Artificial insemination (AI) is a procedure that is used to help an infertile woman become pregnant. Infertility is a disorder in which a woman is unable to become pregnant through sexual intercourse. In AI, sperm from a man is injected into a woman's cervix, uterus, fallopian tube, or ovarian follicle.
Who is a candidate for the procedure?
Artificial insemination is recommended when a woman has been unable to conceive for more than a year. Artificial insemination may be used if:
- the sperm are not able to survive in the cervix because the mucus destroys the sperm
- the woman's cervical mucus does not allow the sperm to be mobile
- there are problems with the shape and structure of the woman's body, making it difficult to conceive
- there are problems with the sperm, including a low sperm count or low motility, the speed at which the sperm move toward the uterus
- there is no apparent reason for the infertility in the man or the woman
To be a candidate for this procedure, a woman must have fallopian tubes that are in good condition and working properly. The tubes should be free of any disease and should not be blocked.
How is the procedure performed?
There are several steps in AI before, during, and after the actual procedure. Before the AI procedure, a fertility medicine may be used to stimulate the production and maturation of the eggs. This also helps prepare the reproductive system for fertilization. The fertility medicines are often taken for about 7 days before the woman normally ovulates.
The woman will be monitored carefully while she is taking fertility medicines. This includes ultrasound scans and blood tests to check her hormone levels. Fertility medicines also increase the chance of having a multiple pregnancy, that is, twins, triplets, or more. This means the pregnancy is a higher risk pregnancy.
The healthcare provider will help the woman find out when she ovulates. A woman can do this by checking her body temperature every day and noting any vaginal discharge. Ultrasound can also help determine when a woman is ovulating.
The location used for sperm injection depends on the cause of the infertility. There are several types of AI, such as:
- intracervical, in which the sperm is injected at the cervix, which is the opening to the uterus
- intrafollicular, in which the sperm is injected into the ovarian follicle
- intratubal, in which the sperm is injected into the fallopian tubes
- intrauterine, in which the sperm is injected into the uterus
The AI procedure is done in a healthcare provider's office or clinic several days before the woman begins to ovulate. Sperm from the woman's partner or from a donor is used. The sperm is collected on the day of the procedure. Depending on the type of AI being done, the sperm may undergo a special so-called washing. This prepares it to be placed into the body. This also makes it more concentrated for fertilization.
Typical steps in AI include:
- The woman is positioned as for a pelvic exam, with her feet up.
- A speculum is inserted into the vagina, as in a pelvic exam.
- Next, the sperm will be drawn into a plastic syringe.
- A catheter, or thin tube, is attached to the syringe and is moved into the appropriate location.
- The sperm is then injected into the cervix, uterus, fallopian tube, or ovarian follicle.
This procedure is usually painless. The entire process may take from 45 minutes to a few hours.
Understanding Your Body, Felicia Stewart M.D., Felicia Guest, Gary Stewart, M.D. and Robert Hatcher, M.D. 1987
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