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Artificial insemination/Intrauterine insemination
Artificial insemination (AI) is a relatively straightforward method
of assisted conception.The two most common types are
Intra-cervical insemination
A semen sample is injected into the top of the vagina whilst the woman
is lying down with her knees up. A plastic cap (similar to those used
for contracpetive purposes) is sometimes placed in the vagina to keep
the sperm near the cervix. It can then be removed 6-8 hours later.
Intrauterine insemination (IUI) A fine plastic tube is inserted into the womans uterus through
which the male partner or donor's sperm is introduced. The sperm is
introduced directly into the womans uterus to help it get closer
to the site of fertilisation, usually combined with ovulation stimulation
in advance.
For intrauterine insemination, the sperm has to be ‘washed’ before being
placed in the uterus. Semen is made up of two parts; plasma and the
sperm cells themselves. The sperm cells are washed to separate them
from the plasma. This has to be done because neat semen can cause severe
uterine pain, cramps and sometimes fainting . The sperm are then incubated
before being carefully placed in the uterus.
To use these techniques, the woman must be ovulating, and her fallopian
tubes must be clear. These insemination techniques can help when:
The mans sperm is being killed off by vaginal secretions, as
the semen is placed beyond this barrier
The couple is unable to have sexual intercourse, either because of
injury or disability
There are difficulties with intercourse such as premature ejaculation
Insemination is timed to take place during the most fertile part of the
womans cycle, sometimes on two or three days in a row, although
more and more clinics are now combining AI/UI with ovulation stimulation,
where the woman takes hormones to stimulate ovulation. This means that
egg release can then be timed carefully (by giving another hormone) to
coincide with the sperm being reintroduced into the uterus and seems to
produce better results with up to 30 per cent success rates in some clinics.
After both procedures the woman will need to rest for a short time afterwards,
and can then go home.
Because successful AI/IUI depends on the ability of sperm to fertilise
an egg, the man will need to produce enough normal sperm in reasonable
numbers. If this is not the case, donor sperm can be used.