Artificial Insemination: How Does It Work?

Ideal Age for Artificial Insemination

Artificial insemination is a relatively simple assisted reproductive technology (ART) procedure. It involves introducing a laboratory-prepared sperm sample from the partner into the woman's uterus to increase the chances of intrauterine fertilization and improve pregnancy rates. Artificial insemination isn't suitable for all infertile patients. A prior assessment considers factors like age, sperm abnormalities, and gynecological issues.

Biologically, there's no universal standard. Each case is unique. However, for women, 50 years is generally considered a limit for artificial insemination. Beyond this, risks for mother and child increase significantly.

Artificial insemination is indicated for couples with unexplained infertility, women with ovulation disorders, cervical abnormalities, and individuals with sperm motility issues or deficiencies.

Examinations

Preliminary examinations are mandatory for both partners before artificial insemination, although they differ slightly.

For women, these include:

• Hormonal tests: Many require specific cycle days. Common tests include estradiol, LH, FSH (days 2-5), prolactin, and TSH. Less frequent tests are AMH, T4, testosterone, androstenedione, and DHEA-s (often for irregular cycles).
• Infectious disease screening: (HIV, hepatitis B, hepatitis C, syphilis (TPHA or RPR), rubella (if unvaccinated), smear, vaginal swab – validity varies by center).
• Genetic screening: (Karyotype, cystic fibrosis (one partner), factor II, factor V, beta-thalassemia (one partner) – validity is usually year-round).
• Pelvic ultrasound: (Days 2-5) for antral follicle count and to rule out pathologies like fibroids or cysts. Further examinations (hysteroscopy, laparoscopy) may be needed if necessary.

For men, these include:

• Semen analysis (sometimes with culture). Hormonal tests (testosterone, FSH, LH, Y chromosome deletion screening) may be added if azoospermia is present.
• Infectious disease screening: (HIV, hepatitis B, hepatitis C, syphilis (TPHA or RPR) – validity varies by center).
• Genetic screening: (karyotype, cystic fibrosis (one partner), beta-thalassemia (one partner)).

In artificial insemination, laboratory-processed sperm is introduced into the woman's uterus to facilitate fertilization. Close monitoring of the woman's cycle and follicle maturation is crucial. If ovulation is problematic, medication (clomiphene or other hormones) can stimulate ovulation over 15 days.

Artificial insemination is painless and performed without anesthesia, making it a quick, low-risk outpatient procedure. Choosing a specialized center with experienced professionals is crucial. Artificial insemination helps overcome certain infertility issues.

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Success Rate

Artificial insemination has a high success rate: approximately 60 out of 100 couples completing four cycles achieve pregnancy. Success varies based on the specific infertility issues. Complete health monitoring, menstrual cycle tracking, and sperm quality assessment are crucial.

Successful conception requires egg and sperm meeting, correct embryo development, and a receptive uterine environment for implantation.

Embryonic abnormalities are a major cause of failure. Other reasons include:

• Unreceptive endometrium
• Insufficient implantation-period hormones
• Difficult embryo transfers (increased risk of uterine contractions and embryo expulsion)
• Uterine anatomical abnormalities
• Unhealthy lifestyle/environmental factors
• Immunological causes

While the exact cause is sometimes unknown, increased embryo transfer numbers improve pregnancy chances. Most patients undergoing artificial insemination achieve pregnancy. Clinics utilize innovative assisted reproduction systems to maximize success and support patient needs.

The decision to use artificial insemination is made with a fertility specialist who reviews the couple's situation, orders tests, and determines the appropriate procedure, including potential surgical sperm retrieval if needed.

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