UNDERSTANDING THE ARTIFICIAL INSEMINATION PROCEDURE

How does the artificial insemination procedure work, and is it right for you? Artificial insemination can help individuals get pregnant when dealing with issues such as:

• Male factor infertility
• Unexplained infertility
• Needing to use donor sperm to get pregnant

There are two different artificial insemination procedures:

• Intrauterine insemination (IUI), which is most common today
• Intracervical insemination (ICI), also known as intravaginal insemination

Let's review the steps to a successful artificial insemination procedure.

Step 1: The physical examTo begin the artificial insemination procedure, both you and your male partner (or your potential donor) will have a complete physical examination, including blood testing.

Your doctor will do a sperm analysis by obtaining a sperm sample from your male partner (or sperm donor). If your partner has ejaculation problems, the doctor can bypass this by extracting sperm from his bladder after he ejaculates. The doctor can then use this sperm during the artificial insemination procedure.

If your partner has low sperm counts, he may give sperm samples from more than one ejaculation, if needed.

Step 2: Fertility drugs and monitoringWhile not required, your doctor may prescribe fertility drugs like Clomid or gonadotropins/injectables before the artificial insemination procedure. Combining hormone treatments with IUI seems to give infertile couples a better chance at pregnancy.

Human chorionic gonadotropin (hCG) may also be administered before the artificial insemination procedure to trigger ovulation. The insertion of your partner’s sperm (or donor sperm) should then be done within 24-36 hours after this injection.

If you take fertility medications, you will be closely monitored with blood tests and ultrasounds to make sure that your eggs are developing in a healthy way.

Your doctor may also recommend that you track your ovulatory cycles by taking a daily basal body temperature (BBT) and/or charting changes to your cervical mucus.

Your doctor may also ask you to monitor your ovulation by testing for an LH surge in your urine. This LH surge will indicate that you are about to ovulate. Once the surge happens, you may choose to do one or two artificial insemination procedures each cycle.

Step 3: Preparing the spermIf you are undergoing IUI the sperm sample will undergo a special washing and processing procedure. After a semen sample is obtained, the sperm are washed and concentrated down to maximize the chances of conception. During this washing and processing phase, potentially toxic chemicals are removed, along with a seminal plasma shell that surrounds each sperm cell.

The process of sperm washing offers several benefits:

• The sperm are concentrated to boost your chances of getting pregnant.
• It may prevent you from having a possible allergic response to the sperm.
• It may help to minimize any uterine cramping.

Step 4: Insertion of the spermThe artificial insemination procedure is quick and usually painless. When the procedure begins, you will lie down as you normally would for a pelvic exam. A speculum will be inserted and the sperm sample will be prepared for insertion. The sperm is placed all the way into the uterine cavity with a thin catheter and syringe.

For those using ICI, the sperm will be placed into the vagina and deposited into the cervix with a soft catheter. 

Step 5: RestAfter the artificial insemination procedure, a cervical cap or sponge is placed into the vagina to keep the sperm near the cervix. This sponge or cap can be removed several hours after the procedure is over.

You may be advised to lie down for 15-20 minutes with the sponge inside of you. Some experts believe that lying down after the procedure boosts your chances of getting pregnant.

To help this process be more relaxing, you may want to bring your partner, or a close friend, or a book – whatever helps you to relax. If you are still unable to get pregnant after several cycles, your doctor may want to do further fertility testing.

Should you use donor sperm with artificial insemination?Many women today use donor sperm with the artificial insemination procedure. Here are some reasons why:

1. If your male partner’s sperm is of poor quality or quantity, donor sperm may help you get pregnant.
2. Some men with genetic disorders may choose to use donor sperm with the artificial insemination procedure so they don’t pass on genetic disorders to their children.
3. Using a sperm donor is also a popular choice for single women or lesbian couples who want to build a family of their own.

Before proceeding with donor sperm and the artificial insemination procedure, your doctor may encourage you to speak to a counselor about any anxieties or concerns. You can usually select your own sperm bank that will provide you with information about each donor. You may find out what the sperm donor looks like, as well as his ethnicity, career and educational background, and personal health information.

Read more about choosing a donor

Donor sperm used in the artificial insemination procedure is analyzed for a variety of health conditions and viruses, including HIV and other infections. Current guidelines recommend that the donor sperm is quarantined for at least six months to ensure its safety.

Ask a doctor about artificial insemination

Sources

• American Pregnancy Association
• American Society for Reproductive Medicine
• American Urological Association Foundation
• RESOLVE: The National Infertility Association
• Women'sHealth.gov