Planning intrauterine insemination should be based on a proven patency and proper functioning of the fallopian tubes and the fertility of the semen. In case of ovulation disorders, the specific treatment can include a pharmacological induction of ovulation in combination with natural procreation. The effectiveness of this procedure is difficult to assess due to the low homogeneity of the groups and the difficulty in objectifying the research findings. However, it is assumed that it does not exceed 7-20% of pregnancies per treatment cycle.
When the partner’s reproductive potential is only slightly decreased, the method of choice is intrauterine insemination (IUI), often in combination with ovulation induction. The purpose of the procedure is to increase the number of competent male gametes at the site of syngamy. For this purpose, the semen is inserted into the vagina, most often with the use of a cervical cap, which allows for long-term contact of the semen with the cervical canal, and the more intense penetration of the sperm into the upper part of the reproductive organs. The more advanced procedure is intrauterine insemination, where properly prepared sperm are introduced into the uterine cavity. This allows you to use the entire pool of live sperm from the ejaculate and avoid losses typical for natural reproduction.
The most well-known of these procedures is intraperitoneal insemination, where relevant fractions of normal sperm are isolated using swim-up techniques, as where Percoll gradient separation occurs, found in the in vitro lab. Such prepared sperm are introduced into the fallopian tubes or peritoneal cavity of the female, into the immediate vicinity of the ova. These methods are effective in 14-60% of pregnancies per treatment cycle, and depend mainly on the reproductive potential of the partner, provided that the semen is properly qualified. The ineffectiveness of the above procedures used during the 6 cycles of treatment should lead to reconsideration of indications, and application of more advanced methods of in vitro fertilization.
This method requires a one-day medical visit during the first three days of menstruation. We evaluate the initial situation, and establish indications and contraindications to treatment. If ovulation induction is required, we determine its optimum method, the scope of monitoring and the expected date. Based on the partner/donor semen analysis, we determine the technical details of the procedure (cervical, intrauterine, intratubal insemination, etc.).