Insemination (synonyms: sperm transfer; sperm cell transfer) refers to a transfer of male sperm into a woman’s genital tract. Insemination is the most common method of artificial insemination. Prerequisites for using the method: functional, that is, inconspicuous fallopian tubes (tubes) on both sides.
Indications (areas of application)
- Impaired interaction between sperm and cervical mucus – disruption of sperm transport, for example, antibodies present against sperm, decreased cervical mucus (mucus formation in the cervix).
- Men with mildly to moderately impaired sperm qualities: low sperm count, decreased sperm motility, or abnormal sperm shape
- Problems of potency
- Ejaculatory disorders One example is retrograde ejaculation, a disorder in which semen is expelled backward into the bladder instead of outward. This disorder is found, among others, in men with diabetes mellitus, in patients after injury or surgery in the area known as the bladder neck, and in patients suffering from paraplegia. Furthermore, this disorder can also be caused by certain medications. In cases of retrograde ejaculation, the sperm cells can be isolated from the urine for insemination.
- Use of cryosperm, that is, frozen sperm. This circumstance is present in men whose sperm was frozen before sterilization, testicular surgery or cancer treatment (X-ray therapy / chemotherapy).
The procedure
In insemination, at the time of ovulation (ovulation) – usually after follicle maturation therapy (hormone therapy) – the previously specially prepared sperm is introduced directly into the uterine cavity (cavum uteri) – intrauterine insemination (IUI) – or into the fallopian tube (tube) – intratubal insemination (ITI) – by means of a thin catheter. The preceding sperm preparation serves in particular to remove the prostaglandins contained in the seminal plasma (fluid from secretin of the so-called accessory sex glands). These could cause contractions on contact with the endometrium (lining of the uterus). Furthermore, sperm preparation serves to induce capacitation of the spermatozoa. Capacitation is the physiological maturation process of spermatozoa in the female genital tract, without which fertilization of the egg is not possible. Nowadays, ready-to-use media for sperm washing and sperm separation by swim-up method are used for sperm preparation. In this method, the ejaculate is coated with the sperm preparation and medium so that the freely moving spermatozoa can swim up over cell fragments and avital spermatozoa. The swim-up method requires approximately 30 to 60 minutes of incubation (“hatching”). For insemination, either the partner’s sperm – homologous insemination – or, if the partner is proven to be safely infertile, that of a donor – heterologous insemination (donogenous insemination) – is used. In case of using donor sperm (donor insemination), it is also called cross-fertilization. Further notes
- The results of a Dutch study of modified ovulation induction (M-OVIN) in women with normogonadotropic anovulation/absent ovulation with normal gonadotropin levels (i.e., hypothalamic-pituitary dysfunction) and clomiphene failure showed that extending drug-induced ovulation to 12 cycles of clomiphene instead of the maximum 6 cycles of clomiphene recommended by the NIC. Furthermore, it was shown that intrauterine insemination (IUI) did not significantly increase the rate of live births compared with “intercourse at the right time” (VZO).CONCLUSION: In women with normogonadotropic anovulation, assisted reproduction should only be performed after 12 cycles on clomiphene. In this case, intrauterine insemination is not required since “intercourse at the right time” is equally effective.
Please note
The physical and mental health of men and women, as well as a healthy lifestyle are important prerequisites for successful fertility treatment. Before starting therapeutic measures, you should in any case – as far as possible – reduce your individual risk factors! Therefore, before starting any reproductive medical measure (e. g.B. IUI, IVF, etc.) perform a health check and nutritional analysis to optimize your personal fertility (fertility).