Artificial insemination (AI) or intrauterine insemination (IUI) refers to the placement of sperm artificially inside the female reproductive system, generally within the uterus. It is an assisted reproduction treatment indicated for women experiencing trouble conceiving.
Depending on the origin of the semen sample, we can distinguish between two types of artificial insemination:
- Artificial insemination by husband (AIH): The washed sperm that is inserted into the female reproductive system has been collected from her husband or partner. It is also called homologous artificial insemination (AIH).
- Artificial insemination by donor (AID): In this case, the semen sample belongs to a donor that has been chosen from a sperm bank. It is commonly used in cases of women without a male partner, such as single women or lesbian couples, and also in cases where the man has been diagnosed with severe male factor infertility due to low sperm quality, a disease or any other factor. It is also known as heterologous artificial insemination or donor insemination (DI).
There is one more type of IUI: at-home artificial insemination. Even though usually it is the gynecologist the responsible for inserting the semen sample into the woman’s uterus, in this case it is the woman herself or her partner who inserts the sample into her vagina aided by a catheter. Thus, there is no need for visiting the gynecologist when this is the chosen type, since it can be done at home, hence its name.
Should you wish to get further information about the different types of artificial insemination, we recommend you to visit the following article: Types of AI.
When is intrauterine insemination indicated?
Artificial insemination is indicated in cases of mild male infertility, e.g. teratozoospermia, asthenozoospermia, and/or mild oligospermia, and also in cases where there exist trouble having full sexual intercourse. Artificial insemination is also indicated when there exist fertility problems in women such as menstrual irregularities, mild endometriosis, or cervical abnormalities.
There is also the chance that a combination between male and female infertility occurs, and also the other way about: when everything is apparently working as expected, but trouble conceiving keeps on arising. This latter case refers to what is known as unexplained infertility or infertility of unknown cause, in which case intrauterine insemination is the technique of choice.
In order to carry out the artificial insemination process and achieve successful results, the woman has to present tubal patency at least in one of the fallopian tubes. As for the semen sample, it must reach the basic values in terms of sperm quality. After sperm capacitation, that is to say, selecting only motile spermatozoa and reducing the quantity of seminal fluid, the Motile Sperm Concentration (MSC) report hast to surpass the amount of 3 million sperm/ml. The presence of any infectious disease must be ruled out as well.
Click the following link in case you wish to find detailed information about this: Requirements for an AI.
Intrauterine insemination step by step
From a technical point of view, IUI stands for a simple process that is performed in the gynecologist’s office, without anesthesia, and just in a few minutes. These four steps are involved in the process:
- Mild ovarian stimulation of the woman
- Sperm capacitation
- Insemination per se
- Preparation of the endometrium
Although the sperm is usually placed inside the uterus —hence the name intrauterine insemination—, we can distinguish several artificial insemination procedures depending on the location where the sperm is inserted: intratubal insemination (ITI), intravaginal insemination (IVI), intracervical insemination (ICI), and intrafollicular insemination (IFI).
Contrary to what some may think, artificial insemination has been used since the 15th Century, when it was used for animal testing in order to find out how the processes of breeding and fertilization worked. First artificial insemination in humans took place in 1790, which proves that this technique has been used for a long period of time. Furthermore, improvements have been made ever since over the years until it has become a highly accurate method as it is now.
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