Artificial Insemination
One effective method of assisting couples in overcoming infertility is artificial insemination or AI. Artificial insemination is a technique in which sperm is directly inserted into a woman’s reproductive organs making conception easier and usually much quicker. Dating back to the 1900’s, artificial insemination is considered the ‘granddaddy’ of fertility treatments. However, there are a lot of uncertainties regarding artificial insemination. This article will attempt to clarify this process by addressing who should seek this method of assisted reproductive technology, any side effects that may be experienced, the various types of artificial insemination, how the procedure is performed, and success rates.
Despite the ease and success of artificial insemination, it is not recommended for everyone. Couples who have certain fertility issues such as a woman with a sperm allergy, unreceptive cervical mucus, endometriosis, abnormalities of reproductive organs, or a man who has low sperm count or weak sperm motility are good candidates for artificial insemination. Also, couples who have an undiagnosed cause of infertility or are unable to engage in sexual intercourse due to a physical disability should consider artificial insemination. However, a woman must have properly functioning fallopian tubes that are in good condition and free of any blockages in order to engage in this particular type of fertility treatment.
For years, people have had the general misconception that the sperm is inserted into a woman’s vagina with a turkey boaster. Luckily this is not the case. In fact there are four different types of artificial insemination.
The variations are simply based on where in the woman the sperm is injected. The four types are:
1. Intracervical – The sperm is inserted into the cervix, which is the opening for the uterus.
2. Intrafollicular – Sperm is directly injected into the ovarian follicle.
3. Intratubal – Sperm is injected into the fallopian tubes.
4. Intrauterine – Sperm is injected into the uterus.
Prior to beginning artificial insemination, there are certain things that must be done to prepare the woman’s body for fertilization. The doctor must first calculate when a woman is ovulating. Then fertility drugs will be prescribed for about 7 days prior to ovulation in an attempt to stimulate the production of and maturation of eggs. While taking these drugs, the woman must be carefully monitored with the use of ultrasound scans and blood tests to check hormone levels.
No matter what type of artificial insemination is used, the procedural steps are the same. The six steps performed during artificial insemination are listed below.
Step 1: Sperm Collection – The man will ejaculate into a sterile container to be used for insemination. If necessary, the sperm will be “washed” to prepare it for entering the woman’s body and this also makes it more concentrated, aiding in fertilization.
Step 2: Pelvic Exam – The woman is positioned for a pelvic examination by laying flat on her back with her legs suspended in the air with stirrups.
Step 3: Speculum – This device is inserted into the woman’s vagina similar to the manner in which a routine yearly exam is conducted.
Step 4: Sperm Retrieval – The sperm that was collected in Step 1 is now retrieved with a plastic syringe.
Step 5: Preparing the Tools – The syringe is attached to a catheter (thin tube) and then carefully placed into the proper position.
Step 6: Injection – This is when the type of artificial insemination becomes important because it is during this step that the sperm is actually injected into the woman’s body at the appropriate location.
Sometimes a seventh step will be necessary. This step is the placement of a cervical cap over the cervix to hold the sperm in the desired area for a few hours, which will be removed later that same day. This entire procedure takes only 45 minutes to one hour and is relatively painless. After all 6 steps have been completed, the woman will be required to lie still for an additional 30 to 40 minutes with her legs elevated. Normal activities are usually able to be resumed a few hours after the procedure.
About two weeks after the procedure, a pregnancy test can be done. If the artificial insemination cycle was successful, prenatal care can begin. However, if the cycle was unsuccessful, another cycle can be started or other methods can be considered.
Many couples actually prefer artificial insemination because of the ease of the process compared to other assisted reproductive technologies, the low risk factor, and the lower cost. The average cost for artificial insemination ranges between $800 and $1,500 per cycle compared to $20,000 or higher per cycle for In Vitro Fertilization.
Of course with any procedure, some side effects, risks, and disadvantages are inevitable. In regards to artificial insemination the risks include:
~ Failure to become pregnant,
~ Multiple pregnancies which can lead to a higher risk of miscarriage and/or birth defects,
~ Abdominal cramping and pain,
~ Overstimulation of the ovaries, and
~ Any side effects that are directly related to the fertility drugs that your doctor may or may not prescribe.
In addition to the above mentioned risks, one of the primary disadvantages of artificial insemination is the demand it places on both partners. Because a woman has only a 24 to 48 hour window of ovulation, the couple must be able to drop everything and go to the doctor’s office for this procedure. Furthermore, the timing of the insemination is crucial and must coincide with the woman’s ovulation cycle, that the man must be able to produce a sperm sample on demand. This can be extremely stressful for the man and can inhibit the process.
In spite of the minor risks and disadvantages, artificial insemination is fairly effective. Depending on the fertility issue, the type of artificial insemination employed, and the use of fertility drugs the success rates vary. With the use of fertility drugs, the success rate in Australia is approximately 15% per cycle. However, certain factors such as age can affect the success of artificial insemination. Women who are older than 35 years of age when beginning AI cycles have a lower success rate.