Insemination

In insemination, we use the natural reproductive potential of the partners. The sperm (after being properly prepared and injected into the uterus) themselves aim to fertilize the egg. The procedure is designed to help only bypass barriers that could prevent fertilization and facilitate the sperm’s path to the egg. In vitro fertilization (IVF) is already a more advanced and complex procedure. First, a woman must undergo ovulation stimulation so that as many ovarian follicles with egg cells inside as possible can be obtained. In the next stage, by means of puncture, the ova are retrieved and transferred to the laboratory, where the fusion of the ovum and sperm already takes place. Fertilization thus takes place outside the woman’s body, rather than inside the body as in the case of insemination. The finished embryos are then cultured for several days and administered to the uterus – this stage is called embryo transfer.

Before insemination, in addition to a basic gynecological examination, a woman should have the following tests performed:

• evaluation of ovarian reserve (AMH, AFC, FSH, Estradiol).
• Sono-HSG (examination of the patency of the fallopian tubes)
• cytological examination
• virological tests (HIV, HCV, HBS, HBC, VDRL, Rubella IgG and IgM, Toxoplasmosis IgG )
• testing for Chlamydia trachomatis, Mycoplasma genitalium, Ureoplasma urealitycum

For men whose female partners are undergoing insemination, it is recommended to perform such tests as:

• blood group determination
• HBs antigen and VDRL (WR)
• anti-HBc antibodies
• antibodies against cytomegalovirus in IgG and IgM classes
• anti-HCV antibodies
• anti-HIV antibodies 1,2

In addition, the doctor may order the following tests for a man: bacteriological culture of semen, testing for chlamydia trachomatis, testing for antisperm antibodies (MAR test).

The effectiveness of insemination depends on the cause of the couple’s problems. If the man and woman are healthy, and the reason for performing insemination is sexual dysfunction and the inability to have vaginal intercourse, then the chances of achieving pregnancy by means of intrauterine insemination will be about 25 – 30%, which is about the same as they are in young, healthy couples having intercourse at the most fertile moment of the cycle. However, it should be remembered that couples also benefit from intrauterine insemination for completely different indications – reduced sperm parameters, mild endometriosis, immunological disorders. In such cases, we can not expect the maximum effectiveness of the procedure – it will be from a few to several percent.

Insemination is not performed in the case of:

• obstructed fallopian tubes – obstructed fallopian tubes are a prerequisite for insemination,
• uterine myomas,
• polyps,
• inflammatory conditions within the reproductive organs,
• disorders of the endometrium,
• semen parameters that do not meet the requirements (sperm concentration and motility significantly below normal),
• the presence of cancer,
• presence of bacteria in the partner’s semen.

The insemination procedure can be repeated several times, but no more than 6 insemination attempts are recommended. If insemination does not result in pregnancy, the couple is offered another form of treatment.

The insemination procedure does not require any special preparation from the partners. The woman should have a filled bladder, as this makes it easier to insert the catheter. To this end, she should drink about 1.5 liters of water before the procedure. The woman’s partner, on the other hand, before donating sperm for insemination, should maintain a 3-day sexual abstinence, abstain from alcohol and other stimulants and avoid physical exertion. The sperm donation takes place in a designated room, in intimate and comfortable conditions.