Intrauterine insemination: indications, advantages, types and implementation. Artificial insemination at home: stages of implementation

Artificial insemination

Artificial insemination

Artificial insemination is a procedure in which specially processed sperm is injected into the woman's uterine cavity through a catheter in order to achieve pregnancy.

Artificial insemination is carried out with the husband's sperm - IISM or donor sperm - IISD.

Insemination can be carried out both in the natural cycle and against the background of stimulation of ovulation (in case of irregular or insufficient ovulation).

In any case, during AI, the patency of the fallopian tubes must be checked, since during insemination, as well as during pregnancy occurring naturally, fertilization occurs in the fallopian tubes. After which the fertilized egg moves through the fallopian tubes and is implanted into the uterus for further development of pregnancy.

Thus, with artificial insemination, with minimal impact on the woman’s body, we achieve pregnancy.

How is the artificial insemination procedure performed?

Immediately before ovulation (or at the moment of ovulation), using a thin and flexible catheter, the husband's sperm, pre-treated by an embryologist, which was collected 1.5-2 hours before, is introduced into the uterine cavity. If donor sperm is used, it must first be thawed (1 hour before insemination), because All donor sperm is kept only in a state of cryopreservation.

The entire procedure is carried out within 5 minutes and is absolutely painless. After this, the woman can lie down for 20-30 minutes.

At VitroClinic, sperm management in intrauterine insemination programs is carried out twice with a difference of 1-2 days. This significantly increases the chances of success.

Contraindications to the artificial insemination procedure

As with any other medical procedure, intrauterine insemination has contraindications. It is not carried out:

• in the presence of an inflammatory process (in one of the spouses);
• with obstruction of the fallopian tubes (adhesions, a history of ectopic pregnancy, abnormalities in the structure of the tubes, etc.)
• in the presence of malignant tumors of any location;
• with space-occupying ovarian formations (cysts, tumors);
• with severe endometriosis.

Indications for artificial insemination with husband's sperm:

1) from the spouse:

• Erectile disfunction;
• Decrease in the number of normal sperm;
• Increased sperm viscosity;
• The presence of antibodies in semen to one’s own sperm (positive MAP test);
• Malformations of the male genital organs, in which either sexual activity is impossible, or ejaculation does not occur in the vagina (eg, hypospadias, retrograde ejaculation);
• Insemination with cryopreserved sperm of a spouse, for example, with pre-frozen sperm in the event of detection of cancer in a spouse requiring chemotherapy, which sharply worsens the quality of sperm.

2) from the spouse:

• Cervical factor of infertility, that is, the inability of sperm to penetrate through the mucus of the cervical canal (with a very long cervix or the presence of antisperm antibodies in the mucus of the cervix - a positive MAP test in a woman);
• Increased vaginal acidity.

3) on the part of both spouses:

• in the absence of pregnancy for unclear reasons (the spouses were examined, no significant abnormalities were identified, but pregnancy did not occur);
• irregular or inadequate sex life.

Intrauterine insemination with donor sperm is a procedure in which purified donor sperm is injected into a woman's uterus. This is done according to the following indications:

1. a woman does not have a sexual partner, but wants to become a mother;
2. the husband does not have his own sperm;
3. unfavorable genetic prognosis (the husband has sperm, but their use is undesirable due to the high risk of pregnancy failure, fetal development abnormalities, severe hereditary diseases).

Sperm for donor insemination is taken from our cryogenic storage facility. All donors undergo a thorough medical examination before donating biomaterial, so there is no risk of infection during insemination with donor sperm.

Artificial insemination with donor sperm in most cases consists of two stages:

1. Mild ovarian stimulation.

   It is carried out with hormonal drugs. The growth of follicles is monitored using ultrasound (folliculometry). The insemination procedure is carried out after an egg ready for fertilization is released from the ovary (twice: the day before and immediately after ovulation).

2. Sperm injection.

   An hour before the procedure, the sperm is thawed. Using a thin and flexible catheter, it is inserted directly into the woman’s uterine cavity, which significantly increases the chances of pregnancy. The procedure is absolutely painless.

Ovarian stimulation is not a mandatory step in the procedure. Insemination can take place in a natural cycle if the patient’s reproductive health is not impaired and her age does not exceed 35 years.

Efficiency and safety of intrauterine insemination with donor sperm

In young women, the effectiveness of artificial insemination with donor sperm is quite high. A third of patients become pregnant after the first attempt, another third after two additional attempts. With age, the chances decrease, which is associated with the decline of female reproductive function. However, even after 40 years of age, pregnancy can occur using artificial insemination.

To undergo this procedure, you can contact VitroClinic. All donors, before donating sperm, undergo careful medical control, so only high-quality biomaterial that has been pre-treated in our spermiology laboratory will be used for fertilization.

The procedure is carried out only using sperm that remains frozen for at least 6 months. This eliminates the possibility of a woman contracting hidden infections. To eliminate the risk of transmitting hereditary diseases, donors undergo a medical genetic examination.

When selecting a donor, the wishes of the patients (height, weight, eye and hair color, education, hobbies, blood type) are taken into account.

Artificial insemination with ovulation stimulation

Artificial insemination with ovarian stimulation in some cases may be more effective than in a natural cycle. The chances of fertilization increase by 2-3 times.

When you contact VitroClinic for medical help regarding infertility, you will need to undergo some examination and tests. The research results will allow the doctor to determine the optimal method of artificial insemination.

The main indications for stimulation before introducing sperm into the uterus:

• the duration of the couple's infertility is 5 years or more;
• the woman does not have a regular cycle;
• pathological change in the concentration of sex hormones in the blood;
• woman's age after 35 years;
• reduced ovarian reserve;
• unsuccessful attempts at artificial insemination in the natural cycle.

Stages of intrauterine insemination with stimulation:

1. Diagnostics.

   The married couple undergoes all necessary tests. Based on their results, a decision is made to carry out artificial insemination with or without simulation, spouse or donor sperm.

2. Stimulation.

   A woman is prescribed daily use of hormonal drugs to stimulate ovulation. As a result, we are guaranteed to receive a mature egg, which increases the chances of pregnancy with artificial insemination.

   We use only gentle ovarian stimulation schemes, individually selecting them for each patient.
   

   After the doctor sees on an ultrasound that the follicles are ready for ovulation, a hormonal drug is prescribed for a single injection so that ovulation occurs and the day of insemination is set.

3. Receiving ejaculate.

   The spouse must donate sperm 1.5-2 hours before the procedure. 3-4 days before this he needs to abstain from any sexual activity. In the case of using cryopreserved sperm, including donor sperm, it is thawed 1-1.5 hours before the start of the procedure.

4. Injection of sperm into the uterus.

   It is performed on a woman in a lying position using a special catheter. The procedure is absolutely painless and takes only 20-30 minutes, taking into account the fact that the patient must lie down for a while after this. To increase the likelihood of conception in this cycle, another insemination procedure is performed every other day.

If a couple is unable to get pregnant, but she really wants it and agrees to actively act in search of a solution to the problem, modern medicine has something to offer in such cases. Today there are many different methods of fertilization or assisted reproductive technologies. And very often doctors recommend starting with insemination as one of the most accessible, simple and natural methods.

IUI method: what is the point?

Insemination is the fertilization of a woman's egg with the help of a man's sperm. It occurs already inside the uterus, that is, the sperm is “planted” right here, saving it from the need to make an additional path to the cherished goal. Because of this feature, this method is also called intrauterine insemination, which is abbreviated as IUI.

The IUI procedure is simple and straightforward: donor sperm (that is, the sperm of the woman’s husband or the potential father of the unborn child) undergoes purification, during which live, mobile, active and full-fledged sperm are selected, and foreign substances that do not play a significant role in the fertilization process are removed from ejaculate.

Thus, the sperm becomes not only of higher quality, but also more concentrated, which significantly increases the chances of success. However, unpurified sperm can also be used for fertilization in this way, but the first option is more preferable for a number of reasons (we are talking not only about increasing the chances of success, but also about reducing various risks).

The effectiveness of the method is also increased due to the fact that the path of sperm to the egg is shortened: they do not need to overcome the vaginal corridor and the cervix, because they are immediately introduced into the uterine cavity.

Intrauterine insemination is carried out with minimal interference in natural processes from the outside, which is a great advantage and advantage of this method. The procedure does not last long and is not painful: sperm is injected into the uterine cavity using a catheter.

Insemination

The husband's sperm, specially purified and prepared, is injected on the days when the woman's egg matures and leaves the follicle naturally, that is, during the ovulation period - the most fertile period in the entire menstrual cycle. In order not to miss the “X” hour, the process of egg maturation is monitored using ultrasound diagnostics (this method is called folliculometry). And when the most favorable moment for pregnancy comes, the sperm of the husband or donor is injected into the uterine cavity.

However, in a number of cases, when, for a variety of reasons, the natural processes of follicle maturation are slowed down or disrupted, women stimulate ovulation with the help of hormonal therapy. In this case, they sometimes talk about artificial insemination, although all these terms - insemination, artificial insemination and intrauterine insemination - are synonymous and denote a single concept.

Pregnancy test after insemination

The most difficult and painful part of insemination is, perhaps, the waiting period. Over the next two weeks, the woman will be impatiently waiting for the result, exhausted and worried: it is after this period of time that the first pregnancy test can be performed after insemination.

Don't worry or get upset: this is just an attempt. In any case, you do not lose anything, but only use one of the chances of a possible pregnancy.

Who is suitable for insemination?

In most cases, the insemination method is offered to couples who are diagnosed with unexplained infertility. The results of all tests and examinations show absolute well-being and good condition of the reproductive system of both partners, but for unknown reasons, pregnancy still does not occur.

In addition, insemination can be a good solution to the problem of conceiving a child for women whose ovulation is absent or occurs with disturbances, but these deviations can be corrected, that is, with the help of therapeutic methods they can be influenced and corrected. As for male problems, insemination is a good solution when a man’s sperm, having overcome the barrier of a woman’s cervix, lose their ability to fertilize.

This method of fertilization can also be used in cases where the results of examinations of partners do not go beyond the established clinical norms, but are at the lower levels of acceptable figures. In such cases, reproductive doctors say that the couple is subfertile.

It makes sense to turn to IUI when there is a high risk of transmitting genetic diseases through the father's line or when a man is infertile: in such cases, donor sperm is used for fertilization, which first undergoes a mandatory six-month freezing to avoid the possibility of transmitting infections. Donor material is also used to fertilize the egg of a woman who does not have a husband or partner but has decided to have a child alone.

Insemination has only a few contraindications. This is obstruction of both fallopian tubes in a woman and a low concentration of viable sperm in the man’s semen. Of course, a candidate for insemination must have adequate mental and physical health to allow her to bear a child. The presence of tumors, pathologies of the uterus, and some mental disorders are contraindications to fertilization by any method.

Insemination: price

Women consider its cost to be one of the most compelling arguments in favor of fertilization through intrauterine insemination. Compared to IVF, such a procedure will cost ten times less, and for many this is a very significant factor.

However, the price of insemination varies greatly depending on the city, clinic, doctors’ qualifications and the package of services provided. On average, the insemination procedure without preparation for it and subsequent support ranges from 100-200 euros, but you should not rely on this cost, since prices vary greatly.

Insemination: reviews

If you have to do more than one insemination procedure, you will need to pay for each subsequent attempt separately. And there may be several such attempts...

At best, the doctor will promise you a 50% guarantee, that is, he will say that conception through insemination occurs in approximately half of all cases. But most doctors give more realistic forecasts: from 7 to 25%. Doctors say that the final result is influenced by a wide variety of factors: the age and health status of potential parents, sperm quality, number of attempts, and others.

If we turn to the practical experience of ordinary women who have undergone IUI one or more times, we can come to the conclusion that only a few actually manage to get pregnant this way. In most cases, judging by the reviews on the forums, attempts at insemination end unsuccessfully.

Sometimes, as a result of such fertilization, an ectopic pregnancy occurs (by the way, the woman must first undergo a test for patency of the fallopian tubes in order to avoid such an undesirable outcome). Some women complain that they begin to get better and gain weight after hormonal therapy prior to the IUI procedure. But in this case, others advise: a competent, qualified specialist is able to select the most suitable therapy that will not have undesirable consequences.

So, the method of intrauterine insemination is the closest to the natural method of conceiving a child. It is relatively safe and convenient, affordable, but the effectiveness still leaves much to be desired...

If after 3-4 attempts (usually no more than six) it was not possible to conceive a child, then the couple will be advised to seek help from IVF or ICSI (which involve more global outside intervention in the process of conception).

In any case, there is no need to despair. A huge number of couples around the world, including in Russia and the former CIS countries, have become happy parents thanks to assisted reproductive technologies and IVF. If you dream of the happiness of parenthood, then you need to go to the end and never lose hope. Don’t forget that the Almighty has his own plans for us: perhaps it was simply not the time before...

Everything will certainly come true!

Especially for - Larisa Nezabudkina

Insemination. Types and techniques of insemination. Possible complications after insemination. Where is artificial insemination performed?

Thank you

How is the insemination procedure performed?

On what day of the natural cycle is insemination done?

On average, ovulation occurs on the 14th day of the menstrual cycle, but in some cases it can occur earlier or later. However, it is impossible to predict the exact time of ovulation, 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. Under 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. The hormone 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 schedule 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 a tugging sensation. 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

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 this case, during ovulation, 2 or more eggs may enter the fallopian tube, which can be fertilized during the artificial insemination procedure. The outcome of such a phenomenon could be multiple pregnancy.

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

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), possessing mobility, begin to move towards 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. Passing through this mucus, most of the sperm die. The surviving sperm enter the uterine cavity and then travel to the fallopian tubes. One of these pipes contains a mature ( ready for fertilization) egg ( female reproductive cell). One of the sperm penetrates its wall earlier than the others and fertilizes it, 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 and so on). 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 syringe plunger, 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 drawn 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 reasons. infertility, as well as if intracervical or intrauterine insemination is ineffective. In terms of execution technique, it is no different from the previously described procedures.

Does insemination hurt?

Is it possible to perform artificial insemination at home?

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.

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?

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 a fertilized egg to the wall of the uterus, resulting in pregnancy not occurring. It is in such cases that patients are prescribed Utrozhestan 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)?

Is it possible to take a bath after artificial insemination?

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 introduced directly into the uterine cavity or into the fallopian tubes, which are normally reliably separated from the environment by the 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?

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

Is it possible to have sex after artificial insemination?

How many hours after insemination does fertilization occur?

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

It is worth noting that after artificial insemination, pregnancy proceeds exactly the same as with conception naturally. 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 mammary glands ;
• absence of menstruation.

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

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?

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 most serious complications of insemination may 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?

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

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 reason for the development infections there may be a woman’s failure to comply with personal rules hygiene immediately before or after performing 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, the appearance of spots on skin, muscle tremors, pronounced fall 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.
• A drop in 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 of the so-called autonomic nervous system, which is accompanied by a reflex dilation of blood vessels, a slowdown in the heartbeat and a decrease in blood pressure. If this complication develops, the woman is strictly forbidden to get up, as this will cause an outflow of blood from 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

Chest pain ( nipples hurt)

Temperature

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 it on your own antipyretics, as this can distort the clinical picture of the disease and make diagnosis difficult.

Will I get my period after insemination?

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)

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?

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

In Moscow

Intrauterine artificial insemination (IUI) is one of the most popular methods of fertilization. The procedure involves injecting sperm directly into the uterine cavity to promote a natural pregnancy. Artificial insemination is also performed with donor sperm.

Previously, the procedure was ineffective. The injection of sperm caused unpleasant, even painful sensations. The risk of infection increased. Under such conditions, the success of the manipulation was only 7-10%. However, many years of research have made it possible to identify a number of laboratory methods that significantly increase the chances of conception after artificial insemination.

Processing sperm in a centrifuge allows you to cleanse it of impurities and enrich the cells with protein and minerals. After special treatment, more active sperm remain, since defective ones are eliminated. By increasing the concentration of healthy cells, the chances of success are increased: some sperm are injected into the uterus, but most of the cells are viable.

Unfortunately, there are many candidates for artificial insemination. It is not enough to feel healthy and not have problems with your sex life. The ability to fertilize depends on internal factors.

If there were injuries to the genital organs (actual and exposure to instruments during surgery), reproductive function could be impaired. The same applies to infectious diseases, because mumps, syphilis, gonorrhea, hepatitis and tuberculosis negatively affect reproduction.

The most common cause of infertility in men is dilation of the seminal veins, which leads to overheating of the testicles. Under the influence of abnormally high temperatures, germ cells die, and if the concentration of active sperm is insufficient, fertilization does not occur. This is due to the fact that it takes not one, but thousands of sperm to travel the entire path to the uterus. Most simply help one overcome obstacles, but without enough sperm, none will reach the goal.

Habits (overeating, smoking, sedentary lifestyle) also have an equally detrimental effect on sperm characteristics. They help reduce the number of healthy cells, change their structure and degree of mobility.

In case of female infertility, artificial insemination with the husband's sperm is relevant if a woman is diagnosed with an unfavorable environment. It often happens that slow sperm have difficulty making their way into the cervix, where they are “finished off” by antibodies. This happens during long-term married life, when the uterus learns to perceive the partner’s reproductive cells as something foreign.

Artificial insemination with sperm is also suitable for some patients with abnormal genital structure. The time and method of introducing sperm plays an important role, because through insemination the natural process of conception is imitated.

The method allows you to carry out those stages of fertilization that do not occur due to deviations. The procedure is divided into 3-5 cycles. If insemination is ineffective after four attempts, they resort to or (depending on the causes of infertility).

Indications and contraindications

Insemination allows you to solve the issue of infertility in men with the following abnormalities:

• sperm subfertility;
• retrograde ejaculation;
• ejaculatory-sexual disorders;
• insufficient amount of seminal fluid;
• displacement of the urethra;
• thickening of sperm;
• low sperm motility;
• complications after vasectomy;
• consequences of radiation or chemotherapy.

Artificial insemination is also a good way to use cryopreserved sperm. The procedure allows a woman with the following abnormalities to become pregnant:

• cervical infertility (problems with the cervix);
• difficulty in penetration of male germ cells into the uterus;
• chronic inflammation of the cervix;
• manipulations resulting in damage to the cervix;
• anatomical or physiological disorders of the uterus;
• ovulation dysfunction;
• vaginismus (reflex muscle spasms that prevent sexual intercourse);
• allergy to sperm.

IUI is recommended in the presence of an excessive number of antisperm bodies, which are characterized as immunological incompatibility of partners. The procedure is also used for unexplained infertility. Contraindications for artificial insemination:

• the age of the patients is more than 40 years (the chance of the procedure being effective is reduced to 3%, which is practically impossible, therefore more promising methods of artificial insemination are recommended);
• presence of more than four unsuccessful attempts at IUI;
• psychological and somatic disorders that exclude any possibility of pregnancy;
• the presence of genetic diseases that can be passed on to the child;
• there are foci of genital tract infections;
• acute inflammation;
• congenital or acquired uterine defects that make the full and healthy development of the fetus impossible;
• pathology of the fallopian tubes;
• ovarian tumors;
• syndrome;
• malignant tumors in any part of the body;
• unexplained bleeding in the genital tract;
• pelvic surgery;
• luteinization syndrome of a non-ovulated follicle (absence of ovulation in the presence of manifestations).

Preparation

The procedure is performed during the ovulation period of the menstrual cycle. Insemination is carried out against the background of natural maturation of the egg or by stimulating the ovaries (ovulation induction). Use fresh or cryopreserved sperm.

The preparation plan includes a consultation with a doctor, who will study the medical history and draw up an individual examination plan. First of all, you should confirm the absence of STIs (sexually transmitted infections).

It is unacceptable to perform IUI for hepatitis, syphilis,. A test for TORCH infections is prescribed. A man undergoes a spermogram to analyze qualitative and quantitative characteristics. To assess the microflora of the genital organs, a smear is taken. At risk are people with ureaplasma, papilloma virus, group B streptococcus.

Diagnosis is important because these infections have no symptoms. If there are pregnancies that were interrupted by themselves, you need to donate blood for an immunological analysis (ELIP-TEST 12).

A woman should keep a menstrual journal, measure her basal temperature, and do ovulation tests. To confirm ovulation, folliculometry is done.

Stages of artificial insemination

Stage 1 – ovarian stimulation

Hormones (FSH, LH) are used for this. Ultrasound monitors the development of the cycle and the formation of the follicle. An analysis of its size and structure is also carried out. After the follicle matures, a hormone that mimics luteal hormone is administered to stimulate natural ovulation. This way the egg is activated.

Stage 2 – sperm preparation

The man provides a sample on the day of the procedure. If cryopreserved sperm is used, it is thawed in advance. I process the sample in a centrifuge and add nutrients (the procedure takes an average of 45 minutes). After separating active germ cells from abnormal ones, the sperm concentration becomes acceptable for implantation.

Stage 3 – insemination

Done on the day of ovulation. It is not advisable to do IUI if you have a respiratory disease, stress, fatigue, or poor health. Cells must be administered within 1-2 hours after treatment. The fact of ovulation is confirmed by folliculometry.

In the absence of ovulation, stimulation is repeated. When ovulation occurs, sperm is collected into a thin cannula, which is inserted into the uterus and injected. It is noteworthy that the procedure itself, despite the scary description, is painless. The woman feels practically nothing. The sensations are comparable to a regular gynecological examination. For this purpose, special disposable flexible instruments are used.

After the sperm is injected, a cap is placed on the cervix to prevent leakage. It is recommended to begin sexual activity 8 hours after removing the cap.

Statistics and probability

It is recommended to resort to insemination no more than 3-4 times. In almost 90% of patients, the desired pregnancy occurs during the first three attempts. The probability of getting pregnant for other women does not exceed 6% per attempt. It is noteworthy that the first three attempts together account for almost 40% of the probability, while the six attempts account for only 50%.

Insemination success rate by age:

• Up to 34 years of age, the first insemination gives up to 13% success, the second – 30%, and the third – 37%.
• From 35 to 37 years old, the first gives 23%, the second – 35%, and the third – 57%.
• From 40 years old, all attempts give a 3% success rate for conception.

If three procedures are unsuccessful, it is advised to turn to other methods of artificial insemination.

Possible complications

After artificial insemination, some complications are possible. So a woman may develop a severe allergy to ovulation-stimulating drugs. Acute inflammatory processes and exacerbation of existing chronic diseases are possible.

Directly upon injection of sperm, a shock reaction is sometimes observed. After IUI, it is possible to increase the tone of the uterus. Also, the risk of ovarian hyperstimulation syndrome cannot be excluded. Some patients experience multiple or ectopic pregnancies after artificial insemination with sperm.