Intrauterine insemination (IUI)
This is a technique in which sperm is introduced into the woman’s uterus with the help of a special, thin catheter, which has been processed in advance in the laboratory in order to increase the sperm potential. In this way, the distance between the sperm and the egg is reduced and the fertilisation process is facilitated.
Insemination with a partner’s sperm is suitable for:
- Young women with pierced trumpets
- Couples whose reasons for infertility are unknown.
- Couples in which the woman has ovulation problems (e.g. polycystic ovary syndrome).
- Couples in which the partner has mild to moderate problems with sperm quality, concentration or motility.
Insemination with donor sperm is suitable for:
- Men with poor sperm quality or no sperm.
- Men who are carriers of a genetic disease that cannot be detected in embryos.
- Women who do not have a partner.
Is insemination done with or without medication?
Insemination can be performed in a natural cycle, i.e. without drugs or after inducing follicular development with the help of drugs. Usually drug-induced ovarian stimulation is chosen in women who have an irregular cycle such as in polycystic ovary syndrome. Monitoring is done with a series of ultrasounds and blood tests to determine hormone levels. When the follicles have reached a sufficient size and number, insemination is performed about 36 hours after an injection of chorionic gonadotropin which causes the eggs to mature and ovulate.
What is the sperm preparation process?
The partner gives sperm just before the scheduled time of insemination (about 1-2 hours before). In cases of sperm donation, the donor sperm is stored in the sperm bank and thawed 1-2 hours before insemination. Sperm processing involves centrifugation in layers of different densities and then washing in a special culture medium of choice in order to concentrate the most motile spermatozoa and separate them from the seminal fluid. The seminal fluid contains leukocytes, immature germ cells and oxygen free radicals that can cause DNA fragmentation, resulting in low fertilisation capacity. Thus, after processing the semen in the laboratory, the quality of the sample to be used for insemination is better.
Success rates
The rates of achieving pregnancy with insemination are relatively low(10-15% per cycle) of course it depends on many factors (age of the woman, quality and number of spermatozoa, etc.). This means that several attempts may be needed to achieve pregnancy. Of course, this technique has the advantage of being much less invasive than IVF and therefore less expensive. However, if the woman is over 40 years old or has a low egg reserve (low AMH), then the success rate after insemination is significantly reduced. At older ages IVF is the appropriate method to maximise the chance of achieving pregnancy
