Artificial insemination

Artificial insemination (AI) is the process by which sperm is placed into the reproductive tract of a female for the purpose of impregnating the female by using means other than sexual intercourse. In humans, it is used as assisted reproductive technology, primarily to treat infertility but is also increasingly used to enable women without a male partner (i.e., single women and lesbians) to produce children by using sperm provided by a sperm donor. The woman is the gestational and genetic mother of the child produced, and the sperm donor is the genetic or biological father of the child.

Specifically, in artificial insemination, freshly ejaculated sperm, or sperm which has been frozen and thawed, is placed in the cervix (intracervical insemination) (ICI)) or in the female's uterus (intrauterine insemination) (IUI) by artificial means.

Modern techniques for human artificial insemination were first developed for the dairy cattle industry to allow many cows to be impregnated with the sperm of a bull with traits for improved milk production.
Preparations

A sperm sample will be provided by the male partner of the woman undergoing artificial insemination, but sperm provided through sperm donation by a sperm donor may be used if, for example, the woman's partner produces too few motile sperm, if he carries a genetic disorder, or if the woman has no male partner. Sperm is usually obtained through masturbation or the use of an electrical stimulator, although a special condom, known as a collection condom, may be used to collect the semen during intercourse.

The man providing the sperm is usually advised not to ejaculate for two to three days before providing the sample in order to increase the sperm count.

A woman's menstrual cycle is closely observed, by tracking basal body temperature (BBT) and changes in vaginal mucous, or using ovulation kits, ultrasounds or blood tests.

When using intrauterine insemination (IUI), the sperm must immediately be “washed” in a laboratory and concentrated in Hams F10 media without L-glutamine, warmed to 37C. (Adams, Robert, M.D."invitro fertilization technique", Monterey, CA, 1988). The process of “washing” the sperm increases the chances of fertilization and removes any mucus and non-motile sperm in the semen. Pre and post concentration of motile sperm is counted.

If sperm is provided by a sperm donor through a sperm bank, it will be frozen and quarantined for a particular period and the donor will be tested before and after production of the sample to ensure that he does not carry a transmissible disease. Sperm samples donated in this way are produced through masturbation by the sperm donor at the sperm bank. A chemical known as a cryoprotectant is added to the sperm to aid the freezing and thawing process. Further chemicals may be added which separate the most active sperm in the sample as well as extending or diluting the sample so that vials for a number of inseminations are produced.

Procedure

When an ovum is released, semen provided by the woman's male partner, or by a sperm donor who is a fertile male who is unrelated to, and may be unknown by, the woman, is inserted into the woman's vagina or uterus. The semen may be fresh or it may be frozen semen which has been thawed. Where donor sperm is supplied by a sperm bank, it will always be quarantined and frozen and will need to be thawed before use. In the case of vaginal artificial insemination, semen is usually placed in the vagina by way of a needleless syringe. A longer tube, known as a 'tom cat' may be attached to the end of the syringe to facilitate deposit of the semen deeper into the vagina. The woman is generally advised to lie still for a half hour or so after the insemination to prevent seepage and to allow fertilization to take place. An alternative method involves the placing of partner or donor sperm in the woman's vagina by means of a specially designed cervical cap, a conception device, which holds the semen in place for a period of time, usually for several hours, to allow fertilization to take place. Using this method, a woman may go about her usual activities while the cervical cap holds the semen in the vagina. A more efficient method of artificial insemination is to insert semen directly into the woman's uterus IUI. Where this method is employed only 'washed' semen may be used and this is inserted by means of a catheter. Specially designed equipment is available for carrying out artificial inseminations. Semen is occasionally inserted twice within a 'treatment cycle'. If the procedure is successful, the woman will conceive and carry to term a baby. A pregnancy resulting from artificial insemination will be no different from a pregnancy achieved by sexual intercourse. However, there may be a slight increased likelihood of multiple births if drugs are used by the woman for a 'stimulated' cycle.

Donor variations

Either sperm provided by the woman's husband or partner (artificial insemination by husband, AIH) or sperm (known as "donor sperm") provided by a known or anonymous sperm donor (artificial insemination by donor, AID or DI) can be used.

Earlier, a popular form of artificial insemination was AIC, in which the sperm of the husband and a donor were mixed. The advantage of this stated that the husband was not the biological father of the child.[citation needed] This was important in an age where artificial insemination was considered to be immoral and tantamount to adultery, with the resulting child being considered as illegitimate and having no inheritance rights.[citation needed] The popularity of AIC has reduced to almost nil for a number of reasons, including advances in genetic testing which make it fairly easy to identify the genetic father with a blood test, the advance of medical treatments for male infertility (such as ICSI), and the declining stigma of assisted reproductive technologies in general.

Techniques

The main techniques used are:

* Intracervical insemination (ICI), the easiest way to inseminate, where semen is injected high into the cervix with a needle-less syringe
* Intrauterine insemination (IUI), where sperm is injected directly into a woman's uterus

Insemination may also be performed into the Fallopian tube although this procedure is no longer generally regarded as having any beneficial effect compared with IUI [1]

See also in vitro fertilisation (IVF) techniques which may involve the use of partner or donor sperm.

Intracervical insemination

ICI is the easiest way to inseminate, where semen is injected high into the cervix with a needle-less syringe. This process most closely replicates the way in which semen is deposited by the penis in the cervix or fornix when the male ejaculates during vaginal intercourse. It is the simplest method of artificial insemination and 'unwashed' or raw semen may be used. It is probably therefore, the most popular method and is used in most home, self and practitoner inseminations, However, more technical procedures may be used which increase the chances of conception.

Intrauterine insemination

'Washed sperm', that is, spermatozoa which have been removed from most other components of the seminal fluids, can be injected directly into a woman's uterus in a process called intrauterine insemination (IUI). If the semen is not washed it may elicit uterine cramping, expelling the semen and causing pain, due to content of prostaglandins. (Prostaglandins are also the compounds responsible for causing the myometrium to contract and expel the menses from the uterus, during menstruation.)

To have optimal chances with IUI, the female should be under 30 years of age, and the man should have a TMS of more than 5 million per ml.[2] In practice, donor sperm will satisfy these criteria. A promising cycle is one that offers two follicles measuring more than 16mm, and estrogen of more than 500 pg/mL on the day of hCG administration.[2]

intratubal insemination

IUI can furthermore be combined with intratubal insemination (ITI), into the Fallopian tube although this procedure is no longer generally regarded as having any beneficial effect compared with IUI [1] ITI however, should not be confused with gamete intrafallopian transfer, where both eggs and sperm are mixed outside the woman's body and then immediately inserted into the Fallopian tube where fertilization takes place.


and this a video show you how it works