Artifician Insemination

The procedure of Artificial Insemination was originally being performed on animals (cattle) for breeding. Later experts started using the same procedure on humans.  Artificial Insemination refers to the process of injecting sperms into the uterus or fallopian tubes or near the ovaries of a woman using an external device.  IntraUterine Insemination (IUI) is the most common method employed for artificial insemination.

Under what conditions a sexologist or a gynaecologist recommend Artificial Insemination?

The answer to this question depends on the physical health condition of man and woman or both.

In case of women:

1. If the women is not able to conceive after one year of unprotected sex
2. If she is having problems with her menstruation (irregular periods etc)
3. If the woman is aged over 40.
4. If the cervix of a woman is not able to produce enough mucus to allow sperm to travel to the egg. Or if the mucus is too much blocking the travel of sperm to the eggs. In some cases, the mucus can be too toxic for the sperms and they die before reaching the egg.
5. If the woman is suffering from a condition called ‘Endometriosis’. In this condition, the lining of the uterus that is supposed to grow inside grows outside the uterus. Artificial Insemination’s success depends on the severity of the problem. In mild to moderate cases, success can be expected. In severe cases, chances of failure are higher.
6. If the woman is allergic to the sperm (proteins in the semen), this can also lead to infertility.
7. If the woman has undergone any cancer or radiation treatment, chances of natural conception goes down.

In case of men:

1. If the man is suffering from Erectile Dysfunction, where he is not able to have sustained erections to perform penetrative sex.
2. Azoospermia – When there is no sperm in the semen sample. Complete absence of sperms.
3. Asthenezoospermia – In this case, sperms will be present in the semen but they will not have the ability to swim/travel up to the egg to fertilize it. (Sperm Motility or Mobility Problems)
4. Oilgozoospermia – When there is not enough quantity of sperms in the semen.
5. Teratozoospermia – This refers to abnormal sperm morphology (shape of the sperms). If higher percentage of sperms is not normal, that can lead to infertility in man and couple.

There are conditions when every report of man and woman are normal, still the couple are not able to beget a child. In such cases too, artificial insemination is performed by the specialist.

Before the insemination procedure:

Depending on the health condition of the woman:

1. Ovulation kit will be provided by the doctor to check the exact day of ovulation.
2. Medication may be given to make the woman ovulate. Some medicines may result in release of multiple eggs.

Healthy and fertile men will be advised not to masturbate or ejaculate for at least 3 to 5 days before collecting the semen.  In most cases, the semen will be collected at the clinic, in a private room. But, for couple living closer to the clinic, the sample can be collected at home. Read the following article to know ‘How to collect semen sample’?

Semen collected less than an hour can be directly used for artificial insemination. Otherwise, the semen needs to be ‘washed’ and then used. In cases where there are weaker sperms present in the semen, a process called ‘centrifuge’ is done to collect the strong sperms. This results in increased chances of conception.

Success rate of Artificial Insemination in the first attempt is only between 5 to 15%. You gynaecologist will/must keep you informed about this.  A maximum of 6 attempts must be made in this procedure. With every attempt, the chances of getting pregnant go up.  However, if pregnancy is not achieved even after 6^th attempt, it is not advisable to try again because, the odds drop drastically.

During the procedure

The woman is made to lie down on a table. Her vaginal walls are separated with a speculum. The doctor then takes the separated, healthy and potential sperms into a catheter and injects them into the uterus through the cervix.  A simple procedure which has to be done with utmost expertise. In very few cases, discomfort and little bleeding may be experienced but that won’t continue for more than a day.

Once the insemination process is done, the woman is made to rest in lying down position for an hour. This gives time to the sperms to swim to the egg and fertilize it. Pregnancy can be confirmed after 2 weeks with regular pregnancy test kits.

What are the risks associated with Artificial Insemination?

1. Medicines given for ovulation can result in release of multiple eggs. In this case, twins or triplets can be expected.
2. When more than one egg fertilizes, the chances of miscarriage increases. In some cases, premature birth may also happen.
3. Ovarian Hyperstimulation Syndrome – Fertility medication and IUI process can result in swelling of ovaries. Most of the times, the symptoms (bloating, abdominal pain, nausea, vomiting) will be very mild and can be treated with normal medicines. In severe cases, hospitalization may be required.