Human Reproduction

TREATMENTS

Intrauterine Insemination

What is Intrauterine Insemination?

Intrauterine Insemination, commonly referred to simply as Insemination, is a low-complexity assisted reproduction treatment that consists of placing motile sperm inside the uterine cavity during ovulation. Fertilization (the union of the sperm and the egg) occurs naturally in the fallopian tube, making any laboratory procedure for egg retrieval or manipulation unnecessary. Ovulation to enable the insemination process may occur through hormonal stimulation or even during a natural cycle (spontaneously).

How is artificial insemination performed?

Intrauterine Insemination usually takes place in three stages: ovarian stimulation, semen processing, and the intrauterine insemination procedure itself.

When is insemination indicated?

Artificial insemination may be the initial treatment for difficulty getting pregnant in the following situations:

Ovulation disorders: Absence or reduced frequency of ovulation, a very common condition in patients with Polycystic Ovary Syndrome;

Mild male factor: Minor abnormalities in the semen analysis, but with an adequate number of motile sperm;

Independent Reproduction: When donor sperm from a sperm bank is required;
Some cases of endometriosis (minimal or mild forms);
Some cases of unexplained infertility;
LGBTQIAP+ couples who require assisted reproduction to build their family.

What are the stages of the treatment?

1
Ovarian Stimulation

At the beginning of the menstrual cycle, an ultrasound is performed to evaluate the ovaries and begin the medications that will stimulate the growth of follicles, which promote ovulation. In theory, an egg will develop inside the growing follicle. This entire process is monitored with serial ultrasound examinations so that we can have greater confidence that ovulation is approaching. When the largest follicle reaches an appropriate size, another medication (human chorionic gonadotropin – hCG) is administered to effectively trigger ovulation, which occurs 36 hours after hCG administration. The entire ovarian stimulation process until ovulation takes, on average, between 9 and 13 days.
2
Semen Processing

Usually, two hours before the intrauterine insemination procedure, the semen is collected, generally through masturbation, and sent to the laboratory, where the seminal fluid is separated from the sperm and the highest-quality, most motile sperm are selected. Only the concentrated sperm sample will later be introduced into the uterine cavity.
3
Insemination

The insemination is usually performed 24 to 36 hours after hCG administration and after semen collection and processing. Using a catheter, the prepared sperm solution is inserted into the uterine cavity after the catheter passes through the cervix. The semen sample is deposited 2 cm from the uterine wall.

Intrauterine Insemination (IUI) step by step:

What is the success rate of insemination?

The pregnancy rate with insemination is relatively low compared to the success rates of in vitro fertilization; however, cumulatively—that is, after multiple attempts—the outcomes can improve. Currently, success can be achieved in 15% to 20% of cases per cycle among women and people with a uterus under the age of 35. After the age of 35, the chances of success begin to decline progressively. Cumulatively (after 3 cycles), the success rate approaches 30% in the best cases. Studies conducted in Europe and the United States have shown that the take-home baby rate varies according to age, as shown in the table below:

Woman’s age (years)	Under 32	32–35	35–37	38–39	40 or older
Take-home baby rate per cycle (%)	14	12	9.7	6.1	2
Take-home baby rate after 3 cycles (%)	32	26.5	22	12.3	4.5

It is important to emphasize that this technique is not suitable for all cases. People with anatomical abnormalities of the fallopian tubes or significant semen abnormalities should not undergo this type of treatment.

by Malvesdev

Origen Rio - Medicina Reprodutiva

Human Reproduction

Intrauterine Insemination

How is artificial insemination performed?

When is insemination indicated?

What are the stages of the treatment?

Ovarian Stimulation

Semen Processing

Insemination

Intrauterine Insemination (IUI) step by step:

What is the success rate of insemination?

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