Artificial insemination (insemination)

Artificial insemination (insemination) is the introduction of alien genetic material in the form of sperm in the genital tract of a woman for the purpose of her pregnancy.

Depending on the method of introduction of sperm, the following methods of artificial insemination are used:

• vaginal, in which sperm is injected into the posterior vaginal vault with a syringe;
• Intracervical method, when sperm is injected into the cervical canal, avoids contact with vaginal contents;
• The uterine method involves the introduction of semen directly into the uterine cavity;
• transabdominal introduction of seminal plasma-free spermatozoa along with one or two eggs into the funnel of the fallopian tube (GIFT).

Each method has positive and negative sides. Although the vaginal method is most simple, but the vaginal contents (pH, bacteria, etc.) adversely affect sperm, which reduces the chances of pregnancy. With the intracervical method, an immunological conflict may develop, due to the presence of antisperm antibodies in the cervical mucus. The introduction of sperm into the uterus can also contribute to the infection, and is often accompanied by painful contractions.

To improve the ejaculate (increase in concentration) before insemination, its fractionation is recommended.

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Indications for insemination of sperm of a husband

Artificial insemination with sperm of the husband is used for hypospadias of the urethra, impotence, absence of ejaculation, with oligospermia with preserved normal sperm motility and absence of morphological changes in them. In such cases, the ejaculate is centrifuged and the sperm-enriched fraction is introduced into the cervical canal. In addition, it is possible to store concentrates of several ejaculates, for which complex equipment is not required.

For artificial insemination, the husband's sperm can use the husband's sperm, taken for cryopreservation immediately before its sterilization, before prescribing cytostatic drugs or before irradiation.

In women with some forms of anatomical-functional, immunological and inflammatory changes in the cervix, in which there is a so-called cervical antagonism, shows artificial insemination by the husband's semen. Vaginismus, hip joint diseases can also be the basis for insemination by the husband's semen.

Indications for insemination with donor sperm

Artificial insemination with donor sperm is carried out according to medical indications, which can be absolute and relative. The absolute includes azoospermia, relative:

• oligozoospermia and oligoastenoteratozoospermia with morphological changes in spermatozoa and a violation of their mobility that can not be treated;
• incompatibility of Rhesus spouses;
• Hereditary diseases in the husband, which can be transmitted to the offspring.

There are contraindications to carrying out artificial insemination with donor sperm. It is inadmissible to carry out the procedure under anesthesia, without a written confirmed consent for insemination of both spouses, without a thorough examination of the spouses and establishing indisputable indications for intervention, with any contraindications to pregnancy, with the possibility of eliminating infertility by treatment or surgery, more than once at the same the same women, except when the child is dead.

Contraindications to artificial insemination are common diseases that contribute to the disability of women, or are a threat to pregnancy, childbirth and her life. Before the artificial insemination of the husband's sperm for 2-3 cycles, a test is performed for functional diagnostic tests or determining the level of progesterone in the middle of the luteal phase of the menstrual cycle. This allows you to determine the presence of ovulatory cycles, as well as perivascular days. In the case of anovulation, the possibility of induction of ovulation is determined before artificial insemination.

Timing for artificial insemination

Since there are possible inaccuracies in determining the exact date of ovulation, artificial insemination is recommended up to 3 times during the cycle. At the 27-day menstrual cycle, it is necessary to begin insemination from the II day, and at the 28-day period - on the 13th day of the cycle and repeat 2-3 times with an interval of 2 days.

After insemination, it is recommended to remain in the prone position for one hour or use a cervical cap to keep the sperm.