Artificial insemination

Artificial insemination consists of introducing sperm into the woman’s uterus. Unlike in vitro fertilization, in artificial insemination (or sperm transfer) fertilization takes place within the woman’s reproductive system and not in a laboratory.

This procedure within assisted reproduction is ideally performed in the following cases:

• For couples where the woman is younger than 37.
• In case of short sterility time (less than 2 years)
• For permeable fallopian tubes
• In the case of slight deviations of the sperm

Also feasible for single women or same-sex couples of two women. In these cases, the use of a donor name is necessary.

The whole process of artificial insemination usually takes 8 to 10 days and consists of 5 phases:

1. Fertility Study

Even if the future mother is younger than 37 years, a detailed fertility study must still be performed in advance. This first step is unavoidable because not necessarily advantageous conditions could arise and possibly then another treatment method of the whole reproductive range would be proposed, such as in vitro fertilization.

At this stage, the oocyte reserve is checked and possible problems in the reproductive system (not only in the oocytes) that could contribute to complicating the pregnancy or even prevent the pregnancy itself are excluded. Furthermore, chromosomal abnormalities can be detected in time that could hinder the pregnancy or avoid passing hereditary diseases to the baby. At this stage, the permeability of the fallopian tubes and sperm quality are also determined in heterosexual couples.

2. Stimulation of the ovaries

In young women and with a good oocyte reserve, the patient could undergo treatment without stimulation, i.e. follow the natural course of the menstrual cycle. Nevertheless, we recommend undergoing ovarian stimulation to increase the chances of successful treatment.

This consists of the controlled administration of daily hormone injections and other medications to promote the maturation of several follicles at the same time (although ideally the number of follicles should not exceed three). This phase lasts 10–12 days from the moment of menstruation, and during this time a comprehensive follow-up of the development of the oocytes is performed by ultrasound and blood analysis.

3. Preparation of the semen

If the male sperm were to be used, a sperm sample would have to be submitted to the andrology laboratory, where it would be processed. Only the spermatozoa with the highest fertilization potential are used. This process is also known as „capacitation of sperm“ and these sperm are candidates for fertilization as „capacitated sperm“.

In the case of sperm donation, the sample is frozen without prior capacitation, and once thawed, capacitation is then performed.

4. Finding the exact right time for insemination

To ensure the highest possible margin of success. Is it essential for artificial insemination to be performed at the perfect moment? This means at the same time as ovulation. The control ultrasounds allow the gynecologist to know when the follicles reach an appropriate number and size for this.

Then the time has come to administer the last hormonal drug that triggers ovulation. Then the exact date is arranged to organize the actual insemination -using the previously capacitated sperm sample.

It is a simple and quick procedure (the whole process takes only a few minutes). Insemination is performed in the office under the highest safety precautions. It is not painful, nor is anesthesia or sedation needed. The sperm is simply inserted vaginally into the uterus, with the help of a thin and flexible cannula.

Once insemination is complete, the patient is able to sit up, is discharged, and can then go about her normal daily activities.

5. Pregnancy Check

Artificial insemination simply brings the spermatozoa closer to the egg at the optimal moment to be fertilized. If ovarian stimulation has preceded, there are more chances that this encounter will happily end in fertilization. Nevertheless, this process must take place naturally. In case fertilization occurs, the embryo should also implant and grow naturally in the uterus.

It is important to remember that this whole process is naturally part of the female reproductive physiology, and medicine cannot accelerate it according to the current state. It is necessary to wait 15 days to check if fertilization has taken place and if the embryo has properly implanted in the uterus. A so-called beta-HCG test is performed in the selected clinic by a blood test and evaluation in the laboratory. Here, the hormone levels of pregnancy are measured in the blood, which allows us to confirm.

7–10 days after that, the patient is asked to have an ultrasound to see if the pregnancy is developing correctly (confirming if there is a yolk sac with embryonic structure).

If all goes well, the expectant mother will be referred to her usual gynecologist for the rest of the checkups during pregnancy.