity after the cervix, just near the fallopian tube. Ovulation induction normally produces more than one egg too; depending on pathology, we could be interested on achieving just one egg. All conditions are prepared for the fecundation to be performed inside the woman’s body.
Intrauterine insemination advantages are: little invasive procedure, low emotional risk, with no pain, and where no anaesthetic is required because introduction of the spermatic sample is performed with a fine and flexible catheter.
Normally, a treatment is indicated to the patient after insemination; progesterone is mainly administered to improve the development of the possible gestation.
Following scientific bibliography, success percentage depends on indications. But in general between 4 and 14% is reached when performing artificial insemination by husband in each cycle. Following our own statistic, a 20 % of pregnancies is reached in our Clinic in each patient and cycle, changing depending on indication.
Success improves when talking about artificial insemination by donor, where between 20% and 40% in each cycle is reached. At MAR&Gen 38% is reached. Miscarriage possibilities once the pregnancy has begun are the same as in a natural cycle. There is not a bigger percentage of neither malformations nor genes alterations in babies conceived after that technique.
Following our protocol, we perform 2 or 3 insemination cycles. Our won data and the studied bibliography show a slow down in success percentage in each cycle. In Vitro Fertilization will be advisable in these cases because, although a complete study of infertility is made, we do not know details about the joining of spermatozoon and egg.
NOTE: Special circumstances when artificial insemination by donor is performed.
- Gametes donation is unknown. This way, the recipient is not allowed to have her own donor. But the recipient is allowed to ask for a donor with some characteristics similar to those of her male partner, such as height, weight, eyes colour, hair colour, skin colour and blood group (following the Spanish Law).
- Nonetheless, our team will take full responsibility about donor election. They must choose one donor as similar as possible to couple characteristics and woman’s family. Any case, the couple must give their consent.
- Donors must be legally of age. Several exams about phenotype, immunological, genetic and hereditary characteristics, together with infectious and transmitted diseases, must be performed.
- Following the Spanish Law, maximum of births after same donor is 6.