Artificial insemination is a fertility treatment in which sperm is inserted into a woman's womb by a fertility specialist, rather than getting there by having sex.
This makes the trip shorter for the sperm and bypasses any possible obstructions. This relatively simple procedure with few side-effects may also be appropriate where donor sperm is being used.
What type of infertility can artificial insemination treat?
Artificial insemination can be used for many kinds of fertility problems. It's a popular infertility treatment for men who have very low sperm counts or sperm that aren't strong enough to swim through the cervix and up into the fallopian tubes. Artificial insemination is also sometimes an option for women who have endometriosis or abnormalities of any of their reproductive parts.
Women with unreceptive cervical mucus are also good candidates for artificial insemination. In these women, the mucus surrounding the cervix is hostile to sperm and prevents sperm from getting into the uterus and fallopian tubes. Artificial insemination allows the sperm to bypass the cervical mucus entirely. Doctors also often suggest artificial insemination when they cannot find a specific reason why a couple is infertile.
If the man is unable to produce enough viable sperm, artificial insemination can be carried out using donor sperm.
Artificial insemination: What to expect
Your specialist may suggest an ovulation kit to make sure you are ovulating when you undergo artificial insemination, but it is common practice to use ultrasound and blood and urine tests to be certain that ovulation is occurring.
When you are ovulating, your partner will be asked to produce a sample of semen. The doctor will suggest that your partner abstain from ejaculating for two to five days in advance to ensure a higher sperm count. If you live close to the clinic, your partner may be able to collect the semen at home by masturbating. Otherwise, the clinic will provide a private room for this purpose. The sperm must be "washed" in a laboratory within one hour of ejaculation.
The process of "washing" the sperm enhances the chance of fertilisation and removes chemicals in the semen that may cause discomfort for the woman. It consists of liquefying the sperm at room temperature for 30 minutes. A harmless chemical is added to separate out the most active sperm. Then a centrifuge is used to collect the best sperm.
The sperm are then placed in a thin tube called a catheter and introduced through the vagina and cervix into the uterus. Artificial insemination is a short, relatively painless procedure that many women describe as being similar to having a cervical smear test. Some women have cramping during the procedure and light bleeding afterward. Immediately after the procedure your doctor will probably tell you to lie down for about 15 to 45 minutes to give the sperm a chance to get to work. After that, you can resume your usual activities.
In some cases, your doctor will prescribe fertility drugs, such as clomifene, to induce superovulation (ovulation of multiple eggs) before having artificial insemination.
Success rates for the procedure vary between about 5% and 30%. Factors that lessen your chance of success include:
- Older age of the woman
- Poor egg quality
- Poor sperm quality
- Severe endometriosis
- Severe damage to fallopian tubes (usually from chronic infection)