MAMA – HAPPY PARENT

INSEMINATION

Insemination is the simplest procedure of medically assisted fertilization. The advantages of insemination are non-invasiveness and low consumption of drugs, while the disadvantage is a rather low success rate per attempt. The pregnancy rate per insemination is between 10-15%, while the birth rate per insemination attempt is around 8-9%, and it is slightly higher with insemination with donor sperm and amounts to around 12% (data from the European ESHRE registry).

However, the low success rate should certainly not discourage couples who have an indication for insemination to start infertility treatment with this simple method. Namely, the cumulative success rate of insemination is comparable to in vitro fertilization, and after three cycles of intrauterine insemination, success is achieved as in one cycle of in vitro fertilization.

In couples with unexplained (idiopathic) infertility, if the infertility does not last longer than two years, and the partner is younger than 38 years, insemination is usually the first choice of infertility treatment. Indications for insemination are also mild male factor, anovulation, cervical factor and mild endometriosis.

Prerequisites for insemination are a normal or borderline (sub-fertile) spermiogram in men, and at least one fallopian tube in women. Intrauterine insemination is performed around the time of ovulation. Ovulation is most often monitored with serial ultrasound examinations (folliculometry). If a woman ovulates, insemination can be performed in a natural cycle (without medication) or a modified natural cycle (a “stopwatch” is given at a follicle size of about 18mm), however, even in women who ovulate spontaneously, MPO procedures are more often performed in stimulated cycles because this increases the chance of success. Clomiphene or letrozole tablets are most often used to induce or stimulate ovulation in the insemination procedure. The tablets are started around the 3rd day of the cycle, for a variable duration of taking. Ultrasound examinations monitor follicle growth, and when the leading follicle size is about 18mm, an injection of hCG (“stopwatch”) is administered. Ovulation will occur approximately 36 hours after the “stopwatch”, so the insemination procedure is planned around that time.

A woman does not need any special preparation for the insemination procedure itself. An hour before the planned insemination, the man gives a semen sample. It is important that abstinence when giving the sample is not shorter than two days, nor longer than five days. The semen for insemination is prepared in the laboratory for human reproduction so that immobile spermatozoa are removed by washing, and the fertilizing potential of the semen is further improved by the addition of a special medium. Ideally, after laboratory processing, at least 5 million motile spermatozoa are inseminated into the uterus. Insemination is performed on an outpatient basis, in a gynecological position, so that the prepared seed is injected into the uterine cavity using a catheter. Immediately after the insemination procedure, the woman can remain lying in the gynecological position for the next 15 minutes, because according to older studies, the success rate is slightly higher then. More recent studies have not confirmed this. In any case, until the pregnancy test, it is recommended to continue performing every day and usual activities, because in this way the level of stress that is inevitably present in all couples in MPO procedures is reduced.

All these procedures can be done in our Clinic in Sarajevo.

If you wish to find out more about the abovementioned, please contact us at:

+387 33 781 735

+387 65 048 119 (Viber)

or send us an e-mail:

info@northwesternmedicalctr.com

or visit us at the following address:

Bulevar Mese Selimovica 17 a, Sarajevo (CORE Business Center)

https://g.co/kgs/L6Yo3j7

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