Difficulties with natural conception can be overcome by using artificial insemination. This involves helping sperm to reach the fallopian tube or cervix directly. Find out in which cases artificial insemination is used and how it is carried out.
If, during the diagnosis of fertility problems, it is found that the cause is difficulty in the movement of sperm through the cervical mucus, artificial insemination may be the right solution for you. At INVICTA Clinics, we do not recommend IVF for everyone. Insemination is often the first treatment of choice for couples starting fertility treatment.
Insemination is the simplest and least invasive method of assisted reproduction for women. The procedure is carried out around the time of ovulation and involves introducing suitably prepared sperm (from the partner or an anonymous donor) into the uterine cavity using a flexible catheter.
The procedure is straightforward and allows two significant barriers that negatively affect sperm motility and count to be bypassed – the acidic vaginal environment and cervical mucus.
An appropriate number of the most viable and high-quality sperm are selected for the procedure. The sperm are also activated, which facilitates fertilisation of the egg.
There are several types of insemination. Depending on where the semen is administered, the following methods are used:
The sperm is introduced into the uterine cavity. This method of insemination is the most popular due to its high success rate.
The sperm is inserted into the cervix.
The sperm is introduced into the fallopian tube.
Depending on patients’ individual health circumstances, the following may be used:
Once this insemination option has been chosen, both partners attend the clinic. First, the male partner provides a semen sample. The semen is then processed in the laboratory – this involves, amongst other things, washing and centrifuging it, which allows us to select the sperm with the highest potential. The entire procedure takes around 2 hours, and only after this time can the female partner be inseminated. Of course, the insemination itself can take place on a different day – this is made possible by the process of freezing the semen, which also allows the stored material to be used for future procedures.
If, for health reasons, your partner’s sperm cannot be used, we recommend insemination using donor sperm. The INVICTA On-line Fertility Bank has a bank of frozen genetic material from anonymous donors. This method of insemination is recommended, amongst other things, following unsuccessful ICSI in vitro fertilisation attempts or where the partner has a genetic condition.
Artificial insemination may be the right option in the following cases:
The couple are having difficulty conceiving, and the cause of their infertility is unclear,
Cervical mucus hinders the movement of sperm through the female reproductive tract,
sperm cells have difficulty moving properly,
a problem with the quantity, quality or motility of the sperm has been identified,
Eggs and sperm do not easily come together naturally,
A medical condition has been diagnosed in the cervix which prevents conception through natural means.
We recommend insemination primarily for couples experiencing infertility caused by at least one of the factors listed below.
failure of sperm liquefaction
ejaculatory disorders (retrograde ejaculation)
hypospadias
sexual dysfunction
spinal cord injuries
reduced sperm parameters (10–20 million/ml, 30–50% motility a+b)
cervical factor – so-called mucus hostility
anti-sperm antibodies
Grade I/II endometriosis
ovulation disorders
Compared to some advanced reproductive procedures, insemination is less invasive. It is also safe and painless. It may result in less stress for the couple. It works in conjunction with the patient’s natural menstrual cycle. It helps to overcome difficulties in conceiving, such as spermatogenesis, amongst other things. Insemination is a more cost-effective option compared to in vitro procedures. It can also serve as an initial step before considering more advanced infertility treatments, offering the couple a less invasive alternative.
In the general population of people experiencing infertility, when insemination is treated as a standard procedure ‘at the patients’ request’, pregnancy is achieved on average in only around 3–5 per cent of cases. The success rate is then comparable to that of a watch-and-wait approach and natural conception attempts.
In some exceptional cases (around 15–20% of patients), it may be justified to perform two insemination procedures in a single cycle. Research shows that, statistically, the chances of pregnancy decrease if a couple undergoes more than three inseminations (a smaller proportion of couples conceive as a result of the fourth and subsequent procedures – for most patients, other treatment options are the solution).
The European Society of Human Reproduction and Embryology (ESHRE) regularly publishes research findings on the effectiveness of various infertility treatments, including insemination. The success of this procedure may depend on a number of factors, including:
a woman’s age (effectiveness is higher for women under 35)
sperm quality
the Clinic’s experienced team and the Embryology Laboratory
optimising standards at every stage of the procedure
Before proceeding with pre-treatment screening, a series of preliminary tests must be carried out, including: a cytological test, an ultrasound scan of the reproductive organs (taking into account the number of antral follicles), blood tests for both partners to screen for sexually transmitted infections (HCV, HIV, HBs-Ag, WR), as well as other tests as required on a case-by-case basis (assessment of ovarian reserve, hormone level tests). Bringing your up-to-date results from the above tests with you to your first appointment at the INVICTA Clinic can speed up the whole process. If you do not have this medical documentation, you and your partner can have all the tests carried out at INVICTA.
A couple’s eligibility for insemination treatment at INVICTA Clinics is based on detailed examinations of both partners and a medical history, and is aimed at identifying appropriate indications for treatment:
(AMH and hormone tests – for women; semen analysis – for men); the aim is to make a preliminary diagnosis of the cause of infertility.
The aim of the test is to check for the presence of the cervical factor; the test must be carried out at the appropriate stage of the cycle at a centre with experience in performing it.
The aim of the examination is to check for any contraindications to the procedure – specifically, whether there is a blockage in the fallopian tubes.
The aim of the test is to identify any contraindications to the procedure – disorders of sperm maturation; a low result may adversely affect the success of the insemination.
The aim of the test is to identify any contraindications to the insemination procedure. Genetic abnormalities in sperm increase the risk of genetic defects or diseases in the foetus, as well as miscarriages; in such cases, sperm selection and the ICI procedure are required.
If this is your first appointment, please arrive at the Clinic around 30 minutes early so that we can carry out a detailed medical history interview. It is very important that you both attend your first appointment together. Right from your first appointment, you can count on the support of a dedicated Care Coordinator assigned to you.
A medical history and detailed examinations of the partners, with a view to identifying indications for treatment.
Insemination can be carried out during a natural cycle or during a stimulated cycle. In the case of a stimulated cycle, it will be necessary to use individually tailored medication.
Only sperm that are normal – in terms of motility and morphology – are used for the procedure.
The procedure is simple; it requires only manual dexterity and the doctor’s experience. Within 3–5 minutes of insemination, the sperm reach the area around the abdominal openings of the fallopian tubes.
Before insemination takes place, the patient undergoes hormonal stimulation, the aim of which is to increase the chances of becoming pregnant. Once the maturity of the Graafian follicle has been confirmed, as indicated by hormone tests and ultrasound scans, the treating doctor decides on the date for the insemination.
The rest of the procedure depends on the type of sperm used. The insemination procedure is not usually painful. It does not require anaesthesia. After the procedure, the patient can walk, drive, etc. Occasionally, there may be some light spotting after the procedure.
The process from the insemination procedure to confirmation of pregnancy can take between 21 and 90 days.
The difference between in vitro fertilisation (IVF) and intrauterine insemination (IUI) is that IUI allows the body to function more independently, making it a more natural but also less effective form of treatment. Insemination is less invasive, requires fewer drugs than IVF and is considerably cheaper – a single IUI cycle usually costs a quarter of the price of a single IVF cycle. Once the sperm has been inserted, the process is left to the body’s natural mechanisms, whereas with IVF the doctor has greater control – they can check whether the egg has been fertilised and select the best embryos to transfer back into the womb.
Contraindications to insemination in women include: inflammation of the reproductive organs, blocked fallopian tubes, severe problems with the endometrium (the lining of the womb), abnormalities of the endometrium, cancer, and cervical adhesions impeding sperm transport. In men: low sperm count, low sperm motility, other problems with semen quality, the presence of bacteria in the semen, hormonal disorders, and severe systemic diseases.
This procedure is usually relatively short and non-invasive. In most cases, insemination is well tolerated, and any discomfort is usually mild. However, it is worth bearing in mind that everyone’s body reacts differently, so some women may experience discomfort. It is important to discuss any concerns and expectations with your doctor before the procedure, as they can adapt their approach to make it as comfortable as possible for you.
If you have been diagnosed with any conditions that may be affecting your ability to conceive, book a consultation at the INVICTA Clinic. A doctor specialising in infertility treatment will refer you for the relevant tests. They will also advise you on which other specialists to consult in order to tailor your treatment plan to your specific needs.
Sometimes, medication is used prior to insemination to help increase the number of mature eggs produced during a single cycle. Monitoring the cycle and ovulation is crucial in order to determine the optimal time for insemination.
Preparing a man for insemination involves preparing the semen prior to collection. The first step is to analyse the semen sample to assess sperm concentration, motility and morphology. To ensure the highest possible sperm quality, it is important to limit the use of stimulants (tobacco, alcohol, drugs), exposure to workplace toxins (industrial chemicals), exposure to high temperatures, and an unhealthy lifestyle. It is advisable to adopt a balanced diet, take up physical activity and ensure you get enough sleep. If you are obese, overweight or underweight, you should aim to return to a normal BMI. In addition, you may wish to consider taking vitamin supplements (particularly vitamins C and E) and zinc.
It is a good idea to begin preparations for insemination by consulting medical staff to confirm the plan and obtain all the necessary information. Before the procedure itself, take a moment to rest and relax – stress and anxiety can have a negative effect on the body. On the day of insemination, it is advisable to avoid sexual intercourse. Before the procedure, ensure you maintain good personal hygiene to avoid potential infections. This simple step can help minimise the risk of complications. Choosing comfortable, loose-fitting clothing can make your visit to the clinic easier and more comfortable. Make sure you have all the necessary documents and medical records with you. If you have any questions or concerns, do not hesitate to raise them before the procedure. In some cases, plans may need to be adjusted due to factors such as egg maturation or other circumstances. Please be flexible and open to any necessary changes.
After the insemination, the medical staff may advise you to rest for a short while. Try to look after yourself, avoid strenuous physical activity and follow your doctor’s advice.
