Artificial insemination is an option for all couples who are unable to have children naturally – this affects as many as 15 percent of all couples. About every seventh couple in Germany is affected by involuntary childlessness. The reasons for childlessness can lie with either the man or the woman; both sexes are affected by infertility with about equal frequency. In the woman, a lack of permeability of the ovaries is usually a reason for infertility, while in the man, the semen has a poor sperm quality.
What is artificial insemination?
Artificial insemination can be performed in different ways. Basically, however, eggs are taken from the woman and sperm from the man; these are then artificially combined. Nowadays, women are becoming mothers later and later. However, from the age of 20 onwards, the probability of becoming pregnant spontaneously by natural means decreases continuously. Artificial insemination is therefore one of the last ways to have a child, especially for older women. But when is the right time to consult a doctor about artificial insemination? If a young woman under 35 does not become pregnant after two years of unprotected sexual intercourse, this is unusual; for someone over 40, on the other hand, it is completely normal. If there is a desire to have a child, you should see a doctor after one year of unsuccessful attempts at the latest. He will first perform a so-called spermiogram to rule out fertility problems in the man. If you have finally decided in favor of artificial insemination, not only the gynecologist treating you is one of the first places to go, but also the fertility clinics. Artificial insemination can be performed in different ways. Basically, however, eggs are taken from the woman and sperm from the man; these are then artificially combined. The chances of pregnancy depend, among other things, on the method chosen and also on the age of the woman; there is no 100 percent guarantee, even with artificial insemination. Part of the cost of artificial insemination is covered by the health insurance, provided that the couple is married and not older than a certain age. The woman must be no older than 40, and the man no older than 50. According to the law, health insurers must cover at least 50 percent of the costs for the first three attempts; some insurers pay even more. Those who are insured with the Knappschaft are well advised; they cover the costs for the first three attempts in full. Due to the ever-decreasing birth rate, efforts are being made to promote artificial insemination more in the future.
Function, effect and goals
Depending on the reason for the unfulfilled desire to have children, various artificial insemination procedures are used. One of the best known and frequently used procedures of artificial insemination is in vitro fertilization. This is the classic “fertilization in a jar”, in which eggs are first removed from the woman and then combined with the man’s sperm in a test tube. If fertilization now takes place, up to three fertilized eggs are reinserted into the mother’s uterus; the risk or chance of a multiple pregnancy thus increases significantly. Such a multiple pregnancy, in turn, is not only more stressful for the woman, but also significantly increases the risk of premature birth. This procedure has a 20 percent chance of success. However, a longer hormonal treatment of the mother is necessary before the eggs are retrieved. Another method is intracytoplasmic sperm injection. Homologous insemination is used quite frequently; the word insemination means nothing other than the insertion of sperm cells. Fertilization therefore takes place in the woman’s body. The previously prepared sperm of the man is either injected into the cervix or inserted directly into the uterus. Insemination is mainly used when the man’s sperm is not mobile enough or there are simply too few sperm cells. In this type of artificial insemination, a distinction is made between homologous and heterologous insemination.In the former, the sperm cells come from the woman’s own partner; in heterologous insemination, sperm from a foreign man are used. This has a success rate of 20 percent; with homologous insemination, it is only between five and ten percent.
Risks, side effects and dangers
Artificial insemination is a heavy burden for the woman. Especially if hormone treatment precedes the procedure, a variety of side effects can occur; nausea, shortness of breath, and pain are just a few. It is also not uncommon for multiple births to occur in hormone-treated women. One risk associated with egg retrieval is infection of the ovaries or fallopian tubes, which is not at all uncommon. Also in men, during sperm collection from the testicles by biopsy or puncture, blood vessels may be injured. In addition, the psychological pressure on the patient should not go unmentioned. The question of whether artificial insemination will lead to the desired child puts a strain on both partners and thus not least on the partnership. Furthermore, financial problems can become a burden; although the health insurance company covers part of the costs, artificial insemination is a financial expense that should not be underestimated. Each attempt at artificial insemination costs about 4,000 euros.
