Artificial Insemination

What Is It?:

Refers to any procedure or technique which attempts conception by placing semen within the female reproductive organs through any means other than sexual intercourse.

Types of Procedure

Intracervical insemination (ICI), Intrauterine insemination (IUI)

In use since

Possibly began with humans before written history; its practical use in animals developed during early 1900's.

Indications

Infertility or one-partner conception with:

  • functioning ovaries and fallopian tubes
  • sperm within normal parameters
  • no advanced endometrial problems
  • no history of pelvic infections

May be particularly useful with:

  • conditions preventing vaginal ejaculation
  • sperm with low motility (movement)
  • cervical mucus that is hostile to sperm
  • presence of sperm antibodies

How It Works:

  • ICI - Fresh ejaculate (semen) is placed directly into the cervix (opening to the uterus) by using a syringe and cannula (long, slender tube).
  • IUI - "Washed" semen is placed directly into the uterus via a catheter through the cervix.

Success Rates:

  • ICI - 2% or higher chance of pregnancy per cycle, depending on infertility cause, etc. There are no national statistics on live birth results.
  • IUI - Higher probability of pregnancy than ICI. Generally, 5 - 20% chance of pregnancy per cycle with an increased rate up to 6th or 7th cycle. Rates are higher when AI is accompanied by superovulation using fertility drugs. Rates are diminished with advancing maternal age.

Typical Procedure Protocol

Pre-procedure:

  • thorough evaluation of both male and female for suspected causes of infertility
  • determination of drugs to be used (or not) and timing of treatment cycle
  • initiation of fertility drugs (if used)
  • monitoring by ultrasound and bloodwork to evaluate ovarian response to drugs and reduce potential side effects
  • if drugs result in ovarian hyperstimulation syndrome, treatment cycle will be discontinued immediately.
  • in case of no drug use, patient may be required to monitor own cycle with ovulation predictor kits and other methods
  • induction of ovulation by hCG, if necessary

During procedure:

  • male partner must produce a semen sample, usually in the clinic (may be collected at home in some cases), or donor semen must be available
  • female partner is inseminated while lying down, feet in stirrups, on examination table
  • female may be advised to refrain from strenuous physical activity for 24 to 48 hours after insemination

Average Costs, excluding pre-treatment evaluation:

  • ICI: US $150 to $500
  • IUI: US $200 to $500
  • Sperm washing: US $ 150 - $200
  • Fertility drugs: US $30 to $75/vial of 75IU, depending on drug used; may require up to 20 or more amps per cycle
  • Monitoring: US $500 - $1,500
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