Artificial insemination is an assisted reproduction treatment that consists of introducing in the woman’s uterus, at the time she is ovulating, a sperm sample which has been prepared in the lab and in which the sperm cells with the highest fertility capacities have been concentrated, with the aim to generate a pregnancy. This is a treatment that is very simple to carry out and without any discomfort for the patient, which at the same time offers very high success rates.
At Amnios in Vitro Project we use the latest technology and have an expert medical team that allows us to offer the highest possible success rates to our patients for their treatments.
In order to decide when artificial insemination with your partner’s sperm is the right technique, the first thing that needs to be done is a sterility study. Generally, this is required in the following cases:
- Couples in which the man has a somewhat lower amount of useful sperm cells.
- Couples in which the woman suffers anomalies ovulating.
- Couples in which the woman has one altered or obstructed fallopian tube, but the other one works properly.
- Couples suffering sterility without a known cause; when no concluding factor is found that causes the lack of pregnancy.
Artificial insemination with donor sperm is a necessary technique in the following cases:
- Women without a male partner.
- Couples where the man has a severe alteration of the sperm cells.
- Couples where the man does not produce any sperm cells.
The artificial insemination treatment we offer at AMNIOS can be carried out in a natural or induced cycle, independently of whether the sperm sample is obtained from the partner or a donor. In any case, the selection of one or the other method depends on various factors, like the woman’s age or the results of the previous fertility study.
The conditions for artificial insemination in a natural cycle are:
- A normal ovarian reserve.
- Normal ovulation cycles.
- Open fallopian tubes (permeable).
With this kind of treatment, we start testing for ovulation through urine samples from day 10 of the cycle (bearing in mind that in a 28 day cycle, usually the woman ovulates around day 14). Once we detect ovulation using the test, we will proceed to prepare the insemination, which is to be carried out the next day.
The main differences compared to the natural cycle are that there is no need for medication, therefore this is somewhat less expensive and that, making use of natural ovulation, the risk of a multiple pregnancy is the same as in a spontaneous pregnancy (around 1%), since the ovulation is not induced.
The success rates of this technique depend on the woman’s age. In women under 38 this rate is about 10-15% per attempt, a not very high percentage (this is the main disadvantage of this technique). The insemination in natural cycle is not recommended for women over 38, due to the low results.
In case this technique does not work in 3 to 4 cycles, artificial insemination using induction of ovulation would be considered.
In the case of artificial insemination with induced or stimulated cycle, the ovulation is induced before the moment of insemination. The treatment starts with a vaginal ultrasound on the second or third day of the cycle, to check that the ovaries are resting and that the ovarian stimulation can commence.
At this moment, the ovarian induction process starts. To do so, the woman gets injected with a hormone (FSH, follicle stimulating hormone) according to the instructions of her specialist. The aim of this stimulation is to obtain 2 or maximum 3 follicles. The process is controlled by means of ultrasound, until it is detected that there are between 1 and 3 follicles of adequate size, i.e. larger than 17 or 18 mm. At this moment, the maturation of the egg cells of the follicles is induced by injecting hCG. The insemination is programmed with in the next 36 hours after the injection of this last hormone.
The ultrasound checks are fundamental to avoid the risk of multiple pregnancies. At times, the ovaries react more strongly than expected and it is then necessary to cancel the cycle. In an ovarian induction cycle for artificial insemination normally two or three ultrasounds are needed.
The main advantage of ovulation induction is that the pregnancy rates are higher (around 20-25% per attempt). The inconvenience however, is that the risk of twin pregnancies is increased (up to 20% of all pregnancies). This also involves extra costs for the treatment.
In women of over 38 we should consider ovarian induction from the start, to increase the chances of success. In women of less than this age, it is possible to start the treatment during the natural cycle.
The sperm for artificial insemination can proceed from the couple itself or from a donor.
The selection of the sperm donor is done based on the physical profile of the man (height, weight, eye colour, hair colour en texture, skin colour, blood group and Rh factor). In case of women without a partner, the selection of the donor depends on the norms as set by the patient.
All our donors have been studied and selected according to the legal requirements in Spain, as established in the Assisted Reproduction Law of 2006, approved by the Royal Decree 1301/2006. Once a donor meets with all these requirements, the sperm sample is frozen and preserved in our sample bank, ready to be used for a treatment with donor sperm.
After a certain number of artificial insemination cycles, many women have achieved pregnancy. However, not in all cases this treatment ends successfully. This may be due to the existence of some pathology (like endometriosis, for example) which might be detectable, or may be difficult to diagnose.
Unsuccessfully ending the artificial insemination treatment, should not mean you have to give up on getting pregnant. There are other treatments that can help you reach your goal. In this case, the next step after artificial insemination is in vitro fertilisation.
Si ya te has sometido a ciclos de inseminación artificial sin éxito, no te desanimes. No es recomendable llevar a cabo más de cuatro ciclos, ya que a partir del cuarto ciclo las probabilidades de éxito descienden notablemente. Si no has llegado al cuarto ciclo, los primeros ciclos pueden aportar una valiosa información que nos ayude a determinar el origen del problema, pudiendo optimizar el procedimiento de cara a futuros ciclos, aumentando así las probabilidades de embarazo.
Acude a una consulta gratuita en AMNIOS, donde valoraremos cómo mejorar tu tratamiento y sus probabilidades.