Artificial Insemination, What do you Need to Know?
Insemination, in vitro fertilization, assisted reproduction… We’ve all heard these terms, but often find it hard to differentiate them and we don’t exactly know what they entail. In this post, we’re going to focus on one of the most commonly heard but also least understood methods: artificial insemination.
When we think of assisted reproduction, one of the first ideas that comes to mind is artificial insemination, and it’s understandable given that the first human artificial insemination took place in the 18th century. It’s a technique characterized by its simplicity, as it essentially involves the introduction of sperm from a male into a woman’s uterus at the most appropriate time in order to increase the chances of pregnancy.
A bit of basic physiology to start with
We know that women’s menstrual cycles last about 28 days, and women with more or less regular cycles produce a mature egg each month. During the first half of the menstrual cycle, this egg matures in the ovary and is released into the fallopian tubes around day 14. The egg will travel through the fallopian tube, awaiting fertilization by a sperm to form an embryo, which will then continue its journey to the uterus, where it will attempt to implant into the endometrium to develop into a baby.
Normally, a 25-year-old woman will have a pregnancy success rate of no more than 25%
Despite appearances, nature isn’t very efficient in this process: the egg needs to be of good quality, released at the right time, sexual intercourse needs to occur during this 4-5 day period, and a sperm of good quality also needs to reach the egg and successfully fertilize it. Moreover, the embryo must complete its journey by implanting into the endometrium, which doesn’t always happen. It’s a bit like aligning the stars. That’s why humans are a relatively infertile species: even with intercourse at the optimal time of the cycle, a 25-year-old woman will have a pregnancy success rate of no more than 25%. If you add an age over 35 or a sperm problem, it becomes even more complicated.
How artificial insemination helps in this process
So, in artificial insemination, the goal is simply to optimize this whole process, making it a bit more efficient than in nature. To carry out artificial insemination, a semen sample (from a partner or donor) is taken and processed in the laboratory to create a concentration of the best sperm, the most mobile and viable ones. Then, we closely monitor the woman’s cycle through ultrasounds during the first half of the cycle to identify the moment when the ovary is about to release the egg. At that point, we induce ovulation and perform the insemination, which involves introducing the concentrated sperm into the uterus, rather than leaving it in the vagina like in a normal sexual relationship, to further facilitate fertilization.
even in the best cases, artificial insemination success rates hover around 30%
Who can opt for this treatment?
This technique is used in cases of male infertility, such as low sperm quality or ejaculation problems, or in cases where individuals need a donor to start a family and have no other cause of infertility.
It’s important to note that artificial insemination is not a magic solution. In fact, it only improves the pregnancy rate by about 10% compared to what a healthy couple of the same age would achieve, and even in the best cases, success rates hover around 30%.
I always recommend patience to my patients with inseminations. We sometimes tend to think that because we’re doing an insemination, pregnancy will be immediate, but it’s not the case. In most cases, 2-4 attempts are needed, but if the technique is well-indicated, perseverance usually pays off!
Dr Claudia Blancafort
Medical Doctor Specialist in Gynecology & Reproductive Medicine.
Dr Claudia Blancafort
Medical Doctor Specialist in Gynecology & Reproductive Medicine.
