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The statistics are disappointing - every year the number of infertile couples only increases, and how many of them want children! Thanks to the latest technologies and progressive treatment methods, babies are born, even though it would seem that this is impossible. Artificial insemination is a procedure that allows a woman diagnosed with infertility to become a mother using donor sperm. What is the essence of the technology, to whom it is contraindicated and how great are the chances of having a child - more on this later.

What is artificial insemination

As one of the methods of artificial insemination, insemination helps parents find their long-awaited child. The procedure significantly increases the likelihood of conception, since it is preceded by a careful selection of material for the operation. Among the sperm, the most active ones are selected, and the weak ones are removed. The protein components of the ejaculate are removed because they can be perceived by the female body as foreign.

Intrauterine insemination is not a panacea for infertility, but only one way to get pregnant artificially. According to research, the positive effect is estimated at a maximum of 30–40 percent. A single session does not guarantee the development of pregnancy, so the operation is performed up to 3 times per monthly cycle. If conception does not occur after several procedures, it is recommended to turn to other methods of artificial insemination. Pregnancy itself with intrauterine insemination is no different from normal.

Why is artificial insemination possible?

It would seem why women cannot get pregnant, but with the artificial introduction of ejaculate, fertilization occurs. One of the features lies in the female body. The fact is that cervical mucus produces antibodies to male sperm. It turns out that it simply kills sperm, and does not facilitate their penetration into the egg. The procedure helps deliver the treated material directly to the uterus, bypassing the cervical canal. In this way, even with low sperm motility, the chance of getting pregnant increases.

Indications

As can be seen from the above, the main indication for artificial intrauterine insemination is the immunological incompatibility of partners. In fact, there are many more individual reasons for resorting to the procedure, so it is worth considering them in more detail. The main problems in women are considered to be inflammatory processes in the cervical canal. The disease prevents sperm from passing into the uterus, preventing a woman from becoming pregnant.

Artificial insemination is used for vaginismus, a problem where sexual intercourse is not possible due to spasms and pain. Injuries and pathologies of the reproductive organ that interfere with getting pregnant, abnormalities in the position of the uterus, infertility of an unclear socket, surgical interventions on the cervix are another of the many reasons to contact the clinic for an insemination procedure.

Until recently, the cause of female infertility was sought only among the weaker sex, but, as studies have shown, male problems are often dominant in this issue. Low motility and a small number of sperm that find it difficult to reach the end point, and azoospermia are some of the main diseases due to which artificial insemination is prescribed if previous treatment does not produce any results. Disorders with potency and ejaculation can also be an indication for the procedure.

Genetic diseases, due to which there is a possible risk of having a sick child or with psychophysical characteristics of the baby, are another reason why artificial insemination is prescribed. True, then the procedure is carried out with the donor’s sperm, to which the husband (and the future official father) gives written consent. Fertilization with seminal fluid from the clinic’s database is also carried out for single women who want to become pregnant.

Advantages

Intrauterine insemination is the first method that is used for problems with conception. The main advantage is the absence of great harm to the female body. It is possible to carry out artificial insemination even if the exact reason infertility. The procedure does not require lengthy preparation, and its implementation does not take much time. The most important advantage of using this method is its low cost.

Preparation

Like any operation, and intrauterine insemination by medical means is such, the procedure requires preparation. Just the desire to do artificial insemination is not enough; you need to come to an appointment with a doctor, who will prescribe an action plan after drawing up a family history and a thorough analysis of the situation during a conversation. Then it is necessary to sign certain papers confirming the consent of the spouses to carry out the conception. If it is necessary to use donor sperm, the number of documents for approval increases significantly.

Tests before insemination

Previously, to determine whether the couple is prepared for the artificial insemination procedure, the following tests are taken from the couple:

• HIV AIDS);
• stick infections;
• hepatitis;
• passive hemagglutination reaction (RPHA).

After a 3-5 day period of abstinence, the man takes a spermogram, which determines sperm motility. In women, the patency of the fallopian tubes will be checked, and the uterus will be examined using hysterosalpingography. Ultrasound detects the presence of ovulation. If there are problems, hormones are used to stimulate egg production. Microflora is cultured to determine the presence of papillomavirus, ureplasma, group B streptococcus, which can cause the impossibility of bearing a fetus.

Sperm preparation

Immediately before the insemination procedure, seminal fluid is given artificially, after which it is examined and processed. There are 2 ways to prepare cells: centrifuge processing and flotation. The first option is preferable, since this increases the chances of conception. Sperm preparation involves removing acrosin from it, a substance that inhibits sperm motility. To do this, portions are poured into cups and left to liquefy, and after 2-3 hours they are activated with special preparations or passed through a centrifuge.

On what day is insemination done?

According to doctors specializing in these issues of gynecology, the best option To carry out artificial insemination is the introduction of sperm into the uterus three times:

• 1-2 days before ovulation;
• On the day of ovulation;
• After 1-2 days, if there are several maturing follicles.

How does the procedure work?

Artificial insemination can be carried out independently or directly with the participation of a specialist in the clinic. To do this, the woman is placed on a gynecological chair, and access to the cervix is ​​opened with the help of a mirror. The doctor inserts a catheter, and biological material is drawn into a syringe connected to it. Then there is a gradual introduction of sperm into the uterine cavity. After insemination, the woman should remain motionless for about 30-40 minutes.

Insemination with donor sperm

If serious diseases are detected in a woman's partner, such as hepatitis, HIV and other potentially dangerous diseases, including genetic ones, then donor sperm is used, which is stored frozen at a temperature of -197°C. Information about a person is not declassified, but the wife can always bring with her a person who has the right to donate seminal fluid for subsequent artificial insemination of the patient.

Husband's sperm

When using biological material from a spouse, sperm collection occurs on the day of the insemination procedure. To do this, the spouses come to the clinic, where biological material is donated. After this, the semen is analyzed and prepared for use. It is important to understand that before donating sperm, a man must abstain from sexual intercourse for at least 3 days in order to improve the quality of sperm.

Artificial insemination at home

Artificial insemination at home is allowed, although according to doctors its effectiveness is considered minimal, however, judging by the reviews, successful attempts have been recorded. At the pharmacy you can buy a special kit for performing manipulations at home. The algorithm differs from that carried out in the clinic in that the sperm is injected into the vagina, and not into the uterus. When performing insemination on your own, you cannot reuse the kit; you must not lubricate your labia with saliva or cream, or inject sperm directly into the cervix.

Efficiency of the method

A positive result with the intrauterine artificial insemination procedure is achieved less frequently than with in vitro fertilization (IVF) and ranges from 3 to 49% (these are the most positive data). In practice, the number of attempts is limited to 3–4, since larger number the sample is considered ineffective. After this, it is necessary to conduct additional research or treatment adjustments. If pregnancy does not occur, you should resort to another method of artificial conception or change the sperm donor.

Risks and possible complications

As such, intrauterine insemination does not cause complications; women are more at risk due to taking medications that cause ovulation, so it is necessary to conduct tests for the possibility of allergies. In addition, the risk of having twins, or less often triplets, increases, due to the fact that several attempts are made to introduce sperm and stimulate the formation of more than one follicle.

Contraindications

Although artificial intrauterine insemination is a simple procedure with virtually no consequences, there are still some restrictions due to which it may be refused. Among them are problems with ovulation itself, which occurs with disturbances, tubal infertility (it is necessary for at least one intrauterine device to be functional), inflammation of the appendages and uterus, hormonal imbalances, infectious and viral diseases.

Insemination - types and techniques of implementation. Possible complications after the procedure. Where do they make it?

Thank you

The site provides background information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

How is the insemination procedure performed?

Insemination is carried out in a specially equipped room of a clinic or hospital. The procedure is performed on an outpatient basis, that is, the woman comes to the doctor directly on the day of insemination, and after its completion goes home.

On what day of the natural cycle is insemination done?

To procedure artificial insemination turned out to be most effective, the doctor first studies the patient’s menstrual cycle, calculating the time of expected ovulation ( that is, the release of a mature egg, ready for fertilization, into the fallopian tube).
Once released from the ovary, the egg can be fertilized within about 24 hours. At this time, artificial insemination is prescribed.

On average, ovulation occurs on the 14th day of the menstrual cycle, but in some cases it can occur earlier or later. However, predict exact time ovulation is impossible, and a woman cannot subjectively feel this. That is why, to maximize the effectiveness of artificial insemination, doctors use a number of diagnostic tests to calculate the moment of ovulation.

To determine the time of ovulation, use:

• Ultrasound of ovarian follicles. IN normal conditions During each menstrual cycle, one main follicle is formed in one of the ovaries - a sac of fluid in which the egg develops. This follicle is visible using ( Ultrasound) ultrasound examination already on the 8th – 10th day of the cycle. Once a given follicle has been identified, it is recommended to perform an ultrasound every day. If the follicle was visible the day before, but during the next procedure it cannot be determined, this indicates that ovulation has occurred.
• Determination of the level of luteinizing hormone ( LH) in blood. This hormone is secreted by a special gland ( pituitary gland) and is involved in the regulation of the menstrual cycle. An increase in the level of this hormone in the middle of the cycle indicates that ovulation will occur within the next 24 to 48 hours.
• Measuring basal body temperature. During the period of ovulation, body temperature increases by approximately 0.5 - 1 degree, which is due to hormonal changes occurring in a woman’s body. However, to notice such a temperature jump, a woman must regularly ( within a few months) keep a graph of basal temperature, measuring it twice a day ( morning and evening, at the same time).
• Examination of cervical mucus. Under normal conditions, the mucus found in the cervical area is relatively dense, cloudy, and poorly extensible. During ovulation, under the influence of female sex hormones, it liquefies, becomes transparent and more viscous, which is used by doctors for diagnostic purposes.
• Subjective feelings of a woman. During ovulation, a woman may experience nagging pain in the lower abdomen, as well as increased sexual desire, which, together with other signs, can be used for diagnostic purposes.

Stimulation of ovulation ( ovaries) before insemination

The essence of this procedure is that before insemination, a woman is prescribed hormonal drugs that stimulate the growth and development of the follicle, egg maturation and ovulation. The need for this procedure arises in cases where it is impossible to perform insemination in the usual way (for example, if a woman does not have a regular menstrual cycle).

To stimulate ovulation before insemination, a woman is most often prescribed recombinant follicle-stimulating hormone ( FSH). This is an analogue of the natural hormone produced by the pituitary gland during the first half of the menstrual cycle. Under its influence, follicles in the ovaries are activated and develop. The FSH drug should be used for 8 to 10 days ( more precise instructions can be given by the attending physician after a full examination, determining the regularity and other features of the menstrual cycle in a particular woman), after which ovulation should occur.

The danger of using this method is that when too high doses of FSH are prescribed, the so-called ovarian hyperstimulation syndrome may develop, when instead of one follicle, several mature at once. IN in this case During ovulation, 2 or more eggs can enter the fallopian tube, which can be fertilized during the artificial insemination procedure. The outcome of this phenomenon can be multiple pregnancy.

Types and techniques of artificial insemination ( intracervical, intrauterine, vaginal)

To date, several techniques have been developed that allow the introduction of male seminal fluid ( sperm) into the female genital tract. However, to understand the mechanism of their action, it is necessary to know how insemination occurs under natural conditions.

With natural insemination ( occurring during sexual intercourse) a man's sperm is ejaculated into a woman's vagina. Then the sperm ( During one sexual act, about 200 million are ejected), having mobility, begin to move towards the uterus. They must first pass through the cervix, a narrow canal that separates the uterus from the vagina. A woman’s cervix contains special mucus that has protective properties. Walking through this slime most of sperm dies. Surviving sperm enter the uterine cavity and then reach fallopian tubes. One of these pipes contains a mature ( ready for fertilization) egg ( female reproductive cell). One of the sperm penetrates her wall earlier than the others and fertilizes her, resulting in pregnancy. The remaining sperm die.

Artificial insemination can be:

• Intracervical ( vaginal). This is the simplest form of the procedure, which is as similar as possible to natural sexual intercourse. No special preparation is required before performing it ( Naturally, before any insemination you should refrain from smoking, drinking alcohol, drugs, etc.). Insemination can be carried out with either fresh, unpurified seminal fluid ( in this case it must be used no later than 3 hours after receipt), and frozen sperm ( from a sperm bank). The essence of the procedure is as follows. In the morning on the appointed day, a woman comes to the clinic, goes into a specially equipped room and lies down in a gynecological chair or on a special table. Special dilating speculum is inserted into her vagina, making it easier to access the cervix. Next, the doctor collects sperm into a special ( with blunt tip) syringe, inserts it into the vagina and brings the tip as close as possible to the entrance to the cervix. After this, the doctor presses on the plunger of the syringe, as a result of which the sperm is squeezed out of it onto the mucous membrane of the cervix. The syringe and speculum are removed, and the woman must remain in the gynecological chair lying on her back for 60 to 90 minutes. This will prevent the leakage of seminal fluid and will also facilitate the penetration of sperm into the uterus and fallopian tubes. One and a half to two hours after the procedure, the woman can go home.
• Intrauterine. This procedure is considered more effective than intracervical insemination. Its essence lies in the fact that after installing speculum in the vagina, sperm is collected into a special syringe, to which a long and thin catheter is attached ( a tube). This catheter is inserted through the cervix into the uterine cavity, after which the sperm is squeezed into it. When performing this procedure, it is recommended to use specially prepared and purified sperm. The introduction of fresh seminal fluid into the uterine cavity can cause contraction of the uterine muscles ( which will reduce the likelihood of fertilization) or even cause severe allergic reactions.
• In-pipe. The essence of the procedure is that pre-prepared sperm are injected directly into the fallopian tubes in which the egg should be located. It is worth noting that, according to the results of recent studies, the effectiveness of this procedure does not exceed that of conventional intrauterine insemination.
• Intrauterine intraperitoneal. With this procedure, a certain amount of previously obtained and processed ( purified) male sperm is mixed with several milliliters of a special liquid, after which the resulting mixture ( about 10 ml) is inserted into the uterine cavity under slight pressure. As a result, the solution containing sperm will penetrate the fallopian tubes, pass through them and enter the abdominal cavity. Thus, the probability of fertilization of an egg, which may be located in the path of the injected solution, significantly increases. This procedure is indicated for unknown causes of infertility, as well as for ineffective intracervical or intrauterine insemination. In terms of execution technique, it is no different from the previously described procedures.

Does insemination hurt?

Artificial insemination is an absolutely painless procedure. Some women may experience discomfort when inserting speculum into the vagina, but there will be no pain. At the same time, it is worth noting that with vaginismus, a woman reacts painfully to any procedures involving the insertion of any instruments into the vagina. Such patients are usually prescribed special sedatives, and if necessary, they can be put into superficial medicated sleep. In this state, they will not feel pain and will not remember anything about the procedure.

Is it possible to perform artificial insemination at home?

At home, you can perform the procedure of artificial intracervical ( vaginal) insemination, which is similar in mechanism of action and effectiveness to natural insemination. Performing other variants of the procedure requires the use of purified sperm, as well as intrauterine insertion of foreign objects, and therefore they should only be carried out by an experienced specialist in a clinic setting.

Preparation includes calculating the day of expected ovulation ( the techniques have been described previously). When ovulation has occurred, you should proceed directly to the procedure itself.

To carry out artificial insemination at home you will need:

• Disposable sterile syringe ( for 10 ml) – can be purchased at any pharmacy.
• Sterile container for collecting semen– for example, a container for taking tests, which can also be purchased at a pharmacy.
• Sterile disposable vaginal dilator- can be bought at the pharmacy, but the procedure can be performed without it.

It is recommended to perform the procedure in a place protected from sunlight ( best at night), as they can damage sperm. After the donor ejaculates semen into a sterile container, it should be left in a warm, dark place for 15 to 20 minutes to allow it to become more fluid. After this, you should draw the sperm into a syringe and insert its tip into the vagina. If a woman uses vaginal dilators, the syringe should be inserted under visual control ( you can use a mirror for this). It should be brought as close to the cervix as possible, but try not to touch it. If a vaginal dilator is not used, the syringe should be inserted into the vagina 3–8 cm ( depending on the anatomical features of the woman). After inserting the syringe, gently press the plunger so that the seminal fluid moves to the surface of the mucous membrane of the cervix.

After the sperm is injected, the syringe and dilator are removed, and the woman is advised to remain in the “lying on her back” position for the next one and a half to two hours. Some experts recommend placing a small cushion under the buttocks so that the pelvis is raised above the bed. In their opinion, this promotes the movement of sperm to the fallopian tubes and increases the likelihood of pregnancy.

Why are utrozhestan and duphaston prescribed after insemination?

These drugs are prescribed to ensure the normal development of the fertilized egg after the procedure. The active component of both drugs is the hormone progesterone or its analogue. Under normal conditions, this hormone is secreted in a woman’s body in the second phase of the menstrual cycle ( it is produced by the so-called corpus luteum, which forms at the site of a mature and ruptured follicle after ovulation). Its main function is to prepare the female body for implantation and development of a fertilized egg.

If during the period after ovulation the concentration of this hormone in a woman’s blood is reduced ( which can be observed in some diseases of the ovaries, as well as in patients over 40 years of age), this can disrupt the process of attachment of the fertilized egg to the wall of the uterus, as a result of which pregnancy will not occur. It is in such cases that patients are prescribed utrogestan or duphaston. They prepare the lining of the uterus for egg implantation and also support fetal development throughout pregnancy.

How to behave after insemination ( do's and don'ts)?

Immediately after the procedure, the woman should lie on her back for at least an hour, which is necessary for normal penetration of sperm into the uterus and fallopian tubes. In the future, she should follow a number of rules and recommendations that will help increase the effectiveness of the procedure and reduce the risk of complications.

Is it possible to take a bath after artificial insemination?

Immediately after performing intracervical insemination ( including at home) taking a bath is not recommended, as this may reduce the effectiveness of the procedure. The fact is that with this technique, part of the sperm is located in the vagina.
If during the first hours after the end of the procedure the woman takes a bath, water ( together with the soaps, gels or other substances it contains) can enter the vagina and destroy some sperm, which will reduce the likelihood of pregnancy. That is why it is recommended to bathe in the bathroom no earlier than 6 to 10 hours after insemination. At the same time, it is worth noting that a light shower under clean water (without using hygiene products) will not affect the outcome of the procedure in any way.

When performing intrauterine or other types of insemination, the patient is allowed to take a bath immediately after returning home. The fact is that in these cases, seminal fluid is injected directly into the uterine cavity or into the fallopian tubes, which are normally reliably delimited from environment cervix. Even if the woman takes a bath immediately after finishing the procedure ( that is, after lying in the gynecological chair for the prescribed one and a half to two hours), water or any other substances will not be able to penetrate the uterine cavity and in any way affect the fertilization of the egg.

Is it possible to swim and sunbathe after insemination?

A woman is allowed to swim in a river, lake, sea or other body of water no earlier than 24 hours after the procedure. Firstly, this is due to the risk of water entering the vagina and destroying the sperm located there. Secondly, during the artificial insemination procedure, the vaginal mucosa may be slightly injured by objects inserted into it ( dilators, syringe). Her protective properties at the same time, will decrease significantly, as a result of which infection can occur when swimming in polluted waters.

There are no special instructions regarding tanning. If a woman has no other contraindications, she can sunbathe in the sun or visit a solarium immediately after the procedure, which will not affect its effectiveness.

Is it possible to have sex after artificial insemination?

Having sex after artificial insemination is not prohibited, since sexual contact will in no way affect the process of sperm advancement and egg fertilization. Moreover, if the cause of a couple's infertility has not been reliably identified before the procedure, regular sexual intercourse may increase the likelihood of pregnancy. That is why there is no need to limit or somehow change your sex life after performing this procedure.

How many hours after insemination does fertilization occur?

Fertilization of the egg does not occur immediately after the insemination procedure, but only 2 to 6 hours after it. This is due to the fact that sperm need time to reach the egg, penetrate its wall and connect its genetic apparatus with it. Under normal conditions ( with natural insemination) the sperm must travel from the cervix to the fallopian tubes, which on average is about 20 cm. This can take him from 4 to 6 hours. Since intracervical insemination is as similar as possible to natural insemination, with this type of procedure the time until fertilization is approximately the same.

In intrauterine insemination, male reproductive cells are introduced directly into the uterine cavity. They do not waste time passing through the mucous barrier in the cervix, as a result of which fertilization can occur earlier with this type of procedure ( after 3 – 4 hours). If intratubal insemination is performed ( when sperm are injected directly into the fallopian tubes), the egg located there can be fertilized within a couple of hours.

Signs of pregnancy after artificial insemination

The first signs of pregnancy can be detected no earlier than a few days after the procedure. The fact is that immediately after fertilization, the egg moves into the uterine cavity, attaches to its wall and begins to actively increase in size there, that is, to grow. This entire process takes several days, during which the fertilized egg remains too small to be detected by any means.

It is worth noting that after artificial insemination, pregnancy proceeds in exactly the same way as during natural conception. Therefore, the signs of pregnancy will be the same.

Pregnancy may be indicated by:

• change in appetite;
• taste disturbances;
• impaired sense of smell;
• increased fatigue;
• increased irritability;
• tearfulness;
• abdominal enlargement;
• engorgement of the mammary glands;
• absence of menstruation.

The most reliable of all these signs is the absence of menstrual bleeding for 2 or more weeks after ovulation ( that is, after performing the procedure). All other symptoms are associated with hormonal changes in the female body during pregnancy, but can also be observed in a number of other conditions.

On what day after insemination should I take a pregnancy test and donate blood for hCG?

After fertilization, the egg enters the uterine cavity and attaches to its wall, after which the embryo begins to develop. From about 8 days after fertilization, embryonic tissue begins to produce a special substance - human chorionic gonadotropin ( hCG). This substance enters the mother’s blood and is also excreted in her urine. It is on determining the concentration of this substance in a woman’s biological fluids that most early pregnancy tests are based.

Despite the fact that hCG begins to be produced approximately 6–8 days after fertilization of the egg, its diagnostically significant concentrations are observed only by the 12th day of pregnancy. It is from this period that hCG can be detected in urine ( For this purpose, standard express tests are used, which can be purchased at any pharmacy) or in a woman's blood ( To do this, you need to donate blood to a laboratory for analysis.).

Why is an ultrasound performed after insemination?

A few weeks after the procedure, the woman should undergo an ultrasound examination of the pelvic organs.

The purpose of performing an ultrasound after insemination is:

• Confirmation of pregnancy. If the fertilized egg attaches to the wall of the uterus and begins to develop, after a few weeks the embryo will reach a significant size, as a result of which it can be detected during an ultrasound examination.
• Identification of possible complications. One of the dangerous complications of insemination can be ectopic pregnancy. The essence of this pathology is that the egg fertilized by the sperm attaches not to the wall of the uterus, but to the mucous membrane of the fallopian tube or even begins to develop in the abdominal cavity. Lab tests ( determination of hCG in the blood or urine of a woman) will indicate that pregnancy is developing. At the same time, the prognosis in this case is unfavorable. With an ectopic pregnancy, the embryo dies in 100% of cases. Moreover, if this condition is not detected in a timely manner, it can lead to the development of complications ( for example, to rupture of the fallopian tube, to bleeding, and so on), which would endanger the woman's life. That is why, during an ultrasound examination, the doctor not only detects the presence of an embryo in the uterine cavity, but also carefully examines other parts of the reproductive system for the purpose of early diagnosis of ectopic pregnancy.

Can twins be born after insemination?

After artificial insemination, as after natural fertilization, one, two, three ( or even more) child. The mechanism for the development of this phenomenon is that during the procedure several mature eggs can be fertilized at once. The likelihood of this increases significantly when insemination is performed after ovarian stimulation, during which ( in the ovaries) several follicles can develop at once, from which several mature eggs, ready for fertilization, can be released simultaneously.

Much less often, multiple pregnancies develop when one egg is fertilized by one sperm. In this case, at the initial stages of development, the future embryo is divided into 2 parts, after which each of them develops as a separate fetus. It is worth noting that the probability of such a development of events is the same with both artificial and natural insemination.

Complications and consequences after artificial insemination

The procedure for performing insemination is relatively simple and safe, as a result of which the list of complications associated with it is quite small.

Artificial insemination may be accompanied by:

• Genital tract infection. This complication can develop if during the procedure the doctor used unsterile instruments or did not comply with hygiene standards. At the same time, the cause of the development of infection may be a woman’s failure to comply with personal hygiene rules immediately before or after the procedure. It is important to remember that any infection is much easier to cure at the initial stage of development. That's why if you experience pain, burning or redness in the genital area, you should immediately consult your doctor.

• Allergic reactions. May occur during intrauterine or intratubal insemination, when poorly prepared ( poorly cleaned) seminal fluid. Allergies can manifest as restlessness, blotchy skin, muscle tremors, a significant drop in blood pressure, or even loss of consciousness. Extremely severe allergic reactions require immediate medical attention as they pose a danger to the patient's life.
• By falling blood pressure. The cause of the development of this complication may be careless, rough manipulation of the cervix during intrauterine insemination. The mechanism for the development of this phenomenon is the irritation of special nerve fibers, the so-called autonomic nervous system, which is accompanied by a reflex dilation of blood vessels, a slowdown in heart rate and a decrease in blood pressure. If this complication develops, the woman is strictly forbidden to get up, as this will cause blood to flow out of the brain and she will lose consciousness. The patient is prescribed strict bed rest for several hours, drinking plenty of fluids, and, if necessary, intravenous fluids and medications to normalize blood pressure.
• Multiple pregnancy. As mentioned earlier, the risk of developing multiple pregnancies increases when insemination is performed after hormonal stimulation of the ovaries.
• Ectopic pregnancy. The essence of this phenomenon is described above.

Nagging pain in the abdomen

During the first hours after intrauterine insemination, a woman may complain of nagging pain in the lower abdomen. The cause of this phenomenon may be irritation of the uterus caused by the introduction of poorly purified sperm into it. In this case, a strong contraction of the uterine muscles occurs, which is accompanied by a disruption of microcirculation in them and the appearance of a characteristic pain syndrome. A few hours after the end of the procedure, the pain goes away on its own, without requiring any treatment. At the same time, it is worth noting that strong contraction of the uterine muscles can disrupt the process of moving sperm to the egg, thereby reducing the likelihood of pregnancy.

Chest pain ( nipples hurt)

Breast pain may appear several weeks after insemination and is most often a sign of a developing pregnancy. The cause of the pain syndrome is a change in the mammary glands under the influence of progesterone and other hormones, the concentration of which in a woman’s blood increases during pregnancy. In addition to painful sensations in the nipple area, slight white discharge may appear, which is also completely normal during pregnancy.

Temperature

During the first 2–3 days after insemination, a woman’s body temperature can rise to 37–37.5 degrees, which is absolutely normal. An increase in temperature by 0.5 - 1 degree is observed during ovulation and is associated with hormonal changes occurring in the female body.

At the same time, it is worth noting that an increase in temperature to 38 degrees or higher, which occurs during the first or second day after insemination, may indicate the development of complications. One of the common reasons for an increase in temperature may be the development of an infection acquired during the procedure ( for example, if the doctor or patient fails to comply with hygiene standards). The development of infection is accompanied by activation of the immune system and the release of many biologically active substances into the blood, which determine the increase in temperature 12–24 hours after infection. The temperature can reach extremely high values ​​( up to 39 – 40 degrees or more).

Another reason for the increase in temperature may be an allergic reaction associated with the introduction of poorly purified seminal fluid into the uterus. Unlike infectious complications, with an allergic reaction the body temperature rises almost immediately ( within the first minutes or hours after the procedure) and rarely exceeds 39 degrees.

Regardless of the cause, an increase in temperature over 38 degrees is a reason to consult a doctor. It is not recommended to take antipyretic drugs on your own, as this may distort clinical picture disease and make diagnosis difficult.

Will I get my period after insemination?

The presence or absence of menstruation after insemination depends on whether sperm can reach the egg and fertilize it. The fact is that under normal conditions, certain changes occur in a woman’s uterus during the menstrual cycle. During the first phase of the menstrual cycle, its mucous membrane is relatively thin. After the egg matures and leaves the follicle, the concentration of the hormone progesterone increases in the woman’s blood. Under its influence, certain changes are observed in the mucous membrane of the uterus - it thickens, the number of blood vessels and glands in it increases. In this way, it prepares for the implantation of a fertilized egg. If implantation does not occur within a certain time, the concentration of progesterone decreases, as a result of which the superficial part of the uterine mucosa dies and is released through the woman’s genital tract. The resulting bleeding is associated with damage to small blood vessels and is usually moderate in nature.

Considering the above, it follows that if menstruation appeared after insemination, conception did not occur. At the same time, the absence of menstruation may indicate a developing pregnancy.

Brown bloody discharge ( bleeding)

Under normal conditions, no vaginal discharge should be observed after insemination. If in the first hours after the procedure a woman experiences slight white discharge, this indicates that the seminal fluid injected into her ( a certain part of it) leaked out. In this case, the likelihood of pregnancy is significantly reduced, since most of the sperm will not reach the fallopian tubes.

The appearance of brown bloody) discharge, accompanied by moderate pain in the lower abdomen, can be observed 12 to 14 days after insemination. In this case, we will be talking about menstrual bleeding, which normally begins 2 weeks after ovulation ( if the egg was not fertilized). At the same time, we can say with confidence that the attempt at conception failed.

This bleeding does not require any treatment and usually stops on its own after 3 to 5 days, after which the next menstrual cycle begins.

Why is the pregnancy test negative after insemination?

If, 2–3 weeks after insemination, a pregnancy test and a blood test for human chorionic gonadotropin show a negative result, this indicates that fertilization of the egg did not occur, that is, pregnancy did not occur. It is important to remember that successful fertilization on the first attempt is observed only in half of the cases, while other women need 2 or more attempts to achieve a positive result. That is why, after a single negative result, you should not despair, but you should try again during the next ovulation. This increases the chances of successful fertilization.

Where ( in which clinic) is it possible to do artificial insemination in the Russian Federation?

IN Russian Federation prices for artificial insemination vary widely ( from 3 – 5 to 60 or more thousand rubles). The cost of the procedure will be determined by its type ( intracervical insemination will be the cheapest, while other techniques will be somewhat more expensive), source of sperm ( insemination with donor sperm will be much more expensive than with the sperm of a husband or regular sexual partner) and other factors.

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There are situations when married couples need the help of specialists to conceive a child. In the arsenal of modern medicine there are several ways to overcome and treat infertility. One such method is artificial insemination. But this method does not have a 100% guarantee of results. In this article we will look at the main reasons for the failure of this method of fertilization.

What is this procedure?

Artificial insemination is a variant of fertilization by introducing sperm into the uterus. This process repeats the pattern of natural conception during sexual intercourse. The sperm that is planned to be introduced into the uterus is prepared in a special way. During the preparation process, unsuitable sperm are eliminated, thereby increasing the chances of successful fertilization. For artificial insemination, both the husband's sperm and frozen donor sperm can be used.

This is how artificial insemination happens.

Reasons for unsuccessful insemination

The procedure does not provide a 100% guarantee of success. It is very important to prepare for it correctly, this will significantly increase your chances. The doctor, after examining the patients and fully examining them, gives instructions. It is extremely important to comply with them. It is also very important to know what reasons can affect insemination.

When and why artificial insemination may not help:

1. For example, if the sperm were not prepared correctly.
2. When a woman's ovaries are poorly prepared.
3. Extremely low experience of the specialist performing the insemination procedure.
4. With a hormonal disorder.
5. For genital tract infection.
6. If the patient is over 30 years old.
7. With previously unsuccessful attempts at natural conception for 4 years.
8. If a woman had ovarian stimulation before starting preparations for insemination. Perhaps the hormonal levels have not recovered from the previous procedure.
9. Pipe factor. If the fallopian tubes are obstructed, the likelihood of successful artificial insemination is extremely low.
10. With previous injuries or surgeries on the pelvic organs.

When is insemination prescribed?

This procedure is prescribed if a man suffers from a sexual disorder or is diagnosed with poor sperm motility. It can also be prescribed if a woman is diagnosed with cervical factor infertility or vaginismus.

Indications for AI with husband's sperm.

Artificial insemination should be prescribed when, after 2 years of regular sexual relations, pregnancy has not occurred. This is what experienced doctors advise to do. A lot depends on proper preparation sperm and ovaries.

Doctors advise not to give up trying to get pregnant on your own. This method of conception will be successful with a probability of 4% to 35%. Try and everything will work out.

There are situations in which you need not waste time on artificial insemination and immediately prepare for IVF. Too low a sperm concentration, blood in the sperm, leukocytes, platelets will seriously interfere with successful conception using artificial insemination. Read and see more information about sperm quality and spermogram here.

Indications for AI with donor sperm.

Many people are interested in the question: “What should be done if insemination is unsuccessful?” If the procedure is unsuccessful, disappointment and apathy naturally set in. There is no need to immediately give up on the procedure. According to statistics Conception in this way occurs only 2-5 times. So take a short break and try again.

How to prepare?

Based on reviews from parents who have successfully undergone artificial insemination, it becomes clear that you must strictly adhere to and follow all the doctor’s instructions. It is imperative to undergo an examination of the fallopian tubes to check them for the presence or absence of adhesions.

Be sure to do folliculometry (ultrasound of the ovaries) before insemination. This way you can check the readiness of the follicles for conception. If they are not ready, the doctor will prescribe a course of drugs to increase their growth.

Severe anxiety and stress can cause unsuccessful insemination. This usually happens after the second attempt, when the woman, understandably, begins to worry about the result.

Most often, artificial insemination is unsuccessful due to improper preparation for it.

After the 3rd unsuccessful attempt at fertilization, you need to pause for a couple of months. When the body recovers, the procedure can be repeated. Remember, infertility has long been treatable (or overcome). Therefore, if artificial insemination does not help you, do not be upset; in the worst case scenario, IVF will help you. Maybe it won’t come to IVF, the main thing is to try and believe that everything will work out.

In this video, a candidate of medical sciences talks about AI:

Write in the comments how you should prepare for artificial insemination, how did you prepare? What should I do to make it successful? What to do if insemination does not help? This experience will help many. Please rate this article with stars. Repost to your social media. Thanks for visiting.

Stages of the artificial insemination method, indications, preparation, chances of getting pregnant

Of all the ART methods, the closest to the natural process of conception is only artificial insemination (AI). The cost of this procedure compared to IVF is attractive, but it is not suitable for everyone.

lasts longer than IVF itself. It is done in reproductive centers around the world. accumulated according to the methodology great experience, and therefore is widely used and brings the expected results.

The essence of AI is the introduction of purified sperm into the genital organs (internal) of a woman.

Historically, four options for insemination at the site of delivery of male germ cells have been formed:

• In the vagina, closer to the cervix. Now this method is called “artificial insemination at home.” The effectiveness of the option is questionable, but there are women who managed to get pregnant this way.

• Directly into the cervix. Nowadays it is used extremely rarely due to lack of effectiveness.

• Into the uterine cavity. Today, this is the most used and effective method of artificial insemination. About him and we'll talk further.

• Into the fallopian tubes.

As with all patients requiring reproductive assistance, when performing AI, doctors follow an individual approach. Indications, contraindications and physiological capabilities of the organisms of future parents are taken into account.

Therefore, artificial intrauterine insemination can take place in different ways:

• with drug stimulation of the ovaries (efficiency increases, since 2-3 eggs mature at once in one cycle);
• without stimulation - in a natural cycle.

Based on their sperm characteristics, it can be recommended.

For single women, clinics provide a special program, according to which the procedure is carried out for those who want to conceive, give birth and raise a child on their own (without the participation of a man).

Artificial insemination: indications

AI can be carried out with male and female factors.

For women, the indications for artificial insemination are as follows:

• infertility of unknown origin;
• endocervicitis;
• sexual disorder – vaginismus – a condition in which natural sexual contact is impossible;
• abnormal locations of the uterus;
• immunological incompatibility - the presence of antisperm antibodies in the mucus of the cervical canal;
• violation of ovulatory function;
• a woman's desire to become pregnant without intercourse.

Indications for artificial insemination for men:

• impotence or lack of ejaculation;
• male subfertility – decreased sperm activity;
• retrograde ejaculation - sperm is thrown into the bladder during ejaculation;
• small volume of ejaculate;
• increased sperm viscosity;
• hypospadias – congenital abnormal structure of the urethra;
• chemotherapy.

AI Stages

Despite its mechanical simplicity, AI is a delicate and responsible work of a team of specialists - a gynecologist-reproductologist, clinic laboratory staff, and doctors of related specialties. The methodology involves a step-by-step and sequential approach.

Stages of artificial insemination:

• Examination. At this stage, a thorough study of the health status of both partners, the identified causes of infertility is carried out, and a strategy for the procedure is determined.

• Treatment. If any somatic and infectious diseases are detected, they are treated. Doctors take measures to improve the condition of a woman’s body, ensure the pregnancy is carried to term, and avoid possible complications during childbirth and the pregnancy itself. If necessary, treatment is prescribed to a man to improve sperm quality.

• If the preparation plan provides for a stimulating effect on the ovaries, a hormonal simulation is performed.

• Direct artificial insemination.

• Determination of pregnancy by hCG monitoring. In the absence of pregnancy, the procedure, according to regulatory documents, is repeated up to 6–8 times. Although recently experts have come to the conclusion that if 3 attempts at AI were unsuccessful, then it is necessary to change tactics and consider the possibility of performing artificial insemination in a different way. For example, IVF, ICSI, PIXI, IMSI.

Preparing for artificial insemination

The effectiveness of artificial insemination depends on how accurate the diagnosis is. At this stage, doctors decide whether stimulation is needed and how to clean the sperm.

A woman's preparation includes:

• detailed medical examination by a gynecologist, therapist, endocrinologist, cardiologist;
• tests;
• ultrasonic monitoring;
• treatment of detected chronic diseases, including infections and inflammation of the genital organs;
• study of the menstrual cycle (needed to determine the cyclicity and regularity of ovulation);
• and the condition of the inner lining of the uterus;
• after treatment, control tests are taken;
• drug stimulation of the ovaries.

Depending on the individual characteristics of the couple, it can take a period from several weeks to six months.

Preparing a man:

• consultation with a urologist;
• tests for sexually transmitted infections;
• analysis of prostate secretion;
• Additionally, a prostate massage may be prescribed;
• treatment and correction of identified disorders.

On what day of the cycle is artificial insemination performed?

Carrying out artificial insemination is effective only in the periovulatory period - these are several days of the cycle during which the release of an egg (or eggs during stimulation) from the follicle is possible. Therefore, the phases of the menstrual cycle are monitored first. To do this, you can measure rectal temperature and build graphs, use ovulation tests. But the most accurate method of monitoring the development and maturation of the egg is ultrasound. Therefore, after critical days, ultrasound is performed quite often, every 1–3 days. The frequency of ultrasound may vary. The higher the degree of maturity of the female reproductive cell, the more often an ultrasound is performed (in order not to miss ovulation and to determine on what day of the cycle artificial insemination should begin).

The ideal option is to introduce sperm into the uterus during the periovulatory period 1–3 times. The first time it is administered a day - two days before ovulation, the second - directly on the day of ovulation. And if several follicles mature in the ovaries, they can burst at intervals of 1–2 days. Then the sperm is injected again. This increases the efficiency of the procedure as a whole.

One of the determining factors on which day of the cycle to perform artificial insemination is the origin of the sperm. If used, then it can be administered based only on ovulation. If you use fresh (native) sperm, then take into account the fact that high sperm quality can only be achieved if you abstain for at least 3 days. Therefore, sperm can be injected immediately after ovulation. It does not harm, as it has been proven to be viable for up to 7 days.

How does artificial insemination work?

On the appointed day, the couple arrives at the clinic. A woman undergoes an ultrasound. A man gives a sperm sample. Sperm cannot be introduced into the uterine cavity immediately without preliminary preparation. This is fraught with anaphylactic shock. This type of allergic reaction develops quite rarely, but its course threatens the patient’s life. Sperm preparation (purification and concentration of the viable fraction) takes about two hours.

How is artificial insemination performed? Quickly, painlessly, under sterile conditions. You don't have to worry about this. And the sensations will be minimal - only at the moment the flexible thin catheter passes the cervical canal of the uterus.

The woman moves into the gynecological chair. Speculums provide access to the cervix. Prepared spermatozoa along with the medium are drawn into a syringe and connected to a catheter. With a slight movement of the catheter, they penetrate the uterine cavity and carefully inject the prepared suspension of the “best” sperm from a syringe. On the first day - that's it. The manipulation is completed. And the woman remains in horizontal position 15–25 minutes. After which he returns to everyday life.

At certain times, the manipulation is repeated 1-2 more times. Follicle monitoring continues until ovulation. And after two weeks, the effectiveness of insemination is assessed - the level of the pregnancy hormone - human chorionic gonadotropin - is determined. If pregnancy is not confirmed, AI is repeated in the next cycle.

Efficiency and chances of getting pregnant

The chance of getting pregnant with artificial insemination is higher in women under 30 years of age, with patency of both fallopian tubes and normal ovulatory function. The average effectiveness of one procedure is 18%. This is slightly more than during natural sexual intercourse. The quality of the sperm used plays a significant role in the positive outcome of AI.

Some fertility clinics claim success rates as high as 28%.

Seventy-eight percent of women succeed in becoming pregnant in the first three cycles of insemination. The effectiveness of subsequent procedures decreases sharply. That is why doctors rationally change the tactics of artificial insemination and recommend other IVF methods after three attempts at insemination.

It should also be mentioned that the chances of artificial insemination increase in stimulated cycles.

For couples facing infertility, assisted reproductive technologies become a chance to become parents.

One of the simplest and available methods assisted reproduction is artificial insemination. What is the essence of the procedure? How to behave after insemination? Who is it indicated for and are there high chances of pregnancy?

Artificial insemination - what is it?

Artificial insemination can rightfully be considered one of the first scientific methods of assisted reproduction. At the end of the 18th century, the Italian doctor Lazaro Spalazzi first tested it on a dog, resulting in healthy offspring of three puppies.

Six years later, in 1790, artificial insemination (AI) was first tested on humans: in Scotland, Dr. John Hunter inseminated a patient with the sperm of her husband, who suffered from an abnormal penis structure. Today the procedure is widely used throughout the world.

Artificial (intrauterine) insemination is a technology that involves the introduction of male sperm into the cervical canal or uterus of a woman. For this, a catheter and syringe are used. The day for AI is calculated taking into account the patient’s menstrual cycle.

It is necessary to accurately determine the periovulatory period, otherwise the procedure will be useless. The technology is used both in the natural menstrual cycle and in the hormonally stimulated one.

Sperm is obtained outside of sexual intercourse in advance (and then frozen, thawing on the day of AI) or several hours before the procedure. It can be processed or introduced unchanged.

How effective is artificial insemination? The statistical results are not very promising: fertilization occurs in only 12% of cases.

Who is the procedure indicated for?

For women, indications for vaginal insemination are:

1. the desire to become pregnant “for oneself” without having a sexual partner;
2. infertility caused by cervical factors (cervical pathologies);
3. Vaginismus.

Indications for insemination on the part of men are as follows:

• infertility;
• disorders of an ejaculatory-sexual nature;
• unfavorable prognosis for genetic diseases transmitted by inheritance;
• sperm subfertility.

In the first three cases, donor sperm is used.

After the procedure: how does the woman feel?

In order to undergo intrauterine insemination, a woman does not need to go to the hospital at all. The procedure is performed on an outpatient basis and lasts only a few minutes.

How does the patient feel? In practice, she experiences sensations that are no different from those during a routine gynecological examination. A speculum is inserted into the vagina, and perhaps the most unpleasant experience is associated with this. They disappear almost immediately after artificial insemination.

For a short time, there may be a painful pulling sensation in the lower abdomen, which is caused by irritation of the uterus. In rare cases, anaphylactic shock may occur with the introduction of unpurified seminal fluid.

To avoid allergic reactions and to improve the quality of sperm, it is recommended to clean it, even if the seed of the patient’s spouse is used as a biomaterial.

How to behave after the procedure is completed?

The gynecologist performing the procedure will definitely tell you how to behave after insemination, warn about possible consequences, and give the necessary recommendations. Immediately after the injection of sperm, the woman will need to remain in a supine position for one and a half to two hours.

A small pillow should be placed under the buttocks - an elevated pelvis facilitates better advancement of injected sperm into the fallopian tubes. This increases the chance of conception, for which, in fact, artificial insemination was carried out.

The success rate of the procedure depends on the patient’s age, the state of her reproductive health, and the quality of the sperm used. To increase the efficiency of AI, the donor material is processed, as a result of which only the highest quality sperm remain.

To ensure that a potentially fertilized egg can fully develop and implantation of the fertilized egg is successful, hormonal therapy with progesterone is prescribed. If three cycles in a row after artificial insemination do not conceive, other methods of assisted reproduction are selected.

What can and cannot be done during insemination?

Fertilization does not occur immediately at the moment of sperm injection; it requires several hours, up to a day, after insemination. What to do to increase the chance of pregnancy?

On the first day you must refuse:

1. from taking a bath, as water helps wash out some of the sperm from the vagina;
2. from douching;
3. from the administration of vaginal medications.

But having sex is not on the list of things that should not be done after insemination; some experts even see a benefit in this: unprotected sexual contact promotes better movement of injected sperm into the tubes.

Conclusion

By following these recommendations after insemination, within a week (that’s how long it takes for a fertilized egg to move into the uterine cavity and attach there) you can conduct a blood test for hCG. This hormone is a marker of pregnancy; it begins to be produced immediately after implantation of the fertilized egg into the uterus. A home express diagnostic method - a pregnancy test - is not advisable to use earlier than 12-14 days. In urine, the concentration of hCG is achieved somewhat later than in the blood.

Video: Intrauterine insemination (IUI)