Artificial Insemination

Artificial insemination (AI) is a successful alternative to in vitro fertilization (IVF) to achieve a pregnancy when there is at least one functioning fallopian tube and adequate sperm. The procedure is less invasive, less time consuming, and less expensive than IVF.

Artificial insemination is performed with sperm either from the partner or from a donor. When there is no sperm available, AI using donor sperm provides an easy and inexpensive way to achieve a pregnancy.

AI is a painless, office-based procedure that involves placing processed, freshly ejaculated partner sperm, or processed frozen donor sperm, directly into the female reproductive tract as a way to achieve a pregnancy. A small flexible catheter is used to place the sperm in the vagina, in the cervix, or in the uterus (intra-uterine insemination or IUI). IUI is the most common of the three types of AI since it provides the highest chance of pregnancy. The procedure is performed around the time of ovulation.

IUI increases pregnancy rates because, by placing sperm directly into the uterus, the cervical mucus barrier is bypassed. With intercourse, only one in ten sperm that are ejaculated actually reaches the fallopian tubes, where the egg is waiting to be fertilized. This reduction in sperm numbers occurs all along the female reproductive tract, but many sperm are lost within the cervical mucus. Thus IUI, by bypassing the cervical mucus, results in a greater number of sperm being available to fertilize the egg, and hence results in a greater chance of pregnancy.

IUI also increases pregnancy rates because the sperm is placed in the uterus at the proper time around ovulation. The time of ovulation is determined by a number of methods, which may include ovulation predictor kits or ultrasounds. If ovulation does not occur naturally, it may be induced by the use of medications. Clomid is commonly used to achieve ovulation; however, it can also thicken the cervical mucus and, hence, create a barrier to the sperm. When IUI is added to a Clomid cycle, pregnancy rates improve.

IUI is an excellent treatment not only to bypass normal cervical mucus, but also when there is poor cervical mucus. Mucus quality can be compromised by infections, by prior surgery on the cervix (such as for abnormal PAP smears), by advancing age, or by the use of medications such as Clomid.

IUI is also an excellent treatment when there are compromised sperm parameters, such as decreased counts, motility, or volume. With IUI, the sperm is processed in such a way as to isolate the best functioning sperm from the ejaculate. It is then concentrated to provide higher numbers of sperm to the egg than would have occurred with intercourse. Of course, if there is a problem with coitus itself, IUI is a great solution.

If the sperm is very poor, or absent altogether, as would occur with ejaculation problems, prior vasectomy, reproductive tract abnormalities, or the lack of a male partner, using donor sperm with IUI is an easy process to achieve a pregnancy. The donor sperm is typically selected from a sperm bank where the donors are extensively screened to prevent the transmission of infections or genetic diseases to the recipient.

IUI is also an effective solution for timing issues. To achieve a pregnancy, the sperm must be available during ovulation. If your partner travels frequently, or is out of town for extended periods of time, he can prepare for his absence by storing his sperm at a cryobank. The IUI procedure allows the introduction of that sperm into the uterus during ovulation.

IUI is also effective in treating unexplained infertility. While the lack of a diagnosis can be frustrating, IUI is an easy, inexpensive method to achieve a pregnancy. Often IUI is combined with medication to increase the number of mature eggs available to the sperm, potentially increasing pregnancy rates. These cycles are carefully monitored by ultrasounds and blood tests to assure a proper ovarian response to the medications, and to confirm the timing of ovulation.

IUI pregnancy rates depend mostly upon egg and sperm quality. The health of the pregnancy is not affected by the process of IUI. IUI is a great alternative to IVF when fallopian tube function and sperm function are adequate; it is less time consuming, less invasive, and less expensive than IVF. When there is no sperm available, the use of donor sperm with IUI provides an easy and inexpensive way to achieve a pregnancy.