Santiago Brugo Olmedo M.D.
Medical Director
Seremas Medicine for men and women
Seremas Home Seremas Procedures Seremas Low Complexity Assisted Reproduction Techniques Seremas Intrauterine Insemination

Intrauterine Insemination

Ovarian stimulation is done through hormones administered to the patient in order to induce ovulation. This stimulation generates the development of several follicles that have oocytes inside them. When there are more oocytes, chances of fertilization increase too and so do the chances of achieving pregnancy. On the other hand, chances of multiple pregnancy increase as well.

Semen preparation is done to optimize the concentration of motile spermatozoa in the sample, and to decrease the content of seminal plasma which contains factors that inhibit normal fertilization and prostaglandins which can cause uterine contraction. To do so, spermatozoa are separated from seminal plasma, concentrated by methods used in the laboratory which can include, for instance, centrifugation and wash with a culture medium. The fraction which contains the best spermatozoa is collected and inseminated. The most frequently used techniques in the laboratory to prepare the samples of semen are swim-up migration or Percoll gradients.

PROCEDURES | Low Complexity Assisted Reproduction Techniques
Schema representing the steps for semen preparation through gradient techniques

Insemination is a simple process, during which, the physician in his office puts a speculum in the woman’s vagina and goes through the cervical canal with a very thin catheter which holds the sample with the spermatozoa prepared by the laboratory and places them at the back of the uterus.

Intrauterine insemination is indicated for those cases where there is a poor interaction between spermatozoa and cervical mucus; when the count of spermatozoa is less than normal levels or in cases of immunological originated or unexplained infertility.

Intrauterine insemination allows spermatozoa to go through the cervix barrier in such a way that most of them get to the uterus cavity and therefore to the Fallopian tubes where fertilization takes place.

The patient must be perseverant and insist on the treatment. One intrauterine insemination might not be enough to achieve pregnancy, needing sometimes up to 3 insemination cycles to get a positive result.

PROCEDIMIENTOS | Técnicas de Reproducción Asistida de Baja Complejidad
Introduction of the catheter inside the uterus for
placement of spermatozoa previously selected

Although currently most cases of male infertility can be solved, there are some occasions when couples need semen donation. Besides, in our country insemination to single women is a practice performed in the doctor’s office, and on the other hand, some men are carriers of congenital diseases which can be transmitted to their offsprings; so in those cases patients decide to use a donor’s sample.

Sperm donors are permanently tested in order to discard any type of transmitted disease, and samples are especially examined to check the existence of HIV antibodies (AIDS). One certain sperm sample is frozen for 6 months before its use. Only if the donor’s sample is negative regarding HIV antibodies after those 6 months quarantine, that sample is used. The bank also checks in a very strict way the presence of hereditary diseases in donors and their close family. It is also important to consider that some hereditary diseases might appear at different stages in life, reason why their existence might be unknown at the moment of donation.

Advantages and disadvantages
The main advantage is that the procedure is simple, not painful and has a low cost. Disadvantages are related to a low risk of multiple pregnancy and ovarian hyperstimulation. Another disadvantage is variability in results depending on different indications.

Results
They depend mainly on the woman’s age and the cause of infertility, but in general we can say that pregnancy rate per cycle is around 10-20%.

To sum up:

What is Intrauterine Insemination?
It is an Assisted Reproduction treatment which consists of placing semen previously prepared in the laboratory, at the back of the patient’s uterus. The objective of this technique is to increase the chances of pregnancy by making several phases of conception process easier.

Seremas Sperm characteristics are improved in the laboratory.
Seremas The distance spermatozoa have to travel is shortened.
Seremas We make sure the patient has ovulated.
Seremas Spermatozoa get to the Fallopian tubes at the right time, shortly after ovulation.

Intrauterine Insemination (IUI)
It is one of the simplest methods used in assisted reproduction. In women who do not ovulate regularly, IUI can be combined with the technique of ovulation induction with gonadotrophins (such as Follicle Stimulating Hormone FSH).

IUI can be used in cases of male or female infertility, or when evident causes of infertility can not be found in the couple. Success rate of IUI is within the range of 10-20% per cycle, with semen within the normal levels and healthy female tubes.

Studies about it have shown that IUI does not help women with seriously harmed or blocked tubes. In the same way, IUI has not proved to be effective in cases when the man has low count of spermatozoa or sperm motility is seriously affected.

SeremasSeremas | Medicine for men and women
SEREMASArenales 1954, 1st floor
Buenos Aires City
Phones: (00 54 11) 5032-3358 / 59 / 60 (Rotative lines)
E-mail: info@seremas.com
Website version 1.0 © 2006-2012 All rights reserved | Disclaimer