Artificial insemination

Patients are advised to undergo artificial insemination treatment in the following cases:

• Incomplete intercourse. Cases of premature ejaculation, vaginismus, retrograde ejaculation or erectile dysfunction.
• Mild sperm abnormalities. In cases of non severe oligoasthenozoospermia. The acceptable limit in order to undergo insemination treatment is a progressive motile sperm count (REM) greater than 5 million and the absence of sperm morphology abnormalities (teratozoospermia).
• Ovulation abnormalities. Patients with polycystic ovarian syndrome or hypothalamic amenorrhea.
• Uterine abnormalities. Whether they are congenital (uterine malformations), or acquired (fibroids, polyps, intrauterine adhesions, endometritis).
• Unexplained infertility. Insemination would only be advisable if the couple has been having fertility issues for less than 3 years.
• A need for donor sperm. In cases where azoospermia cannot be solved by testicular biopsy, testicular biopsies where no viable sperm are obtained, genetic illnesses in the male partner which cannot be screened for using PGT, or females without a male partner.

One of the most commonly asked questions once a patient has undergone artificial insemination treatment is whether she needs to stay on bed rest following the procedure. Many people believe that resting after the spermatozoids have been deposited in the uterus will encourage proper fertilisation and embryo implantation.

In fact, there are no scientific studies to date which have shown that bed rest following artificial insemination favours or increases the chances of achieving a pregnancy. Thus, taking this precaution is not necessary. Your gynaecologist would only recommend bed rest in the event that there is another specific issue which requires it.

The patient will generally wait about half an hour before leaving the clinic, but this is simply for patient comfort and so that she can relax a bit following the procedure.

Once at home, the patient should carry on with her usual daily activities, though we recommend avoiding strenuous physical activity and competitive sports. There is absolutely no problem for the patient to continue working, meaning no medical leave of absence needs to be requested. It’s advisable to get half an hour of exercise daily (for example walking), and to continue leading your normal day to day life so that the wait time between the insemination and the pregnancy test causes as little stress and anxiety as possible.

In some cases the patient may feel some discomfort in the uterus while the insemination is being performed, but it normally disappears as soon as the procedure is over. This discomfort is generally caused by catheter placement, though it’s very rare as the doctor will use a thin, flexible catheter which is carefully guided through the cervix and into the uterus.

Some side effects that are extremely rare include swelling of the abdomen and legs, or abdominal discomfort. Is some cases the patient may feel tired or in pain, but there is never a direct relationship between staying on bed rest and increased success rates.

Spotting during the days following an insemination or embryo transfer is one of the most concerning symptoms for patients. However, spotting or light bleeding doesn’t mean that you haven’t gotten pregnant and it’s not necessarily the arrival of your period.

Sometimes bleeding occurs as a result of embryo implantation, as this process causes small blood vessels in the endometrium to break. Other times, the blood may be originating from an area of the endometrial lining that is beginning to shed, announcing arrival of the menstrual cycle.

In the event that a patient is spotting or bleeding, all we can do is wait. Spotting and bleeding don’t confirm anything and there is unfortunately nothing we can do except wait a little while longer for the pregnancy test result. Until that time, the patient must continue following her treatment plan until it’s time to take the pregnancy test and her doctor can indicate how she needs to proceed.

A tubal ligation is performed to prevent an egg and sperm from meeting, so it’s a form of contraception. The procedure involves cauterising or clamping off the fallopian tubes so that they are blocked off from the uterus.

Although years ago it was believed that fallopian tube anatomy could be restored through surgery, it has been demonstrated that operations to try to reverse tubal ligations are ineffective and once a female’s tubes have been tied they will never be able to recover their original function.

If a patient who has undergone a tubal ligation wishes to get pregnant again, the treatment she will need is In Vitro Fertilisation.

Yes, implantation of an embryo in the endometrium is a process that requires maternal immune tolerance toward the embryo which is genetically different from her. The interaction of proteins which are present in seminal fluid will encourage these necessary immune changes.

That’s why patients are advised to have complete, unprotected intercourse around the time of fertilisation (after the insemination procedure), -unless there is a reason contraindicating it-, as intercourse increases the patient’s chances of achieving a viable pregnancy.

Assisted reproduction makes it possible for you to become a mother without the need for a partner. The treatment needed to achieve a pregnancy will depend on your particular case. In order to determine which treatment you’ll need, we’ll first have to evaluate some preliminary testing and confirm, among other factors, your ovarian reserve. In addition, age plays a fundamental role in this process, as the likelihood of achieving a pregnancy -either naturally or artificially-, declines as a woman ages.

If you are under the age of 38 and you have a good ovarian reserve, Artificial Insemination could be a possibility.