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The statistics are disappointing - every year the number of infertile couples only increases, and how many of them want children! Thanks to the latest technologies and progressive methods of treatment, babies are born, although it would seem that this is impossible. Artificial insemination is a procedure that allows a woman diagnosed with infertility to become a mother with the help of donor sperm. What is the essence of the technology, to whom it is contraindicated, and how great are the chances of giving birth to a child - more on that later.
Being one of the methods of artificial insemination, insemination helps parents to find a long-awaited child. The procedure significantly increases the likelihood of conception, since it is preceded by a careful selection of material for the operation. Among spermatozoa, the most active ones are selected, and the weak ones are removed. The protein components of the ejaculate are removed, because they can be perceived by the female body as foreign.
Intrauterine insemination is not a panacea for infertility, but only one of the ways to get pregnant artificially. According to studies, the positive effect is estimated at a maximum of 30-40 percent. A single session does not guarantee the development of pregnancy, so the operation is performed up to 3 times per monthly cycle. If conception does not occur after several procedures, it is recommended to turn to other methods of artificial insemination. The very same pregnancy with intrauterine insemination is no different from the usual.
It would seem why women cannot become pregnant, and with the artificial introduction of ejaculate, fertilization occurs. One of the features lies in the female body. The fact is that antibodies to male sperm are produced in the cervical mucus. It turns out that it simply kills the spermatozoa, and does not contribute to their penetration to the egg. The procedure helps to deliver the processed material directly to the uterus, bypassing the cervical canal. In this way, even if the spermatozoa are immobile, the chance of getting pregnant increases.
As can be seen from the above, the main indication for artificial intrauterine insemination is the immunological incompatibility of partners. In fact, there are much more individual reasons for resorting to the procedure, so it is worth considering them in more detail. The main problems in women are considered to be inflammatory processes in the cervical canal. The disease prevents the passage of sperm into the uterus, preventing a woman from becoming pregnant.
Artificial insemination is used for vaginismus - a problem when sexual intercourse is not possible due to spasms and pain. Injuries and pathologies of the genital organ that prevent pregnancy, anomalies in the position of the uterus, infertility of an obscure nest, surgical interventions on the cervix are another of the many reasons to go to the clinic for an insemination procedure.
Until recently, the cause of female infertility was sought only in the weaker sex, but, as studies have shown, male problems are often dominant in this matter. Low motility and a small number of spermatozoa, which are difficult to reach the end point, and azoospermia are one of the main diseases due to which artificial insemination is prescribed if the previous treatment has not given any results. Disorders with potency and ejaculation can also become an indication for the procedure.
Genetic diseases, due to which there is a risk of the birth of a patient or with the psychophysical characteristics of a baby, is another reason why artificial insemination is prescribed. True, then the procedure is performed with the donor's sperm, to which the husband (and the future official father) gives written consent. Fertilization with seminal fluid from the base of the clinic is also carried out for single women who want to become pregnant.
Intrauterine insemination is the first of the methods that is used for problems with conception. The main advantage is the absence of great harm to the female body. Artificial insemination can be carried out even if the exact cause of infertility has not been established. The procedure does not require long preparation, and its implementation does not take much time. The main advantage of using this method is its low cost.
Like any operation, and medically intrauterine insemination is such, the procedure requires preparation. One desire to do artificial insemination is not enough, you need to come to an appointment with a doctor who will prescribe an action plan after compiling a family history and a thorough analysis of the situation during the conversation. Then it is necessary to sign certain papers confirming the consent of the spouses to carry out the conception. If it is necessary to use donor sperm, the number of documents for approval increases significantly.
Previously, in order to find out the preparedness for the artificial insemination procedure, the couple is tested:
After a 3-5 day period of abstinence, a man gives a spermogram, which determines the mobility of spermatozoa. In women, the patency of the fallopian tubes is checked, with the help of hysterosalpingography, the uterus is examined. An ultrasound scan detects ovulation. If there are problems, then hormones stimulate the production of an egg. Sowing of microflora is carried out to determine the presence of papillomavirus, ureplasma, group B streptococcus, which can cause the impossibility of bearing a fetus.
Immediately before the insemination procedure, seminal fluid is artificially surrendered, after which it is examined and processed. There are 2 ways to prepare cells: centrifugation and flotation. The first option is preferable because it increases the chances of conception. Preparation of sperm consists in removing acrosin from it, a substance that inhibits sperm motility. To do this, portions are poured into cups and left to liquefy, and after 2-3 hours they are activated with special preparations or passed through a centrifuge.
According to doctors specializing in these issues of gynecology, the best option for artificial insemination is the introduction of spermatozoa into the uterus three times:
Artificial insemination can be carried out independently or directly with the participation of a specialist in the clinic. To do this, the woman is placed on a gynecological chair, with the help of a mirror, access to the cervix is opened. The doctor inserts a catheter, and biological material is collected into a syringe connected to it. Then there is a gradual introduction of spermatozoa into the uterine cavity. After insemination, the woman should remain motionless for about 30-40 minutes.
If serious diseases are detected in a woman's partner, such as hepatitis, HIV and other potentially dangerous diseases, including genetic ones, then donor sperm is used, which is stored frozen at a temperature of -197 ° C. Data about a person is not declassified, but a woman can always bring with her a person who has the right to donate seminal fluid for subsequent artificial insemination of the patient.
When using the biological material of the spouse, sperm sampling takes place on the day of the insemination procedure. To do this, the spouses come to the clinic, where biological material is donated. After that, the seminal fluid is analyzed and prepared for use. It is important to understand that before donating sperm, a man must refrain from sexual intercourse for at least 3 days in order to improve the quality of spermatozoa.
Artificial insemination is allowed at home, although according to doctors, its effectiveness is considered minimal, however, judging by the reviews, successful attempts have been recorded. In the pharmacy, you can buy a special kit for manipulation at home. The algorithm differs from that carried out in the clinic in that the sperm is injected into the vagina, and not into the uterus. When carrying out insemination on your own, you cannot reuse the kit, it is forbidden to lubricate the labia with saliva or cream, and also to inject sperm directly into the cervix.
A positive result in the procedure of intrauterine artificial insemination is achieved less frequently than in in vitro fertilization (IVF) and ranges from 3 to 49% (these are the most positive data). In practice, the number of attempts is limited to 3-4, since a larger number of attempts is considered ineffective. After that, it is necessary to conduct additional studies or correction of treatment. If there is no pregnancy, you should resort to another method of artificial conception or change the sperm donor.
As such, intrauterine insemination does not cause complications, women are more at risk due to taking drugs that cause ovulation, so it is imperative to test for the possibility of allergies. In addition, the risk of having twins increases, less often triplets, due to the fact that several attempts are made to introduce sperm and stimulate the formation of more than one follicle.
Although artificial intrauterine insemination is a simple procedure with little or no consequences, there are still some restrictions on which it can be refused. Among them, there are problems with ovulation itself, which occurs with violations, tubal infertility (it is necessary that at least one intrauterine labor is capable), inflammation of the appendages and uterus, hormonal disruptions, infectious and viral diseases.
It is impossible to say for sure how much artificial insemination costs, since prices will differ in each clinic in Moscow. It is important to understand that the procedure consists of several stages, including consultation, tests, treatment. It is necessary to take into account the price of the medicines that will have to be taken. If donor sperm is used, then it is worth adding to the price and its cost. To date, according to information provided on the Internet, the following figures can be named:
Attention! The information provided in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment, based on the individual characteristics of a particular patient.
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Artificial intrauterine insemination with husband's or donor's sperm - indications, preparation for surgery and price
Unfortunately, not every woman is given to experience the happiness of motherhood through natural insemination. Due to various physiological and psychological reasons, many of the fair sex experience certain difficulties in conceiving. In this case, various methods of artificial insemination may be the only possible way to defeat diagnosed infertility. What is the difference between artificial insemination, in vitro fertilization and other types of ART? Which method is the most reliable and safe? A small medical educational program will help you understand the features of the most popular procedures and make an informed decision that will help the couple experience the thrill of parenthood.
Assisted reproductive technologies used in medicine are relevant in the case of diagnosed infertility in a woman or her partner, which could not be stopped by medical and surgical therapy. Suspicion of a disappointing diagnosis may arise if a couple of childbearing age has an active and regular sex life without the use of contraceptives, but the desired pregnancy does not occur within one year or more. This period can be extended depending on the age of the partners: for example, women over 35 and men over 40 may take longer to successfully conceive, despite full fertility.
And even after the diagnosis of "infertility" is made, one should not despair and consider artificial insemination methods as the only possible option - most of the causes of infertility are successfully treated with proper therapy. With a decrease in fertility, not only the woman, but also her partner will have to undergo a thorough examination, because, despite the prevailing stereotype, in about 30% of cases the cause of infertility lies precisely in the man, and another 15-20% are due to combined factors, in which an equal contribution both partners contribute to the emergence of a pathological situation. And only if infertility treatment does not bring the desired result, you will have to think about assisted reproduction.
Modern approaches to assisted reproductive technologies are not limited to in vitro fertilization - there are many different ways to help desperate spouses have a child, it all depends on the diagnosis, the causes of infertility, and the characteristics of the patient's history. The most common types of ART are:
Let's take a closer look at each of the proposed methods.
Such medical manipulation is one of the simplest and most natural methods of assisted reproduction. In this case, the previously cleaned and processed partner's ejaculate is injected directly into the woman's uterus through a thin catheter, which significantly increases the chance of successful fertilization. The high efficiency of the proposed method in comparison with the natural process is explained by the fact that the seminal fluid does not have to independently overcome the fallopian tubes, and the special processing of sperm before insemination allows to increase the concentration of active germ cells and enrich the seed with nutrients necessary for fertilization.
Artificial insemination can be done for many reasons, but the most common ones are:
If it is difficult to obtain a semen sample for the procedure (for example, with erectile dysfunction or obstruction of the vas deferens), a puncture may be required to obtain ejaculate. If this procedure is also useless, you can use donor material.
As before any serious medical procedure, before artificial insemination, a thorough examination of future parents is carried out for hidden pathologies and contraindications. Both a man and a woman must pass swabs for STIs and blood tests without fail. In addition, the patient may be assigned an ultrasound of the pelvic organs, and her partner - a triple spermogram.
After excluding contraindications, the attending physician conducts ultrasound monitoring of ovulation, which allows you to determine the most optimal moment for artificial insemination. As soon as the eggs are ready for fertilization, the centrifuged semen is directly introduced into the uterine cavity. If the expectant mother has reproductive problems (for example, lack of ovulation or disturbed hormonal levels), mild pharmacological stimulation may first be required.
The procedure itself is absolutely painless, and therefore does not require anesthesia or subsequent hospitalization. It will be possible to evaluate the effectiveness of the artificial insemination carried out no earlier than after 14-16 days (using a conventional pregnancy test). It is possible and necessary to confirm the result in 3-4 weeks with the help of ultrasound.
Today, IVF is one of the most effective methods that allows you to cope with diagnosed infertility that is not amenable to either medical or surgical treatment. The process of in vitro fertilization itself implies that the conception will be carried out "in vitro", that is, outside the body of the expectant mother. The standard IVF method includes several key steps:
This list can vary significantly depending on the history and condition of the patient, so the necessary IVF protocol is determined only by the attending physician after detailed diagnosis and research.
Stimulation of ovulation before in vitro fertilization can be carried out according to a short and long protocol. The first method is usually recommended for women under 35 years of age with primary replanting. Short hormone therapy is carried out with relatively small doses of drugs, rarely causes side reactions, but is less effective than a long one.
A long protocol significantly increases the number of mature eggs capable of fertilization, allows you to control the process of ovulation, and therefore increases the likelihood of successful fertilization. However, a long course of high doses of hormones in this case increases the risk of pituitary complications in the expectant mother. This method is usually prescribed for older patients or women with a history of unsuccessful IVF attempts.
Ultrasound examination allows you to evaluate the effectiveness of hormonal stimulation, determine the number and degree of maturation of follicles. If the woman's reproductive system does not respond to hormones (or does not respond enough), the cycle is considered unsuccessful, and the doctor either interrupts the protocol or adjusts the dosage of the drug. If everything goes according to plan, an egg puncture is scheduled for artificial insemination.
When the ultrasound shows that the follicles are in the final phase of maturation, the patient undergoes aspiration of the eggs. The procedure itself is slightly painful, and therefore requires local anesthesia or general anesthesia. After the extraction of the follicular fluid, the most promising eggs are released from it, which are involved in the subsequent fertilization.
At the same time, the man must provide a fresh ejaculate sample required for the procedure. If the husband's sperm are absolutely not viable, donor material can be used in agreement with both patients.
Fertilization itself is carried out in the laboratory by the standard method of insemination or with the help of ixi, when the spermatozoon is introduced into the egg. The resulting zygotes are placed on a nutrient medium and sent to a thermostat for further cultivation. After 3-5 days, the most viable embryos are examined for the absence of various pathologies, after which they are prepared for replanting.
Usually, the time interval between puncture and replanting takes from 2 to 5 days, depending on the rate of embryo development and the condition of the expectant mother. To increase the success rate of in vitro fertilization, 2-3 most promising embryos are implanted - that is why the chance of multiple pregnancy after IVF is significantly higher than with natural conception.
The process of moving the embryos is carried out using a special catheter that passes through the cervical canal. The procedure is quite simple and usually takes no more than an hour, so the patient can be discharged home the very next day. However, for the onset of pregnancy after replanting, a woman will need a two-week hormonal therapy, which will allow her to maintain the desired phase of the cycle in the body.
The effectiveness of IVF is assessed only after 3-4 weeks by ultrasound, since standard pregnancy tests can give erroneous results due to hormone therapy.
The choice of one or another method of artificial insemination should be carried out after a thorough diagnosis of both spouses and in accordance with the recommendations of doctors, however, basic knowledge will allow you to make an informed decision. Only a thorough and scrupulous approach will help you overcome infertility and experience true happiness, holding a long-awaited baby in your arms!
Unfortunately, in our time, up to 20% of couples face the problem of infertility. If a diagnosis has been made, and the cause of the disease cannot be eliminated, then artificial insemination by IVF comes to the rescue. It is carried out when the spouses cannot conceive a child for several years.
If a couple fails to conceive a child naturally, you should pay attention to artificial methods.
What is artificial insemination often called? The abbreviation IVF is commonly used, which means in vitro conception. It is used in the presence of various pathologies in women and men. This is a procedure that has overcome infertility.
Fertilization occurs by introducing sperm into the uterus (insemination) or extracorporeally (in vitro - in vitro, outside the body).
Perform the procedure in clinics that specialize in this.
The efficiency is about 35%.
There are 2 types of fertilization. In each case, the type is selected individually, taking into account medical indications. Types of artificial insemination are represented by sperm insemination (partner - IISM or donor - IISD); ECO:
How artificial insemination takes place is the essence of the method: spermatozoa in a test tube are placed in an egg. When they merge, the material is introduced into the female uterus. With a successful procedure, several embryos can take root. After all, they use not one egg, but several.
Classical are IVF, IVF together with ICSI.
The ICSI method is auxiliary. This method is used for help when the sperm of a man is of poor quality (improper structure of spermatozoa, low mobility). Having selected viable spermatozoa, they are injected into the egg using a microscope, special. surgical instruments.
Fertilization methods also include:
Important! If the family wants one child, then the rest of the implanted embryos can be removed (reduction). But sometimes it provokes a miscarriage.
The main indication is infertility, not amenable to treatment. For women, this is:
Indications for men for an additional ICSI method:
In such cases, an operation is performed or a puncture is taken to obtain sperm. Having selected healthy cells, they are connected to the egg.
Note! Bad habits, low immunity, physical inactivity, excess weight are also contraindications.
There are absolute contraindications (either they do not perform the procedure at all, or they are carried out under the strictest control, with high caution, with constant supervision) for both sides, these are:
Geneticists have performed artificial insemination of pigs before, and continue to do so now. The method has been used on women for over 100 years.
Perform the procedure in specialized honey. clinics, after a complete examination of a couple planning a pregnancy. It is important to exclude contraindications. It is necessary to pass a bunch of tests, pass a lot of tests. A woman must:
To get eggs, a few weeks of hormones stimulate ovulation. When maturing, the eggs are removed by a reproductive specialist and placed in a test tube.
An important advantage of IVF is the genetic diagnosis of the embryo (detection of deviations, possible diseases, developmental anomalies).
You can check all chromosomes, choose only healthy embryos.
This process is quite labor intensive. How artificial insemination is done - let's get acquainted in stages:
Having decided on a serious procedure, you should only contact professionals who have been practicing artificial insemination of women for more than one year.
Feel free to contact the clinic if:
Since 2015, the IVF procedure has been free in Russia. For this you need:
Spouses, partners and single women can choose a clinic from the presented list of the federal program.
Under the terms, it is allowed to make a non-fixed number of fertilization attempts, until the result is obtained.
Insurers give about 100 thousand rubles for each procedure. The rest, if necessary, is paid by customers.
Standing in line for IVF, they draw up a compulsory medical insurance policy (a passport is presented, an examination is carried out, a diagnosis is made, they are sent to a commission, a clinic is selected, paperwork is processed).
Worth noticing! The insurance does not cover the ICSI procedure if the infertility is male (unsuitable sperm). You will have to make the payment yourself (the average cost is 15 thousand rubles).
Also, you can always make a paid procedure. Prices are different. They must be immediately clarified with the manager of the clinic, and find out what is included in the price.
When it comes to artificial insemination, most often patients are offered the IVF procedure. However, reproductive medicine has other methods that are more effective in certain cases. Each artificial insemination has its own characteristics, indications and contraindications.
Conventionally, the methods of assisted reproductive medicine are divided into insemination and injections. Inseminations are not expensive, but the chances of successful conception are less, and the list of indications is shorter. In vitro conception is more expensive, but more effective and possible even in severe cases of female and male infertility.
Artificial insemination has long become familiar and normal. People can constantly debate the ethics of such a conception, but one thing cannot be denied - a medical procedure is often the only way to have children of your own.
Artificial insemination allows you to control and regulate the process of fusion of germ cells. Usually this phrase refers to the IVF procedure, although there are other methods of assisted reproductive medicine. There are three methods that combine all varieties: IVF, and insemination. All of them lead to the fusion of the egg and sperm, but under different conditions.
Artificial insemination is possible only if the woman is potentially capable of carrying and giving birth to a child. Cardinal measures are usually recommended after 1.5-2 years of infertility therapy (except in cases that are not amenable to treatment).
Artificial insemination is legal in Russia. Official registration of marriage is not required, but if it is, confirmation of the spouse is required. Patients must be over 18 years of age. There are donor cell banks in every country.
Women under 38 years of age before artificial insemination must receive official confirmation of the diagnosis and treatment failure (usually 1.5-2 years). Women older than this age can undergo the procedure immediately and without prior treatment.
If the examination reveals any diseases that may interfere with any of the stages of artificial insemination, pregnancy or childbirth, the procedure is postponed. Patients are prescribed treatment and manipulations are carried out only when the condition is stable.
All methods of artificial insemination are short and normally tolerated by patients. Therefore, it is possible to repeat the procedure without long interruptions.
IVF and its modifications, ICSI, IISM and IISD, donor programs and surrogacy are classified as assisted reproductive technologies. They are resorted to in cases where there is no chance of pregnancy occurring naturally or the probability is less than with the use of reproductive technologies. All methods of artificial insemination can be divided into two groups: artificial insemination and intracytoplasmic injections. Insemination implies the fertilization of the egg in the conditions of the female body, and with IVF and ICSI - outside the body.
In cases where partners have problems directly with germ cells, it is possible to use donor material. All donors undergo a complete medical genetic examination, which eliminates the risk of inheriting dangerous diseases.
Women who are unable to bear a child can turn to. Donor sperm is used only after its double examination with an interval of three months. Before IVF, preimplantation genetic diagnosis is carried out, which reveals genetic pathologies, abnormalities in chromosomes, and possible developmental anomalies.
The injection method is more complicated than insemination, it requires the fulfillment of certain conditions and is divided into several stages. First, a woman is prescribed hormonal drugs to stabilize the endocrine system and prepare the body for ovulation and fertilization. The doctor regularly checks the maturation of the eggs. Stimulation helps to grow some good eggs.
After retrieving the eggs and combining them with sperm, the cells are placed in an incubator at a certain temperature that will promote conception. This process takes several days. Artificial insemination can be carried out using the ICSI or IVF method.
IVF procedure is the most popular method of artificial insemination. In this case, conception occurs outside the woman's body in artificially created conditions. IVF is a fairly young method, which nevertheless has already become the gold standard of reproductive medicine. The procedure was first performed in 1978 in England. According to statistics, IVF reduces the risk of fetal pathologies.
In vitro fertilization is considered the most effective and reliable method of assisted reproductive medicine. The egg is removed from the woman's body and fertilized "in vitro" using the husband's or a donor's sperm. After cell fusion, the embryo is placed in the uterus. Subsequent pregnancy is no different from pregnancy after natural conception. Children born in this way do not suffer from any specific diseases and do not have abnormalities.
Doctors control the process of egg maturation by controlling the level of hormones. During this period, a woman can lead a normal life, but taking into account the recommendations of doctors on nutrition, physical activity and emotional state.
After hormonal therapy, the stimulation of egg maturation is carried out, then they are removed from the ovaries using puncture and ultrasound scanning. At this time, the partner donates sperm, it is processed and prepared. Then, under special conditions, the materials of the spouses are mixed and placed in an incubator so that a natural combination of cells occurs.
After fertilization, the embryologist analyzes the development of the embryos. The most viable are transferred to the uterus. Usually, several fertilized cells are used to increase the chances of attaching at least one. Therefore, after IVF, twins and triplets are often born. The resulting embryos can be cryopreserved to be used in the future or in the absence of pregnancy after the procedure. In the case of engraftment of several embryos, a part can be removed, but the woman must make such a decision.
If the patient has serious problems with egg maturation, donor cells can be used. In vitro fertilization is much more effective than insemination. The first procedure is successful in 33% of cases. The disadvantages of IVF are long-term hormone therapy and high cost. Prices start from 80 thousand rubles, but on average an IVF procedure costs 120-200 thousand rubles. The final figure is determined by the complexity of the chosen technique, the degree of stimulation, the need to use donor sperm and additional services in each particular clinic.
The ICSI procedure is the fertilization of the egg by intraplasmic infection of the spermatozoon. Usually, the method is recommended for male infertility, caused by a violation of the quantity and quality of the composition of sperm. This method is a real lifesaver for many patients as it requires only one sperm cell. The doctor selects the most mobile and viable and injects it into the egg. After a few weeks, the uterus and the attachment of the embryo are checked by ultrasound. Often, during artificial insemination, a woman is prescribed hormonal drugs to maintain pregnancy.
ICSI is recommended when IVF and other methods have failed. The procedure is indicated for female and male infertility, even in the most severe cases. According to statistics, as a result of ICSI, pregnancy occurs in every third woman (60-70% of the probability of successful fertilization).
Compared to IVF, the procedure is more delicate: one sperm is selected, which is injected into one egg using an ultra-thin glass needle. ICSI gives hope even in the most severe cases of infertility, especially in males. After a few days, the doctor selects the most viable embryos.
The purpose of this event is to form several normal eggs so that doctors have a choice. Hormone regimens are called protocols. They differ for different methods of artificial insemination, are selected and adjusted individually for each patient. All protocols are divided into short and long.
Usually, before stimulation, a course of oral contraceptives is prescribed for 1-2 weeks to suppress the secretion of sex hormones. This is necessary to prevent natural ovulation when one cell matures.
The protocol is usually started on days 1-2 of the menstrual cycle. The patient is prescribed follicle-stimulating drugs, human chorionic gonadotropin, gonadotropin-releasing hormone agonists or antagonists. A woman is given injections of follicle-stimulating hormone (Gonal or Puregon) and gonadotropin-releasing hormone (Buserelin, Goserelin, Diferelin). The drugs are administered daily. Every few days, a blood test is performed to determine the concentration of estrogen, and an ultrasound to measure the follicles.
Follicle-stimulating hormone is canceled at an E2 estrogen concentration of 50 mg / l and a follicle size of 16-20 mm. Typically, such indicators are available on the 12-15th day of stimulation. On this day, injections of human chorionic gonadotropin are added. Gonadotropin-releasing is canceled the day before hCG is cancelled. The doctor determines the duration of the course according to the results of ultrasound. 36 hours after the abolition of hCG, cells are collected.
The short protocol also starts on the second day of the cycle. A woman is injected with all three drugs every day, analyzing the growth of follicles every 2-3 days. In the presence of three follicles of 18-20 mm, the drugs are canceled (hCG is administered for another 1-2 days). Eggs are collected 35-36 hours after the last injection.
Sex cells are obtained using a needle that is inserted into the ovaries through the peritoneum or vagina. The woman is under anesthesia, so she does not experience discomfort. The procedure takes up to 30 minutes. Sperm is obtained by masturbation. If there are difficulties, male germ cells are taken through similar manipulations.
Insemination methods involve the introduction of sperm into the uterine cavity using a catheter. Conception occurs in much the same way as with natural fertilization. For artificial insemination, the sperm of a partner or a donor is used.
Before insemination, both partners need to undergo a complete examination and identify the causes of infertility. Preparation for the procedure includes a consultation with a therapist and a gynecologist, a blood test (HIV, viral hepatitis, syphilis and other infections), a smear test. It is necessary to determine the blood type and Rh factor of partners and evaluate their compatibility. A man must pass a sample for a spermogram, and a woman determines the time of ovulation, examines the uterus and fallopian tubes.
If no contraindications are identified, preparation can begin. According to indications, doctors can prescribe drug stimulation of ovulation. Sperm is taken in advance (2-3 hours). When donor material is selected, frozen sperm is used.
Sperm is processed, spermatozoa are separated from seminal fluid. The resulting mixture is injected into the uterus through a catheter. The procedure takes a few minutes and does not cause discomfort to the patient.
On average, artificial insemination costs from 30 thousand rubles when using partner sperm and from 40 thousand when using donor sperm.
The IISM procedure is recommended in the case when the woman's reproductive system was not subject to pathological changes, there are no adhesions, erosions, convolutions, and the fallopian tubes are passable, but the partner's sperm has insufficient characteristics for natural conception. For sperm, they are processed and endowed with the properties necessary for fertilization. During the procedure, the partner's processed sperm is artificially injected into the uterus.
IISM can be prescribed in case of incompatibility of partners. The reasons for this phenomenon are different, but usually this is an aggressive effect of the flora of the vagina or uterus on spermatozoa. The introduction of sperm directly into the uterus eliminates the contact of the seed with the microflora of the vagina, which greatly increases the chances of successful fertilization. The injection procedure is painless, the embryos are passed through a thin catheter.
For one menstrual cycle, intrauterine insemination can be carried out 2-4 times. It is necessary to undergo an examination and pass tests in order to calculate the most favorable time.
The IISD procedure is recommended in the presence of poor indicators of the partner's spermogram. Donor sperm should also be used in the case when the reason for the incompatibility of the spouses is not clear, there is a high risk of a blood conflict, or there were dangerous hereditary pathologies in the family. IISD is carried out only with the joint consent of the partners.
The procedure itself is not much different from insemination with the husband's sperm. IISD and IISM are similar procedures that are carried out under the same conditions. You can also repeat 2-4 times per cycle, but the effectiveness of the procedure is 30% more (according to statistics, with ISIS, the chances of success are 40%).
Methods IISM and IISD are recommended for male infertility, sexual disorders, immunological conflict. During preparation, the patient should visit the clinic regularly to monitor the number of maturing follicles and the growth of the endometrium in the uterus.
GIFT (gamete intrafallopian transfer) is a procedure for transplanting egg and sperm gametes into fallopian corpses. Artificial insemination by this method requires special training and the fulfillment of certain conditions. You can place gametes only in passable fallopian tubes and at a strictly selected time. Since only one ovulation occurs per menstrual cycle, GIFT can only be done once a month.
ZIPT (zygote intrafallopian transfer) is a procedure for transplanting a zygote into the fallopian tubes. In this case, the fertilization of the egg is carried out outside the body, after which the embryo is placed in the fallopian tubes.
GIFT and ZIFT procedures are carried out in a hospital. The doctor uses a laparoscope and an ultrasound scan. If, during the placement of gametes, the mixture is injected from the side of the peritoneum through a small puncture, then the embryo is implanted through the cervix. The ZIPT procedure is carried out after ovulation and hormonal preparation of the uterus. The methods of GIFT and ZIFT are extremely rarely used in reproductive clinics in Russia, since they are inferior in efficiency to standard IVF.
Instruction
Artificial insemination or insemination is used for certain diseases (impotence, lack of ejaculation, hypospadias, etc.) with anatomical changes in the cervix, vaginismus, as well as when antisperm antibodies are detected in cervical mucus in women. With this method of artificial insemination, sperm is injected into the uterine cavity or into the lumen of the fallopian tubes. One of the spermatozoa is a mature egg, after which it is implanted to the wall of the uterus.
Insemination is carried out two or three times during one menstrual cycle, the procedure must be repeated at least three cycles. If pathological changes were detected during the examination of the husband, donor sperm is used. The reason for using donor sperm is also the Rhesus conflict, which is not treatable, as well as genetic diseases in the husband's next of kin. The positive result of the procedure will largely depend on the diseases that the couple has. As a rule, after insemination, pregnancy occurs in eighty percent of cases.
In vitro fertilization is performed outside the body. This procedure is resorted to if the woman's fallopian tubes are removed, with low patency and obstruction of the fallopian tubes, in the absence of the effect of long-term treatment (more than five years), in case of unexplained infertility. Before IVF, a study of the state of the genital organs is carried out. The uterus and ovaries of a woman should retain their functions, there should be no neoplasms, inflammations and anatomical changes in the reproductive organs.
The in vitro fertilization procedure includes: receiving eggs from a woman, fertilizing the eggs with the husband's or donor's sperm, monitoring the embryos in the laboratory, transferring the embryos into the uterine cavity. Miscarriage during IVF occurs in 40% of cases, fetal death during childbirth is often observed. Doctors associate these circumstances with the age of women in labor, as well as with pathologies in their reproductive system.
Artificial insemination by ICSI (intracytoplasmic injection) is performed in severe male infertility. During the procedure, a sperm cell is injected into an egg extracted from the body of a woman's ovary. The difference between this method and IVF is that during ICSI, one, the most viable spermatozoon is selected, which is placed inside the egg with a needle, and during in vitro fertilization, the spermatozoa are located together with the eggs in a special solution and penetrate inside on their own.
