It would seem that everything turned out the way I wanted: a successful career, happy marriage, arranged life, best friends and pleasant leisure time.

But there is no happiness...

Infertility... A terrible word. Sounds like a sentence. But that's just the sound. Thanks to reproductive methods of treatment, the problem of infertility does not exist today.

Artificial insemination (AI)

is the simplest, most accessible and, in some cases, effective method of assisted reproductive technology. This is a procedure in which pre-treated sperm is injected into the uterus outside of sexual intercourse. What happens next is as usual: sperm move through the fallopian tubes to the egg and fertilize it. A pregnancy obtained in this way is no different from a normal pregnancy.

Indications for AI:

• male factor infertility (poor sperm analysis, sexual dysfunction);
• cervical infertility in women (changes in the properties of uterine mucus, involuntary contractions of the vaginal muscles caused by fear of sexual intercourse);
• lack of a partner for a woman.

If you have similar problems, perhaps conducting AI is your path to long-awaited happiness.

Necessary examinations before performing AI

This is how it is with us, if pregnancy occurs naturally, then it doesn’t matter at all who is sick and what. And if you turn to doctors for “long-awaited happiness,” then you must be healthy.I stood on the threshold of the clinic and was preparing to take the first step...

You will have to undergo a full examination for sexually transmitted infections (both partners), have an ultrasound done to exclude possible gynecological diseases, which may be an obstacle to the onset or gestation of pregnancy (for a woman), do a spermogram analysis (for a man).

To prescribe an AI procedure, it is necessary to exclude the presence of diseases in a woman that prevent pregnancy. After all, if menstruation occurs on time, this is not at all a reason to think that you are healthy, and a mature and ovulated follicle does not at all mean that a full-fledged one has matured. good quality egg.

But the most important condition for carrying out AI is cross-country ability fallopian tubes, or at least one pipe. If you haven't been offered a tubal check, run away from this quack doctor. Lack of information about the fallopian tubes not only sharply reduces the effectiveness of AI, but also increases the risk of ectopic pregnancy.

The examination scheme is simple: they check the functioning of the ovaries (maturation of the eggs), the patency of the tubes (the place where the egg meets the sperm), the condition of the uterine cavity (the ability of the embryo to attach).

The decision on the advisability of insemination will be based, among other things, on sperm quality indicators.

… Full examination in a modern reproductive clinic it took me (and my husband) a little over 2 weeks. I didn’t take leave, I just ran to the doctor or the laboratory in the morning, and then to work. I can say that the examination is not a cheap pleasure, but the doctor assured me that such a thorough examination has its advantages. Firstly, the AI ​​procedure is prescribed to me according to my indications and the obstacles to pregnancy will be minimized. Secondly, I will be sure that during the subsequent pregnancy my child will not be threatened by any infection, because carrying out treatment with a child already under the heart is quite dangerous and not always possible. And yet, I realized that I had taken the most important first step towards long-awaited pregnancy.

Preparing for AI

When all the tests and examination conclusions are ready, the doctor will decide on the advisability of performing AI. If this reproductive treatment method is right for you, you proceed to the next step - preparing for the AI ​​procedure. Preparation for insemination involves determining the date of ovulation, hormonal stimulation of the ovaries (if necessary), monitoring the growth of the endometrium in the uterus, and preparing sperm.

Ovulation - the time when a mature egg leaves the ovary/follicle, occurs approximately in the middle menstrual cycle. The most favorable time conception - a day before ovulation and several hours after, this time is ideal for carrying out AI. Although insemination 2-3 days before ovulation can also lead to pregnancy.

To determine the time of ovulation with an accuracy of at least the day and maturity of the egg, ultrasound monitoring is performed. From the beginning of the menstrual cycle in which AI is supposed to be performed, ultrasound is performed several times, tracking the functioning of the ovaries and the growth of one or more follicles (eggs). Ovulation occurs when the follicle reaches a size of 18-22 mm.

In addition to ultrasound, you can independently determine the time of ovulation using ovulation tests. Such tests, similar to tests for determining pregnancy by urine, are sold in pharmacies and can show those “cherished” days when ovulation occurs.

AI can be carried out either in a natural cycle or with the use of hormonal stimulation of the ovaries, which will lead to the maturation of several follicles/eggs and increases the likelihood of pregnancy. In the second case, starting from the first day of the cycle, the doctor prescribes stimulant drugs.

In addition to controlling the growth and maturation of follicles/ova, important factor for pregnancy to occur is the thickness of the endometrium in the uterus at the time of ovulation. When carrying out ultrasound monitoring, the growth of the endometrium is monitored and if the growth is insufficient (by the time of ovulation it should be at least 9 mm), additional hormonal drugs for growing the endometrium.

Preparing sperm for AI takes about 2 hours. It takes about an hour to liquefy it, then the sperm must be processed without delay, otherwise its quality will deteriorate. Treated sperm can be stored for several hours without losing its quality. If cryopreserved sperm is used, it will take more time to defrost it.

On the 7th day of the menstrual cycle, I had my first ultrasound. Even then, the dominant follicle was visible, storing that same egg.

On the 12th day of the cycle, an ovulation test showed two lines. This means that ovulation will occur within 24 hours. I was happy like crazy, as if I was already pregnant. My beautiful egg will be ready to meet her prince very soon!

On the 13th day of the cycle, in the morning, the doctor confirmed that ovulation was about to occur, the endometrium had grown to 11 mm, and suggested insemination.

I called my husband and asked him to come urgently.

AI procedure itself

The AI ​​procedure itself (sperm injection) takes several minutes. The woman sits comfortably in the gynecological chair. Specially prepared sperm is injected directly into the uterine cavity using a catheter. That's all! The procedure is performed by one person, usually your doctor.

The procedure was painless, I only felt a slight tugging. After injecting the sperm, the doctor left me to lie down for 20-30 minutes. I lay there and imagined the process of conception, the meeting of egg and sperm, fertilization. I dreamed about my future baby, I thought what he would be like, who he would look like and what gender. For some reason I imagined a girl with blond pigtails and plump lips. I was in a positive mood and positive result and I became confident that I would become a mother very soon!

The estimated cost of AI consists of several components:

initial consultation with a doctor - 100-300 UAH.

examination for infections, viruses, hormonal examinations - 1000 UAH.

checking the patency of the fallopian tubes - x-ray (for women) - 300-450 UAH.

spermogram (for men) - 100-250 UAH.

cost of ultrasound monitoring (at least 2-3 ultrasounds required) - 100-150 UAH.

insemination procedure (including sperm preparation) - 1000 UAH.

Thus, the estimated cost of the AI ​​procedure is 2800 - 3450 UAH. This amount can be increased in the case of using donor sperm (approximately 500 UAH) and using medications for ovarian stimulation (the cost is comparable to the cost medical services for insemination - 1000 UAH).

By the way, a higher price for the insemination procedure compared to other clinics does not always mean that this clinic has a better result.

AI success rate and possible reasons for failure

Pregnancy as a result of insemination occurs less frequently than during natural sexual activity in healthy couples, and than during in vitro fertilization(ECO). That is, the probability of pregnancy in one cycle during insemination is less than 30%. Therefore, you should be prepared to carry out at least 3-4 cycles of insemination. However, each subsequent AI will cost less by the amount of the examination and will be approximately 1400 - 1550 UAH.

If pregnancy does not occur after 3-4 cycles of insemination, it is recommended to change the treatment method.

Possible reasons for failure:

1. Insemination was not carried out according to indications; there are obstacles to pregnancy. To avoid failure for this reason, in fact, a full examination is carried out.

2. Insemination was carried out insufficiently qualified or carelessly. Perhaps the ovulation period was not set correctly or there was a delay in sperm preparation, which affected its quality. In this case, you may want to think about changing clinics or doctors.

3. Bad luck. If you have only completed 1-2 cycles of inseminations and are confident in your doctor, most likely you are just out of luck. Talk to your doctor about using ovarian stimulation if it was absent, changing stimulation medications, performing 2-3 inseminations per cycle if only 1 was performed, increasing the time of sexual abstinence for a man before donating sperm (up to 5 days).

On the 22nd day of the cycle, I felt that I was pregnant. Has settled in me new life and has already made itself felt. Before, I would never have believed this, and no one believed me. And I felt it!

With some unbearable effort I restrained myself from taking the test, because it was too early.

I behaved more quietly than usual, as if I was afraid of scaring away my happiness. And I waited every minute.

On the 26th day of the cycle, the test showed the coveted two stripes - one was very pale, but we saw it! I AM PREGNANT!

Tears of happiness...my...husband...

HAPPINNES EXISTS!

P.S. By the way, we are having a girl!

Various are increasingly gaining popularity in last years. The most complex and time-consuming procedure is the process of taking female and male gametes, which are combined in specially prepared conditions. Has no less popularity intrauterine insemination. How the procedure goes and its effectiveness - all this will be described in this article. You will also learn the main reviews about this event and be able to get acquainted with the opinions of doctors.

What is intrauterine insemination?

This article will tell you how the procedure goes. However, before doing this, it is worth knowing a few things.

Insemination is a unique method of fertilization. It does not involve classical sexual intercourse. Partners may not even touch each other. A man and a woman may be separated by a long distance at the time of conception. Procedure artificial insemination- this is a manipulation in which ejaculate is introduced directly into the cavity reproductive organ. So, this bypasses the vagina and cervical canal. This operation can be performed with freshly collected sperm or frozen material. In the second case, the ejaculate is pre-processed. It is worth noting that you can conceive a child in this way using material from your husband or an outside donor.

Who is the procedure prescribed for?

In what cases do doctors say that a couple needs artificial intrauterine insemination (how the procedure takes place will be described below)? Indications for this may vary. Often this is a pathology in a man or woman. However, sometimes the disease can affect both partners. The main indications for manipulation include the following:

• Production of antisperm bodies in a woman’s vagina. This often happens with prolonged life together. It is worth noting that not all doctors confirm this assumption. A postcoital test will help identify pathology.
• Long-term infertility associated with absence, provided that the second sexual partner has good performance spermograms.
• Insufficient sperm activity in a man. In this case, it is advisable to first carry out medication correction.

There are other (individual) indications. For example, insemination is carried out for couples who for a long time cannot conceive a baby for unknown reasons. Often, this method of fertilization is used by couples who are forced to spend a long time apart. In this case, they simply physically cannot conceive a child on their own.

Contraindications to fertilization in this way

Before insemination is carried out, the doctor must schedule a conversation with both partners. The doctor explains the effectiveness of the manipulation and also informs about contraindications. You should refuse the procedure in the following cases:

• obstruction of the fallopian tubes in a woman;
• Availability inflammatory process in the vagina;
• for pathologies cervical canal and cervix;
• menstruation period;
• lack of ovulation.

In the latter case, the procedure is performed only after a certain correction. Only a doctor can choose an individual preparation regimen for a specific couple.

Where is the procedure performed?

If insemination is indicated for you, your doctor will tell you how the procedure goes. The operation can only be performed within the walls of a hospital. It could be government agency or a private clinic.

In the first case, you will need some documents confirming that you really need such a procedure. It is also necessary to have your passport and insurance policy with you. Be prepared to stay in the clinic for several days. Private institutions perform the manipulation at the request of the client. However, be prepared for the fact that in this case you will have to pay a certain amount for insemination. The average cost of such an operation is in the price range from 5 to 40 thousand rubles. Much depends on the condition of the partners and the preliminary preparation of the material.

Intrauterine insemination: how is the procedure performed? Preparation

Before insemination, the couple must undergo certain examinations. Preparation includes a spermogram. A man must take this test after five days of abstinence. The remaining studies are carried out exclusively by representatives of the fairer sex. This includes blood diagnostics, determination of the condition of the fallopian tubes (metrosalpingography), examination of the uterine cavity (hysterosalpingography). Also, the doctor must make sure that in the body expectant mother ovulation occurs. This can be done using ultrasound examination or by determining the level of certain hormones.

Based on the test results, the spermogram should be normal. Otherwise, the sperm is processed immediately before insemination. Fallopian tubes women should be passable throughout their entire length, and present in the vagina normal microflora. How does artificial insemination work? Let's consider the algorithm of actions.

Carrying out insemination: algorithm

How does insemination occur? Doctors say that the woman is first examined using an ultrasound sensor. Doctors must make sure that the ovaries have at least three follicles. Their size is also assessed. According to experts, ovulation should occur in the coming hours.

Before insemination is performed, sperm is collected. If necessary, it is processed and cleaned. Also sometimes it makes sense to fill the substance useful substances to prolong the viability of sperm. A woman sits in a doctor's office.

The gynecologist draws the partner's or donor's sperm into a syringe. A thin tube - a catheter - is connected to its end. A soft hose is inserted into the cervix and reaches internal pharynx. After this, the specialist injects the contents of the syringe into the cavity of the reproductive organ.

Effectiveness of manipulation: expert assessment

You already know how insemination is done. Reviews from doctors say that when natural fertilization there is a higher probability of a successful outcome than from this procedure. According to reproductologists, the effectiveness of this method is estimated at no more than 20 percent. At the same time, repeated insemination increases the chance of a good outcome.

Pre-treatment of sperm and stimulation of the ovaries lead to the fact that the effectiveness of the procedure is estimated at 40 percent.

Opinions of doctors and patients about artificial insemination

You already know how insemination is carried out. Reviews from patients indicate that this is a rather painful manipulation. Unpleasant sensations appear when a catheter is inserted into the cervix. Also, some women report that they had minor spotting after the procedure.

Doctors say that if the procedure is not followed, inflammation can develop in a woman’s uterus. Special danger this situation represents when the operation is successful.

Instead of a conclusion...

You learned what insemination is, how the manipulation is carried out and what its effectiveness is. Remember that this procedure is not a panacea. The result of the procedure can be found out within ten days after artificial insemination. The most accurate result can be shown by a blood test to determine the level human chorionic gonadotropin. Follow all the rules for preparing for manipulation. This will increase the chance of a positive outcome. I wish you success!

We want to support married couples and single women who have decided to undergo a procedure such as intrauterine insemination (hereinafter referred to as IUI or AI). Unfortunately, not everything in life is always simple and smooth: some people experience loneliness when they have long wanted to find a family, while others experience illness, loss of loved ones, and other misfortunes. There is no need to think that you are the one who is unlucky - everyone experiences some kind of misfortune. And you shouldn’t be embarrassed that you have to go to doctors - we don’t hesitate to see a doctor if, for example, we broke our leg in order to get rid of the pain and be able to walk in the future.

It’s just that artificial insemination of a person, intrauterine insemination, turning to doctors to find a child is less familiar to us, that’s all. This is also less common for the people around us. Methods artificial insemination(including intrauterine artificial insemination) in Moscow and the regions everyone helps every year more married couples Artificial insemination - donor, or with your husband's sperm - will give you the desired result - your child. However, if you are not ready or do not want to face the wariness, skepticism, and even ridicule of others - natural human reactions to something new and unusual - and do not feel confident in convincing people and achieving their understanding of the situation, then you probably should not Tell your loved ones that you have resorted to a procedure such as intrauterine artificial insemination.

The results after insemination - a successful pregnancy - will please both you and your loved ones. Conceiving a child is an intimate, personal matter, and concerns only you. You can answer questions from loved ones or smile mysteriously. The artificial insemination methods used are up to you, your spouse and your doctor.

The oncoming misfortune is sometimes so depressing that complete despondency sets in. But over time, you realize that the problem will not be solved on its own and life will not get better on its own. Artificial insemination in humans - medical method treatment, there is nothing obscene in it. The problem of artificial insemination is largely contrived by people who are uninformed on this issue. If this procedure is indicated for you, artificial insemination - donor or with your husband's sperm - you need to think carefully about everything and act. You need to overcome adversity, not surrender to it. There are always ways to solve a problem. Perhaps it’s not always easy, it’s not always easy to accept something psychologically, you don’t always have enough patience and will. Sometimes you just don't know how to solve a problem, or which way is better.

Artificial insemination. Indications:

• couples where not everything is okay on the part of the man (sexual disorders or bad sperm)
• single women (if there are no problems “on the female side”)

Many single women really want to have a baby. What to do if there is no one nearby suitable partner? Women will learn what artificial insemination is, who became pregnant after artificial insemination, where artificial insemination is performed, how much artificial insemination costs - in Moscow and the regions. Having clarified all the questions, women go to the selected clinic, where they undergo artificial insemination. If intrauterine insemination is carried out successfully, after insemination the long-awaited pregnancy occurs. And it doesn’t matter how much artificial insemination costs; the result is a new life, your child is in your arms. I would like to wish single women good luck and understanding and help from loved ones with raising a child.

Let's look at men's problems in more detail. Certain problems in reproductive sphere are now found in men, including young men, quite often, and, unfortunately, are not always treatable. The problem of artificial insemination for men is quite acute. This is a heavy blow to male pride and simply a human misfortune. This often disrupts the harmony in the couple.

It makes no sense at all to do nothing in this situation, to get away from it - sooner or later the problem will have to be solved, one will have to somehow determine one’s destiny, and procrastination usually leads to the growth of problems.

In this situation, it is important to collect complete information that can help you modern medicine, where exactly and how successfully. It is also important to visit clinics and doctors in person to get answers to your questions and doubts. If artificial insemination is indicated for you, tests will help you choose the right treatment tactics.

I would like to separately mention that bad sperm is not a diagnosis, it is an analysis. If a man has not been examined and there is no conclusion about the diagnoses, causes of poor sperm and the possibility of treatment, it is too early to make predictions whether pregnancy is possible naturally or whether artificial intrauterine insemination or another ART method is needed.

In case of serious pathologies of sperm, if it cannot be corrected, insemination with the husband’s sperm cannot help solve the problem. In these cases, medicine can only help with insemination with donor sperm or IVF/ICSI with husband's sperm.

The role and importance of a man in conception, if one has to resort to artificial methods, not only does not become lower, it becomes much higher and more responsible. Even if donor sperm is used, this is your child, thanks to you a new life is born, and he will be the same as you raise him.

Artificial insemination (AI) is a method of assisted reproduction (along with IVF, IVF/ICSI), in which, as with other methods, some stage of conceiving a child occurs artificially.

General information

Insemination is the artificial introduction of sperm into a woman's genital tract. The entire further process occurs naturally: sperm run from the uterus into the fallopian tubes, where they meet a mature egg released from the ovaries and also entered the fallopian tubes, fertilize it, and then the fertilized egg enters the uterus, where it attaches to the wall of the uterus and gives rise to pregnancy.

Inseminations are carried out near the time of ovulation (the release of a mature egg from the ovary), approximately in the middle of the menstrual cycle.

Previously, the introduction of sperm into the vagina was used, but more successful is the recent introduction of sperm into the uterus - the so-called intrauterine insemination (IUI).

During intrauterine insemination, sperm is pre-processed, making it similar to the composition that sperm acquires in the vagina on the way to the uterus during natural sexual intercourse, and selecting the “squeeze” from the sperm most capable of fertilization. The introduction of unprocessed sperm directly into the uterus is unacceptable.

Artificial insemination. Indications

Inseminations are performed on single women and are used to achieve pregnancy in spouses in infertile marriages if treatment to achieve a natural pregnancy has not been successful.

Artificial insemination. Results: Pregnancy as a result of insemination can occur in a woman only when there are no diseases that prevent pregnancy. In case of obstruction/absence of fallopian tubes, endometriosis high degree, in the absence of ovaries or uterus, insemination is not performed.

As a method of assisted reproduction, they are distinguished:

• artificial insemination with husband's sperm (AISM)
• artificial insemination with donor sperm (AISD)

Artificial insemination with husband's sperm (AISM)

IISM are indicated and can overcome infertility only in those cases when the artificial introduction of sperm bypasses the obstacle(s) due to which pregnancy did not occur, namely:

• at sexual disorders, vaginismus, irregular sex life,
• with cervical (cervical) factor infertility, when the husband’s sperm die in the wife’s vagina,
• with slight deterioration in sperm quality compared to normal,
• in case of infertility of unknown origin, when the couple has undergone a full range of examinations, and the cause has not been found, but the use of IVF seems premature, insufficiently justified or too expensive.

In all cases, except the first, it is assumed that the couple has undergone a full infertility examination in accordance with full list examination, and there is a conclusion about the causes of infertility. If a couple is indicated for artificial insemination, tests will help choose the right treatment.

All of the above cases are quite rare and make up only a small percentage of infertility cases.

When inseminating with the husband's sperm, fresh (native) sperm is used, which is donated at the clinic immediately before insemination on the same day, several hours in advance. To carry out insemination, the husband must be examined for at least all sexually transmitted infections.

The child born as a result of such insemination is genetically related to the woman and her husband.

Artificial insemination with donor sperm (AISD)

I believe that before resorting to IVF, it is worth taking the chance of AI with donor sperm (AISD). Why??

It is important to understand that if pregnancy does not occur from insemination with donor sperm, nothing will prevent the use of IVF. If you first go the IVF route and pregnancy does not occur after several attempts, there is a risk that reproductive health And mental condition a woman’s condition will worsen as a result of IVF, and the use of insemination with donor sperm will then turn out to be inappropriate, that is, there will be no other way.

Insemination with donor sperm has advantages relative to IVF/ICSI:

• there are no strong hormonal stimulations that can negatively affect health unborn child,
• transmission to next generations is excluded male infertility(possible transmission during IVF/ICSI has not been studied by medicine),
• There is no risk to the mother's health, unlike the IVF procedure.

IISD are used:

• if the quality of the husband’s sperm is poor (as an alternative to IVF, IVF/ICSI) or the woman does not have a sexual partner/husband.

In this case, the sperm of an anonymous donor from the clinic’s donor sperm bank can be used, or the sperm of a donor you bring yourself - this can be your husband’s closest relative (brother, father), a person you know or barely know, but who agrees to act as a donor.

The child born as a result of such insemination will be genetically related to the woman and the donor, but the real father of the child - officially and in fact - becomes the woman's husband, if she has one. Doctors maintain medical confidentiality, and pregnancy after insemination is managed as normal pregnancy. The donor has no paternity rights or obligations.

More information about donors.

According to the order of the Ministry of Health of the Russian Federation, in order to avoid the transmission of infections, medical institutions are allowed to use only cryopreserved donor sperm, which has been frozen and stored in quarantine for at least six months to detect hidden infections.

Since not every man’s sperm can withstand freezing/thawing without seriously deteriorating its quality, only men whose sperm has this property (cryotolerant) are accepted as anonymous donors.

Anonymous donors are examined for all sexually transmitted infections; the absence of mental disorders and congenital deformities is also mandatory.

Other requirements for anonymous donors depend on the clinic: the most stringent requirements are genetic tests on potential heredity, the presence of 2 healthy children.

Carefully choose a clinic where to have artificial insemination! Clinics search for and attract anonymous donors themselves. The number of donors whose sperm makes up a donor sperm bank can be only 2-3 people, or there can be dozens. General information about the donor is provided on appearance, nationality, blood type, presence of children, education and occupation.

When inseminating with the sperm of a donor you bring yourself, as an exception, fresh sperm, not cryopreserved for six months, can also be used. If artificial insemination is carried out in this mode. The cost of the procedure will be lower, the waiting time will be reduced, and the likelihood of pregnancy after artificial insemination will increase.

To carry out insemination, the donor you bring yourself must be screened for at least all sexually transmitted infections.

Where to do artificial insemination. Official registration

Inseminations are carried out in clinics dealing with reproduction problems, in the same place where IVF is carried out (see list on the website). Insemination is carried out by a reproductive specialist (a separate specialization in gynecology) with the participation of an embryologist involved in sperm preparation.

To carry out artificial insemination, an official agreement is signed with the clinic - consent to insemination, with passport data.

If a woman is officially married, then both the wife and husband sign an official consent to insemination both for insemination with her husband’s sperm and for insemination with donor sperm.

When performing insemination with the sperm of a donor you bring yourself, his official consent is also signed. At the same time, his passport details and the passport details of the spouses or single woman for whom he agrees to become a donor are indicated.

Insemination procedure

Before insemination, a woman should be examined for sexually transmitted infections and an ultrasound should be done to exclude possible gynecological diseases that may be an obstacle to pregnancy or pregnancy.

Insemination is carried out near the time of ovulation - the release of a mature egg from the ovary, approximately in the middle of the menstrual cycle. Ideally, if in the time interval “one day before ovulation - several hours after”, since this is the most favorable time for conception. Although insemination a day or two or three before ovulation can also lead to pregnancy.

In order to determine the time of ovulation with an accuracy of at least one day, and to make sure that the egg is mature, ultrasound monitoring is performed: from the beginning of the menstrual cycle in which AI is supposed to be performed, ultrasounds are performed several times, tracking the functioning of the ovaries and the growth of one or more follicles (ovules). Follicle growth is usually 2 mm/day and ovulation occurs when the follicle reaches a size of 18-22 mm.

In addition to ultrasound, ovulation tests (similar to urine pregnancy tests), sold in pharmacies, are used to accurately determine the time of ovulation.

AI can be performed using hormonal stimulation of the ovaries. Hormonal stimulation is carried out with the same drugs as for IVF (see the page "pharmacology in IVF" >>>), but usually in significantly smaller doses.

Stimulation can produce multiple follicles/eggs and slightly better quality ones, increasing the likelihood of pregnancy. It should be mentioned that drugs with active substance"clomiphene" (clostil, clostilbegit) are outdated drugs with many side effects and less efficiency.

If the follicle/s are pre-ovulatory, an ovulation provocateur - human chorionic gonadotropin (hCG) - may be prescribed.

Two days after ovulation, hormonal support for the second phase of the cycle with the drugs duphaston and utrozhestan can be prescribed, which contributes to the onset and maintenance of pregnancy.

In addition to mature follicles/eggs, an important factor for pregnancy is the thickness of the endometrium in the uterus at the time of ovulation. During ultrasound monitoring, the growth of the endometrium is also monitored, and if the growth is insufficient (at the time of ovulation it should be at least 9 mm), additional hormonal drugs are prescribed to grow the endometrium (estrophem, progynova, divigel).

Inseminations can be carried out without prescribing any medications.

In one menstrual cycle, 1 or 2-3 inseminations can be performed. This depends on whether one or more follicles/eggs mature and when each one ovulates (follicles can ovulate 1-2 days apart) and how accurately the timing of ovulation can be predicted.

In the case of using cryopreserved donor sperm, 2-3 inseminations can be performed at intervals of 24 hours.

When fresh (native) sperm is used, it should be assumed that good sperm quality requires sexual abstinence, ideally 3-5 days. Therefore, insemination is carried out either 1 time - on the day of expected ovulation, or 2 times with an interval of 2-3 days - for example, 2 days before ovulation, and a few hours before or after ovulation. Ultrasound monitoring is carried out until it is determined that ovulation has occurred (!).

Preparing sperm for AI takes about 2 hours: about an hour is spent on the so-called liquefaction, then the sperm must be processed without delay (otherwise its quality deteriorates). Treated sperm can be stored for several hours without losing its quality. If cryopreserved sperm is used, more time is required to defrost the sperm.

The insemination procedure itself (injection of sperm) takes several minutes and is carried out on a gynecological chair.

Sperm is injected through special catheter directly into the uterus. The procedure is painless, you may only feel a slight stretching. After the procedure, you may feel some tension in the uterus (tone) for several hours. After the injection of sperm, you must remain on the chair in the same position for 15 minutes, then you can get up. A little leakage of fluid is normal.

On the day of insemination, you should limit physical exercise and maintain the same regime as on critical days (menstruation). Because insemination directly interferes with the uterus, increasing the risk of infection, greater hygiene and caution must be observed. The mode of life in the following days is without restrictions.

The same doctor, a reproductive specialist, provides consultations, performs ultrasound monitoring, makes all appointments and performs the actual insemination. An embryologist is involved in the storage and preparation of sperm for insemination.

Hormonal support of the second phase of the cycle with utrozhestan and duphaston prevents menstruation from starting, even if pregnancy has not occurred. Therefore, if hormonal support is used, 2 weeks after ovulation you need to take a blood test for pregnancy (blood for hCG).

When negative analysis support is cancelled; if positive, support continues until consultation with a doctor.

Cost of insemination

Artificial insemination. Price. The cost of AI consists of several components: the initial consultation with a doctor, the cost of ultrasound monitoring, the insemination procedure itself, the preparation of sperm for insemination, the cost of donor sperm (if sperm from the clinic’s donor sperm bank is used), the cost of the medications used.

Thus, the cost of insemination depends on the chosen clinic, on whether ovarian stimulation drugs and other drugs are used, and whether a donor sperm bank is used.

In some clinics, when artificial insemination is performed, the price is set as a total price for everything that is performed during the cycle - for ultrasound monitoring and insemination, regardless of whether 1 or 2-3 procedures are required. There are clinics where payment is made for each type of service - separately for ultrasound monitoring, or even for each ultrasound, separately - for each insemination procedure.

Therefore, when finding out the cost of insemination in a given clinic, you should separately ask how much the entire necessary set of services costs.

The cost of donor sperm from a donor sperm bank is paid separately. Medications purchased independently at a clinic or pharmacy, cost modern drugs for stimulation is comparable to the cost of medical services for insemination.

A higher price compared to other clinics for a “kit” or directly for the insemination procedure does not always mean that this clinic has a better result. On average, insemination in clinics in Moscow and St. Petersburg costs several hundred dollars per menstrual cycle.

Artificial insemination. Who got pregnant? Probability of success and possible reasons for failure.

Pregnancy as a result of insemination occurs less frequently than during natural sexual activity in healthy couples, and than during IVF. That is, the probability of pregnancy in one cycle during insemination is less than 30%. Therefore, you should be prepared to carry out at least 3-4 cycles of insemination.

If pregnancy does not occur after 3-4 cycles of insemination, it is recommended to change the treatment method or donor.

This limitation is partly due to the fact that it is undesirable to stimulate the ovaries for more than 3-4 cycles, and partly because there is more effective method- IVF (however more expensive and less harmless to health). However, carry out more than 3-4 cycles of insemination without using ovarian stimulation, simulating natural sex life, may be quite reasonable.

Possible reasons for failure:

a) insemination is not carried out according to indications, there are obstacles to pregnancy,

b) insemination was carried out insufficiently qualified or negligently,

c) bad luck.

More details about each of the reasons:

a) Indications.

If a woman has not undergone fertility testing, it cannot be ruled out that she has diseases that prevent pregnancy. It is also important to understand that a mature and ovulated follicle does not mean that a full-fledged, good-quality egg has matured. If a woman has hormonal disorders, ovarian dysfunction or her age over 35 - possible reason there may be failures poor quality eggs.

It should be noted separately that AISM occurs when sperm counts decrease. To decide whether insemination is advisable, 2-3 spermograms are necessary, since sperm parameters can vary greatly. When preparing sperm for insemination, the embryologist gives an independent opinion on the quality of the sperm and a prognosis to what extent pregnancy is possible - it is important to know this conclusion in order to make a decision about further treatment if pregnancy does not occur.

b) Professionalism of doctors.

The entire scheme of actions for the insemination cycle is described above. Thus, the reason for failure may be:

• delay in sperm preparation,
• low quality of biological media used for sperm processing in this clinic,
• insufficiently accurately determined time of ovulation and carrying out inseminations not at the optimal time, lack of verification that ovulation has occurred, prescription of an ovulation provocateur when the size of the follicle/s is undergrown or overgrown,
• thin (immature) endometrium in the uterus.

If you feel negligence or contradictions in the actions of the doctor, you should think about changing the clinic or doctor.

c) Bad luck.

If you do not find the reasons for failure in reasons a) and b) and have only completed 1-2 cycles of inseminations, most likely you are simply unlucky yet.

You can use ovarian stimulation if it was absent, change stimulation drugs, perform 2-3 inseminations in a cycle, if only 1 was performed, increase the time of sexual abstinence of a man before sperm donation (up to 5 days). The absence of pregnancy for even several cycles of inseminations does not mean that a woman cannot become pregnant during natural sexual activity with a healthy man.

Based on the information collected and the experience of those who have gone through insemination, consultations with many fertility doctors, try to understand whether it is worth resorting to AI in your case and how to do all this. AI may be your chance!

Send us your successful stories! They will give real hope to those who are hesitant, doubtful or afraid of failure!

The problem of infertility in married couples is not necessarily associated with malfunction reproductive system from one of the partners. There are many cases in which a woman does not have significant health problems, and the analysis of male spermogram is far from ideal. Or, on the contrary, a man is able to conceive a child naturally, but his partner’s body produces anti-sperm antibodies, which prevent them from conceiving and bearing a child naturally.

Problems of this kind have practically no impact on the general state of health, but at the same time they do not allow the couple to become happy parents. And this or that deviation is not always amenable to successful treatment. In such cases, people are forced to resort to the procedure of artificial insemination, which has been successfully carried out in our clinic for several years.

In the vast majority of cases, it is possible to solve the problem of infertility using a simple and relatively inexpensive procedure of artificial insemination, or, in other words, artificial insemination. This type artificial insemination should be carried out exclusively an experienced doctor, whom you trust. Doctor Lazarev Alexander Pavlovich, author of thirty scientific works in the field of treatment various forms infertility, has already helped more than 1,500 married couples experience the joy of the birth of a long-awaited baby. Our clients will be offered an individual treatment regimen depending on the form of infertility, and multidisciplinary consultations and medical procedures are carried out in rooms and laboratories equipped according to world standards.

Types of artificial insemination

Today, several types of artificial insemination are practiced, which differ in the method and location of introducing sperm into the patient’s body:

• vaginal;
• uterine;
• intracervical;
• intrauterine;
• intrafollicular;
• intracavitary.

In some cases, the ejaculate can be delivered to the fallopian tubes (perfusion). However, the most famous and frequently used method of artificial insemination is intrauterine.

What is Artificial Insemination?

Artificial insemination is one of the most common and available ways conceiving a child, which consists of delivering pre-prepared male sperm directly into the uterine cavity of the expectant mother. This procedure differs from IVF and ICSI methods in that in this case fertilization does not occur in laboratory conditions, but in the woman’s body itself.

Chances of attack desired pregnancy when carrying out Artificial insemination is much higher than when trying to conceive a baby naturally. This is explained by the fact that during the procedure, male ejaculate undergoes special processing and, using special instruments, is placed directly into the uterine cavity. Thus, the task of sperm is much simpler - they reach the goal much faster and meet the egg. In this case, it does not matter if sperm motility is somewhat reduced and their number does not correspond to the norm.

Indications for artificial insemination: men

Artificial insemination is indicated for men who have following problems reproductive sphere:

• insufficient volume of sperm released;
• decreased ability of sperm to fertilize an egg;
• premature or late ejaculation;
• sexual disorders of various types, including impotence;
• consequences of chemotherapy in the treatment of tumors;
• increased viscosity of ejaculate;
• the need to freeze male biomaterial.

Indications for artificial insemination: women

If problems are diagnosed on the part of a woman, then these are usually:

• involuntary spasms of the vagina and uterus during sexual intercourse;
• lack of ovulation;
• production of antisperm antibodies by the cervix;
• infections and inflammations of the internal genital organs;
• increased level of acidity in the vagina;
• irregular structure reproductive organs;
• allergic reactions to ejaculate;
• history of surgical interventions in the uterine area;
• unknown causes of infertility in a couple.

Important! In order to be able to carry out the artificial insemination procedure, a woman’s fallopian tubes must be patent and the quality of the processed ejaculate must be high.

The probability of fertilization in a woman under 30 years of age is slightly higher than in older late age. If the partner’s spermogram has an unsatisfactory result, it is recommended to use donor material for conception.

Who is Artificial Insertion contraindicated for?

Unfortunately, not all patients are indicated for artificial insemination. Such contraindications include:

1. Various psychical deviations in a patient in whom it is not possible to conceive and bear a healthy child.
2. Diseases and abnormalities in the development of the uterus, since bearing a fetus becomes impossible.
3. Neoplasms in the ovarian region.
4. Malignant formations in a woman’s body.
5. Inflammatory processes.

Benefits of artificial insemination

Despite the simplicity and relative accessibility of this manipulation, this method artificial insemination has a fairly high percentage of effectiveness. Because the male sperm placed directly into the uterine cavity, thereby avoiding many of the problems that Everyday life interfered with the fertilization process:

1. There is no effect of the secretion that is produced by the woman’s cervix and contributes to the retention and passage of sperm through the genital tract.
2. It becomes possible to control the ovulation process, and also ensures the fusion of female and male germ cells in the required period of time.
3. The sperm is pre-processed in a laboratory, which improves its quality several times and increases the likelihood of pregnancy in a woman compared to normal sexual intercourse.
4. Low cost - this method artificial conception is considered one of the most accessible today.
5. The consequences for the patient’s body after the procedure are minimized.
6. The manipulation itself is a simple process and does not require lengthy preparation.
7. Quite a high performance.

Conditions for artificial insemination

In order for this method to give the required result, the following requirements must be met:

• the woman should not have problems with the patency of the fallopian tubes;
• there should be no pathologies in the uterine cavity;
• the quality of the partner’s sperm is satisfactory;
• the supply of follicles in a woman’s body must be sufficient;
• The married couple has no contraindications to the IVF procedure.

Before proceeding with the artificial insemination procedure, the couple must be fully examined for general condition body. Then the male biomaterial is prepared, cleaned, and the woman is monitored and monitored for ovulation in the current cycle. After which the AI ​​procedure itself is performed - intrauterine fertilization of the egg with the sperm of a donor or the patient’s partner.

The process of preparing partners for the procedure can take up to several months. A man needs to have a spermogram analyzed, and a woman needs to have an ultrasound of the pelvic organs, check the fallopian tubes for patency, and be tested for various sexually transmitted infections, HIV, hepatitis and syphilis. As a rule, both spouses are recommended to drink alcohol three months before the expected conception. multivitamin complex, adjust your weight if necessary and stop smoking cigarettes and drinking alcoholic beverages.

Many childless couples ask the question: “What is insemination and how does the procedure work?” In some cases, the woman undergoes additional stimulation for the purpose of maturation more eggs. In the process of sperm purification, the highest quality and active sperm are cultivated from it, and the sperm itself is purified from seminal plasma. The artificial insemination procedure itself is carried out within the walls of the clinic, in an office equipped with everything necessary, under completely sterile conditions.

The process of artificial insemination

How does fertilization occur during insemination? Artificial insemination is prescribed for the period when a woman is about to ovulate. Artificial insemination is carried out by a fertility doctor and embryologist, who takes care of the cleaning and preparation of male ejaculate. Before starting the manipulation, it is necessary to conclude an agreement with medical institution. If a married woman wishes to use donor material, the written consent of her husband will be additionally required. In order to carry out AI, the specialist will need the following medical instruments: tweezers, a syringe, a speculum, a catheter with processed sperm and sterile cotton wool.

A woman is invited to an office equipped with a gynecological chair and is placed in horizontal position- the patient’s pelvis should be slightly elevated. In this position, the doctor, using a special instrument, places the sperm of the partner or donor under pressure directly into the uterine area. The manipulation lasts about two to three minutes. After the procedure, it is best for the woman to remain quiet for a while, 30-40 minutes, and then she can leave the walls of the medical facility.

Typically, the AI ​​procedure is carried out three times during the current cycle in order to increase its effectiveness. If the cycle does not end with menstruation, then around the 18th day the woman is asked to take a pregnancy test.

Important! Before visiting a doctor, it is prohibited to perform any vaginal douching, as well as various manual examinations.

Chances of success

Statistically, to achieve desired result When using the artificial insemination method, several attempts are required. As for the financial side of the issue, such manipulation costs are approximately equal to one IVF procedure. That is why, if your partner’s sperm quality is not very high, and your own ability to conceive does not inspire strong confidence, it is recommended to immediately carry out the most effective in vitro fertilization procedure.

In general, the likelihood of a successful outcome is determined by several factors:

• the true cause of infertility;
• age of future parents;
• period of infertility;
• number of treatment cycles;
• quality of male ejaculate.

In order to increase the likelihood of a long-awaited pregnancy, you should this procedure according to strict indications, take an additional sperm test for DNA and an NVA test.

Stages of the artificial insemination method, indications, preparation, chances of getting pregnant

Of all the ART methods, the closest to natural process conception is only artificial insemination (AI). The cost of this procedure compared to IVF is attractive, but it is not suitable for everyone.

lasts longer than IVF itself. It is made in reproductive centers Worldwide. Much experience has been accumulated in the methodology, and therefore it is widely used and brings the expected results.

The essence of AI is the introduction of purified sperm into the genital organs (internal) of a woman.

Historically, four options for insemination at the site of delivery of male germ cells have been formed:

• In the vagina, closer to the cervix. Now this method is called “artificial insemination at home.” The effectiveness of the option is questionable, but there are women who managed to get pregnant this way.

• Directly into the cervix. Nowadays it is used extremely rarely due to lack of effectiveness.

• Into the uterine cavity. Today, this is the most used and effective method of artificial insemination. About him and we'll talk further.

• Into the fallopian tubes.

As with all patients requiring reproductive assistance, when performing AI, doctors comply with individual approach. Indications, contraindications and physiological capabilities of the organisms of future parents are taken into account.

Therefore, artificial intrauterine insemination can take place in different ways:

• With drug stimulation ovaries (efficiency increases, since 2-3 eggs mature at once in one cycle);
• without stimulation - in a natural cycle.

Based on their sperm characteristics, it can be recommended.

For single women, clinics provide a special program, according to which the procedure is carried out for those who want to conceive, give birth and raise a child on their own (without the participation of a man).

Artificial insemination: indications

AI can be carried out with male and female factors.

For women, the indications for artificial insemination are as follows:

• infertility of unknown origin;
• endocervicitis;
• sexual disorder – vaginismus – a condition in which natural sexual contact is impossible;
• abnormal locations of the uterus;
• immunological incompatibility - the presence of antisperm antibodies in the mucus of the cervical canal;
• violation of ovulatory function;
• a woman's desire to become pregnant without intercourse.

Indications for artificial insemination for men:

• impotence or lack of ejaculation;
• male subfertility – decreased sperm activity;
• retrograde ejaculation - sperm is thrown into the bladder during ejaculation;
• small volume of ejaculate;
• increased sperm viscosity;
• hypospadias – congenital abnormal structure of the urethra;
• chemotherapy.

AI Stages

Despite its mechanical simplicity, AI is a delicate and responsible work of a team of specialists - a gynecologist-reproductologist, clinic laboratory staff, and doctors of related specialties. The methodology involves a step-by-step and sequential approach.

Stages of artificial insemination:

• Examination. At this stage, a thorough study of the health status of both partners, the identified causes of infertility is carried out, and a strategy for the procedure is determined.

• Treatment. When identifying any somatic and infectious diseases they are treated. Doctors take measures to improve the condition of a woman’s body, ensure pregnancy and avoid possible complications during childbirth and pregnancy itself. If necessary, treatment is prescribed to a man to improve sperm quality.

• If the preparation plan provides for a stimulating effect on the ovaries, a hormonal simulation is performed.

• Direct artificial insemination.

• Determination of pregnancy by hCG monitoring. In the absence of pregnancy, the procedure, according to regulatory documents, is repeated up to 6–8 times. Although recently experts have come to the conclusion that if 3 attempts at AI were unsuccessful, then it is necessary to change tactics and consider the possibility of performing artificial insemination in a different way. For example, IVF, ICSI, PIXI, IMSI.

Preparing for artificial insemination

The effectiveness of artificial insemination depends on how accurate the diagnosis is. At this stage, doctors decide whether stimulation is needed and how to clean the sperm.

A woman's preparation includes:

• detailed medical examination by a gynecologist, therapist, endocrinologist, cardiologist;
• tests;
• ultrasonic monitoring;
• treatment of detected chronic diseases, including infections and inflammations of the genital organs;
• study of the menstrual cycle (needed to determine the cyclicity and regularity of ovulation);
• and state inner shell uterus;
• after treatment, control tests are taken;
• drug stimulation of the ovaries.

Depending on the individual characteristics for a married couple it can take anywhere from a few weeks to six months.

Preparing a man:

• consultation with a urologist;
• tests for sexually transmitted infections;
• analysis of prostate secretion;
• Additionally, prostate massage may be prescribed;
• treatment and correction of identified disorders.

On what day of the cycle is artificial insemination performed?

Carrying out artificial insemination is effective only in the periovulatory period - these are several days of the cycle during which the release of an egg (or eggs during stimulation) from the follicle is possible. Therefore, the phases of the menstrual cycle are monitored first. To do this you can measure rectal temperature and build charts, use ovulation tests. But most precise method control over the development and maturation of the egg is ultrasound. Therefore after critical days Ultrasound is performed quite often, every 1–3 days. The frequency of ultrasound may vary. The higher the degree of maturity of the female reproductive cell, the more often an ultrasound is performed (in order not to miss ovulation and to determine on what day of the cycle artificial insemination should begin).

The ideal option is to introduce sperm into the uterus during the periovulatory period 1–3 times. The first time it is administered a day - two days before ovulation, the second - directly on the day of ovulation. And if several follicles mature in the ovaries, they can burst at intervals of 1–2 days. Then the sperm is injected again. This increases the efficiency of the procedure as a whole.

One of the determining factors on which day of the cycle to perform artificial insemination is the origin of the sperm. If used, then it can be administered based only on ovulation. If fresh (native) sperm is used, then take into account the fact that high quality There can be sperm only if you abstain for at least 3 days. Therefore, sperm can be injected immediately after ovulation. It does not harm, as it has been proven to be viable for up to 7 days.

How does artificial insemination work?

On the appointed day, the couple arrives at the clinic. A woman undergoes an ultrasound. A man gives a sperm sample. Sperm cannot be introduced into the uterine cavity immediately without prior preparation. This is fraught anaphylactic shock. This species is developing allergic reaction quite rare, but its course threatens the patient’s life. Sperm preparation (purification and concentration of the viable fraction) takes about two hours.

How is artificial insemination performed? Quickly, painlessly, under sterile conditions. You don't have to worry about this. And the sensations will be minimal - only at the moment the flexible thin catheter passes the cervical canal of the uterus.

The woman moves into the gynecological chair. Speculums provide access to the cervix. Prepared spermatozoa along with the medium are drawn into a syringe and connected to a catheter. With a slight movement of the catheter, they penetrate the uterine cavity and carefully inject the prepared suspension of the “best” sperm from a syringe. On the first day - that's it. The manipulation is completed. And the woman remains in a horizontal position for 15–25 minutes. After which he returns to everyday life.

IN certain deadlines the manipulation is repeated 1–2 more times. Follicle monitoring continues until ovulation. And after two weeks, the effectiveness of insemination is assessed - the level of the pregnancy hormone - human chorionic gonadotropin - is determined. If pregnancy is not confirmed, AI is repeated in the next cycle.

Efficiency and chances of getting pregnant

The chance of getting pregnant with artificial insemination is higher in women under 30 years of age, with patency of both fallopian tubes and normal ovulatory function. The average effectiveness of one procedure is 18%. This is slightly more than during natural sexual intercourse. The quality of the sperm used plays a significant role in the positive outcome of AI.

Some fertility clinics claim success rates as high as 28%.

Seventy-eight percent of women succeed in becoming pregnant in the first three cycles of insemination. The effectiveness of subsequent procedures decreases sharply. That is why doctors rationally change the tactics of artificial insemination and recommend other IVF methods after three attempts at insemination.

It should also be mentioned that the chances of artificial insemination increase in stimulated cycles.