Artificial insemination is a method of treating infertility by inserting semen directly into a womb.
Medical scientists developed the procedure to breed livestock. Since then, they have adapted the technique for use in humans.
Intrauterine insemination (IUI) is the most common method of artificial insemination.
Artificial insemination can benefit couples or individuals with a range of needs.
In the United States, 6 percent of women aged 15 to 44 years are unable to conceive or maintain a pregnancy after one year of unprotected sex.
The Centers for Disease Control and Prevention (CDC) suggest that a woman should consider seeing a fertility doctor to discuss treatment if she is:
- unable to conceive within one year of trying
- prone to irregular periods
- over 35 years of age and trying to conceive
Doctors also recommend fertility treatment if a woman has two or more spontaneous miscarriages.
IUI can help in the following medical situations:
- IUI can help support a couple that produces healthy sperm and eggs but is unable to have intercourse, possibly due to a medical condition, such as erectile dysfunction.
- In women with cervical factor infertility, the cervix either does not produce the mucus that helps sperm travel to the womb, or the mucus contains a substance that kills the sperm. Artificial insemination can help bypass this problem.
- Endometriosis causes the cells from the womb lining start to grow outside the womb, for example, in the ovaries or the fallopian tubes. Artificial insemination can be successful in mild to moderate cases of endometriosis. Many women with endometriosis can conceive naturally.
- In rare cases, a woman may have an allergic reaction to certain proteins in sperm or semen. The artificial insemination can remove most of these before applying the sperm.
- Some men are unable to produce enough sperm for successful fertilization, or their sperm may not be sufficiently motile. This means the sperm cannot move towards the egg effectively.
- Certain medical treatments carry infertility as a risk, such as radiation therapy.
Before the treatment, a man can freeze some of his sperm for future use in artificial insemination.
In some couples, there is no clear reason for infertility, but the doctor may recommend IUI regardless.
The important parts of an IUI procedure are obtaining and preparing the semen sample and implanting it into the uterus.
Preparation of the semen sample
The sperm may come from a partner, but this is not always the case. If a partner cannot provide sperm, a woman can choose to receive a sperm donation.
This is an option for single women, women in a same-sex relationship, or in cases where the male partner has infertility.
If the procedure uses a donor, they will provide the sample will to a sperm bank. The staff at the facility then quarantines the sample and tests it for any transmittable diseases.
The facility keeps the sperm frozen and thaws it out before making any preparations. Before the freezing process, they add a chemical called cryptoprotectant that protects the sperm in cold storage.
If the partner is donating his semen, the couple will provide the sample.
There are several methods for achieving this using:
- a collection condom that collects semen during sexual intercourse
- surgical sperm aspiration, where a physician removes sperm directly from the male reproductive tract
- vibratory or electric stimulation if the male cannot ejaculate without assistance or devices
Once the clinic has the sperm, they “wash” it to remove elements that could interfere with fertilization.
What happens during an IUI?
Insemination is ready to begin after preparation.
During the procedure, the fertility doctor implants the sperm directly into the uterus with a fine catheter, keeping the vagina walls open using a speculum. The catheter enters the uterus through the cervix, and the doctor pushes the sperm through the catheter.
For the best results, IUI normally occurs very soon after ovulation. The ovaries have only just produced eggs, at fertility is at its highest during this point in the menstrual cycle.
Most women ovulate approximately 2 weeks after the first day of the cycle.
The doctor may give the woman an ovulation prediction kit (OPK). This is a device that detects hormone levels in the urine or saliva, giving an accurate prediction of the ovulation date.
There are a few risks when undergoing artificial insemination.
The risk of conceiving twins or triplets increases if a woman receives IUI at the same time as other fertility medication, such as gonadotrophin.
A pregnancy with more than one fetus increases the chances of complications, such as premature birth or miscarriage.
Nowadays, doctors only prescribe fertility medication when there are difficulties with ovulation, or producing the egg cells from which an embryo develops.
Ovarian hyperstimulation syndrome (OHSS) can the ovaries to swell after combining fertility medication and IUI. It is rare, and symptoms are usually mild-to-moderate, but it can sometimes have serious complications.
In mild cases of OHSS, symptoms include bloating, slight abdominal pain, and possibly nausea and vomiting. More severe cases may feature dehydration, chest pain and shortness of breath.
Staying hydrated and taking paracetamol normally alleviates the pain, but more severe cases may require hospital treatment.
While IUI is less effective than more intensive procedures, such as in-vitro fertilization (IVF), it has a 5 to 15 percent chance of success during the first insemination.
This chance dramatically increases by the sixth insemination for women who are less than 40 years of age, according to a 2013 study in a German clinic.
In the study, the average number of cycles before a successful conception, or one that led to a live birth, was 2.24.
However, doctors do not recommend more than six cycles of IUI, as the chance of a successful conception after the sixth cycle are very small.
At this stage, try an alternative method, such as in-vitro fertilization (IVF).
After IUI treatment, the woman should wait 2 weeks before taking a home pregnancy test, because pregnancy hormones will not show in a test before then.
the physician may suggest a blood test for a more accurate result.
Artifical insemination, or IUI, is a procedure to help conception in a woman experiencing infertility.
The fertility doctor injects sperm is into the womb using surgical tools. A couple will often receive IUI if a man or woman experiences infertility due to an underlying condition or previous treatment.
The clinic collects a sperms sample from a male donor, stores it in extremely low temperatures, and then implants it into the uterus.
A few cycles may be necessary before a pregnancy occurs, but the procedure has a high rate of success by the sixth cycle.
Is my insurance likely to cover artificial insemination?
Some commercial insurance companies cover IUI and infertility services. It depends on the carrier and the locality and varies greatly between policies.Valinda Riggins Nwadike Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.