Intrauterine (artificial) insemination is one of the modern assisted reproductive technologies used to achieve pregnancy in couples diagnosed with infertility, during which the woman's uterus or her cervical canal the man's sperm is injected.

Indications for a procedure such as intrauterine insemination with the husband's sperm on the part of a man are:

Subfertile sperm (when the fertilizing ability of sperm is reduced or, more simply put, male infertility) ;

Ejaculatory-sexual disorders.

A woman may also have indications for this procedure:

Cervical factor infertility (in which changes in the properties of the cervical mucus are observed, preventing the penetration of a sufficient number of sperm into the uterine cavity);

Vaginismus (when the pubococcygeus muscle involuntarily contracts, making any vaginal penetration impossible);

Increased chances of pregnancy with female infertility.

Before the procedure, the couple must undergo full examination. Artificial insemination, reviews of which can be read on the Internet, is carried out on the days of a woman’s ovulation, which the gynecologist determines in advance. This technology can be used within natural cycle patients, however, practice shows that in most cases it is preceded by hormonal stimulation of superovulation, which somewhat increases the effectiveness of this procedure.

The man is asked to donate sperm 1-3 hours before insemination, although it is also possible to use thawed sperm that has been cryopreserved in advance liquid nitrogen. Currently, before introducing sperm into the uterus, women are required to undergo a processing process, which consists of separating sperm from seminal fluid, for which two or three times reprecipitation of sperm is carried out with dilution of the sperm with a physiological medium in a centrifuge. Previously, it was also possible to use native (unprocessed) sperm, however, without pre-treatment there is a likely risk of developing anaphylactic shock, in addition, thanks to the pre-treatment of sperm, the number of motile sperm increases, and “inferior” ones are eliminated and a sterile one is introduced into the uterus nutrient medium, enriched with a complex of minerals and proteins and containing sperm.

The insemination procedure itself is absolutely painless; sperm is injected into the uterus through a special plastic catheter, to which a syringe with sperm is attached. Fertilization then occurs naturally, i.e. sperm independently reach the egg through fallopian tubes. Intrauterine insemination lasts only a few minutes.

Unfortunately, there are a number of contraindications for women to undergo this procedure: - defects and pathologies of the development of the uterus, which make pregnancy impossible; - tumors and tumor-like neoplasms of the ovary; - acute inflammatory diseases; - malignant formations; - mental, as well as somatic diseases that are a contraindication for pregnancy.

In some cases, after insemination, patients are prescribed progesterone medications to support the luteal phase. This appointment is not mandatory, however, practice shows that taking progesterone drugs is still desirable, since luteal phase deficiency is often detected.

Unfortunately, artificial insemination, reviews of which are further proof, is not a panacea for infertility. As studies show, its successes are quite modest: pregnancy occurs in only 8-12% with a single use of this technique, i.e. much less often than with natural fertilization. The chances of each couple in this case differ significantly and can be 3-40% depending on many factors, such as the duration of infertility, the woman’s age, concomitant diseases, etc. The main conditions for pregnancy using artificial insemination are normal patency of the fallopian tubes and good sperm count. In many clinics, confirmation of tubal patency is prerequisite carrying out the procedure, since the lack of information not only significantly reduces the effectiveness of insemination, but also increases the risk of ectopic pregnancy. The research method can be any: hysterosalpingography, transvaginal or classical laparoscopy, hydrosonography.

Couples are most likely to become pregnant if:

Woman under 30 years of age;

Before insemination, mild stimulation of ovarian ovulation was performed;

All spermogram parameters are within normal limits.

Also an important success factor is the professionalism of doctors, so if a question arises about intrauterine insemination, you should take seriously the choice of the clinic where the procedure will be performed, as well as the choice of a specialist.

On average, treatment with this method covers 3-5 cycles, as a rule, in 87% of patients pregnancy occurs in the first three cycles of artificial insemination, the chances of each subsequent attempt do not exceed only 6%, so if after 3-4 attempts pregnancy still does not comes, the couple is recommended to have more complex methods of assisted reproductive technologies - IVF or ICSI, which have now moved from the category of medical sensations to the category of ordinary medical procedures, confirming in Once again that infertility is not a death sentence.

First this method was used back in 1784 - an Italian doctor performed artificial insemination dogs, as a result of which she gave birth to three absolutely healthy puppies. Intrauterine insemination for a woman was first performed 6 years later, in 1790, by a Scottish doctor.

It should be remembered that reproductive age, unfortunately, is limited, so you should not waste precious time, measured by nature, and at the first suspicion of infertility, contact a specialist who will help determine the cause of non-pregnancy and prescribe appropriate treatment.

For couples facing infertility, auxiliary reproductive technologies become a chance to become parents.

One of the simplest and available methods assisted reproduction is artificial insemination. What is the essence of the procedure? How to behave after insemination? Who is it indicated for and are there high chances of pregnancy?

Artificial insemination - what is it?

Artificial insemination can rightfully be considered one of the first scientific methods assisted reproduction. At the end of the 18th century, the Italian doctor Lazaro Spalazzi first tested it on a dog, resulting in healthy offspring of three puppies.

Six years later, in 1790, artificial insemination (AI) was first tested on humans: in Scotland, Dr. John Hunter inseminated a patient with the sperm of her husband, who suffered from an abnormal penis structure. Today the procedure is widely used throughout the world.

Artificial (intrauterine) insemination is a technology that involves the introduction of male sperm into the cervical canal or uterus of a woman. For this, a catheter and syringe are used. The day for conducting AI is calculated taking into account menstrual cycle patients.

It is necessary to accurately determine the periovulatory period, otherwise the procedure will be useless. The technology is used both in the natural menstrual cycle and in the hormonally stimulated one.

Sperm is obtained outside of sexual intercourse in advance (and then frozen, thawing on the day of AI) or several hours before the procedure. It can be processed or introduced unchanged.

How effective is artificial insemination? The statistical results are not very promising: fertilization occurs in only 12% of cases.

Who is the procedure indicated for?

For women, indications for vaginal insemination are:

1. the desire to become pregnant “for oneself” without having a sexual partner;
2. infertility caused by cervical factors (cervical pathologies);
3. Vaginismus.

Indications for insemination on the part of men are as follows:

• infertility;
• disorders of an ejaculatory-sexual nature;
• poor prognosis regarding genetic diseases inherited;
• sperm subfertility.

In the first three cases, donor sperm is used.

After the procedure: how does the woman feel?

In order to undergo intrauterine insemination, a woman does not need to go to the hospital at all. The procedure is performed on an outpatient basis and lasts only a few minutes.

How does the patient feel? In practice, she experiences sensations that are no different from those during a routine gynecological examination. A speculum is inserted into the vagina, and perhaps the most unpleasant experience is associated with this. They disappear almost immediately after artificial insemination.

Pain may be experienced for a short period of time pulling sensations in the lower abdomen, which is caused by irritation of the uterus. IN in rare cases available anaphylactic shock when introducing unpurified seminal fluid.

To avoid allergic reactions and to improve the quality of sperm, it is recommended to clean it, even if the seed of the patient’s spouse is used as a biomaterial.

How to behave after completion of the procedure?

The gynecologist performing the procedure will definitely tell you how to behave after insemination and warn about possible consequences, will give necessary recommendations. Immediately after the injection of sperm, the woman will need to remain in a supine position for one and a half to two hours.

A small pillow should be placed under the buttocks - an elevated pelvis facilitates better advancement of injected sperm into the fallopian tubes. This increases the chance of conception, for which, in fact, artificial insemination was carried out.

The success rate of the procedure depends on the patient’s age, the state of her reproductive health, and the quality of the sperm used. To improve AI efficiency donor material undergoes processing, as a result of which only the highest quality sperm remain.

So that a potentially fertilized egg can fully develop and implantation of the fertilized egg is successful, it is prescribed hormone therapy progesterone. If three cycles in a row after artificial insemination do not conceive, other methods of assisted reproduction are selected.

What can and cannot be done during insemination?

Fertilization does not occur immediately at the moment of sperm injection; it requires several hours, up to a day, after insemination. What to do to increase the chance of pregnancy?

On the first day you must refuse:

1. from taking a bath, as water helps wash out some of the sperm from the vagina;
2. from douching;
3. from the administration of vaginal medications.

But having sex is not on the list of things that should not be done after insemination; some experts even see a benefit in this: unprotected sexual contact promotes better movement of injected sperm into the tubes.

Conclusion

By following these recommendations after insemination, within a week (that’s how long it takes for a fertilized egg to move into the uterine cavity and attach there) you can conduct a blood test for hCG. This hormone is a marker of pregnancy; it begins to be produced immediately after implantation of the fertilized egg into the uterus. A home express diagnostic method - a pregnancy test - is not advisable to use earlier than 12-14 days. In urine, the concentration of hCG is achieved somewhat later than in the blood.

Video: Intrauterine insemination (IUI)

If the described process occurs during natural sexual intercourse, we are talking about natural ( natural) insemination. At the same time, artificial insemination can be used to develop pregnancy.
IN in this case pre-received men's seminal fluid introduced into the female genital tract artificially ( by using special devices and technician), which can also lead to artificial insemination eggs and pregnancy. Sexual intimacy ( sexual contact) is excluded.

How is artificial insemination different from IVF and ICSI?

During in vitro fertilization, the process of fusion of male and female reproductive cells occurs outside the body of the expectant mother. Pre-obtained eggs are placed in a test tube, where optimal conditions are created to support their vital functions. Then pre-obtained male germ cells are added to the same test tube ( spermatozoa). Through certain time one of the sperm penetrates the egg and fertilizes it. After this, the fertilized egg is introduced into the uterine cavity and attached to its walls. The pregnancy then develops as usual.

One of the types of in vitro fertilization is the procedure of intracytoplasmic sperm injection ( ICSI). Its essence lies in the fact that a pre-selected and prepared sperm is injected directly into the female reproductive cell, which increases the chances of their successful fusion. If fertilization is successful, the fertilized egg is also placed in the uterine cavity, after which a normal pregnancy begins to develop.

Is it possible to choose the sex of a child with artificial insemination?

Indications for artificial insemination with husband's sperm ( homologous insemination) or donor ( heterologous insemination)

The homological method is spoken of in cases where the seminal fluid of the husband or the woman’s regular sexual partner is used during the procedure.
If a woman does not have a permanent sexual partner, and also if his sperm cannot be used for fertilization ( because of various diseases or anomalies), donor sperm can be introduced into the uterine cavity. In this case we are talking about heterological insemination.

It is worth noting that regardless of whose seminal fluid is used for fertilization, the technique of performing the procedure does not change.

Testimony from a woman ( infertility)

Indications for artificial insemination on the part of a woman are:

• Vaginismus. This is a disease of a woman in which the penetration of something into the vagina causes severe spasm ( reduction) muscles, which is accompanied by severe pain. Pain can occur both during sexual intercourse and when using hygienic tampons. It can be extremely difficult or even impossible for such women to conceive a child naturally, as a result of which they may resort to artificial insemination. During the procedure, the woman can be put into a medical sleep, as a result of which she will not experience any painful sensations.
• Endocervicitis. This is an inflammatory disease that affects the mucous membrane of the cervical canal. The cause of the pathology can be various infections, injuries, hormonal disorders, failure to comply with personal hygiene rules, and so on. As a result of the development of the inflammatory process, a woman may experience pain during sexual intercourse. Moreover, this can impede the passage of sperm into the uterine cavity, as a result of which the likelihood of pregnancy with natural insemination will be significantly reduced.
• Immunological incompatibility of the couple. The essence of this pathology is that the body of a particular woman ( that is, her the immune system, normally providing protection against invasion of foreign bacteria, viruses and other agents) begins to produce antibodies against the sperm of her sexual partner ( husband). Moreover, during natural insemination, sperm will die before they can reach the egg and fertilize it.
• Operations in the cervical area. After surgery, scars may remain on the cervix, which may impede the passage of sperm.
• Anomalies in the development and/or location of the female genital organs. As a result of abnormal development, disturbances in the shape and location of the uterus, cervix and/or fallopian tubes may occur. All this can impede the process of sperm reaching the egg, thereby leading to infertility.
• With a lack of estrogen. IN normal conditions in the area of ​​the cervix there is cervical mucus, which prevents the penetration of infectious agents, as well as sperm ( during natural intercourse) into the uterine cavity. During the period of ovulation ( when the egg matures, that is, becomes ready for fertilization and moves into the fallopian tube) stands out a large number of estrogen ( female sex hormones). Estrogens change the properties of cervical mucus, making it less thick and more distensible, which facilitates the passage of sperm into the uterine cavity. With a lack of estrogen, the mucus will remain thick all the time, as a result of which sperm will not be able to reach the egg and fertilize it.
• Unexplained infertility. If, after a full examination of the woman and her sexual partner, it is not possible to identify the cause of infertility, the doctor may also advise resorting to artificial insemination. For some couples this may result in pregnancy, while for others it may require more effective methods (for example, in vitro fertilization).
• Lack of a regular sexual partner. If a woman lives on her own but wants to have a child, she can also undergo artificial insemination, during which her egg will be fertilized with the sperm of another man ( donor).

Is artificial insemination indicated for tubal obstruction or with one patent tube?

If both fallopian tubes are completely obstructed, artificial insemination is not advisable, since the injected sperm will not be able to reach the egg and fertilize it. In this case, it is recommended to treat the obstruction or perform an in vitro fertilization procedure.

At the same time, it is worth noting that partial obstruction, as well as obstruction of only one tube, is not a contraindication for performing artificial insemination. If both tubes are partially obstructed, sperm introduced into the uterine cavity or the tube itself can reach the egg and fertilize it. Also, the process of fertilization can occur with one passable tube, if at the time of the procedure a mature egg is found in it.

Indications for insemination with husband's sperm

Indications for artificial insemination on the part of the husband are:

• Inability to ejaculate ( ejaculation) in the vagina. The cause of this condition may be dysfunction of the male genital organs. Also this state may be observed when damaged spinal cord men, when the whole is paralyzed Bottom part body ( including genitals).
• Retrograde ejaculation. With this pathology, the process of normal ejaculation is disrupted, as a result of which sperm enters the urinary tract men. Insemination and fertilization do not occur in this case, since the seminal fluid does not enter the woman’s genital tract.
• Deformations of the male genital organs. If there are anatomical abnormalities in the development of the penis, sexual intercourse may be impossible, as a result of which the couple may also resort to artificial insemination. Similar conditions may also occur after traumatic injuries penis.
• Oligospermia. Normally, during sexual intercourse, a man secretes at least 2 ml of seminal fluid. It is believed that with less sperm there will not be enough sperm to penetrate through cervical mucus and reached the egg.
• Oligozoospermia. With this pathology, the number of sperm in a man’s semen is reduced. Most of them die on the way to the egg, as a result of which the likelihood of fertilization is reduced.
• Asthenozoospermia. With this pathology, sperm motility decreases, as a result of which they also cannot reach the egg. Intrauterine or intratubal insemination will help solve the problem.
• Performing chemotherapy/radiotherapy. If the patient was diagnosed tumor disease, before starting treatment, he can donate his sperm to a special storage facility. In the future, it can be used for artificial insemination.

Indications for insemination with donor sperm

Artificial insemination with donor sperm is indicated:

• With azoospermia in the husband. With this pathology, there are no sperm in the man’s seminal fluid ( male reproductive cells), as a result of which fertilization of the egg is impossible. It is worth noting that in the so-called obstructive form of azoospermia, the cause of the disease is a mechanical obstacle that forms on the path of sperm release. In this case, the husband's sperm obtained using special techniques can be used.
• With necrospermia in the husband. With this pathology, there are no living sperm in the male seminal fluid that could fertilize the egg.
• In the absence of a permanent sexual partner. If a single woman wants to have a child, she can also resort to artificial insemination with donor sperm.
• If your husband has genetic diseases. In this case, there is a high risk that these diseases can be transmitted to the unborn child.

How many times can you do insemination and what are the chances of getting pregnant?

The success of artificial insemination is determined by:

• The quality of the preliminary examination. Before performing the procedure, it is extremely important to conduct a full examination of the couple and identify the cause of infertility. If you miss this moment and perform insemination with your husband’s sperm on a woman who, for example, has complete tubal obstruction, there will be no effect. At the same time, if low-quality male sperm is used, the procedure will also be ineffective.
• Cause of infertility. If the cause of infertility is partial obstruction of the fallopian tubes, pregnancy can occur only after 2–3 inseminations. At the same time, if a man’s sperm quality is poor, the likelihood of pregnancy also decreases.
• Number of attempts. It has been scientifically proven that the probability of pregnancy with the first insemination is about 25%, while with the 3rd attempt it is more than 50%.

Contraindications to artificial insemination

Artificial insemination is contraindicated:

• In the presence of inflammatory diseases genital tract. Performing the procedure if you have an infection in the vagina, cervix, or uterus itself can make the procedure extremely painful. This also increases the risk of spreading infection and developing dangerous complications. The likelihood of pregnancy in this case is reduced. That is why insemination should be performed only in the absence of these diseases.

• In the presence of ovarian tumors. During pregnancy, the ovaries produce sex hormones that maintain the pregnancy. With ovarian tumors, their hormone-producing function may be disrupted, which can cause complications during pregnancy.
• If there are contraindications for pregnancy or childbirth. This list includes many pathologies, from diseases of the uterus, cardiovascular, respiratory and other body systems to mental disorders women with whom she will not be able to bear or give birth to a child.
• With akinospermia in the husband. The essence of this pathology is that male reproductive cells are completely devoid of mobility. Such sperm will not be able to reach the egg and fertilize it, as a result of which it makes no sense to perform artificial insemination with such seminal fluid. In this case, it is recommended to resort to in vitro fertilization, which is highly likely to lead to pregnancy.
• In the presence of infectious diseases at my husband's. In this case, the risk of infection of the woman during the procedure remains.

Is artificial insemination possible for endometriosis?

Carrying out artificial insemination can promote pregnancy, but does not guarantee its successful development and outcome. The fact is that with endometriosis, the strength of the uterine wall can be impaired. In this case, during the growth and development of the fetus, it may rupture, which will lead to the death of the fetus or even the mother. That is why, in the presence of endometriosis, you should first carry out a full diagnosis and evaluate everything possible risks and execute necessary treatment, and only after that proceed to artificial insemination.

Is insemination performed for polycystic ovary syndrome?

Is artificial insemination performed for uterine fibroids?

Is artificial insemination done after 40 years of age?

Is it possible to perform insemination with teratozoospermia?

Preparing women and men for artificial insemination

Before planning artificial insemination, consultation is necessary:

• Therapist– for the purpose of identifying diseases of internal organs.
• Gynecologist ( for women) – in order to identify diseases of the female reproductive system.
• Andrologist ( for men) – for the purpose of identifying diseases or disorders of the male reproductive system.

• Urologist ( for women and men) – for the purpose of identifying diseases genitourinary system, including infectious ones.
• Mammologist ( for women) – a specialist who identifies and treats diseases of the mammary glands.
• Endocrinologist- a doctor who treats endocrine glands (His consultation is necessary if there is a violation of the production of certain hormones).

Tests before insemination

To carry out artificial insemination you must pass:

• General blood analysis. Allows you to determine the concentration of red blood cells ( red blood cells) and hemoglobin. If a woman has anemia ( anemia, characterized by a decrease in the number of red blood cells and hemoglobin) first, its cause should be identified and eliminated, and only then insemination should be carried out. Also, a general blood test allows us to identify possible active infectious and inflammatory processes in a woman’s body ( this will be indicated by an increase in the concentration of leukocytes - cells of the immune system).
• General urine analysis. This study allows you to detect the presence of infection of the genitourinary system. Also, the presence of blood in the urine may indicate more serious illnesses kidneys, which can negatively affect the course of pregnancy.
• Blood chemistry. This analysis allows you to evaluate functional state liver, kidneys, pancreas, heart and many other organs. At pronounced violation their functions, the procedure is contraindicated, since serious complications may develop during a subsequent pregnancy.
• Test for STIs ( sexually transmitted infections). These infections include HIV ( AIDS virus), gonorrhea, syphilis, chlamydia and so on. Their presence in the expectant mother jeopardizes the development of pregnancy and the health of the fetus, as a result of which they should be cured before insemination ( if possible).
• Tests for sex hormones. A study of male and female sex hormones is carried out to identify possible reason infertility. Moreover, assessment of the functioning of the female reproductive system is necessary in order to determine whether a woman will be able to bear a child if pregnancy occurs. The fact is that the course of pregnancy, as well as the process of childbirth, are controlled various hormones. If their secretion is impaired, this can lead to the development of complications during pregnancy or childbirth ( up to the death of the fetus).
• Analysis for Rh factor.

Intrauterine artificial insemination (IUI) is one of the most popular methods of fertilization. The procedure involves injecting sperm directly into the uterine cavity to promote a natural pregnancy. Artificial insemination is also performed with donor sperm.

Previously, the procedure was ineffective. The injection of sperm caused unpleasant, even painful sensations. The risk of infection increased. Under such conditions, the success of the manipulation was only 7-10%. However, many years of research have made it possible to identify a number laboratory methods, which significantly increase the chances of conception after artificial insemination.

Processing sperm in a centrifuge allows you to cleanse it of impurities and enrich the cells with protein and minerals. After special processing active sperm more remain, as inferior ones are eliminated. By increasing the concentration of healthy cells, the chances of success are increased: some sperm are injected into the uterus, but most of the cells are viable.

Unfortunately, there are many candidates for artificial insemination. It is not enough to feel healthy and not have problems with your sex life. The ability to fertilize depends on internal factors.

If there have been injuries to the genital organs (actual and impact with instruments during surgery), reproductive function could have been broken. The same applies to infectious diseases, because mumps, syphilis, gonorrhea, hepatitis and tuberculosis negatively affect reproduction.

The most common cause of infertility in men is varicose veins. seminal canal, which leads to overheating of the testicles. Under the influence of abnormally high temperatures germ cells die, and if the concentration of active sperm is insufficient, fertilization does not occur. This is due to the fact that it takes not one, but thousands of sperm to travel the entire path to the uterus. Most simply help one overcome obstacles, but without enough sperm, none will reach the goal.

Habits (overeating, smoking, sedentary lifestyle life). They help reduce the number of healthy cells, change their structure and degree of mobility.

In case of female infertility, artificial insemination with the husband's sperm is relevant if the woman is diagnosed with unfavorable environment. It often happens that slow sperm have difficulty making their way into the cervix, where they are “finished off” by antibodies. This happens during long-term married life, when the uterus learns to perceive the partner’s reproductive cells as something foreign.

Artificial insemination with sperm is also suitable for some patients with abnormal genital structure. Important role the time and method of introducing sperm plays a role, because through insemination it is simulated natural process conception.

The method allows you to carry out those stages of fertilization that do not occur due to deviations. The procedure is divided into 3-5 cycles. If insemination is ineffective after four attempts, they resort to or (depending on the causes of infertility).

Indications and contraindications

Insemination allows you to solve the issue of infertility in men with the following abnormalities:

• sperm subfertility;
• retrograde ejaculation;
• ejaculatory-sexual disorders;
• insufficient amount of seminal fluid;
• displacement of the urethra;
• thickening of sperm;
• low sperm motility;
• complications after vasectomy;
• consequences of radiation or chemotherapy.

Artificial insemination is also in a good way use cryopreserved sperm. The procedure allows a woman with the following abnormalities to become pregnant:

• cervical infertility (problems with the cervix);
• difficulty in penetration of male germ cells into the uterus;
• chronic inflammation of the cervix;
• manipulations resulting in damage to the cervix;
• anatomical or physiological disorders of the uterus;
• ovulation dysfunction;
• vaginismus (reflex muscle spasms that prevent sexual intercourse);
• allergy to sperm.

IUI is recommended in the presence of an excessive number of antisperm bodies, which are characterized as immunological incompatibility of partners. The procedure is also used for unexplained infertility. Contraindications for artificial insemination:

• the age of the patients is more than 40 years (the chance of the procedure being effective is reduced to 3%, which is practically impossible, therefore more promising methods of artificial insemination are recommended);
• presence of more than four unsuccessful attempts VMI;
• psychological and somatic disorders which exclude any possibility of pregnancy;
• the presence of genetic diseases that can be passed on to the child;
• there are foci of genital tract infections;
• acute inflammation;
• congenital or acquired uterine defects that make the full and healthy development of the fetus impossible;
• pathology of the fallopian tubes;
• ovarian tumors;
• syndrome;
• malignant tumors in any part of the body;
• unexplained bleeding in the genital tract;
• pelvic surgery;
• luteinization syndrome of a non-ovulated follicle (absence of ovulation in the presence of manifestations).

Preparation

The procedure is performed during the ovulation period of the menstrual cycle. Insemination is carried out against the background of natural maturation of the egg or by stimulating the ovaries (ovulation induction). Use fresh or cryopreserved sperm.

The preparation plan includes a consultation with a doctor, who will study the medical history and draw up an individual examination plan. First of all, you should confirm the absence of STIs (sexually transmitted infections).

It is unacceptable to perform IUI for hepatitis, syphilis,. A test for TORCH infections is prescribed. A man undergoes a spermogram to analyze qualitative and quantitative characteristics. To assess the microflora of the genital organs, a smear is taken. At risk are people with ureaplasma, papilloma virus, group B streptococcus.

Diagnosis is important because these infections have no symptoms. If there are pregnancies that were interrupted by themselves, you need to donate blood for an immunological analysis (ELIP-TEST 12).

A woman should keep a journal of her menstrual cycle, measure basal temperature and do ovulation tests. To confirm ovulation, folliculometry is done.

Stages of artificial insemination

Stage 1 – ovarian stimulation

Hormones (FSH, LH) are used for this. Ultrasound monitors the development of the cycle and the formation of the follicle. An analysis of its size and structure is also carried out. After the follicle matures, a hormone that mimics luteal hormone is administered to stimulate natural ovulation. This way the egg is activated.

Stage 2 – sperm preparation

The man provides a sample on the day of the procedure. If cryopreserved sperm is used, it is thawed in advance. I process the sample in a centrifuge, add nutrients(the procedure takes on average 45 minutes). After separating active germ cells from abnormal ones, the sperm concentration becomes acceptable for implantation.

Stage 3 – insemination

Done on the day of ovulation. It is not advisable to perform IUI when respiratory disease, stress, overwork, feeling unwell. Cells must be administered within 1-2 hours after treatment. The fact of ovulation is confirmed by folliculometry.

In the absence of ovulation, stimulation is repeated. When ovulation occurs, sperm is collected into a thin cannula, which is inserted into the uterus and injected. It is noteworthy that the procedure itself, despite the scary description, is painless. The woman feels practically nothing. The sensations are comparable to normal gynecological examination. For this purpose, special disposable flexible instruments are used.

After the sperm is injected, a cap is placed on the cervix to prevent leakage. It is recommended to start sex life 8 hours after removing the cap.

Statistics and probability

It is recommended to resort to insemination no more than 3-4 times. Almost 90% of patients desired pregnancy occurs precisely during the first three attempts. The probability of getting pregnant for other women does not exceed 6% per attempt. It is noteworthy that the first three attempts together account for almost 40% of the probability, while the six attempts account for only 50%.

Insemination success rate by age:

• Up to 34 years of age, the first insemination gives up to 13% success, the second – 30%, and the third – 37%.
• From 35 to 37 years old, the first gives 23%, the second – 35%, and the third – 57%.
• From 40 years old, all attempts give a 3% success rate for conception.

If three procedures are unsuccessful, it is advised to turn to other methods of artificial insemination.

Possible complications

After artificial insemination, some complications are possible. So a woman may develop a severe allergy to ovulation-stimulating drugs. Acute inflammatory processes and exacerbation of existing chronic diseases are possible.

Directly upon injection of sperm, a shock reaction is sometimes observed. After IUI, it is possible to increase the tone of the uterus. Also, the risk of ovarian hyperstimulation syndrome cannot be excluded. Some patients experience multiple or ectopic pregnancies after artificial insemination with sperm.

Proper preparation for artificial insemination (AI)

(AI) largely depends on the state of the reproductive system of male and female organisms. As a rule, both are cooked. But they start with a complete and detailed examination.

Where to begin?

The first step is to choose a specific clinic or doctor, focusing on reviews, results, distance from your place of residence, availability of a license for sperm processing, and experience in performing AI. Distance to the clinic is an important factor, since preparation for AI provides control over the growth and maturation of follicles using an ultrasound machine. That is, you will need to make visits to the clinic every other day (sometimes daily).

Then it is rational to tune in to what may not happen in the first cycle. And if this happens, it’s not the end of the world, but simply your first step. The effectiveness of the procedure in one cycle is no more than 10–12%, and in 3 attempts – 30–36% (under 36 years of age) and 24% (over 36 years of age). The maximum possible number of inseminations is 6, but modern look differs slightly from the recommendations of regulations. If 3-4 attempts are unsuccessful, then the probability of getting pregnant in subsequent cycles is low, then diagnostic or IVF is recommended.

How long does it take to prepare?

The duration of preparation for artificial insemination is determined based on the couple’s examination results and the need for treatment as concomitant diseases that interfere with bearing a child, as well as diseases of the reproductive system itself.

Up to 40% of reproductive losses occur from. If disturbances are detected in this endocrine organ, it will take time to correct its functioning.

The duration of preparation for AI is influenced by the need for weight correction. Moreover, this can be aimed at both weight loss and weight gain, depending on the initial data. Subcutaneous adipose tissue is also endocrine organ, whose hormones are involved in the process.

Preparatory stage involves screening the male and female body for the presence. If diseases are identified, treatment is carried out. After treatment it will take time to complete removal drugs and their metabolites from the body.

An important condition for AI is. If there are changes in the quantitative and qualitative composition of sperm, then therapy is prescribed to increase the fertility of the ejaculate. If sperm count is extremely low, reproductive clinics offer insemination with donor sperm.

The maximum period of preparation for artificial insemination is 6 months.

Tests before insemination

The examination before AI is aimed at increasing the effectiveness of the procedure, eliminating contraindications to pregnancy (checking whether a woman can carry a child) and factors that can negatively affect the fetus and the course of pregnancy.

Therefore, consultations with the following specialists will be needed:

• therapist;
• endocrinologist;
• surgeon;
• Laura;
• dentist

Must be carried out ultrasound examination, according to indications - hysterosalpingography, laparoscopy, hysterosalpingoscopy, endometrial biopsy. Using these methods, the condition of the uterus, tubes, and uterine mucosa is determined. If both pipes are not passable () – AI is not advisable. Obstruction of one of the tubes is not a contraindication to intrauterine insemination.

If you are taking any medications to treat concomitant diseases, be sure to tell your therapist about it. Most likely, he will replace them in advance with drugs that are allowed during pregnancy.

Preparation for artificial insemination involves taking blood tests:

• to determine the state of hormonal balance;
• to determine the presence/exclusion of sexually transmitted infections, TORCH complex;
• be sure to get tested (women and men) for syphilis, hepatitis C and B, and HIV;
• control the degree of blood clotting (to prevent complications), determine the group and rhesus (to exclude or take measures, the blood type of the baby and mother).

Blood clotting affects the growth of the endometrium and its ability to accept an embryo (implantation).

In addition, smears to determine the degree of vaginal cleanliness, oncocytology, and fluorography are necessary.

According to indications, they donate blood for the presence of antisperm antibodies (suppress the activity of sperm), (they are the cause of fetal death and other complications during pregnancy).

In the absence of contraindications, after the treatment, the next stage of preparation for AI begins - determining the “correct” period for the procedure.

Study of the menstrual cycle. Folliculometry

Ultrasound monitoring allows you to monitor the presence or absence of ovulation. A woman may or may not ovulate during her cycle. In this case, wait until the follicle matures next cycle or maturation of the follicle on the side of the patent tube (if one is not functioning).

Typically, follicles are observed over several cycles. Sometimes, to study the menstrual cycle, doctors ask patients to measure rectal temperature or do ovulation tests. But folliculometry remains a more practical method.

The most effective is to carry out the procedure the day before and on the day. To do this, every other day, using an ultrasound machine, follicle growth is monitored starting from the 9th day of the cycle. It should be noted that the start of monitoring depends on the duration of the menstrual cycle. The shorter it is, the earlier folliculometry begins.

Stimulation before insemination

Artificial insemination with stimulation (in a stimulated cycle) is more effective. With initiated hyperovulation, the quality of mature eggs is higher and their number is greater (1-3). This means that the chances of results increase.

For stimulation, the same drugs are used as for IVF (only in smaller doses). Often, in order to stimulate the ovaries before intrauterine insemination, the following are prescribed: clostilbegit, menogon, puregon. Start taking medications on days 3–5 of the cycle. Most often these are injections (intramuscular or subcutaneous).

When the follicle reaches the required diameter, usually 24 mm, one of the drugs based on human chorionic gonadotropin (choragon, pregnyl) is injected intramuscularly. The next day after the injection, insemination is performed.

Preparing for insemination for men

Your partner needs to have a spermogram. If the results are unsatisfactory, you will need to consult an andrologist or urologist, possibly therapeutic correction. For proper preparation men for intrauterine insemination, we recommend that you read the articles:
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Please note that a man should stop smoking and drinking alcohol. This also applies to beer, because this drink contains substances similar to female sex hormones, and this adversely affects the development of sperm.

Abstinence before insemination

Your doctor will give you recommendations for abstinence. In fact, there will be no long breaks, because 3 days are enough for the complete accumulation of sperm in the required volume and the correct ratio of seminal fluid and germ cells. The maximum break can be 5 days. This is dictated by the fact that the absence of ejaculation over a longer period of time leads to stagnation and a deterioration in the partner’s sperm parameters.

Vitamins in preparation for AI

It has long been known that vitamins promote conception. The most important are, and vitamin B₆. But it is strongly not recommended to take it on your own when preparing for artificial insemination, especially vitamin complexes and additives. Talk to your doctor about whether and how to start vitamin preparation for AI.

A month before the procedure, it is better to give preference proper nutrition- complete protein, herbal products With high content folic acid, vitamin E and vegetable oils. The right balance will allow you to customize as much as possible reproductive systems men and women to perform their functions. The only vitamin that you can take on your own without a doctor’s recommendation (but you need to inform him) is this folic acid at a dose of 400 mcg.