Artificial Insemination: How Fertilization Works
The method of fertilization consists of injecting sperm into the woman's uterus during her fertile period, that is, when she is ovulating, thus facilitating the union of the gametes to the formation of the embryo. The first artificial insemination test was made in the United States in 1884. For a long time, it was the only alternative pregnancy for couples with some infertility problem. Here in Brazil it has been in existence since the 1970s.
How Artificial Insemination is done
First man will have to collect a portion of semen at home or in the laboratory through of masturbation. Samples are selected in the laboratory, separating the spermatozoa according to their mobility and removing immature cells and cell debris. Sperm can also be obtained in a semen bank if donation is required. As for the woman, she can take medications to induce ovulation (used in programmed intercourse), which can be taken orally or subcutaneously through injections. During stimulation, serial ultrasonography is performed to monitor the growth of the follicles (where the ovules are found).
When the follicles are ready, a medicine is given that allows the release of the eggs. At the time the woman is ovulating, the sperm placement inside the woman's uterus is marked. This is a medical procedure performed at a human reproduction clinic. The process works similar to the Pap smear: a duck's beak is inserted into the woman's vagina and then a very thin catheter through which the sperm pass. The positioning of the catheter is done using an ultrasound device. Sperm can be deposited in the cervix, in the process called ultracervical insemination , or closer to the fallopian tubes, in intrauterine insemination . Currently the second method is the most used, for having better results. After all this procedure, the pregnancy test is done within 12 days.
Duration of treatment
The period between the start of treatment and confirmation of pregnancy or not lasts for about one month. The woman begins the medication at the beginning of the menstrual cycle for about 15 days and insemination is performed after the release of the ova, which usually coincides with the woman's fertile period. After 12 days the pregnancy test is done to verify success.
For whom Artificial Insemination is indicated
This method is usually indicated for couples with some slight alteration in spermatozoa (such as slow or difficult to move gametes), for cases of change in the uterus, such as mild endometriosis or even when there is no apparent reason for infertility.
Artificial insemination can also be done with donated spermatozoa in cases where the partner of the woman does not have them in her semen or in the case of homoaffective couples.
Preparation for Artificial Insemination
The man should be in sexual abstinence two to five days before the collection of the semen, to guarantee its quality. It is also important that it prevents excessive stress, heat in the genital region, excessive consumption of alcohol and smoking in this period.
For women, it is important that they are up to date with their gestation health, with the correct weight, vaccines, without smoking and supplementing with folic acid. A check-up is important to check for any chronic illness that needs to be controlled during pregnancy.
What to Expect from Artificial Insemination
The success rate per cycle is around 20%. In the case of artificial insemination the more age a woman has, the lower the chances of becoming pregnant. After the age of 35, the chances of success of this method are reduced.
In case of failure, it is generally suggested that up to two further attempts for this treatment can be made in consecutive cycles without harm. After that, the treatment is considered ineffective and you need to talk to the specialist to suggest other options, such as IVF.
Artificial Insemination Risks
In this method there is a 15% chance of a twin pregnancy . This is considered a risk because pregnancies with more than one baby involve more prenatal care and usually result in premature births, which are dangerous for both the mother and the fetus.
Another risk is the Hypertension Syndrome Ovary (SHO), when there is a greater production of the hormone estradiol, synthesized in the ovaries, which increases the swelling and the chances of the woman having thrombosis during pregnancy. However, this risk is less frequent at insemination because it is a treatment that uses low doses of hormones in most cases.
The contraindications are the same as in an ordinary pregnancy, it is necessary that women with health problems consult your doctor before the procedure. And when there is a risk of inherited or infectious disease, a prior expert opinion becomes essential.
The use of ovulation induction medications is contraindicated for women with ovarian, uterine, or mammary carcinoma and tumors of the hypothalamus or gland pituitary
Where access to treatment
Most fertilization clinics perform artificial insemination. But it is necessary to check if the doctor who will perform it has a specialization in reproductive medicine.
Infertility specialist gynecologist Lucas Yamakami (CRM-SP 112.079), Clínica VidaBemVinda
Gynecologist and obstetrician specialized in human reproduction Fernanda de Paula Rodrigues (CRM-SP 121.922), Huntington Reproductive Medicine
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