Artificial insemination

Artificial insemination, or 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 intercourseor NI. In humans, it is used as assisted reproductive technology, using either sperm from the woman's male partner or sperm from a sperm donor (donor sperm) in cases where the male partner produces no sperm or the woman has no male partner (i.e., single women and lesbians). In cases where donor sperm is used 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. Artificial insemination is widely used for livestock breeding, especially for dairy cattle and pigs. Techniques developed for livestock have been adapted for use in humans. Specifically, freshly ejaculated sperm, or sperm which has been frozen and thawed, is placed in the cervix (intracervical insemination ICI) or, after washing, into the female's uterus (intrauterine insemination IUI) by artificial means. In humans, artificial insemination was originally developed as a means of helping couples to conceive where there were 'male factor' problems of a physical or psychological nature affecting the male partner which prevented or impeded conception. Today, the process is also and more commonly used in the case of choice mothers, where a woman has no male partner and the sperm is provided by a sperm donor.

In humans
[edit]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, or 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 mucus, or using ovulation kits, ultrasounds or blood tests. When using intrauterine insemination (IUI), the sperm must have been washed in a laboratory and concentrated in Hams F10 media without L-glutamine, warmed to 37C.
[1]

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. For fresh shipping, a semen extender is used. If sperm is provided by a private donor, either directly or through a sperm agency, it is usually supplied fresh, not frozen, and it will not be quarantined. Donor sperm provided in this way may be given directly to the recipient woman or her partner, or it may be transported in specially insulated containers. Some donors have their own freezing apparatus to freeze and store their sperm. Private donor sperm is usually produced through masturbation, but some donors use a collection condom to obtain the sperm when having sexual intercourse with their own partners. [edit]Procedure When an ovum is released, semen provided by the woman's male partner, or by a sperm donor, 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. Specially designed equipment is available for carrying out artificial inseminations. 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. A more efficient method of artificial insemination is to insert semen directly into the woman's uterus. Where this method is employed it is important that only 'washed' semen be used and this is inserted into the uterus by means of a catheter. Sperm banks and fertility clinics usually offer 'washed' semen for this purpose, but if partner sperm is used it must also be 'washed' by a medical practitioner to eliminate the risk of cramping. Semen is occasionally inserted twice within a 'treatment cycle'. A double intrauterine insemination has been theorized to increase pregnancy rates by decreasing the risk of missing the fertile windowduring ovulation. However, a randomized trial of insemination after ovarian hyperstimulation found no difference in live birth rate between single and double intrauterine insemination.
[2]

An alternative method to the use of a needless syringe or a catheter involves the placing of partner or donor sperm in the woman's vagina by means of a specially designed cervical cap, a conception device or conception cap. This holds the semen in place near to the entrance to the cervix 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. One advantage with the conception device is that fresh, non-liquified semen may be used. 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. [edit]Donor

variations

Either sperm provided by the woman's husband or partner (artificial insemination by husband, AIH) or sperm provided by a known or anonymous sperm donor (artificial insemination by donor, AID or DI) can be used. [edit]Techniques Intrauterine insemination, Intravaginal insemination, Intracervical insemination, and Intratubal insemination [edit]Intracervical insemination ICI is the easiest way to inseminate. This involves the deposit of raw fresh or frozen semen (which has been thawed) by injecting it high into the cervix with a needle-less syringe. This process closely replicates the way in which fresh semen is directly deposited on to the neck of the cervix by the penis during vaginal intercourse. When the male ejaculates, sperm deposited this way will quickly swim into the cervix and toward the fallopian tubes where an ovum recently released by the ovary(s) hopefully awaits fertilization. It is the simplest method of artificial insemination and 'unwashed' or raw semen is normally used. It is probably therefore, the most popular method and is used in most home, self and practitioner insemination procedures. Timing is critical as the window and opportunity for fertilization, is little more than 12 hours from the release of the ovum. For each woman who goes through this process be it AI (artificial insemination) or NI (natural insemination); to increase chances for success, an understanding of her rhythm or natural cycle is very important. Home ovulation tests are now available. Doing and understanding Basal Temperature Tests over several cycles; there is a slight dip and quick rise at the time of ovulation. She should note the color and texture of her vaginal mucous discharge. At the time of ovulation the protective cervical plug is released giving the vaginal discharge a stringy texture with an egg white color. A woman may also be able check the softness of the nose of her cervix by inserting two fingers. It should be considerably softer and more pliable than normal. Advanced technical (medical) procedures may be used to increase the chances of conception. When performed at home without the presence of a professional this procedure is sometimes referred to as intravaginal insemination or IVI.
[3]

[edit]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.) The woman should rest on the table for 15 minutes after an IUI to optimize the pregnancy rate.
[4]

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.
[5]

In practice, donor sperm will satisfy these criteria. A promising cycle is one that offers

two follicles measuring more than 16 mm, and estrogen of more than 500 pg/mL on the day of hCG administration.
[5]

A short period of ejaculatory abstinence before intrauterine insemination is associated with However, GnRH agonist administration at the time of implantation does not improve
[7]

higher pregnancy rates.

[6]

pregnancy outcome in intrauterine insemination cycles according to a randomized controlled trial.

It can be used in conjunction with ovarian hyperstimulation. Still, advanced maternal age causes decreased success rates; Women aged 3839 years appear to have reasonable success during the first two cycles of ovarian hyperstimulation and IUI. However, for women aged 40 years, there appears to be no benefit after a single cycle of COH/IUI.
[8]

It is therefore recommended to consider in vitro fertilization after one failed COH/IUI cycle for women aged

40 years.

[8]

[edit]Intrauterine tuboperitoneal insemination Intrauterine tuboperitoneal insemination (IUTPI) is insemination where both the uterus and fallopian tubes are filled with insemination fluid. The cervix is clamped to prevent leakage to the vagina, best achieved with the specially designed Double Nut Bivalve (DNB) speculum. The sperm is mixed to create a volume of 10 ml, sufficient enough to fill the uterine cavity, pass through the interstitial part of the tubes and the ampulla, finally reaching the peritoneal cavity and the Pouch of Douglas where it would be mixed with the peritoneal and follicular fluid. IUTPI can be useful in unexplained infertility, mild or moderate male infertility, and mild or moderate endometriosis. [edit]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.
[10] [9]

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. [edit]Pregnancy

rate

Success rates, or pregnancy rates for artificial insemination may be very misleading, since many factors including the age and health of the recipient have to be included to give a meaningful answer, e.g. definition of success and calculation of the total population.
[11]

For couples with unexplained infertility, unstimulated IUI is no more effective

than natural means of conception.

[12][13]

Approximate pregnancy rate as a function oftotal sperm count (may be twice as large as total motile sperm count). Values are for intrauterine insemination. (Old data, rates are likely higher today)[citation needed]
[14] [14][unreliable source?]

Generally, it is 10 to 15% per menstrual cycle using ICI, and about 60 to 70% have achieved pregnancy after 6 cycles.
[15]

and 15-20% per cycle for IUI.

In IUI,

As seen on the graph, the pregnancy rate also depends on the total sperm count, or, more specifically, the total motile sperm count (TMSC), used in a cycle. It increases with increasing TMSC, but only up to a certain count, when other factors become limiting to success. The summed pregnancy rate of two cycles using a TMSC of 5 million (may be a TSC of ~10 million on graph) in each cycle is substantially higher than one single cycle using a TMSC of 10 million. However, although more cost-efficient, using a lower TMSC also increases the average time taken before getting pregnant. Women whose age is becoming a major factor in fertility may not want to spend that extra time. [edit]Samples

per child

How many samples (ejaculates) that are required give rise to a child varies substantially from person to person, as well as from clinic to clinic. However, the following equations generalize the main factors involved: For intracervical insemination:

N is how many children a single sample can give rise to. Vs is the volume of a sample (ejaculate), usually between 1.0 mL and 6.5 mL[16] c is the concentration of motile sperm in a sample after freezing and thawing, approximately 5-20 million per
ml but varies substantially

rs is the pregnancy rate per cycle, between 10% to 35% [17] [14] nr is the total motile sperm count recommended for vaginal insemination (VI) or intra-cervical insemination
(ICI), approximately 20 million pr. ml.
[18]

The pregnancy rate increases with increasing number of motile sperm used, but only up to a certain degree, when other factors become limiting instead.
Derivation of the equation (click at right to view)[show]

Approximate live birth rate (rs) among infertile couples as a function of total motile sperm count(nr). Values are for intrauterine insemination.[citation needed]

With these numbers, one sample would on average help giving rise to 0.1-0.6 children, that is, it actually takes on average 2-5 samples to make a child. For intrauterine insemination (IUI), a centrifugation fraction (fc) may be added to the equation: fc is the fraction of the volume that remains after centrifugation of the sample, which may be about half (0.5) to a third (0.33).

On the other hand, only 5 million motile sperm may be needed per cycle with IUI (nr=5 million) Thus, only 1-3 samples may be needed for a child if used for IUI. [edit]History In the 1970s, direct intraperitoneal insemination (DIPI) was occasionally used, where doctors

[17]

injected sperm into the lower abdomen through a surgical hole or incision, with the intention of letting them find the oocyte at the ovary or after entering the genital tract through the ostium of the fallopian tube.
[19]

1. 2.

^ Adams, Robert, M.D."invitro fertilization technique", Monterey, CA, 1988 ^ Bagis T, Haydardedeoglu B, Kilicdag EB, Cok T, Simsek E, Parlakgumus AH (May 2010). "Single versus double intrauterine insemination in multi-follicular ovarian hyperstimulation cycles: a randomized trial". Hum Reprod 25 (7): 168490. doi:10.1093/humrep/deq112. PMID 20457669.

3. 4.

^ European Sperm Bank USA ^ Laurie Barclay. "Immobilization May Improve Pregnancy Rate After Intrauterine Insemination". Medscape Medical News. Retrieved October 31, 2009.

5.

^ a b Merviel P, Heraud MH, Grenier N, Lourdel E, Sanguinet P, Copin H (November 2008). "Predictive factors for pregnancy after intrauterine insemination (IUI): An analysis of 1038 cycles and a review of the literature". Fertil. Steril. 93 (1): 7988. doi:10.1016/j.fertnstert.2008.09.058. PMID 18996517.

6.

^ Marshburn PB, Alanis M, Matthews ML, et al. (September 2009). "A short period of ejaculatory abstinence before intrauterine insemination is associated with higher pregnancy rates". Fertil. Steril. 93 (1): 286 8. doi:10.1016/j.fertnstert.2009.07.972. PMID 19732887.

7.

^ Bellver J, Labarta E, Bosch E, et al. (June 2009). "GnRH agonist administration at the time of implantation does not improve pregnancy outcome in intrauterine insemination cycles: a randomized controlled trial". Fertil. Steril. 94 (3): 1065 71. doi:10.1016/j.fertnstert.2009.04.044. PMID 19501354.

8.

^ a b Harris, I.; Missmer, S.; Hornstein, M. (2010). "Poor success of gonadotropin-induced controlled ovarian hyperstimulation and intrauterine insemination for older women". Fertility and sterility 94 (1): 144 148. doi:10.1016/j.fertnstert.2009.02.040. PMID 19394605. edit

9.

^ Leonidas Mamas, M.D.,Ph.D (March 2006). "Comparison of fallopian tube sperm perfusion and intrauterine tuboperitoneal insemination:a prospective randomized study". Fertility and Sterility Journal 85(3): 735 740. doi:10.1016/j.fertnstert.2005.08.025. PMID 16500346.

10. ^ Hurd WW, Randolph JF, Ansbacher R, Menge AC, Ohl DA, Brown AN (February 1993). "Comparison of intracervical, intrauterine, and intratubal techniques for donor insemination". Fertil. Steril. 59 (2): 33942. PMID 8425628. 11. ^ IVF.com 12. ^ Fertility treatments 'no benefit'. BBC News, 7 August 2008 13. ^ Bhattacharya S, Harrild K, Mollison J, et al. (2008). "Clomifene citrate or unstimulated intrauterine insemination compared with expectant management for unexplained infertility: pragmatic randomised controlled trial". BMJ 337: a716. doi:10.1136/bmj.a716. PMID 18687718. 14. ^ a b c Utrecht CS News Subject: Infertility FAQ (part 4/4) 15. ^ Intrauterine insemination. Information notes from the fertility clinic at Aarhus University Hospital, Skejby. By PhD Ulrik Kesmodel et al. 16. ^ Essig, Maria G.; Edited by Susan Van Houten and Tracy Landauer, Reviewed by Martin Gabica and Avery L. Seifert (2007-02-20). "Semen Analysis". Healthwise. WebMD. Retrieved 2007-08-05. 17. ^ a b Cryos International - What is the expected pregnancy rate (PR) using your donor semen? 18. ^ Cryos International - How much sperm should I order? 19. ^ Oral Sex, a Knife Fight and Then Sperm Still Impregnated Girl. Account of a Girl Impregnated After Oral Sex Shows Sperms' Incredible Survivability By LAUREN COX. abcNEWS/Health Feb. 3, 2010

20. ^ The Jockey Club has never allowed artificial insemination. 21. ^ 1981 Wolf Foundation Prize in Agriculture 22. ^ John O. Almquist Dairy Breeding Research Center

Artificial insemination
Provides information on artificial insemination techniques.

By Dr. Marcus | Last Updated February 14, 2010 9:53 PM GMT

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Artificial insemination is a term that covers a range of techniques of placing sperm into the female genital tract. Such inseminations may include intravaginal insemination, intracervical insemination, intrauterine insemination, intraFallopian insemination and intraperitoneal insemination, where sperm are placed inside the pelvis near the mouth of the Fallopian tubes and ovaries). The most commonly used techniques are intrauterine insemination followed by intracervical and intravaginal insemination. Artificial insemination may use the husbands sperm (AIH) or donor sperm (AID).
Who might benefit from insemination?

There are selected groups of patients to whom sperm donation is recommended.

Men who are unable to ejaculate inside their wifes vagina for whatever reasons. This is the classical indication. Causes for ejaculation failure include diabetes, multiple sclerosis, spinal cord injury and retrograde ejaculation, where sperm are released backward into the bladder instead of urethra. Retrograde ejaculation may be due to diabetes, trauma or operation in the bladder neck or a side effect of certain drugs.

Men with mildly low sperm count, poor quality sperm or antisperm antibodies. Men who wish to freeze their sperm for possible future use before vasectomy, chemotherapy orradiotherapy for cancer. Women with mild endometriosis. Women with cervical mucus hostility or poor cervical mucus. Couples with unexplained infertility.

Some infertility clinics may offer intrauterine insemination of a HIV negative woman with washed and prepared sperm of her HIV positive husband/partner.
Evaluation of couples seeking insemination treatment

The doctor will review in depth the medical history, perform physical and internal examination. The husband or male partner will be asked to produce a semen sample for semen analysis and MAR test to check for the presence or absence of antisperm antibodies. Some infertility clinics will only accept couple for treatment if both partners have negative screen for HIV (AIDS) Hepatitis B and Hepatitis C. The female partner may also be tested for immunity to German Measles (rubella). Your doctor may also recommend a hysterosalpingogram, laparoscopy or Hy-Co-Sy before insemination to check for tubal obstruction. A blood test to check for ovulation

Intravaginal insemination
This is very rarely performed, but still has a place for couples in whom the females partner ovulates regularly. The male partner is unable to ejaculate into his wifes vagina but can ejaculate by other means such as by masturbation or by using a penile vibrator and the sperm count and quality are good. Timing of intravaginal insemination The precise timing of insemination is important. Inseminations should be timed to occur around ovulation. Ovulation predictors such as 'clear plan' to predict urine LH surge are more accurate than measurement of basal body temperature or evaluating your cervical mucus. Insemination is performed about 24 hours after the surge. The intravaginal insemination procedure The male partner collects his semen into a sterile pot and then withdraws the whole specimen into a sterile syringe. Thereafter, the female partner or wife places the semen into her vagina using the syringe 'self insemination'. Care should be taken not to inject air into the vagina. The biggest advantages of this procedure are convenience and privacy of being performed at home and it only cost the price of a 'clear plan', a sterile pot and a syringe. Success rates of intravaginal insemination Success rates are in the region of 5-10% per treatment cycle.

Intrauterine insemination (IUI)

The intrauterine insemination (IUI) procedure is the most commonly used method of artificial insemination husband (AIH). It is a relatively simpler and cheaper than in-vitro fertilization (IVF). Intrauterine insemination (IUI) is effective treatment for selected groups of patients. Careful selection of patients for IUI is the cornerstone for achieving good success rates. Intrauterine insemination has a higher success rates than intravaginal insemination or intra-cervical insemination because it places the good motile sperm near the Fallopian tubes and if combined with ovarian stimulation, then there will be usually more than an egg available for insemination and fertilization. The intrauterine insemination (IUI) procedure The intrauterine insemination procedure involves direct placing of washed and prepared sperm inside the cavity of the womb around the time of ovulation (spontaneous or induced).

Ovarian stimulation
Artificial insemination can be performed either in a natural cycle or a stimulated cycle. The latter, ovarian stimulation involves giving the female partner fertility drugs such as clomiphene tablets, FSH or hMGeither separately or in a combination to stimulate the ovaries to produce a few follicles.The committee on the Safety Of Medicine in the UK has advised that no medical products using urine sources in a country which has repeated cases of the variant form of Creutzfeldt Jakob Disease (vCJD) be used for treatment, including Metrodin high purity. There is evidence that intrauterine insemination (IUI) with ovarian stimulation results in higher success rates than IUI only. The benefits of increased pregnancy rates and live birth rates achieved with ovarian stimulation must be balanced against the increased cost of the fertility drugs, the cost of cycle monitoring and the potential complications such as multiple pregnancy and ovarian hyperstimulation syndrome (OHSS).

Monitoring the insemination treatment

The development of follicles and endometrium (lining of the womb) is monitored by blood hormone tests and ultrasound scans. When the leading follicle measures 18-mm in diameter and the endometrium is well developed, an hCG injection is given to time insemination.

Monitoring of the cycle is essential in stimulated cycles to see whether an excessive number of follicles develop, indicating the possibility of ovarian hyperstimulation syndrome (OHHS) and high orders multiple pregnancy (triplets or more). If more than four mature follicles develop, most infertility clinics will advise you that either to withhold hCG injection abandoned the cycle and abstain from intercourse. Alternatively, convert the treatment cycle to in-vitro fertilization (IVF) or gamete intra-Fallopian transfer (GIFT) if appropriate.

The History of Artificial Insemination

By: Diane Fitzpatrick Many think of artificial insemination as a modern-day technology, but the first successful human artificial insemination in the 1950s was predated by centuries of scientific study and experimentation. Artificial insemination, the process by which sperm is planted in the female reproductive tract to artificially impregnate the female, began in the lab and was first tested on animals. Modern techniques used in human artificial insemination were first used on cattle by dairy farmers wishing to improve milk production by impregnating cows with the sperm of bulls with preferable genetic traits. Unofficial history claims that crude attempts to artificially inseminate Juana, the wife of King Henry IV of Castile in the 1400s, was an early endeavor to artificially impregnate an infertile couple. Milestones in the History of Human Artificial Insemination 1790 - John Hunter first reports artificial insemination in medical literature. 1899 - Efforts begin in Russia to develop practical methods for human artificial insemination. 1909 - Human artificial insemination grows more controversial. The Catholic Church objects to all forms of artificial insemination. 1939 - The first animal, a rabbit, is conceived by artificial insemination. Mid 1940s - Artificial insemination becomes an established industry. In Nazi Germany, doctors performed artificial insemination experiments on Jews, gypsies and concentration camp internees. 1949 - Scientists develop improved methods of freezing and thawing sperm. 1950 - Cornell University scientists discover that antibiotics can be added to the sperm solution in artificial insemination processes. 1953 - the first successful pregnancy from artificial insemination of frozen sperm is reported. 1970s - The sperm bank industry is developed and aritificial insemination becomes commercialized. Human Artificial Insemination Today As the end of the 20th century neared, controversy and concern over artificial insemination in humans faded and the demand for donor sperm increased. By 1987, US doctors were performing artificial insemination on about 172,000 women per year, resulting in some 65,000 births. Legal issues, particularly in artificial insemination cases with donor sperm, have raised debate over the parental rights of sperm donors, privacy rights and the ethics in sperm donor banks for artificial insemination. Some European countries have regulations that deem artificial insemination babies as legitimate offspring of the mother's husband; other countries have not addressed the issue in the law.

Artificial Insemination Process

The artificial insemination process has proved to be a boon for many couples who desire to have children, but are unable to conceive naturally. The artificial insemination procedure may require a lot of consideration before you can opt for it, but is surely is an effective option. Read on for more information on the artificial insemination process.

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Home Insemination Kit Want a private, cost effective way to start a family? Let us help. www.totalconception.com Process Free Manuals and Support Information about Process www.FixYa.com/Process Infertility and the inability to have children could be quite distressing for couples longing to start a family. The artificial insemination process could be a possible solution to most types of infertility problems. The first successful IVF treatment took place in 1981 and since then many infertile couples have been resorting to this procedure as a possible solution to their infertility problem. However, before deciding to opt for the artificial insemination procedure, there are a lot of points to be considered by the couple, especially regarding the length of the procedure and the time and commitment required for its success. Read more on artificial insemination procedure. Process of Artificial Insemination The process of artificial insemination involves preparing and placing sperms directly into the cervical canal or the reproductive tract of the female and does not involve sexual intercourse. Artificial insemination is useful in treating infertility caused due to a low sperm count, problems in the cervical mucus or sperms that are not active. You will need to consult a gynecologist to determine if artificial insemination is the right procedure to treat your infertility problems. Once it is determined that you can go ahead with the procedure, certain medical tests would be conducted for the couple as a part of the preparation for the artificial insemination process. It would be advisable to determine the artificial insemination cost and the time schedule required prior to the commencement of the procedure. Read more on human artificial insemination. How does Artificial Insemination Work? There are several artificial insemination steps involved in this fertility treatment procedure. Once all the tests have been conducted, the doctor will be able to recommend which artificial insemination method should be opted for. There are three different methods of artificial insemination, the intrauterine insemination (IUI), the intracervical insemination (ICI) and the intratubal insemination. Of these, the IUI and the ICI are the most common methods of artificial insemination, which are easy and safe as well. The intratubal insemination method is comparatively rare due to its low success rates. The following will brief you about the artificial insemination steps. Step# 1: Based on the medical reports, the doctor may or may not advice the female partner to take fertility medication that stimulates production and maturation of eggs. This fertility medication needs to be taken just before the commencement of the menstrual cycle. Step# 2: The woman's ovulation cycle is determined, using body basal temperature and ultrasound and, the hormone levels are closely monitored. Step# 3: A sperm sample is obtained from the male partner, which is 'washed' and concentrated. This needs to be done so that the mucus and non-motile sperms are removed which will increase the possibility of fertilization. Step# 4: At the beginning of ovulation, the sperm is inserted into the woman's reproductive tract, using a catheter in the IUI method or a needle less syringe in the ICI method. Both these methods are painless, but the ICI is a quicker method. If the egg is fertilized, that is, if pregnancy occurs, it can be detected 2 weeks later. The number of artificial insemination cycles that you would need to undergo would depend upon the cause and extent of the infertility problem. Consuming fertility medication during the artificial insemination process will increase your chances of getting pregnant. In case of failure of this process, the stimulated artificial insemination process can be opted for. For more information, you can refer to:

Artificial Insemination at Home Cost of Artificial Insemination

The success rate of artificial insemination procedures are quite high and there are other procedures too in case this one fails to treat your infertility problem. It's success rate would also depend on your diet and lifestyle habits followed while undergoing the procedure. So, make sure you talk to your doctor and gather as much information as possible on the do's and dont's of this procedure. Good Luck!

Who Invented Artificial Insemination for Humans?

By Neal Litherland, eHow Contributor

Artificial insemination, which is the impregnation of female with sperm through some means other than copulation, is not new. However, like many practices that have been shaped through human history, there have been many contributions and contributors to artificial insemination. It's therefore difficult to choose a single mother or father of the idea.

History
1. Artificial insemination, as an idea, has been around since the 1700s. Experiments were conducted with plants and animals, and by the 1800s, artificial insemination was being used on a variety of farms. This allowed the impregnation of many females, though only one male might have been needed to provide the semen. It was only natural scientific curiosity that led artificial insemination from animals to humans.

Steps
2. In 1884, the first recorded sperm donor allowed a couple to have a child. Other milestones include the idea of in vitro fertilization being proposed in a New England medical journal in 1937, reports of donor sperm being used in England in 1945 and four pregnancies being reported through the use of donor sperm in 1955.

Modern Artificial Insemination

3. Many scientists throughout the world and throughout time have contributed to advancing artificial insemination. Robert Edwards, however, is one of the more prominent modern scientists connected with the practice. Involved in the creation of the first "test tube" baby, Edwards published an article in 1969 in the periodical "Nature" about artificially fertilizing human eggs.

Varieties
4. Many techniques have developed that fall under the umbrella of artificial insemination. The use of donor sperm, the use of a spouse's sperm and even a blending of the two have all been used. Also, there are processes that put the semen directly into a woman's uterus or her cervix. There has also been progress in many related fields, such as the menstrual cycle, the sperm count of the donor and health issues associated with all partiesinvolved that have helped advance artificial insemination. The people involved in those fields also deserve credit for the growth of artificial insemination.

Concerns
5. As with nearly any technology, there are moral and ethical concerns associated with artificial insemination that haven't gone away. While artificial insemination is no longer associated with forced sterilization (a common trend in the early 1900s), there are still issues such as the parenthood of the child, whether lesbian couples

should be allowed to use artificial insemination and the question of whether frozen sperm from a loved one should be used after their death. While these concerns have troubled courts and the populace, they're still being hotly debated more than a century after they were created, right alongside the advancing technology of artificial insemination.

Facts on Artificial Insemination

By Hannah Rice Myers, eHow Contributor

For those who are having trouble conceiving, or for those who are single or are in a gay or lesbian relationship, artificial insemination has proven to be a wonderful means to having a family. Before undergoing the procedure, though, be sure you're getting all the information you can.

Methods
1. There are two methods most commonly used for artificial insemination: intracervical and intrauterine. The intracervical method is the most common and is better suited for singles, gay and lesbian couples--and couples who have no underlying problem with their reproductive organs but whose male partner may have problems with ejaculation during intercourse. It's a painless and quick procedure that places the sperm directly into the cervix so it may then swim to the Fallopian tubes and fertilize the egg naturally. The intrauterine method is a bit more uncomfortable, and may cause some cramping after. During this procedure the sperm is implanted directly into the uterus, bypassing the cervix and increasing the chances of fertility. It's often used in combination with fertility drugs, and timing with ovulation is essential. It's a good option for men or women who suffer from a reproductive problem such as cervical muscus or low sperm count.

Donors
2. When choosing to undergo artificial insemination, you have the choice of using your mate's sperm or using donor sperm. If opting to use donor sperm, most women use a sperm bank. Women are given general information about the donors, including their hair and eye color, height and weight--and in some cases their religion and temperament. Once their decision has been made, they purchase the sperm and it is washed and shipped to the clinic they will use for insemination. When using a sperm bank, the woman can be sure that: the donor has signed away her parental rights to the child; the sperm has been tested for virility and diseases (including genetic abnormalities, HIV and hepatitis); and the sperm is washed after purchase, meaning the slower-moving sperm is removed so that only the best sperm are used for the procedure.

Cost
3. The average cost in the United States for artificial insemination (if a partner's sperm is used) is in the hundreds of dollars per cycle. That price can increase many times over per cycle if fertility medications and ultrasounds are required. Prices vary depending on the clinic and geographic location, and can increase if donor sperm is used. Some insurances may cover the cost of part or all of the procedure; if not, the couple may be required to pay the cost up front.

Success Rate
4. This depends on what the fertility problem may be, the age of yourself and your partner, and the method used. For those using the intrauterine method, the success rate ranges between 5 and 20 percent. If a fertility drug is used in combination with the method, the success rate is closer to 20 percent. For those using the intracervical method, the success rate ranges between 6 and 30 percent.

Time Frame
5. In most cases, the procedure takes less than an hour to complete. If the use of fertility drugs is required, the woman may need to be on them for about a week before ovulating. It may take three to six cycles of treatment before another treatment method is attempted or pregnancy is achieved.

Timing
6. Timing is crucial--especially when using fertility drugs to help increase the chances of fertilizing the egg. The couple must be ready to leave for the doctor's office or clinic the moment ovulation occurs, though typically they have 24 to 36 hours' notice. If using the mate's sperm, he must be prepared to produce sperm in the office by masturbating in a cup quickly.

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The Benefits of Artificial Insemination

By Hannah Rice Myers, eHow Contributor

Artificial insemination offers benefits to people who want to have a baby but cannot conceive for one reason or another. First and foremost, artificial insemination offers infertile couples the chance to start a family. Women who choose to remain single but want to have a child also use artificial insemination to become pregnant. There are two different types of procedures used during artificial insemination. The first involves inserting the sperm directly into the cervix (intracervical insemination, or ICI) and most resembles natural intercourse; this is because the sperm still need to travel to the uterus on their own for fertilization to take place. The second procedure involves inserting the sperm directly into the uterus (intrauterine insemination, or IUI), which increases the chance for fertilization because the sperm do not need to travel to the uterus on their own.

Cost
1. Compared to other fertility procedures, such as in vitro fertilization (IVF), artificial insemination is relatively inexpensive. The National Infertility Association (see References) reported that the average cost for one cycle of IVF is $8,158--although other estimates run much higher--and for one cycle of artificial insemination, $865. Some insurance companies will cover part of the costs.

Side Effects
2. Artificial insemination is less invasive than other infertility treatment methods and has fewer side effects. Sometimes fertility drugs are prescribed for the woman, the man, or both, but not always. The procedure is also painless.

Options
3. Most often married couples will use the husband's sperm for artificial insemination, but if there are health or fertility problems with the man, or a woman who wants to have a baby does not have partner, individuals may choose to use a sperm bank. Sperm banks screen their donors carefully, and donors sign legal forms and relinquish all parental rights. Often women or couples can choose the donor based on physical features, health, and even temperament and religion. Another option offered by artificial insemination is the use of donor eggs, if the woman cannot produce healthy eggs on her own.

Closest to Natural
4. Artificial insemination allows for natural fertilization to take place in the body. This aspect appeals to couples who want to create a baby in a way closest to traditional intercourse.

Screening
5. Regardless of whether the sperm used for artificial insemination comes from the husband, a sperm bank, or another donor, it is always washed and tested before the insemination in order to reduce the likelihood of passing any genetic defects on to the baby.

Home Insemination Kitwww.totalconception.com

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Articles > Journals > Social and Theoretical Sciences journals > Journal of Comparative Family Studies articles >September 2005

Article: Medically assisted conception: revolutionizing family or perpetuating a nuclear and gendered model?
Article from: Journal of Comparative Family Studies Article date: September 22, 2005

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INTRODUCTION

In recent decades, family life has been transformed by more effective birth control, women's stronger presence in higher education and paid work, global labour markets, and greater emphasis on personal choice and individual fulfillment. These changes in the larger society have encouraged more consensual relationships, delayed childbirth and declining fertility (Beck-Gernsheim 2002, Lewis 2003). At the same time, women's delayed childbirth and certain lifestyle choices have increased fertility problems. Medical interventions now permeate the entire childbearing experience but new technologies permit more low fertility couples to reproduce and enable more women to bear children outside nuclear families. Fertility clinics have been established throughout the world and more people are turning to them for help with conception. Fertility treatments began in the 1960s and the first 'test-tube' baby was born in 1978 in Britain. Since then, a wide range of procedures have now become routine, such as egg retrieval, in vitro fertilization (IVF) and reimplantation into a woman's womb (Coney and Else 1999: 1), although Australian data indicates that only 1.7% of all babies are born with assisted conception (Ford et al 2003). Nevertheless, frozen sperm and embryos now make conception possible after their donor's death, postmenopausal women can bear children, and potential parents can contract 'surrogates' to bear children for them (ibid). Assisted conception also enables more single and lesbian women to reproduce outside nuclear families, and sperm or egg donation and surrogacy could alter generational lines and parental roles. Generally, new reproductive and genetic technologies have to potential to radically transform family life (Eichler 1996). While technology permits both childless marriages and greater childbearing options, social pressure to reproduce continues. This includes the implicit assumption that all 'normal' adults will develop permanent intimate relationships, will want to reproduce, and will actually become parents (Veevers 1980, Morell 1994, Cameron, 1997). Many people still dream of what they consider to be a normal family, with a committed marriage and their own biological children. In fact, social research suggests that most heterosexual couples assume that they will have children when they find a suitable partner (May 1995, Daniluk 2001, Exley and Letherby 2001). Consequently, unexpected infertility causes considerable anxiety and self-doubt, especially when having children is synonymous with adulthood. The media and some sociologists focus on the radical potential of reproductive technologies to change family life and the wider society. However, this paper questions the extent of social change generated by medically assisted conception by showing how it is actually being used in New Zealand by ordinary people with fertility problems. Five themes are drawn from qualitative interviews with men and women seeking treatment in Auckland, New Zealand's largest city. These include the close link between fertility and identity, the marital stress associated with the inability to conceive, social exclusion felt by those who cannot reproduce, the increasing normalization of medically assisted conception, and negative visions of life without children. Through a discussion of these interview themes, combined with overseas research, I argue that medically assisted conception is more likely to reproduce nuclear families with gendered roles than to become a revolutionary force altering the family as an institution. Before the details of the New Zealand research are discussed, the radical potential of reproductive technologies needs to be further outlined. THE RADICAL POTENTIAL OF REPRODUCTIVE TECHNOLOGIES For years, various medical interventions such as anesthetics, episiotomies, inductions and caesarean sections have been used in childbirth but these procedures are becoming widespread with more babies delivered by obstetricians in hospitals and the development of new reproductive technologies (Tew 1998). Innovations in assisted conception have led to the establishment of fertility clinics offering a range of medical and support services to patients with fertility problems. The increasing use of these technologies has caused considerable concern about the 'medicalization of childbirth' and the potential commercialization of family formation, exploitation of workingclass women as surrogate mothers, and 'commodification' of eggs, sperm, and reproductive services. For these reasons, both researchers and activists argue for greater state control of human genetic research and assisted conception (Baird 1997, Tew 1998, Coney and Else 1999). A number of researchers have noted that reproductive and genetic technologies are already reshaping families because they permit us to separate biological and social parenthood, change generational lines, and select the sex of the foetus (Doyal 1995, Eichler 1996, 1997, Michaels 1996, Squier 1996). These interventions enable more couples to become parents (regardless of their sexual orientation), extend the age of childbearing for women, eliminate the need for a male partner (with sperm donors as the new absent fathers), and provide the opportunity to

create 'designer babies' by carefully selecting sperm or egg donors with certain characteristics. Pre-natal diagnoses allow foetuses to be evaluated to determine whether or not they are worthy of being born (Eichler 1996) and abortions are available in many jurisdictions if the foetus has disabilities. Squier (1996) suggested that the range of interventions into reproduction alter the perceived relationship between foetus and mother. This 'medicalization of motherhood', including new techniques of medical imaging, visualising technology, and other prenatal testing, can gain precedence over the ideas and experiences of the gestating woman. Eichler (1997) argued that parental roles have already become complicated over the past few decades with the emergence of cohabiting relationships, same-sex partners, divorce, and remarriage. Yet new reproductive and genetic technologies further complicate parental roles by blurring the role designations of mother, father, and child. Who is the mother of the child in a surrogacy relationship, she asks? Is it the woman who gave birth or the woman who was part of the commissioning couple? Does it matter whose egg was involved? What does it now mean to be a father? Does a man become a father if he impregnates a woman but has no social contact with the child? Does he become a father when he contracts another woman to use his sperm to make a baby, which he then adopts with his legal wife? The English language has not yet evolved to encompass these new relationships and social scientists have had little chance to study them (Eichler 1997). Sociologists typically argue that parenthood is socially constructed because it is influenced by changing social and cultural expectations, evolves through regular social interaction, and varies with feelings of closeness as well as responsibility. Yet we do not know whether or not the new parental configurations created by reproductive technologies will negatively influence the lives of the parents and children involved. We have seen only some preliminary research on these issues (Adair and Rogan 1998: 271). The portrayal of reproduction technology as new, experimental or potentially dangerous, however, has shifted and is now regarded by many as mainstream medical practice (Albury, 1999, Van Dyck, 1995). Examining popular representations of medically assisted reproduction, Albury (1999), Franklin (1990) and Van Dyck (1995) highlighted narratives that appeal to scientific progress, medical expertise, humanist cures for disease, and a politics of choice. These representations operate to achieve a 'normalization' of reproduction technology. Both Bharadwaj (2000) and Van Dyck (1995) showed that the discourse used within medicine and journalism is complementary, with the media as a key site through which assisted reproduction has been legitimated. As new technologies for assisted conception become widespread, Becker (2000: 15) argued that they create a competitive medical marketplace, competing for patients with package deals, instalment payments, non-medical support services and other enticements. Fertility treatments are expensive and unless a public health system or private insurance covers them, they fall outside the price range of many families. Assisted conception varies in price by the procedure, the use of drugs, and subsidies by the state. In vitro fertilization is one of the most expensive and unless subsidized can cost patients many thousands of dollars. The small minority who end up with a healthy baby from reproductive technologies may find these costs acceptable, but 'we know little about the majority who go away with empty arms' (Doyal 1995: 149). As medically assisted conception has been perfected, success rates have increased but some patients do not fully understand how low they actually are. Misunderstandings have been possible by talking about pregnancy rates rather than live birth rates, despite the fact that miscarriage rates for such procedures are about 25% (Baird 1997). Recent Australian research shows that adverse infant outcomes, such as pre-term delivery, low birth weight, stillbirth and neonatal death, are higher among assisted conception births compared to all births (Ford et al 2003). British and Australian research indicates that IVF ends in success for less than a third of those who embarked on it (Doyal 1995: 149), only 15% per treatment cycle (HFEA 1997, Ford et al 2003). The probability of producing a live birth from IVF declines substantially with age, and among women aged 40 to 44, the chance was only 5.5%. With donor eggs, however, the probability of having a live birth increased to 17.7% per IVF cycle for women aged 40 to 44 (HFEA 1997). Researchers also note the hierarchy of treatments in the minds of patients undergoing medically assisted reproduction. Letherby (1999) found that couples Read all of this article with a FREE trial

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