AI and Assisted Reproductive Technology (ART): 5 Answers to Your Questions

What is the procedure for artificial insemination, an ART technique?

Artificial insemination is an assisted reproductive technology (ART) method used to treat infertility. This technique involves artificially introducing sperm into a woman's reproductive tract.

Artificial insemination is not suitable for all patients suffering from infertility, depending on various factors such as age, sperm abnormalities, or gynecological symptoms. For individuals with these disorders, in vitro fertilization (IVF) is recommended. Artificial insemination, on the other hand, is indicated in the following cases: couples suffering from infertility of unknown origin, ovulation disorders in women, cervical abnormalities, and individuals suffering from sperm abnormalities or deficiencies resulting from motility disorders.

When a couple decides to use artificial insemination, the first step is to assess all patient factors to determine the most appropriate fertility method.

After analyzing the woman's uterus and fallopian tubes, the potential and mobility of the man's sperm are also examined.

At this stage, the doctor will determine whether to proceed with artificial insemination or in vitro fertilization.

The starting day will then be established using a specific menstrual cycle calendar to reconcile ovarian stimulation using gynecological examinations and ultrasounds.

To perform artificial insemination, the preparation of male sperm involves selecting sperm with good mobility. To this end, samples are collected and treated with enabling methods, eliminating dead or poor sperm and improving the characteristics of the sample useful for insemination.

At this stage, after stimulating the ovulation process, artificial insemination is performed in specialized clinics and assisted reproduction clinics. A speculum is first inserted, then a cannula is introduced into the cervix and the sperm sample is introduced into the uterus.

At the end of the procedure, the woman will have time to rest at the clinic and resume her normal daily activities. She will then be informed of when she should take a pregnancy test or any medication to take.

ART using artificial insemination with an anonymous or known donor: what is the difference?

ART techniques are subdivided into levels I, II, and III according to their complexity and the need for anesthesia. They are also distinguished based on the origin of the gametes used for fertilization techniques: homologous if they come from the couple's gametes, heterologous if they come from outside the couple (from a donor). In some countries, couples with infertility problems can choose homologous fertilization, where the gametes belong to the couple, or heterologous fertilization, where one or both gametes come from a donor outside the couple. This technique is used when assisted homologous fertilization cannot be used due to the permanent sterility of one or both partners.

In general, when heterologous fertilization is authorized, patients must be adult couples of different sexes, married or cohabiting, of potentially fertile age, and both alive. In addition, it is advisable to act according to the principle of gradual techniques. That is, when clinical examinations show that a couple suffers from non-absolute or idiopathic infertility, and the age of the female partner allows it, both partners undergo homologous assisted fertilization. If no benefit is obtained from the latter, the option of gamete donation is considered. These conditions may vary from country to country.

The techniques used by heterologous fertilization are the same as those used by the homologous procedure.

Women can benefit from heterologous fertilization techniques:

• with hypergonadotropic hypogonadism, that is, with hormonal problems that prevent natural conception and that do not respond to hormonal stimulation preparatory to an assisted fertilization cycle;
• of advanced reproductive age;
• with reduced ovarian reserve after failure of homologous fertilization;
• suffering from or carrying a significant genetic abnormality or having a family history of a condition for which carrier status cannot be determined;
• with poor-quality oocytes and/or embryos or repeated failed conception attempts using ART techniques;
• with an iatrogenic infertility factor (damage caused by a clinical diagnosis or therapeutic treatment);

Sperm donation is authorized if the male partner:

• presents severe proven male infertility (azoospermia, severe oligoasthenozoospermia or fertilization failure after intracytoplasmic sperm injection - ICSI);
• has incurable ejaculatory dysfunction;
• is a carrier of a significant genetic abnormality or has a family history of a condition for which carrier status cannot be determined;
• has a sexually transmitted infection that cannot be eliminated;

The success rate of artificial insemination treatment, whether homologous or heterologous, depends on many factors such as the woman's age, the duration of the couple's infertility, the type of infertility, and the treatment chosen.

How much does this ART technique, artificial insemination, cost?

The prices of artificial insemination can vary considerably depending on the case. For example, heterologous fertilization with donor sperm with intrauterine insemination will cost the patient less than insemination with "in vitro donor sperm", which remains cheaper than in cases where the couple uses donor oocytes.

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Can you have artificial insemination when you are single?

Generally, artificial insemination is only authorized for couples. However, there are some countries where this rule is not mandatory.

IVF/artificial insemination: what is the difference between these ART techniques?

In vitro fertilization is more complex since it requires the collection of eggs and fertilization in the laboratory to transfer the resulting embryos into the uterus. In artificial insemination, on the other hand, eggs are not collected. Each of these techniques has specific indications, so, when wondering, for example, why artificial insemination does not work, one should not try to change the ART technique because artificial insemination probably remains the most suitable technique for your needs. Ask your doctor for advice to succeed in artificial insemination.

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