Insemination how is the procedure. On what day of the natural cycle is insemination done? Is artificial insemination possible after tubal ligation?

If a couple fails to get pregnant, but she really wants it and agrees to actively act in search of a solution to the problem, modern medicine has something to offer in such cases. Today, there are many different methods of fertilization or assisted reproductive technologies. And very often doctors recommend starting from insemination as one of the most accessible, simple and natural methods.

IUI method: what is the point?

Insemination is the fertilization of a woman's egg with a man's sperm. It occurs already inside the uterus, that is, the spermatozoon is “planted” right here, saving it from having to do additional path to the desired goal. Because of this feature, this method is also called intrauterine insemination, which sounds and is abbreviated as IUI.

The IUI procedure is simple and uncomplicated: donor sperm (that is, the sperm of a woman’s husband or potential father of an unborn child) is cleaned, during which live, mobile, active and full-fledged spermatozoa are selected, and foreign substances that do not play significant role during fertilization, are removed from the ejaculate.

Thus, the sperm becomes not only of better quality, but also more concentrated, which significantly increases the chances of success. However, unpurified sperm can also be used for fertilization in this way, but the first option is more preferable for a number of reasons ( we are talking not only about increasing the chances of success, but also about reducing various risks).

The effectiveness of the method is also increased due to the fact that the path of spermatozoa to the egg is reduced: they do not need to overcome the vaginal corridor and the cervix, because they are immediately introduced into the uterine cavity.

Intrauterine insemination is carried out with minimal interference in the natural processes from the outside, which is a great advantage and plus of this method. The procedure is short and does not deliver pain: sperm is injected into the uterine cavity using a catheter.

insemination

Specially purified, prepared husband's sperm is injected on the days when the woman's egg matures and leaves the follicle in a natural way, that is, during the ovulation period - the most fertile in the entire menstrual cycle. In order not to miss the “X” hour, the process of egg maturation is monitored with the help of ultrasound diagnostics(this method is called folliculometry). And when the most favorable moment for pregnancy comes, the husband's or donor's sperm is injected into the uterine cavity.

However, in some cases, when different reasons the natural processes of maturation of the follicles are slowed down or disrupted, a woman's ovulation is stimulated with the help of hormone therapy. In this case, sometimes they talk about artificial insemination, although all these terms - insemination, artificial insemination and intrauterine insemination - are synonymous and denote a single concept.

Pregnancy test after insemination

The most difficult and painful in insemination is, perhaps, the waiting period. Over the next two weeks, the woman will look forward to the result, harassing and worrying: it is after such a period of time that the first pregnancy test after insemination can be carried out.

Do not worry and be upset: this is just an attempt. In any case, you do not lose anything, but only use one of the chances for a probable pregnancy.

Who is suitable for insemination?

In most cases, insemination is offered to couples diagnosed with unexplained infertility. The results of all analyzes and examinations show absolute well-being and good condition reproductive system both partners, but unknown reasons pregnancy still does not occur.

In addition, insemination can be a good solution to the problem of conceiving a child for women who have no or irregular ovulation, but these deviations can be corrected, that is, with the help of therapeutic methods they can be influenced and corrected. Concerning male problems, then insemination is a good way out, when the spermatozoa of a man, overcoming the barrier in the form of a woman's cervix, lose their ability to fertilize.

This method of fertilization can also be used in cases where the results of examinations of partners do not go beyond the established clinical norms, but are at the lower marks of acceptable numbers. Reproductologists in such cases say that the couple is subfertile.

It makes sense to turn to VMI when there is high risk transmission genetic diseases on the father's side or when the man is infertile: in such cases, donor sperm is used for fertilization, which first undergoes a mandatory six-month freeze to avoid the possibility of transmission of infections. Donor material is also used to fertilize the egg of a woman who does not have a husband or partner, but has decided to give birth to a child alone.

Insemination has only a few contraindications. This is the obstruction of both fallopian tubes in a woman and low concentration viable spermatozoa in a man's semen. Of course, the candidate for insemination must have the appropriate mental and physical health to carry a child. The presence of tumors, uterine pathologies, some mental disorders are contraindications to fertilization by any method.

Insemination: price

One of the strongest arguments in favor of fertilization by intrauterine insemination for women is its cost. Compared to IVF, such a procedure will cost ten times cheaper, and for many this is a very significant factor.

However, the price of insemination varies greatly depending on the city, clinic, qualifications of doctors and the package of services provided. On average, the insemination procedure without preparation for it and subsequent support ranges from 100-200 euros, but you still should not focus on this cost, since the prices are very different.

Insemination: reviews

If you have to do more than one insemination procedure, then you will need to pay for each subsequent attempt separately. And there may be several such attempts ...

AT best case the doctor will promise you a 50% guarantee, that is, he will say that conception with the help of insemination occurs in about half of all cases. But most doctors give more realistic forecasts: from 7 to 25%. Doctors say that the final result is influenced by a wide variety of factors: the age and health of potential parents, the quality of sperm, the number of attempts, and others.

If we turn to practical experience ordinary women who have undergone IUI one or more times, it can be concluded that only a few actually manage to get pregnant in this way. In most cases, judging by the reviews on the forums, insemination attempts end unsuccessfully.

Sometimes, as a result of such fertilization, an ectopic pregnancy occurs (by the way, a woman must first be tested for patency of the fallopian tubes in order to avoid such an undesirable outcome). Some women complain that they begin to recover and gain weight after hormone therapy prior to the IUI procedure. But in this case, others advise: competent qualified specialist is able to choose the most appropriate therapy, which will not have undesirable consequences.

So, the method of intrauterine insemination is the closest to natural way conception of a child. It is relatively safe and convenient, affordable, but the effectiveness still leaves much to be desired…

If after 3-4 attempts (usually no more than six) it was not possible to conceive a child, then in this case the couple will be recommended to turn to IVF or ICSI (which provide for more global outside intervention in the process of conception).

In any case, you should not despair. A huge number of couples around the world, including in Russia and the countries of the former CIS, have become happy parents thanks to assisted reproductive technologies and IVF. If you dream of the happiness of parenthood, then you need to go to the end and in no case lose hope. Do not forget that the Almighty has his own plans for us: perhaps it was just not the time before ...

Everything will surely come true!

Especially for - Larisa Nezabudkina

artificial insemination

artificial insemination

Artificial insemination is a procedure in which specially processed sperm is introduced into the uterine cavity through a catheter in order to achieve pregnancy.

Artificial insemination is carried out with the husband's sperm - IISM or donor sperm - IISD.

Insemination can be carried out both in the natural cycle and against the background of ovulation stimulation (with irregular or insufficient ovulation).

In any case, when conducting AI, the patency of the fallopian tubes should be checked, since during insemination, as well as during pregnancy naturally fertilization takes place in the fallopian tubes. After that, the fertilized egg moves through the fallopian tubes and is implanted in the uterus for further development pregnancy.

Thus, with artificial insemination, with minimal impact on the woman's body, we achieve pregnancy.

How is artificial insemination performed?

Immediately before ovulation (or at the time of ovulation), using a thin and flexible catheter, the husband's sperm pre-treated by the embryologist, which was collected 1.5-2 hours before, is introduced into the uterine cavity. If donor sperm is used, then it is preliminarily (1 hour before insemination) thawed, because. all donor sperm is kept only in a state of cryopreservation.

The whole procedure is carried out within 5 minutes and is absolutely painless. After that, the woman can lie down for 20-30 minutes.

In VitroClinic, sperm management in intrauterine insemination programs is carried out twice with a difference of 1-2 days. This greatly increases the chances of success.

Contraindications to the artificial insemination procedure

As with any other medical manipulation, intrauterine insemination has contraindications. It is not carried out:

• in the presence of inflammatory process(one of the spouses);
• with obstruction of the fallopian tubes (adhesions, a history of ectopic pregnancy, anomalies in the structure of the tubes, etc.)
• in the presence of malignant tumors any localization;
• at bulk formations ovaries (cysts, tumors);
• with severe endometriosis.

Indications for artificial insemination with husband's sperm:

1) by spouse:

• Erectile dysfunction;
• Decrease in quantity normal spermatozoa;
• Increased viscosity of semen;
• The presence of antibodies in the semen to their own spermatozoa (positive MAP test);
• Malformations of the genital organs of a man, in which either sexual activity is impossible, or ejaculation does not occur in the vagina (eg, hypospadias, retrograde ejaculation);
• Insemination with spouse's cryopreserved sperm, for example, with pre-frozen sperm if detected oncological disease in a spouse requiring chemotherapy, which sharply worsens the quality of sperm.

2) by the spouse:

• Cervical infertility factor, that is, the inability of spermatozoa to penetrate the mucus of the cervical canal (with a very long cervix or the presence of antisperm antibodies in the mucus of the cervix - a positive MAP test in a woman);
• Acidity vagina.

3) by both spouses:

• in the absence of pregnancy unclear reasons(the spouses were examined, no significant deviations were found, but pregnancy does not occur);
• irregular or incomplete sex life.

Intrauterine insemination with donor sperm is a procedure in which purified donor sperm is injected into a woman's uterus. This is done according to the following indications:

1. a woman does not have a sexual partner, but she wants to become a mother;
2. the husband does not have his own sperm;
3. unfavorable genetic prognosis (the husband has spermatozoa, but their use is undesirable due to the high risk of pregnancy fading, fetal abnormalities, severe hereditary diseases).

Sperm for insemination by a donor is taken from our cryostorage. All donors before donating biomaterial undergo a thorough medical examination, therefore, there is no risk of infection during insemination with donor sperm.

Artificial insemination with donor sperm in most cases consists of two stages:

1. Gentle stimulation of the ovaries.

   It is carried out with hormonal drugs. The growth of follicles is monitored by ultrasound (folliculometry). The insemination procedure is carried out after the egg ready for fertilization comes out of the ovary (twice: on the eve and immediately after ovulation).

2. Sperm injection.

   An hour before the procedure, the sperm is thawed. With the help of a thin and flexible catheter, it is inserted into the woman's uterine cavity immediately, which significantly increases the chances of pregnancy. The procedure is absolutely painless.

Stimulation of the ovaries is not a mandatory step in the procedure. Insemination can take place in a natural cycle if the patient's reproductive health is not impaired, and her age does not exceed 35 years.

Efficacy and safety of intrauterine insemination with donor sperm

In young women, the effectiveness of artificial insemination with donor sperm is quite high. A third of patients become pregnant after the first attempt, another third - after two additional attempts. With age, the chances decrease, which is associated with the extinction of the female reproductive function. However, even after 40 years of age, pregnancy is possible with the help of artificial insemination.

To undergo this procedure, you can contact VitroClinic. All donors, before donating sperm, undergo a thorough medical control, so only high-quality biomaterial that has been pre-treated in our spermological laboratory will be used for fertilization.

The procedure is carried out only with the use of sperm that has been frozen for at least 6 months. This eliminates the possibility of infection of a woman hidden infections. To eliminate the risk of transmission of hereditary diseases, donors undergo a medical genetic examination.

When selecting a donor, the wishes of patients (height, weight, eye and hair color, education, hobbies, blood type) are taken into account.

Artificial insemination with ovulation stimulation

Artificial insemination with ovarian stimulation in some cases may be more effective than in the natural cycle. The chances of fertilization increase by 2-3 times.

When you turn to VitroClinic for medical help for infertility, you will need to undergo some examination and tests. The test results will allow the doctor to determine best method performing artificial insemination.

The main indications for stimulation before the introduction of sperm into the uterus:

• duration of couple infertility 5 years or more;
• the lack of a regular cycle in a woman;
• pathological change blood concentrations of sex hormones;
• woman's age after 35 years;
• reduced ovarian reserve;
• unsuccessful attempts at artificial insemination in the natural cycle.

Stages of intrauterine insemination with stimulation:

1. Diagnostics.

   Married couple surrenders everything necessary tests. Based on their results, a decision is made to carry out artificial insemination with or without simulation, with the sperm of a spouse or a donor.

2. Stimulation.

   A woman is prescribed daily use of hormonal drugs to stimulate ovulation. As a result, we are guaranteed to get a mature egg, which increases the chances of pregnancy with artificial insemination.

   We use only gentle ovarian stimulation schemes, individually selecting them for each patient.
   

   After the doctor sees the readiness of the follicles for ovulation on the ultrasound, a hormonal preparation is prescribed for a single injection so that ovulation occurs and the day of insemination is assigned.

3. Receiving ejaculate.

   The spouse must donate sperm 1.5-2 hours before the procedure. 3-4 days before that, he needs to refrain from any sexual activity. In the case of using cryopreserved sperm, including donor sperm, it is thawed 1-1.5 hours before the procedure.

4. Introduction of sperm into the uterus.

   It is performed on a woman in a prone position, using a special catheter. The procedure is absolutely painless and takes only 20-30 minutes, taking into account the fact that the patient must then lie down a bit. To increase the likelihood of conception in this cycle, another insemination procedure is performed every other day.

Insemination. Types and techniques of insemination. Possible Complications after insemination. Where is artificial insemination done?

Thanks

How is the insemination procedure carried out?

On what day of the natural cycle is insemination done?

On average, ovulation occurs on the 14th day. menstrual cycle However, in some cases it may occur earlier or later. However, predict exact time ovulation is impossible, and a woman cannot subjectively feel it. That is why, to maximize the effectiveness of artificial insemination, doctors use a number of diagnostic tests to calculate the moment of ovulation.

To determine the time of ovulation, use:

• Ultrasound of ovarian follicles. AT normal conditions during each menstrual cycle, one main follicle is formed in one of the ovaries - a vial of fluid in which the egg develops. This follicle is visible with ( ultrasound) ultrasound already on the 8th - 10th day of the cycle. After this follicle has been determined, daily ultrasound is recommended. If the day before the follicle was visible, and on following procedure it cannot be determined, this indicates that ovulation has occurred.
• Determination of the level of luteinizing hormone ( LG) in blood. This hormone is secreted by a special gland ( pituitary gland) and is involved in the regulation of the menstrual cycle. An increase in the level of this hormone in the middle of the cycle indicates that ovulation will occur within the next 24 to 48 hours.
• Measurement basal body temperature body. During the period of ovulation, there is an increase in body temperature by about 0.5 - 1 degree, which is due to hormonal changes occurring in the body of a woman. However, in order to notice such a temperature jump, a woman must regularly ( within a few months) keep a graph of basal temperature, measuring it twice a day ( morning and evening at the same time).
• Study of cervical mucus. Under normal conditions, the mucus located in the cervical area is relatively dense, cloudy, and poorly extensible. During ovulation, under the influence of female sex hormones, it liquefies, becomes transparent and more viscous, which is used by doctors for diagnostic purposes.
• Subjective feelings of a woman. During ovulation, a woman may experience pulling pains in the lower abdomen, as well as increased sexual desire, which, together with other signs, can be used for diagnostic purposes.

Stimulation of ovulation ovaries) before insemination

To stimulate ovulation before insemination, a woman is most often prescribed recombinant follicle-stimulating hormone ( FSH). This is an analogue of the natural hormone produced by the pituitary gland during the first half of the menstrual cycle. Under its influence, the follicles in the ovaries are activated and develop. The FSH preparation should be used within 8 to 10 days ( more precise instructions can be given by the attending physician after a full examination, determining the regularity and other features of the menstrual cycle in a particular woman), followed by ovulation.

The danger of using this method lies in the fact that when prescribing too high doses of FSH, the so-called ovarian hyperstimulation syndrome may develop, when several follicles mature at once instead of one. In this case, during ovulation, 2 or more eggs can enter the fallopian tube, which can be fertilized during the artificial insemination procedure. The outcome of this phenomenon may be multiple pregnancy.

Types and techniques of artificial insemination ( intracervical, intrauterine, vaginal)

With natural insemination ( occurring during intercourse) male sperm is erupted into the woman's vagina. Then the spermatozoa during one sexual intercourse, about 200 million of them are erupted), which have mobility, begin to move towards the uterus. First, they must pass through the cervix, a narrow canal that separates the uterine cavity from the vagina. A special mucus is located in the cervix of a woman, which has protective properties. Passing through this slime most of spermatozoa dies. The surviving spermatozoa enter the uterine cavity and then reach the fallopian tubes. In one of these tubes is a mature ( ready for fertilization) ovum ( female sex cell ). One of the spermatozoa penetrates its wall earlier than the others and fertilizes it, as a result of which pregnancy begins. The rest of the spermatozoa die.

Artificial insemination can be:

• Intracervical ( vaginal). This is the most simple form a procedure that is as similar as possible to natural sexual intercourse. No special preparation before its implementation is required ( Naturally, before any insemination, one should refrain from smoking, taking alcohol, drugs, etc.). Insemination can be done with fresh unpurified seminal fluid ( in this case, it must be used no later than 3 hours after receipt), and frozen sperm ( from a sperm bank). The essence of the procedure is as follows. In the morning on the appointed day, a woman comes to the clinic, goes into a specially equipped room and lies down in a gynecological chair or on a special table. Special expanding mirrors are inserted into her vagina, which facilitates access to the cervix. Next, the doctor collects sperm in a special ( with a blunt tip) syringe, inserts it into the vagina and brings the tip as close as possible to the entrance to the cervix. After that, the doctor presses on the syringe plunger, as a result of which the sperm is squeezed out of it onto the cervical mucosa. The syringe and speculum are removed, and the woman must remain in the gynecological chair lying on her back for 60 to 90 minutes. This will prevent the leakage of seminal fluid, and will also facilitate the penetration of spermatozoa into the uterus and fallopian tubes. One and a half to two hours after the procedure, the woman can go home.
• Intrauterine. This procedure considered more effective than intracervical insemination. Its essence lies in the fact that after the installation of mirrors in the vagina, the sperm is collected in a special syringe, to which a long and thin catheter is attached ( a tube). This catheter is inserted through the cervix into the uterine cavity, after which the sperm is squeezed into it. When performing this procedure, it is recommended to use specially prepared and purified sperm. The introduction of fresh seminal fluid into the uterine cavity can cause contraction of the uterine muscles ( which will reduce the chance of conception) or even cause severe allergic reactions.
• Intratubal. The essence of the procedure is that pre-prepared spermatozoa are injected directly into the fallopian tubes, in which the egg should be located. It should be noted that according to the results latest research the effectiveness of this procedure does not exceed that of conventional intrauterine insemination.
• Intrauterine intraperitoneal. With this procedure, a certain amount of previously received and processed ( purified) male sperm mixed with a few milliliters of a special liquid, after which the resulting mixture ( about 10 ml) is introduced into the uterine cavity under slight pressure. As a result, the solution containing spermatozoa will penetrate into the fallopian tubes, pass through them and enter the abdominal cavity. Thus, the probability of fertilization of the egg, which can be located in the path of the injected solution, is significantly increased. Such a procedure is indicated for unidentified causes of infertility, as well as for the ineffectiveness of intracervical or intrauterine insemination. According to the technique of execution, it is no different from the previously described procedures.

Does insemination hurt?

Is it possible to perform artificial insemination at home?

Preparation includes calculating the day of the expected ovulation ( methods have been described previously.). When ovulation has occurred, you should proceed directly to the procedure itself.

To carry out artificial insemination at home, you will need:

• Disposable sterile syringe ( per 10 ml) - can be purchased at any pharmacy.
• Sterile container for collecting seminal fluid- for example, a container for testing, which can also be purchased at a pharmacy.
• Sterile disposable vaginal dilator- you can buy at a pharmacy, but you can perform the procedure without it.

After the introduction of sperm, the syringe and dilator are removed, and the woman is advised to remain in the “lying on her back” position for the next one and a half to two hours. Some experts recommend placing a small roller under the buttocks so that the pelvis is raised above the bed. In their opinion, this contributes to the promotion of spermatozoa to the fallopian tubes and increases the likelihood of pregnancy.

Why is utrogestan and duphaston prescribed after insemination?

If in the period after ovulation the concentration of this hormone in the blood of a woman is reduced ( which can be observed in some diseases of the ovaries, as well as in patients older than 40 years), this can disrupt the process of attaching a fertilized egg to the wall of the uterus, as a result of which pregnancy will not occur. It is in such cases that patients are prescribed utrogestan or duphaston. They prepare the uterine lining for egg implantation and also support the development of the fetus throughout pregnancy.

How to behave after insemination ( do's and don'ts)?

Can I take a bath after artificial insemination?

When performing intrauterine or other types of insemination, the patient is allowed to take a bath immediately after returning home. The fact is that in these cases, seminal fluid is injected directly into the uterine cavity or into the fallopian tubes, which are normally reliably delimited from environment cervix. Even if the woman takes a bath immediately after the end of the procedure ( that is, after lying in the gynecological chair for one and a half to two hours), water or any other substances will not be able to penetrate the uterine cavity and in any way affect the fertilization of the egg.

Can I swim and sunbathe after insemination?

Concerning sunburn of any special instructions no. If a woman has no other contraindications, she can sunbathe in the sun or visit a solarium immediately after the procedure, which will not affect its effectiveness in any way.

Is it possible to have sex after artificial insemination?

How many hours after insemination does fertilization occur?

With intrauterine insemination, male germ cells are injected directly into the uterine cavity. They do not waste time getting through the mucosal barrier in the cervix, as a result of which, with this type of procedure, fertilization may occur earlier ( after 3 - 4 hours). If intratubal insemination is performed ( when sperm are injected directly into the fallopian tubes), the egg located there can be fertilized in a couple of hours.

Signs of pregnancy after artificial insemination

It is worth noting that after artificial insemination, pregnancy proceeds in exactly the same way as with natural conception. Therefore, the signs of pregnancy will be the same.

Pregnancy may be indicated by:

• change in appetite;
• taste disorders;
• impaired sense of smell;
• increased fatigue;
• increased irritability;
• tearfulness;
• an increase in the abdomen;
• engorgement of the mammary glands;
• absence of menstruation.

On what day after insemination should I do a pregnancy test and donate blood for hCG?

Despite the fact that hCG begins to be produced approximately 6-8 days after the fertilization of the egg, its diagnostically significant concentrations are observed only by the 12th day of pregnancy. It is from this period that hCG can be detected in the urine ( for this, standard express tests are used, which can be bought at any pharmacy) or in the blood of a woman ( To do this, you need to donate blood for analysis to the laboratory.).

Why is ultrasound prescribed after insemination?

The purpose of ultrasound after insemination is:

• Confirmation of pregnancy. If the fertilized egg is attached to the wall of the uterus and begins to develop, after a few weeks the embryo will reach a significant size, as a result of which it can be determined during an ultrasound examination.
• Identification of possible complications. One of the formidable complications of insemination can be an ectopic pregnancy. The essence of this pathology lies in the fact that the egg fertilized by the sperm is not attached to the wall of the uterus, but to the mucous membrane of the fallopian tube or even begins to develop in the abdominal cavity. Laboratory tests (determination of hCG in the blood or urine of a woman) at the same time will indicate that the pregnancy is developing. At the same time, the prognosis in this case is unfavorable. At ectopic pregnancy the embryo dies in 100% of cases. Moreover, if this condition is not detected in a timely manner, it can lead to the development of complications ( for example, to rupture of the fallopian tube, to bleeding, and so on), which would endanger the woman's life. That is why during an ultrasound examination, the doctor not only detects the presence of an embryo in the uterine cavity, but also carefully examines other parts of the reproductive system in order to early diagnosis ectopic pregnancy.

Can twins be born after insemination?

Much less often, multiple pregnancy develops when one egg is fertilized by one sperm. In this case, at the initial stages of development, the future embryo is divided into 2 parts, after which each of them develops as a separate fetus. It should be noted that the probability of such a development of events is the same for both artificial and natural insemination.

Complications and consequences after artificial insemination

Artificial insemination may be accompanied by:

• Genital tract infection. This complication can develop if during the procedure the doctor used non-sterile instruments or did not comply with hygiene standards. At the same time, the reason for the development of infection may be a woman's failure to follow the rules of personal hygiene immediately before or after the procedure. It is important to remember that any infection is much easier to cure on initial stage development. That is why if you experience pain, burning or redness in the genital area, you should immediately consult with your doctor.

• Allergic reactions. May occur with intrauterine or intratubal insemination, when poorly prepared ( poorly cleaned) seminal fluid. Allergies can be manifested by anxiety, skin spots, muscle tremors, a marked drop in blood pressure, or even loss of consciousness. Extremely heavy allergic reactions demand immediate medical care because they pose a danger to the life of the patient.
• fall blood pressure. The reason for the development of this complication may be careless, gross manipulations with the cervix during intrauterine insemination. The mechanism of development of this phenomenon is the irritation of special nerve fibers so-called vegetative nervous system, which is accompanied by a reflex expansion blood vessels, slowing heart rate and lowering blood pressure. With the development of this complication, a woman is strictly forbidden to get up, as this will cause an outflow of blood from the brain, and she will lose consciousness. The patient is shown strict bed rest for several hours, drinking plenty of water, and if necessary - intravenous administration fluids and medicines to normalize blood pressure.
• Multiple pregnancy. As mentioned earlier, the risk of multiple pregnancy increases with insemination after hormonal stimulation ovaries.
• Ectopic pregnancy. The essence of this phenomenon is described above.

Drawing pains in the abdomen

Chest pain ( sore nipples)

Temperature

At the same time, it is worth noting that an increase in temperature to 38 degrees and above, which occurs during the first or second day after insemination, may indicate the development of complications. One of common causes temperature increase may be the development of an infection introduced during the procedure ( for example, if the doctor or patient does not comply with hygiene standards). The development of the infection is accompanied by the activation of the immune system and the release of many biologically active substances into the blood, which determine the temperature increase 12-24 hours after infection. Temperatures can reach extremely high values (up to 39 - 40 degrees and more).

Another reason for the increase in temperature may be an allergic reaction associated with the introduction of poorly purified seminal fluid into the uterus. Unlike infectious complications, with an allergic reaction, body temperature rises almost immediately ( within the first minutes or hours after the procedure) and rarely exceeds 39 degrees.

Regardless of the cause, a temperature increase of more than 38 degrees is a reason to see a doctor. It is not recommended to take antipyretic drugs on your own, as this can distort clinical picture disease and make it difficult to diagnose.

Will there be periods after insemination?

Considering the foregoing, it follows that if menstruation appeared after insemination, conception did not occur. At the same time, the absence of menstruation may indicate in favor of a developing pregnancy.

Brown spotting ( bleeding)

The appearance of brown bloody) discharge, accompanied by moderate pain in the lower abdomen, can be observed 12 to 14 days after insemination. In this case, it will be about menstrual bleeding, which normally begins 2 weeks after ovulation ( if the egg has not been fertilized). At the same time, it can be said with certainty that the attempt to conceive failed.

This bleeding does not require any treatment and usually stops on its own after 3 to 5 days, after which the next menstrual cycle begins.

Why is the pregnancy test negative after insemination?

Where ( in which clinic) is it possible to do artificial insemination in the Russian Federation?

In Moscow

Artificial insemination is one way to help infertile couples become parents. It is considered a type of IVF, but the main difference is how the insemination procedure takes place. In this case, fertilization is carried out inside the female body, and is more simple and accessible than.

Types of procedure

Artificial insemination can be done with the sperm of a spouse or a donor. The use of donor biomaterial is usually carried out due to the low quality of the partner's male seminal fluid, genetic pathologies, or is used by single women who want to find the joy of motherhood.

This is done in several ways:

1. intracervical, the introduction of sperm into the cervix. AT recent times rarely used, due to low efficiency;
2. intrauterine, delivery of male germ cells into the uterine cavity. It is this method that is the most effective and most often used in practice;
3. vaginal - the introduction of sperm into the vagina, next to the cervix.

The latter method is often referred to as "home insemination". Despite the fact that medical workers have doubts about the effectiveness of the procedure, and they do not understand why insemination is done at home, some women managed to achieve a positive result.

How to do it yourself:

• choose the right date - either directly at the time of ovulation, or 2-3 days before it;
• using a sterile syringe without a needle to introduce sperm into the vagina;
• spermatozoa are able to maintain mobility, being in the open air, no more than 3 hours. Therefore, it is important to have time to introduce them into the vagina during this time, and it is desirable to use the biomaterial after the first ejaculation, as the most viable;
• after the procedure, it is recommended to lie down with your legs raised up, or stand in the “birch” position.

For those who decide to this method fertilization, you need to know that during the procedure, which is carried out in the laboratory, the sperm undergoes a special treatment and components that stimulate conception are introduced into it.

Artificial insemination occurs by the method of delivering male germ cells to a woman's body.

To carry out the procedure at home, you can purchase a special kit designed for this purpose. When self-transfer of seminal fluid into the vagina, you should not try to penetrate deep into the cervix, otherwise you can cause injury and infection.

The procedure is carried out either with the use of hormonal drugs to stimulate ovulation, or in a natural cycle.

According to medical statistics, 16% of married couples in Russia are infertile, that is, they cannot conceive a child within a year. How can artificial insemination help? Read about indications and contraindications for the procedure and the chances of success in our review.

The essence of the technique of artificial insemination

Artificial, or intrauterine, insemination (AI or IUI) is a method of infertility treatment that is most similar to natural conception. The pre-treated sperm of the husband or donor is introduced into the uterine cavity of the woman during the periovulatory period (at this time the follicle ruptures and the egg is released from it), which is confirmed by ultrasound. If necessary, ovulation can be programmed for a specific day by prescribing drugs. On the day of ovulation, a man donates sperm, which is prepared (cleaned and concentrated) for IUI.

Important!
According to the order of the Ministry of Health of Russia dated August 30, 2012 No. 107n “On the procedure for the use of assisted reproductive technologies, contraindications and restrictions on their use”, only cryopreserved sperm can be used for artificial insemination with donor sperm. When inseminating with the husband's sperm, both raw and pre-prepared sperm can be used.

Indications

IUI is performed in the following cases:

1. Using husband's sperm:

• subfertile sperm of the husband (the number of spermatozoa per unit volume is reduced - oligospermia, the speed of movement of spermatozoa is reduced - asthenospermia);
• cervical infertility factor - a condition when spermatozoa are unable to penetrate the uterine cavity through the cervical (cervical) mucus;
• violations in the sexual sphere of the couple (vaginismus, erectile dysfunction, lack of ejaculation, hypospadias, retrograde ejaculation), making natural conception impossible;
• idiopathic infertility (the cause of infertility cannot be determined).

• the absence of a sexual partner in a woman;
• high risk of developing hereditary diseases (on the part of the husband);
• severe violation of spermatogenesis in the husband (absence of spermatozoa in the semen - azoospermia).

Contraindications

Conducting intrauterine artificial insemination is contraindicated in:

• obstruction of both fallopian tubes;
• benign tumors, ovarian cysts, congenital anomalies uterus and ovaries;
• oncology of any localization;
• congenital malformations of the genital organs;
• severe and recurrent forms of blood diseases and hematopoietic organs, endocrine diseases (diabetes severe disease, disease thyroid gland etc.), severe diseases of the heart and blood vessels, lungs, gastrointestinal tract, kidneys, active forms of tuberculosis, mental illness.

In fact, IUI is contraindicated in all diseases in which pregnancy itself is contraindicated.

Unsuccessful repeated attempts at IUI (more than 3 times) are the basis for switching to another treatment method, such as IVF.

Before an intrauterine insemination procedure

During the IUI planning phase, the couple undergoes an in-depth examination.

Required for a woman:

1. Blood test for group and Rh factor.
2. Clinical blood test (the result is valid for 1 month).
3. Blood tests for syphilis, HIV, hepatitis B and C (results are valid for 3 months).
4. Vaginal smear tests cervical canal and urethra on the flora and the degree of purity of the vagina (results are valid for 1 month).
5. Urinalysis (the result is valid for 1 month).
6. The conclusion of the therapist on the state of health (valid for 2 years).
7. Cytological examination of smears from the cervix (for atypical cells).
8. Blood tests for hormone levels - FSH, LH, prolactin.
9. Infectious examination for chlamydia, ureaplasmosis and mycoplasmosis (it is desirable to study smears from the vagina and cervical canal by PCR).
10. Statements of all transferred data transactions histological examination(if available).

Man must:

1. Blood test for syphilis, HIV, hepatitis B and C (results are valid for 3 months).
2. Spermogram.

How does artificial insemination work?

The essence of the IUI procedure is to monitor, under ultrasound control, the growth of follicles in the ovaries until they mature (diameter 18–19 mm) and then introduce purified and concentrated sperm of the husband or donor into the uterine cavity using a catheter at the time of ovulation (rupture of the follicle with the release of their mature egg). At the same time, it is impossible to see the presence or absence of an egg in the follicle with IUI (the diameter of the egg is 150 microns and it can only be viewed under a binocular magnifier or a microscope after the egg is removed from the follicle during IVF).

IUI can be carried out in a natural cycle - in this case, 1 follicle will grow and, accordingly, you can count on 1 egg and not very high efficiency procedures. To increase the effectiveness of IUI, ovulation stimulants (Klostilbegit, Gonal, Puregon, etc.) are used from the 2nd–5th day of the cycle strictly under medical supervision. Their appointment causes multiple growth of follicles in the ovaries and, accordingly, eggs, which, on the one hand, increases the likelihood of pregnancy, but on the other hand, it can cause multiple pregnancy(twins, triplets, etc.), which is undesirable, since it is associated with complications for the mother and children during pregnancy.

The procedure is absolutely painless.

With artificial insemination with the husband's sperm, the ejaculate (by masturbation) is surrendered 2-3 hours before the procedure itself. 3-7 days prior to this, sexual abstinence is necessary. Some doctors advise abstaining from alcohol for at least 2.5 months - this is how long it takes for the formation of spermatozoa, exposure high temperatures(bath). After that, there are:

• sperm quality analysis;
• liquefaction of semen at room temperature for 20-40 minutes;
• purification of sperm and obtaining a "concentrate" from actively mobile, morphologically complete spermatozoa.

For the isolation of such spermatozoa, the most commonly used flotation method or density gradient centrifugation method.

Flotation Method. A nutrient medium is added to a test tube with a liquefied ejaculate and mixed. The tube is centrifuged, and under the influence of gravity, the spermatozoa sink to the bottom of the container. The liquid fraction is removed from the test tube, and 1 ml of nutrient medium is layered on the spermatozoa. The test tube is placed in the incubator, actively mobile spermatozoa move to the upper layers, and motionless forms remain below. The embryologist takes the medium with active spermatozoa from the upper layer into the catheter and passes it to the doctor for IUI.

Density gradient centrifugation method. Colloidal liquids with different densities are placed in layers in a test tube. The ejaculate is added as the top layer. The tube is placed in a centrifuge. The most mobile and viable spermatozoa during the procedure move to its bottom, from where a sample is taken for insemination.

When it comes to sperm donation, the donor is carefully examined before taking the ejaculate. After donation, the ejaculate is preserved for at least 6 months and re-examined before use. On the day of ovulation, cryopreserved (frozen) sperm is thawed, processed (cleansing and concentration of spermatozoa are carried out using the methods indicated above) and injected into the woman's uterine cavity in the manner indicated earlier.

After IUI

Prepared spermatozoa are introduced into the uterine cavity with a special catheter. Further, the woman must remain in horizontal position 15–20 minutes. After that, you can lead a normal life. The effectiveness of the intrauterine insemination procedure is checked after 2 weeks, determining the level chorionic gonadotropin(HCG) - pregnancy hormone.

The effectiveness of artificial insemination

Many factors influence the effectiveness of artificial insemination. The main factors are the age of the couple, functional state ovaries and sperm quality. But researchers are also studying the possibility of the influence of ejaculate preparation methods, the duration of the procedure, the number of inseminations. While they have not come to the final conclusions that would increase the effectiveness of the procedure, the average probability of pregnancy with intrauterine insemination does not exceed 17–25%.

Therefore, after 3 cycles of insemination, if pregnancy has not occurred, it is recommended not to continue trying, but to switch to other methods (for example, IVF).

It is also obvious that there are more chances for success in couples in which the woman is younger than 35 years old, has 2 passable tubes, and the husband's spermogram is close to normal.

Safety for maternal and child health

Complications from intrauterine insemination are extremely rare and are more often associated with exposure to drugs that are used to stimulate ovulation.

Insertion of a catheter into the uterus may cause mild cramping that resolves quickly. It is possible to attach an infection, but subject to all the necessary asepsis requirements, this is unlikely.

Allergic reactions to components of the washing medium may occur: albumins and antibiotics. But they are very rare.

How much does an IUI procedure cost in Moscow?

One procedure of intrauterine insemination can be carried out within the framework of compulsory medical insurance, in the direction of a gynecologist. If there are indications for this manipulation and if there are quotas, the patient is sent to the fertility clinic.

But in reality, many couples prefer not to wait for a quota, but to do the procedure for a fee. The total cost will be the sum of the prices for all the necessary stages of the procedure:

• consultation of a reproductive specialist (several may be needed);
• a full course of necessary examinations;
• donor sperm (if necessary);
• ultrasonic monitoring of follicle growth until the moment of ovulation and the formation of the corpus luteum;
• sperm preparation;
• insemination procedure (including consumables).

Many clinics prefer to charge for a turnkey procedure. In this case, it can cost from 20 to 50 thousand rubles, depending on whether the sperm of the husband or a donor is used. But, as a rule, it is cheaper than paying all necessary procedures as they go through.

The inability to conceive often affects psychological condition married couple. If the problem is obvious, you should not hope for luck or that the situation will resolve itself. Assisted reproductive procedures, including artificial insemination, can help you become parents even when conception is not possible naturally.

Which Moscow clinic can I contact?

We asked the head physician of the Embryo clinic Kim Nodarovich Kechiyan, candidate of medical sciences and laureate of the Prize of the Government of the Russian Federation, to talk about what to look for when choosing medical Center for artificial insemination:

“The inability to conceive a child is a delicate issue. Of course, before contacting a specialist, people study reviews and compare prices. The reputation of the clinic is certainly important and has been developed over the years. For example, our center has been providing services since 1992, and during this time we have helped more than 8,000 babies to be born. But, in addition to the analysis of subjective impressions, one should not forget that most modern reproductive services are a complex set of activities. And when patients can receive all this complex in one clinic, it is not only convenient and fast, but also economical.”

Editorial opinion

Despite understandable doubts and fears, one should not expose oneself to unnecessary worries by deciding on the procedure of artificial insemination. The technology today has been worked out almost to perfection, and doctors are doing an excellent job of preventing and preventing possible - single and minor - complications.