How does artificial insemination work? How does artificial insemination take place? Tests before insemination

Exist different methods artificial insemination.

The goal of each of them is to achieve pregnancy. Fertilization can occur both in the body of a woman and in a laboratory.

Types of artificial insemination

The most commonly used methods of artificial insemination are:

IVF - fertilization of the egg "in vitro";
artificial insemination- the introduction of sperm into the uterus.

There are other methods, but most of them have either historical or experimental significance (GIFT, ZIFT and others). Only IVF and artificial insemination have a wide clinical application in most countries.

Intrauterine insemination

According to WHO standards, assisted reproductive technology is not considered. But in Russia, it refers to the methods of artificial insemination, which is indicated in the Order of the Ministry of Health No. 107n.

The essence of the method is that a woman is introduced into the uterus with the help of a catheter, the sperm of a spouse or a donor. At first sight, this species artificial insemination is no different from the natural way of pregnancy.

But in reality, artificial insemination has a number of advantages, namely:

Possibility of accumulation and processing of sperm before injection, which helps to overcome the male factor of infertility.
Sperm is injected directly into the uterus, bypassing the cervical canal, which eliminates the cervical factor of infertility (a form of reduced fertility in which sperm cannot pass the cervical canal due to thickening of the cervical mucus).
The likelihood of pregnancy increases in case of low sperm motility, because they have to overcome a much shorter distance to the egg.
The possibility of conceiving a child with the help of donor sperm, if a man has genetic diseases that make his fatherhood impossible (absolute infertility) or dangerous for the child (unfavorable genetic prognosis).
The possibility of conception of a child by single women using donor sperm.

The advantages of artificial insemination over a more complex method of fertilization such as IVF is the simplicity of the procedure and low cost.

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IVF Method

The most effective method of artificial insemination today is IVF or in vitro fertilization.

The essence of the method:

The body of a woman is stimulated with hormones so that several eggs mature in the ovary at once during one cycle.
With the help of ultrasound, the growth of follicles is monitored.
On the right day, they are punctured with the extraction of eggs.
The cells are fertilized with the sperm of a spouse or a donor.
The resulting embryos are then cultured for 3-5 days.
The best embryos, one or two, are transferred to the uterus. After that, if successful, pregnancy occurs.
If the attempt was unsuccessful, the transfer is repeated in the next cycle.

There are many IVF programs. They differ in the protocol for stimulating superovulation. In addition, IVF uses many additional reproductive technologies.

Among them:

- manual introduction of sperm into the egg. Used for male factor infertility.
IMSI is performed as part of ICSI. It involves the preliminary selection of sperm with the best morphological structure under a high magnification of the microscope.
PICSI is performed as part of ICSI. It involves the selection of a spermatozoon based on an assessment of the ability of male germ cells to interact with hyaluronic acid.
PGD is a diagnostic procedure aimed at studying the genotype of embryos. Helps to detect chromosomal and genetic abnormalities in time.
cryopreservation- freezing of germ cells. It makes it possible to save "extra" embryos for their use in the next cycle. It is used in case of failure of the first IVF attempt. It is also used for long-term storage of biomaterial, including donor.
The use of donor germ cells- is indicated for age-related infertility, absolute infertility, genetic diseases in one of the partners, and is also used by single women.

Surrogate motherhood is considered a separate form of artificial insemination. Bearing a third-party woman's child is used if there are contraindications to pregnancy in the genetic mother.

Many couples who are faced with the problem of conception are looking for ways to become parents, in which case the question often arises, which method to choose.

Despite the fact that there are many ways in modern medicine, it is important to start with less radical procedures.

Note!

To achieve the greatest chance of conception, it is important to know the date of ovulation. It is possible to determine its occurrence different ways eg scheduling, tests, .

Before taking action, many women do not go to the doctor, but start asking questions on the Internet search engine, for example, how is insemination done at home, experienced reviews help to gain confidence before the procedure.

However, it is worth getting the advice of your doctor to have an accurate idea of what can and cannot be done during insemination.

What is needed for the procedure

Before starting manipulations, it is necessary to prepare a sterile container for collecting sperm, a disposable syringe without a needle of 10 ml, if necessary, a disposable sterile vaginal dilator is purchased.

The spouse or partner must collect the sperm in a container prepared in advance. You can’t use it right away, you need to wait until it becomes a little thinner.

It takes approximately 10-20 minutes. At this time, the container can be wrapped in a towel to keep it warm, avoiding too high temperatures and shaking.

You can store sperm in this way for no more than two hours.

Step-by-step instruction

It should be understood that it will be impossible for a person without special education to introduce sperm into the uterine cavity itself without damaging it.

Therefore, artificial insemination at home is possible only on the condition that the syringe is inserted into the vagina as deeply as possible without damaging the cervix.

The pressure on the plunger of the syringe must be carried out carefully, without damaging the spermatozoa.

If a vaginal dilator was used or it is also called a mirror, then the scheme of actions will be slightly different. For the convenience of its introduction, it is permissible to use a lubricant, without spermicidal lubricant.

The dilator is inserted with a downward slope, at an angle of 45 °. The legs of the mirror should be moved apart by 2-3 cm so that the cervix becomes visible. With the help of the latch, the expander is fixed in this position for further actions.

Note!

You can not push the legs of the dilator too wide, so as not to injure the surface of the vagina.

The pressure on the piston should be smooth. The contents of the syringe should not fall into the neck area, but only at its base, as this can lead to injury. After the manipulation, it is necessary to smoothly loosen the dilator and close it, only then remove it from the vagina.

Success rate after home insemination

Both with natural fertilization and insemination, no one can give a 100% guarantee that everything will work out the first time.

According to statistics, if artificial insemination of a woman is carried out at home, then the chances of success are no more than 20%.

It may take not one, but two or three attempts. If a woman has the growth of several eggs, it is best to carry out several such procedures during one cycle, this will increase the chances of a successful conception.

As a rule, when establishing infertility with unexplained reasons for its occurrence, it is recommended to first resort to such a procedure as artificial insemination without stimulation.

That is, when the eggs are produced by the body on their own, without the need to take hormonal drugs (for example, duphaston or).

In this case, it will be possible to carry out a similar procedure for six consecutive months no more. If pregnancy does not occur, you will have to resort to the method.

Conclusion

As can be seen from the article, the procedure itself is not very complicated and is quite feasible at home. The percentage of success depends not only on the physical, but also on the psychological state of the couple.

It is possible to combine the procedure with sexual intercourse, since it is likely that when a woman has an orgasm, there are more chances for successful fertilization.

However, do not be upset if the attempt was unsuccessful the first time, it is important to have a positive attitude and save your strength so that the body is healthy and strong before pregnancy.

Video: Artificial insemination. Pros and cons

Instruction

Artificial insemination or insemination is used for certain diseases (impotence, lack of ejaculation, hypospadias, etc.) with anatomical changes in the cervix, vaginismus, as well as when antisperm antibodies are detected in cervical mucus in women. With this method of artificial insemination, sperm is injected into the uterine cavity or into the lumen of the fallopian tubes. One of the spermatozoa is a mature egg, after which it is implanted to the wall of the uterus.

Insemination is carried out two or three times during one menstrual cycle, the procedure must be repeated at least three cycles. If, during the examination, the husband was identified pathological changes using donor sperm. The reason for using donor sperm is also the Rhesus conflict, which is not treatable, as well as genetic diseases in the husband's next of kin. Positive result procedures will largely depend on the diseases that the couple has. As a rule, after insemination, pregnancy occurs in eighty percent of cases.

In vitro fertilization is performed outside the body. This procedure is resorted to if the woman's fallopian tubes are removed, with low patency and obstruction of the fallopian tubes, in the absence of the effect of long-term treatment (more than five years), in case of unexplained infertility. Before IVF, a study of the state of the genital organs is carried out. The uterus and ovaries of a woman should retain their functions, there should be no neoplasms, inflammations and anatomical changes in the reproductive organs.

The in vitro fertilization procedure includes: receiving eggs from a woman, fertilizing the eggs with the husband's or donor's sperm, monitoring the embryos in the laboratory, transferring the embryos into the uterine cavity. Miscarriage during IVF occurs in 40% of cases, fetal death during childbirth is often observed. Doctors associate these circumstances with the age of women in labor, as well as with pathologies in their reproductive system.

Artificial insemination by ICSI (intracytoplasmic injection) is performed in severe cases male infertility. During the procedure, a sperm cell is injected into an egg extracted from the body of a woman's ovary. The difference between this method and IVF is that during ICSI, one, the most viable spermatozoon is selected, which is placed inside the egg with a needle, and during in vitro fertilization, the spermatozoa are located together with the eggs in a special solution and penetrate inside on their own.

Content

The statistics are disappointing - every year the number of infertile couples only increases, and how many of them want children! Thanks to the latest technologies and progressive methods of treatment, babies are born, although it would seem that this is impossible. Artificial insemination is a procedure that allows a woman diagnosed with infertility to become a mother with the help of donor sperm. What is the essence of the technology, to whom it is contraindicated, and how great are the chances of giving birth to a child - more on that later.

What is artificial insemination

Being one of the methods of artificial insemination, insemination helps parents to find a long-awaited child. The procedure significantly increases the likelihood of conception, since it is preceded by a careful selection of material for the operation. Among spermatozoa, the most active ones are selected, and the weak ones are removed. The protein components of the ejaculate are removed, because they can be perceived by the female body as foreign.

Intrauterine insemination is not a panacea for infertility, but only one of the ways to get pregnant artificially. According to studies, the positive effect is estimated at a maximum of 30-40 percent. A single session does not guarantee the development of pregnancy, so the operation is performed up to 3 times per monthly cycle. If conception does not occur after several procedures, it is recommended to turn to other methods of artificial insemination. The very same pregnancy with intrauterine insemination is no different from the usual.

Why is artificial insemination possible?

It would seem why women cannot become pregnant, and with the artificial introduction of ejaculate, fertilization occurs. One of the features lies in the female body. The fact is that antibodies to male sperm are produced in the cervical mucus. It turns out that it simply kills the spermatozoa, and does not contribute to their penetration to the egg. The procedure helps to deliver the processed material directly to the uterus, bypassing the cervical canal. In this way, even if the spermatozoa are immobile, the chance of getting pregnant increases.

Indications

As can be seen from the above, the main indication for artificial intrauterine insemination is the immunological incompatibility of partners. In fact, there are much more individual reasons for resorting to the procedure, so it is worth considering them in more detail. The main problems in women are considered to be inflammatory processes in the cervical canal. The disease prevents the passage of sperm into the uterus, preventing a woman from becoming pregnant.

Artificial insemination is used for vaginismus - a problem when sexual intercourse is not possible due to spasms and pain. Injuries and pathologies of the genital organ that prevent pregnancy, anomalies in the position of the uterus, infertility of an obscure nest, surgical interventions on the cervix are another of the many reasons to go to the clinic for an insemination procedure.

Until recently the reason female infertility searched only for the weaker sex, but, as studies have shown, men's problems are often dominant in this matter. Low motility and a small number of spermatozoa, which are difficult to reach the end point, and azoospermia are one of the main diseases due to which artificial insemination is prescribed if the previous treatment has not given any results. Disorders with potency and ejaculation can also become an indication for the procedure.

Genetic diseases, due to which there is a risk of the birth of a patient or with the psychophysical characteristics of a baby, is another reason why artificial insemination is prescribed. True, then the procedure is performed with the donor's sperm, to which the husband (and the future official father) gives written consent. Fertilization with seminal fluid from the base of the clinic is also carried out for single women who want to become pregnant.

Advantages

Intrauterine insemination is the first of the methods that is used for problems with conception. The main advantage is the absence of great harm female body. Artificial insemination can be carried out even if the exact cause of infertility has not been established. The procedure does not require long preparation, and its implementation does not take much time. The main advantage of using this method is its low cost.

Preparation

Like any operation, and medically intrauterine insemination is such, the procedure requires preparation. One desire to do artificial insemination is not enough, you need to come to an appointment with a doctor who will prescribe an action plan after compiling a family history and a thorough analysis of the situation during the conversation. Then it is necessary to sign certain papers confirming the consent of the spouses to carry out the conception. If it is necessary to use donor sperm, the number of documents for approval increases significantly.

Tests before insemination

Previously, in order to find out the preparedness for the artificial insemination procedure, the couple is tested:

HIV AIDS);
torch infections;
hepatitis;
passive hemagglutination reaction (RPHA).

After a 3-5 day period of abstinence, a man gives a spermogram, which determines the mobility of spermatozoa. In women, the patency of the fallopian tubes is checked, with the help of hysterosalpingography, the uterus is examined. An ultrasound scan detects ovulation. If there are problems, then hormones stimulate the production of an egg. Sowing of microflora is carried out to determine the presence of papillomavirus, ureplasma, group B streptococcus, which can cause the impossibility of bearing a fetus.

Semen preparation

Immediately before the insemination procedure, seminal fluid is artificially surrendered, after which it is examined and processed. There are 2 ways to prepare cells: centrifugation and flotation. The first option is preferable because it increases the chances of conception. Preparation of sperm consists in removing acrosin from it, a substance that inhibits sperm motility. To do this, portions are poured into cups and left to liquefy, and after 2-3 hours they are activated with special preparations or passed through a centrifuge.

What day is insemination done

According to doctors specializing in these gynecological issues, the best option for artificial insemination is the introduction of spermatozoa into the uterus three times:

1-2 days before ovulation;
On the day of ovulation;
After 1-2 days in the presence of several maturing follicles.

How is the procedure

Artificial insemination can be carried out independently or directly with the participation of a specialist in the clinic. To do this, the woman is placed on a gynecological chair, with the help of a mirror, access to the cervix is opened. The doctor inserts a catheter, and biological material is collected into a syringe connected to it. Then there is a gradual introduction of spermatozoa into the uterine cavity. After insemination, the woman should remain motionless for about 30-40 minutes.

Insemination with donor sperm

When identifying serious illnesses in a woman's partner, such as hepatitis, HIV and other potentially dangerous diseases, including genetic ones, then donor sperm is used, which is stored frozen at a temperature of -197 ° C. Data about a person is not declassified, but a woman can always bring with her a person who has the right to donate seminal fluid for subsequent artificial insemination of the patient.

Husband's cum

When using the biological material of the spouse, sperm sampling takes place on the day of the insemination procedure. To do this, the spouses come to the clinic, where biological material is donated. After that, the seminal fluid is analyzed and prepared for use. It is important to understand that before donating sperm, a man must refrain from sexual intercourse for at least 3 days in order to improve the quality of spermatozoa.

Artificial insemination at home

Artificial insemination is allowed at home, although according to doctors, its effectiveness is considered minimal, however, judging by the reviews, successful attempts have been recorded. In the pharmacy, you can buy a special kit for manipulation at home. The algorithm differs from that carried out in the clinic in that the sperm is injected into the vagina, and not into the uterus. When carrying out insemination on your own, you cannot reuse the kit, it is forbidden to lubricate the labia with saliva or cream, and also to inject sperm directly into the cervix.

Method efficiency

A positive result in the procedure of intrauterine artificial insemination is achieved less frequently than in in vitro fertilization (IVF) and ranges from 3 to 49% (these are the most positive data). In practice, the number of attempts is limited to 3–4, since more samples are considered ineffective. After that, it is necessary to conduct additional studies or correction of treatment. If there is no pregnancy, you should resort to another method of artificial conception or change the sperm donor.

Risks and possible complications

As such, intrauterine insemination does not cause complications, women are more at risk due to taking drugs that cause ovulation, so it is imperative to test for the possibility of allergies. In addition, the risk of having twins increases, less often triplets, due to the fact that several attempts are made to introduce sperm and stimulate the formation of more than one follicle.

Contraindications

Although artificial intrauterine insemination is a simple procedure with little or no consequences, there are still some restrictions on which it can be refused. Among them, there are problems with ovulation itself, which occurs with violations, tubal infertility (it is necessary that at least one intrauterine labor is capable), inflammation of the appendages and uterus, hormonal disruptions, infectious and viral diseases.

Price

It is impossible to say for sure how much artificial insemination costs, since prices will differ in each clinic in Moscow. It is important to understand that the procedure consists of several stages, including consultation, tests, treatment. It is necessary to take into account the price of the medicines that will have to be taken. If donor sperm is used, then it is worth adding to the price and its cost. To date, according to information provided on the Internet, the following figures can be named:

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Attention! The information provided in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment, based on the individual characteristics of a particular patient.

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Discuss

Artificial intrauterine insemination with husband's or donor's sperm - indications, preparation for surgery and price

We want to support married couples and single women who decide to undergo a procedure such as intrauterine insemination (hereinafter referred to as IUI or AI). Unfortunately, not everything in life is always simple and smooth: some people experience loneliness when they have long wanted to find a family, while others experience illness, loss of loved ones, and other misfortunes. No need to think that it was you who were unlucky - everyone has some kind of trouble. And do not be ashamed that you have to go to the doctors - we do not hesitate to go to the doctor if, for example, we broke our leg in order to get rid of the pain and be able to walk in the future.

Just artificial insemination of a person, intrauterine insemination, going to doctors in order to have a child, is less familiar to us, that's all. This is less familiar to the people who surround us. Methods of artificial insemination (including intrauterine artificial insemination) in Moscow and the regions every year help everyone more family couples. Artificial insemination - donor, or husband's sperm will give you the desired result - your child. However, if you are not ready or do not want to meet wariness, skepticism, and even ridicule from those around you - natural human reactions to something new and unusual - and do not feel confident in convincing people and achieving their understanding of the situation, then you probably should not tell loved ones that you have resorted to such a procedure as intrauterine artificial insemination.

The results after insemination - a successful pregnancy - will please you and your loved ones. Conceiving a child is an intimate, personal matter, and concerns only you. You can answer questions from loved ones in this way or smile mysteriously. The methods of artificial insemination used in this case are up to you, your spouse and your doctor.

The misfortune that has piled up is sometimes so depressing that complete despondency comes. But over time, you realize that the problem will not be solved by itself and life will not get better on its own. Artificial insemination of a person is a medical method of treatment, there is nothing obscene in it. The problem of artificial insemination is largely contrived by people uninformed in this matter. If you are shown this procedure, artificial insemination - donor or husband's sperm - you need to think carefully about everything and act. Trouble must be overcome, not surrendered to it. There are always ways to solve a problem. Perhaps not always easy, not always easy to accept something psychologically, not always enough patience and will. Sometimes you just don't know how to solve a problem, or which way is best.

Artificial insemination. Indications:

couples where not everything is in order on the part of the man (sexual disorders or bad sperm)
single women (if there are no problems "on the female part")

Many single women really want to have a baby. But what if there is no suitable partner nearby? Women will learn what artificial insemination is, who became pregnant after artificial insemination, where artificial insemination is done, how much artificial insemination costs - in Moscow and the regions. Having clarified all the questions, women turn to a selected clinic where artificial insemination is performed. If intrauterine insemination is successful, long-awaited pregnancy occurs after insemination. And it doesn't matter how much artificial insemination costs; result - new life, your child is in your arms. I would like to wish single women good luck and understanding and help from loved ones with raising a child.

Let's take a closer look at men's issues. These or those problems in the reproductive sphere are now found in men, including young men, quite often, and, unfortunately, are not always treatable. The problem of artificial insemination for men is quite acute. This is a heavy blow to male pride and just a human misfortune. Often this also disrupts the harmony in the pair.

It is completely pointless not to do anything in this situation, to get away from it - sooner or later the problem will have to be solved, somehow determine one's fate, and delay usually leads to the proliferation of problems.

In this situation, it is important to collect complete information, which can help you modern medicine where exactly and how successfully. It is also important to visit clinics and doctors in person to get answers to your questions and doubts. If artificial insemination is indicated for you, tests will help you choose the right treatment tactics.

I would like to mention separately that bad sperm is not a diagnosis, it is an analysis. If a man has not been examined and there is no conclusion about the diagnoses, causes of poor sperm and the possibility of treatment, it is too early to predict whether pregnancy is possible naturally or whether artificial intrauterine insemination or another ART method is needed.

With serious sperm pathologies, if this cannot be corrected, insemination with the husband's sperm cannot help solve the problem. In these cases, medicine can only help with insemination with donor sperm or IVF / ICSI with husband's sperm.

The role and significance of a man in conception, if you have to resort to artificial methods, not only does not become lower, it becomes much higher and more responsible. Even if donor sperm is used, this is your child, thanks to you a new life is born, and he will be the way you raise him.

Artificial insemination (AI) is a method of assisted reproduction (along with IVF, IVF / ICSI), in which, as with other methods, a certain stage of conception of a child occurs artificially.

General information

Insemination is the introduction of sperm into the genital tract of a woman by artificial means. The whole further process occurs naturally: the spermatozoa run from the uterus to the fallopian tubes, where they meet the mature egg that has left the ovaries and also entered the fallopian tubes, fertilizes it, and then the fertilized egg enters the uterus, where it attaches to the wall of the uterus and gives rise to pregnancy.

Insemination is carried out near the time of ovulation (the release of a mature egg from the ovary), approximately in the middle of the menstrual cycle.

Previously, the introduction of sperm into the vagina was used, but more recently, the introduction of sperm into the uterus, the so-called intrauterine insemination (IUI), has been used more successfully.

With intrauterine insemination, the sperm is pre-treated, making it similar to the composition that the sperm acquires in the vagina on its way to the uterus during natural intercourse, and selecting the "squeeze" from the most fertile spermatozoa. The introduction of raw sperm directly into the uterus is unacceptable.

Artificial insemination. Indications

Inseminations are performed on single women and are used to achieve pregnancy in spouses in a barren marriage, if treatment to achieve a natural pregnancy has not been successful.

Artificial insemination. Results: Pregnancy as a result of insemination can occur in a woman only when there are no diseases that prevent pregnancy. In case of obstruction / absence of fallopian tubes, high endometriosis, absence of ovaries or uterus, insemination is not carried out.

As a method of assisted reproduction distinguish:

artificial insemination with husband's sperm (IISM)
artificial insemination with donor sperm (IISD)

Artificial insemination with husband's sperm (IISM)

ISIS are indicated and can overcome infertility only in those cases when the artificial introduction of sperm bypasses that / those obstacle / I, due to which / s pregnancy did not occur, namely:

with sexual disorders, vaginismus, irregular sexual life,
with cervical (cervical) factor of infertility, when the husband's spermatozoa die in the wife's vagina,
with slight deterioration in sperm quality compared to normal,
with infertility of unknown origin, when the couple went through a full list of examinations, and the cause was not found, however, the use of IVF is seen as premature, insufficiently justified or too expensive.

In all cases, except for the first one, it is assumed that the couple has undergone a full examination for infertility according to the full list of examinations, and there is a conclusion about the causes of infertility. If a couple is indicated for artificial insemination, tests will help choose the right treatment.

All of the cases listed above are quite rare and account for only a small percentage of cases of infertility.

When inseminating with the husband's sperm, fresh (native) sperm is used, which is donated at the clinic immediately before insemination on the same day, a few hours in advance. For insemination, the husband must be examined for at least all sexually transmitted infections.

The child born as a result of such insemination is genetically related to the woman and her husband.

Artificial insemination with donor sperm (IISD)

I believe that before resorting to IVF, it is worth taking advantage of the chance of AI with donor sperm (IISD). Why??

It is important to understand that if pregnancy does not occur from insemination with donor sperm, nothing will prevent IVF from being applied. If at first you follow the path of IVF and pregnancy does not occur after several attempts, there is a risk that the reproductive health and mental state of the woman will worsen as a result of IVF, and the use of insemination with donor sperm will then turn out to be inappropriate, that is, there will be no other way.

Insemination with donor sperm has advantages over IVF/ICSI:

there are no strong hormonal stimulations that can negatively affect health unborn child,
the transmission of male infertility to the next generations is excluded (possible transmission during IVF / ICSI has not been studied by medicine),
there is no risk to the health of the mother, unlike the IVF procedure.

IISD are applied:

with poor quality of the husband's sperm (as an alternative to IVF, IVF / ICSI) or the absence of a sexual partner / husband in a woman.

In this case, the sperm of an anonymous donor from the donor sperm bank of the clinic can be used, or the sperm of a donor that you bring yourself - this can be the closest relative of the husband (brother, father), a person you know or unfamiliar, but who agrees to act as a donor.

The child born as a result of such insemination will be genetically related to the woman and the donor, but the real father of the child - officially and in fact - becomes the woman's husband, if he exists. Doctors keep medical secrecy, and pregnancy after insemination is carried out as a normal pregnancy. The donor has no paternity rights and obligations.

More about donors.

According to the order of the Ministry of Health of the Russian Federation, in order to avoid the transmission of infections, medical institutions are allowed to use only cryopreserved donor sperm that has been frozen and kept in quarantine for at least six months to detect latent infections.

Since the sperm of not every man can withstand freezing / thawing without a serious deterioration in its quality, only men whose sperm has this property (cryotolerant) are accepted as anonymous donors.

Anonymous donors are examined for all sexual infections, the absence of mental abnormalities and congenital deformities is also mandatory.

Other requirements for anonymous donors depend on the clinic: the most stringent requirements are genetic tests for potential heredity, the presence of 2 healthy children of their own.

Carefully choose a clinic where to do artificial insemination! Clinics search and attract anonymous donors themselves. The number of donors whose sperm makes up a donor sperm bank may be only 2-3 people, or there may be dozens. About the donor, general data about appearance, nationality, blood type, the presence of their children, education and occupation are provided.

When inseminating with the sperm of a donor that you bring yourself, as an exception, not cryopreserved for half a year, but fresh sperm can also be used. If artificial insemination is carried out in this mode. The cost of the procedure will be lower, the waiting time will be reduced, and the likelihood of pregnancy after artificial insemination will also increase.

Insemination requires examination of the donor, which you bring yourself, at least for all sexually transmitted infections.

Where to do artificial insemination. official registration

Inseminations are carried out in clinics that deal with reproduction problems, in the same place where IVF is performed (see the list on the website). Insemination is carried out by a reproductive specialist (a separate specialization in gynecology) with the participation of an embryologist who prepares sperm.

For artificial insemination, an official agreement is signed with the clinic - consent to insemination, with passport data.

If a woman is officially married, then both the wife and the husband sign the official consent for insemination both for insemination with the husband's sperm and for insemination with the donor's sperm.

When carrying out insemination with the sperm of a donor whom you bring yourself, his official consent is also signed. At the same time, his passport data and passport data of spouses or a single woman for whom he/she agrees to become a donor are indicated.

Insemination procedure

Before insemination, a woman should be examined for sexually transmitted infections and an ultrasound should be done to exclude possible gynecological diseases that may be an obstacle to the onset or bearing of pregnancy.

Insemination is carried out near the time of ovulation - the release of a mature egg from the ovary, approximately in the middle of the menstrual cycle. Ideally, if in the time interval "a day before ovulation - a few hours after", since this is the most auspicious time for conception. Although insemination a day or two or three before ovulation can also lead to pregnancy.

In order to determine the time of ovulation with an accuracy of at least a day, and to make sure that the egg is mature, ultrasound monitoring is performed: from the beginning of the menstrual cycle in which AI is supposed to be performed, ultrasound is done several times to monitor the work of the ovaries and the growth of one or more follicles (oocytes). Follicle growth is usually 2 mm/day and ovulation occurs when the follicle reaches a size of 18-22 mm.

In addition to ultrasound, ovulation tests (similar to urine pregnancy tests) sold in pharmacies are used to accurately determine the time of ovulation.

IS can be performed using hormonal stimulation of the ovaries. Hormonal stimulation is carried out with the same drugs as for IVF (see page "pharmacology in eco" >>>), but usually in significantly lower doses.

Stimulation can produce multiple follicles/eggs and some better quality, which increases the chance of pregnancy. It should be mentioned that drugs with the active ingredient "clomiphene" (clostil, clostilbegit) are outdated drugs with many side effects and less efficient.

With a pre-ovulation size of the follicle / s, an ovulation provocateur - human chorionic gonadotropin (hCG) can be prescribed.

Two days after ovulation, hormonal support for the second phase of the cycle can be prescribed with duphaston and utrozhestan, which contributes to the onset and maintenance of pregnancy.

In addition to mature follicles / eggs an important factor for the onset of pregnancy is the thickness of the endometrium in the uterus at the time of ovulation. During ultrasound monitoring, the growth of the endometrium is also monitored, and if the growth is insufficient (by the time of ovulation it should be at least 9 mm), additional hormonal preparations for building up the endometrium (estrophem, proginova, divigel).

Insemination can be carried out without the appointment of any medications.

In one menstrual cycle 1 or 2-3 inseminations can be carried out. It depends on whether one or more follicles / eggs mature and when each of them ovulates (follicles can ovulate with an interval of 1-2 days) and depending on how accurately you can predict the time of ovulation.

In the case of using cryopreserved donor sperm, 2-3 inseminations can be carried out with an interval of a day.

When fresh (native) semen is used, it should be assumed that for good quality sperm requires sexual abstinence, ideally 3-5 days. Therefore, insemination is carried out either 1 time - on the day of the expected ovulation, or 2 times with an interval of 2-3 days - for example, 2 days before ovulation, and a few hours before or after ovulation. Ultrasound monitoring is carried out until it is established that ovulation has occurred (!).

Preparation of sperm for AI takes about 2 hours: about an hour is spent on the so-called liquefaction, then the sperm must be processed without delay (otherwise its quality deteriorates). Processed semen can be stored for several hours without losing its quality. If cryopreserved sperm is used, then more time is required to thaw the sperm.

The very procedure of insemination (introduction of sperm) takes several minutes, is carried out on a gynecological chair.

Sperm is injected through a special catheter directly into the uterus. The procedure is painless, you can only feel a slight pull. After the procedure, you may feel some uterine tension (tonus) for several hours. After the introduction of sperm, you must remain on the chair in the same position for 15 minutes, then you can get up. A little fluid leakage is normal.

On the day of insemination, physical activity should be limited and the same regimen should be maintained as on critical days (menstruation). Since insemination directly interferes with the uterus, which increases the risk of infections, more thorough hygiene and caution should be observed. Mode of life in the following days - without restrictions.

Consults, conducts ultrasound monitoring, makes all appointments and conducts the actual insemination by the same doctor - a reproductive specialist. The embryologist is engaged in the storage and preparation of sperm for insemination.

Hormonal support for the second phase of the cycle with utrozhestan, duphaston does not allow menstruation to begin, even if pregnancy has not occurred. Therefore, if hormonal support is used, 2 weeks after ovulation, you need to take a blood test for pregnancy (blood for hCG).

In case of a negative analysis, support is canceled, in case of a positive analysis, support is continued until a consultation with a doctor.

Cost of insemination

Artificial insemination. Price. The cost of AI consists of several components: the initial consultation with a doctor, the cost of ultrasound monitoring, the insemination procedure itself, the preparation of sperm for insemination, the cost of donor sperm (if sperm from the clinic’s donor sperm bank is used), the cost of the drugs used.

Thus, the cost of insemination depends on the chosen clinic, whether ovarian stimulation drugs and other drugs are used, whether a donor sperm bank is used.

In some clinics, when artificial insemination is carried out, the price is set for everything that is carried out during the cycle - for ultrasound monitoring and insemination, regardless of whether 1 or 2-3 procedures are required. There are clinics where payment is made for each type of service - separately for ultrasound monitoring, or even each ultrasound, separately - for each insemination procedure.

Therefore, when finding out the cost of insemination in this clinic, you should separately ask how much the entire necessary set of services costs.

The cost of donor sperm from the donor sperm bank is paid separately. Medications are bought independently in a clinic or pharmacy, the cost of modern stimulation drugs is comparable to the cost of medical services for insemination.

A higher price than other clinics for a "kit" or directly for the insemination procedure does not always mean that this clinic has a better result. Carrying out insemination in clinics in Moscow and St. Petersburg on average costs several hundred ye per menstrual cycle.

Artificial insemination. Who got pregnant? Probability of success and possible reasons for failure.

Pregnancy as a result of insemination occurs less frequently than during natural sexual life in healthy couples, and than during IVF. That is, the probability of pregnancy in one cycle during insemination is less than 30%. Therefore, you should tune in to at least 3-4 cycles of insemination.

If pregnancy does not occur after 3-4 cycles of insemination, it is recommended to change the method of treatment or the donor.

This limitation is partly due to the fact that it is undesirable to stimulate the ovaries for more than 3-4 cycles, and partly because there are more effective method- IVF (however more expensive and less harmless to health). However, more than 3-4 cycles of insemination without the use of ovarian stimulation, simulating natural sexual activity, may be quite reasonable.

Possible reasons for failure:

a) insemination is carried out not according to indications, there are obstacles to the onset of pregnancy,

b) the insemination was carried out insufficiently qualified or negligently,

c) bad luck.

More details about each of the reasons:

a) Indications.

If a woman has not been tested for fertility, it cannot be ruled out that she has diseases that prevent pregnancy. It is also important to understand that a mature and covulated follicle does not mean that a full-fledged, good-quality egg has matured. If a woman has hormonal disorders, ovarian disorders, or her age is over 35 - possible cause failure may be poor egg quality.

It should be noted separately IISM with a decrease in sperm counts. To decide whether insemination is advisable, 2-3 spermograms are needed, since sperm counts can vary greatly. When preparing sperm for insemination, the embryologist gives an independent opinion on the quality of the sperm and the prognosis of how pregnancy is possible - it is important to know this conclusion in order to decide on further treatment if pregnancy does not occur.

b) The professionalism of doctors.

The whole scheme of actions for the insemination cycle is described above. Thus, the reason for failure may be:

delay in sperm preparation,
low quality of biological media used in semen processing in this clinic,
insufficiently accurate time of ovulation and insemination not at the optimal time, lack of verification that ovulation has occurred, the appointment of an ovulation provocateur with an undergrown or overgrown follicle / s,
thin (undergrown) endometrium in the uterus.

If you feel negligence, contradictions in the actions of the doctor, you should think about changing the clinic or doctor.

c) Bad luck.

If you do not find reasons for failure in reasons a) and b) and have only done 1-2 cycles of insemination, most likely you are just not lucky yet.

You can apply ovarian stimulation, if it was absent, change stimulation drugs, carry out 2-3 inseminations in a cycle, if only 1 was carried out, increase the time of sexual abstinence for a man before donating sperm (up to 5 days). The absence of pregnancy during even several cycles of insemination does not mean that a woman cannot become pregnant during natural sexual activity with a healthy man.

Based on the information collected and the experience of those who have gone through insemination, consultations with many fertility doctors, try to understand whether it is worth resorting to AI in your case and how to do it all. Maybe AI is your chance!

Submit your good stories! They will give real hope to those who are thinking and doubting or afraid of failure!