All About Artificial Insemination (AI)

Artificial Insemination: The Definition

Artificial insemination is a first-level assisted reproductive technology (ART). This method is one of the simplest and least invasive therapeutic options recommended for couples wishing to have a child but unable to conceive spontaneously.

Artificial insemination simply mimics natural reproduction: spermatozoa, previously selected in a laboratory, are artificially deposited in the woman's reproductive tract at a time close to ovulation. Thus, the meeting of male gametes with the oocyte and fertilization normally take place in the female genital tract. Artificial insemination is particularly useful when spermatozoa have difficulty passing through the vagina and cervix due to an obstruction or a lack of quantity or quality of spermatozoa.

Fundamentally, the method involves artificially introducing male spermatozoa into the woman's reproductive tract. Artificial insemination is performed during the periovulatory period on a spontaneous cycle or after moderate pharmacological stimulation. The objective is to promote the spontaneous meeting of the two gametes (woman's oocytes and man's spermatozoa) in the woman's body. The probability of becoming pregnant varies from 10 to 15% per attempt, depending on the underlying pathology and the patient's age.

What is the difference between IVF and IUI?

IVF and IUI are different ART techniques. Indeed, during IUI, a sperm sample from the partner or a donor is introduced into the patient's uterus at the time of ovulation. The sperm sample is prepared beforehand in the laboratory to select the best spermatozoa. IVF, on the other hand, is a treatment in which the oocyte is fertilized by sperm in the laboratory.

Furthermore, IVF is a more complex procedure as it requires the retrieval of eggs and fertilization in the laboratory to transfer the resulting embryos into the uterus. In IUI, however, egg retrieval is not performed.

Artificial insemination can be repeated each cycle without the need to wait a few months to increase the chances of success.

In the case of in vitro fertilization, it is recommended to wait for the ovaries to return to their normal state before resuming stimulation, i.e., it is necessary to wait a few cycles before performing it again. Generally speaking, there is no limit to the number of in vitro fertilizations, but it is rare for more than three to be performed.

Who is artificial insemination for?

The artificial insemination technique is not suitable for all patients suffering from infertility, depending on various factors such as age, sperm abnormalities, or gynecological symptoms. For people with these disorders, in vitro fertilization 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 people suffering from abnormalities or deficiencies in sperm resulting from motility disorders.

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What tests should be done before artificial insemination?

As with any ART technique, artificial insemination requires tests to be performed before the procedure:

• For the female partner, the recommended preliminary examinations are a transvaginal pelvic ultrasound, a hormonal profile performed during the menstrual phase, generally the first 5 days of the cycle (FSH, LH, estradiol, TSH and AMH). pre-conception and infectious examinations (Rubella, Cytomegalovirus, Toxoplasmosis, HbSAg, HBsAg, HCV, HIV, TPHA, Hb electrophoresis, Blood group and haemochrome) and routine preventive examinations of the female reproductive system performed during the last year (Pap test and mammogram).
• For the male partner, the recommended preliminary examinations to assess an ART pathway are pre-conception and infectious examinations (HbSAg, HBcAb, HCV, HIV, TPHA, Hb electrophoresis) and a complete sperm examination, preferably including a capacitation test.

How does the patient prepare for artificial insemination?

During drug hormonal treatment, ultrasound controls and hormone assays are performed to monitor ovulation.

How is artificial insemination performed?

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

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

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

The day of the insemination itself will then be established using a specific menstrual cycle calendar to reconcile ovarian stimulation with gynecological examinations and ultrasounds.

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

At this stage, after stimulating the ovulation process, artificial insemination is performed in specific 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 when she should take a pregnancy test or any medication to take.

The success rate of artificial insemination

90% of patients undergoing artificial insemination treatment achieve pregnancy. Clinics are also equipped with innovative assisted reproduction systems to offer the desired results and guarantee maximum care for the needs of all patients.

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