Artificial insemination
Encyclopedia
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 intercourse
or natural insemination
. 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, 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 pig
s. 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.
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
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. 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.
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 window during ovulation. However, a randomized trial of insemination after ovarian hyperstimulation found no difference in live birth rate between single and double intrauterine insemination.
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. The baby will be the woman's biological child, and the biological child of the man whose sperm was used to inseminate her, whether he is the woman's partner or a donor. 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.
Intravaginal insemination,
Intracervical insemination, and
Intratubal insemination
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.
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 prostaglandin
s. (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.
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. 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. A short period of ejaculatory abstinence before intrauterine insemination is associated with higher pregnancy rate
s. However, GnRH agonist administration at the time of implantation does not improve 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 38–39 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. It is therefore recommended to consider in vitro fertilization after one failed COH/IUI cycle for women aged ≥40 years.
s 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.
although this procedure is no longer generally regarded as having any beneficial effect compared with IUI. 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.
s 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. For couples with unexplained infertility
, unstimulated IUI is no more effective than natural means of conception.
Generally, it is 10 to 15% per menstrual cycle
using ICI, and and 15-20% per cycle for IUI. In IUI, about 60 to 70% have achieved pregnancy after 6 cycles.
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.
However, the following equations generalize the main factors involved:
For intracervical insemination:
The pregnancy rate increases with increasing number of motile sperm used, but only up to a certain degree, when other factors become limiting instead.
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:
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.
Artificial insemination is used in many non-human animals, including sheep, horse
s, cattle
, pigs
, dog
s, pedigree animals generally, zoo
animals, turkeys and even honeybees. It may be used for many reasons, including to allow a male to inseminate a much larger number of females, to allow use of genetic material from males separated by distance or time, to overcome physical breeding difficulties, to control the paternity of offspring, to synchronise births, to avoid injury incurred during natural mating, and to avoid the need to keep a male at all (such as for small numbers of females or in species whose fertile males may be difficult to manage).
Semen is collected, extended, then cooled or frozen. It can be used on site or shipped to the female's location. If frozen, the small plastic tube holding the semen is referred to as a straw. To allow the sperm to remain viable during the time before and after it is frozen, the semen is mixed with a solution containing glycerol or other cryoprotectants. An extender is a solution that allows the semen from a donor to impregnate more females by making insemination possible with fewer sperm. Antibiotics, such as streptomycin, are sometimes added to the sperm to control some bacterial venereal diseases. Before the actual insemination, estrus may be induced through the use of progestogen and another hormone
(usually PMSG
or Prostaglandin F2α).
Artificial insemination of farm animals is very common in today's agriculture industry in the developed world, especially for breeding dairy cattle. (75% of all inseminations) Swine are also bred using this method (up to 85% of all inseminations). It provides an economical means for a livestock
breeder to improve their herds utilizing males having very desirable traits.
Although common with cattle and swine, AI is not as widely practised in the breeding of horses. A small number of equine associations in North America accept only horses that have been conceived by "natural cover" or "natural service" – the actual physical mating of a mare
to a stallion
. The Jockey Club
being the most notable of these - no AI is allowed in Thoroughbred
breeding. Other registries such as the AQHA and warmblood
registries allow registration of foals created through AI, and the process is widely used allowing the breeding of mares to stallions not resident at the same facility - or even in the same country - through the use of transported frozen or cooled semen.
Modern Artificial Insemination was pioneered by Dr. John O. Almquist of the Pennsylvania State University. His improvement of breeding efficiency by the use of antibiotics (first proven with penicillin in 1946) to control bacterial growth, decreasing embrionic mortality and increase fertiilty, and various new techniques for processing, freezing and thawing of frozen semen significantly enhanced the practical utilization of AI in the livestock industry, and earned him the 1981 Wolf Foundation Prize in Agriculture. Many techniques developed by him have since been applied to other species, including that of the human male.
The, John O. Almquist Dairy Breeding Research Center, at Penn State University, is a unique facility for research on reproduction in farm animals. It is one of only three centers worldwide providing substantial housing for mature bulls. The Center has a long-standing working relationship with the artificial insemination industry. Today we have a new methodology named "Barceló Method for Artificial Insemination" patented by Carlos Alberto Barceló Rojas from Villahermosa, Tabasco, México. It's a revolutionary method for impregnanting cows. Some cattleman are using it successfully in their farms located in the south of México with percentages over 90%. Patent Application WO/2011/034411
Spermatozoon
A spermatozoon is a motile sperm cell, or moving form of the haploid cell that is the male gamete. A spermatozoon joins an ovum to form a zygote...
is placed into the reproductive tract of a female for the purpose of impregnating the female by using means other than sexual intercourse
Sexual intercourse
Sexual intercourse, also known as copulation or coitus, commonly refers to the act in which a male's penis enters a female's vagina for the purposes of sexual pleasure or reproduction. The entities may be of opposite sexes, or they may be hermaphroditic, as is the case with snails...
or natural insemination
Insemination
Insemination is the deliberate introduction of sperm into the uterus of a mammal or the oviduct of an oviparous animal for the objective of impregnating a female for reproduction...
. In humans, it is used as assisted reproductive technology
Assisted reproductive technology
Assisted reproductive technology is a general term referring to methods used to achieve pregnancy by artificial or partially artificial means. It is reproductive technology used primarily in infertility treatments. Some forms of ART are also used in fertile couples for genetic reasons...
, 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, 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
Livestock
Livestock refers to one or more domesticated animals raised in an agricultural setting to produce commodities such as food, fiber and labor. The term "livestock" as used in this article does not include poultry or farmed fish; however the inclusion of these, especially poultry, within the meaning...
breeding, especially for dairy cattle
Dairy cattle
Dairy cattle are cattle cows bred for the ability to produce large quantities of milk, from which dairy products are made. Dairy cows generally are of the species Bos taurus....
and pig
Pig
A pig is any of the animals in the genus Sus, within the Suidae family of even-toed ungulates. Pigs include the domestic pig, its ancestor the wild boar, and several other wild relatives...
s. 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
Cervix
The cervix is the lower, narrow portion of the uterus where it joins with the top end of the vagina. It is cylindrical or conical in shape and protrudes through the upper anterior vaginal wall...
(intracervical insemination – ICI) or, after washing, into the female's uterus
Uterus
The uterus or womb is a major female hormone-responsive reproductive sex organ of most mammals including humans. One end, the cervix, opens into the vagina, while the other is connected to one or both fallopian tubes, depending on the species...
(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.
Preparations
A sperm sample will be provided by the male partner of the woman undergoing artificial insemination, but sperm provided through sperm donationSperm donation
Sperm donation is the provision by a man, , of his sperm, with the intention that it be used to impregnate a woman who is not usually the man's sexual partner, in order to produce a child....
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
Masturbation
Masturbation refers to sexual stimulation of a person's own genitals, usually to the point of orgasm. The stimulation can be performed manually, by use of objects or tools, or by some combination of these methods. Masturbation is a common form of autoeroticism...
or the use of an electrical stimulator, although a special condom
Condom
A condom is a barrier device most commonly used during sexual intercourse to reduce the probability of pregnancy and spreading sexually transmitted diseases . It is put on a man's erect penis and physically blocks ejaculated semen from entering the body of a sexual partner...
, 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
Basal body temperature
Basal body temperature is the lowest temperature attained by the body during rest . It is generally measured immediately after awakening and before any physical activity has been undertaken, although the temperature measured at that time is somewhat higher than the true basal body temperature...
and changes in vaginal mucus, or using ovulation kits, ultrasounds or blood tests.
When using intrauterine insemination (IUI), the sperm must have been “washed
Sperm washing
Sperm washing is a term used to describe the process in which individual sperms are separated from the seminal fluid. The sperms are then used in intrauterine insemination or in vitro fertilization ....
” in a laboratory and concentrated in Hams F10 media without L-glutamine, warmed to 37C. 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
Sperm bank
A sperm bank, semen bank or cryobank is a facility that collects and stores human sperm mainly from sperm donors, primarily for the purpose of achieving pregnancies through third party reproduction, notably by artificial insemination...
, 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
Masturbation
Masturbation refers to sexual stimulation of a person's own genitals, usually to the point of orgasm. The stimulation can be performed manually, by use of objects or tools, or by some combination of these methods. Masturbation is a common form of autoeroticism...
by the sperm donor at the sperm bank
Sperm bank
A sperm bank, semen bank or cryobank is a facility that collects and stores human sperm mainly from sperm donors, primarily for the purpose of achieving pregnancies through third party reproduction, notably by artificial insemination...
. A chemical known as a cryoprotectant
Cryoprotectant
A cryoprotectant is a substance that is used to protect biological tissue from freezing damage . Arctic and Antarctic insects, fish, amphibians and reptiles create cryoprotectants in their bodies to minimize freezing damage during cold winter periods. Insects most often use sugars or polyols as...
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
Semen extender
Semen extender is a liquid diluent which is added to semen to preserve its fertilizing ability. The extender allows the semen to be freighted to the female, rather than requiring the male and female to be near to each other...
or diluting the sample so that vials for a number of inseminations are produced. For fresh shipping, a semen extender
Semen extender
Semen extender is a liquid diluent which is added to semen to preserve its fertilizing ability. The extender allows the semen to be freighted to the female, rather than requiring the male and female to be near to each other...
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.
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
Catheter
In medicine, a catheter is a tube that can be inserted into a body cavity, duct, or vessel. Catheters thereby allow drainage, administration of fluids or gases, or access by surgical instruments. The process of inserting a catheter is catheterization...
. 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 window during ovulation. However, a randomized trial of insemination after ovarian hyperstimulation found no difference in live birth rate between single and double intrauterine insemination.
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
Conception device
A conception device is a medical device which is used to assist in the achievement of a pregnancy, often, but not always, by means other than sexual intercourse or NI...
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
Conception device
A conception device is a medical device which is used to assist in the achievement of a pregnancy, often, but not always, by means other than sexual intercourse or NI...
is that fresh, non-liquified semen may be used.
If the procedure is successful, the woman will conceive and carry to term a baby. The baby will be the woman's biological child, and the biological child of the man whose sperm was used to inseminate her, whether he is the woman's partner or a donor. 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 provided by a known or anonymous sperm donor (artificial insemination by donor, AID or DI) can be used.Techniques
Intrauterine insemination,Intravaginal insemination,
Intracervical insemination, and
Intratubal insemination
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 cervixCervix
The cervix is the lower, narrow portion of the uterus where it joins with the top end of the vagina. It is cylindrical or conical in shape and protrudes through the upper anterior vaginal wall...
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
Cervix
The cervix is the lower, narrow portion of the uterus where it joins with the top end of the vagina. It is cylindrical or conical in shape and protrudes through the upper anterior vaginal wall...
by the penis
Penis
The penis is a biological feature of male animals including both vertebrates and invertebrates...
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.
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 uterusUterus
The uterus or womb is a major female hormone-responsive reproductive sex organ of most mammals including humans. One end, the cervix, opens into the vagina, while the other is connected to one or both fallopian tubes, depending on the species...
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 prostaglandin
Prostaglandin
A prostaglandin is any member of a group of lipid compounds that are derived enzymatically from fatty acids and have important functions in the animal body. Every prostaglandin contains 20 carbon atoms, including a 5-carbon ring....
s. (Prostaglandins are also the compounds responsible for causing the myometrium to contract and expel the menses from the uterus, during menstruation
Menstruation
Menstruation is the shedding of the uterine lining . It occurs on a regular basis in sexually reproductive-age females of certain mammal species. This article focuses on human menstruation.-Overview:...
.) The woman should rest on the table for 15 minutes after an IUI to optimize the pregnancy rate.
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. In practice, donor sperm will satisfy these criteria. A promising cycle is one that offers two follicles
Ovarian follicle
Ovarian follicles are the basic units of female reproductive biology, each of which is composed of roughly spherical aggregations of cells found in the ovary. They contain a single oocyte . These structures are periodically initiated to grow and develop, culminating in ovulation of usually a single...
measuring more than 16 mm, and estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...
of more than 500 pg/mL on the day of hCG
Human chorionic gonadotropin
Human chorionic gonadotropin or human chorionic gonadotrophin is a glycoprotein hormone produced during pregnancy that is made by the developing embryo after conception and later by the syncytiotrophoblast .. Some tumors make this hormone; measured elevated levels when the patient is not...
administration. A short period of ejaculatory abstinence before intrauterine insemination is associated with higher pregnancy rate
Pregnancy rate
Pregnancy rate in infertility treatment is the success rate for pregnancy. It is the percentage of all attempts that leads to pregnancy, with attempts generally referring to menstrual cycles where insemination or any artificial equivalent is used, which may be simple artificial insemination or AI...
s. However, GnRH agonist administration at the time of implantation does not improve pregnancy outcome in intrauterine insemination cycles according to a randomized controlled trial
Randomized controlled trial
A randomized controlled trial is a type of scientific experiment - a form of clinical trial - most commonly used in testing the safety and efficacy or effectiveness of healthcare services or health technologies A randomized controlled trial (RCT) is a type of scientific experiment - a form of...
.
It can be used in conjunction with ovarian hyperstimulation. Still, advanced maternal age
Advanced maternal age
Advanced maternal age is defined as an increase in the age at which women give birth to their first child, is now a widespread, and indeed near universal, phenomenon across the OECD countries....
causes decreased success rates; Women aged 38–39 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. It is therefore recommended to consider in vitro fertilization after one failed COH/IUI cycle for women aged ≥40 years.
Intrauterine tuboperitoneal insemination
Intrauterine tuboperitoneal insemination (IUTPI) is insemination where both the uterus and fallopian tubeFallopian tube
The Fallopian tubes, also known as oviducts, uterine tubes, and salpinges are two very fine tubes lined with ciliated epithelia, leading from the ovaries of female mammals into the uterus, via the utero-tubal junction...
s are filled with insemination fluid. The cervix
Cervix
The cervix is the lower, narrow portion of the uterus where it joins with the top end of the vagina. It is cylindrical or conical in shape and protrudes through the upper anterior vaginal wall...
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
Peritoneal cavity
The peritoneal cavity is a potential space between the parietal peritoneum and visceral peritoneum, that is, the two membranes that separate the organs in the abdominal cavity from the abdominal wall...
and the Pouch of Douglas where it would be mixed with the peritoneal and follicular fluid
Follicular fluid
Follicular fluid is a liquid which fills the follicular antrum and surrounds the ovum in an ovarian follicle. This fluid is rich in hyaluronic acid.-External links:* *...
. IUTPI can be useful in unexplained infertility
Unexplained infertility
Unexplained infertility is infertility that is idiopathic in the sense that its cause remains unknown even after an infertility work-up, usually including semen analysis in the man and assessment of ovulation and fallopian tubes in the woman.-Possible causes:...
, mild or moderate male infertility, and mild or moderate endometriosis.
Intratubal insemination
IUI can furthermore be combined with intratubal insemination (ITI), into the Fallopian tubeFallopian tube
The Fallopian tubes, also known as oviducts, uterine tubes, and salpinges are two very fine tubes lined with ciliated epithelia, leading from the ovaries of female mammals into the uterus, via the utero-tubal junction...
although this procedure is no longer generally regarded as having any beneficial effect compared with IUI. ITI however, should not be confused with gamete intrafallopian transfer
Gamete intrafallopian transfer
Gamete intrafallopian transfer is a tool of assisted reproductive technology against infertility. Eggs are removed from a woman's ovaries, and placed in one of the Fallopian tubes, along with the man's sperm...
, where both eggs and sperm are mixed outside the woman's body and then immediately inserted into the Fallopian tube where fertilization takes place.
Pregnancy rate
Success rates, or pregnancy ratePregnancy rate
Pregnancy rate in infertility treatment is the success rate for pregnancy. It is the percentage of all attempts that leads to pregnancy, with attempts generally referring to menstrual cycles where insemination or any artificial equivalent is used, which may be simple artificial insemination or AI...
s 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. For couples with unexplained infertility
Unexplained infertility
Unexplained infertility is infertility that is idiopathic in the sense that its cause remains unknown even after an infertility work-up, usually including semen analysis in the man and assessment of ovulation and fallopian tubes in the woman.-Possible causes:...
, unstimulated IUI is no more effective than natural means of conception.
Menstrual cycle
The menstrual cycle is the scientific term for the physiological changes that can occur in fertile women for the purpose of sexual reproduction. This article focuses on the human menstrual cycle....
using ICI, and and 15-20% per cycle for IUI. In IUI, about 60 to 70% have achieved pregnancy after 6 cycles.
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.
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
- 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%
- nr is the total motile sperm count recommended for vaginal insemination (VI) or intra-cervical insemination (ICIICIICI or Ici may mean:* ICI programming language, a computer programming language developed in 1992* Ici , an alternative weekly newspaper in Montreal, CanadaICI is also an abbreviation which may mean:...
), approximately 20 million pr. ml.
The pregnancy rate increases with increasing number of motile sperm used, but only up to a certain degree, when other factors become limiting instead.
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.
History
In the 1980s, direct intraperitoneal insemination (DIPI) was occasionally used, where doctors 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.Artificial insemination in livestock and pets
Horse
The horse is one of two extant subspecies of Equus ferus, or the wild horse. It is a single-hooved mammal belonging to the taxonomic family Equidae. The horse has evolved over the past 45 to 55 million years from a small multi-toed creature into the large, single-toed animal of today...
s, cattle
Cattle
Cattle are the most common type of large domesticated ungulates. They are a prominent modern member of the subfamily Bovinae, are the most widespread species of the genus Bos, and are most commonly classified collectively as Bos primigenius...
, pigs
PIGS
PIGS is a four letter acronym that can stand for:* PIGS , Phosphatidylinositol glycan anchor biosynthesis, class S, a human gene* PIGS , the economies of Portugal, Italy , Greece and Spain...
, dog
Dog
The domestic dog is a domesticated form of the gray wolf, a member of the Canidae family of the order Carnivora. The term is used for both feral and pet varieties. The dog may have been the first animal to be domesticated, and has been the most widely kept working, hunting, and companion animal in...
s, pedigree animals generally, zoo
Zoo
A zoological garden, zoological park, menagerie, or zoo is a facility in which animals are confined within enclosures, displayed to the public, and in which they may also be bred....
animals, turkeys and even honeybees. It may be used for many reasons, including to allow a male to inseminate a much larger number of females, to allow use of genetic material from males separated by distance or time, to overcome physical breeding difficulties, to control the paternity of offspring, to synchronise births, to avoid injury incurred during natural mating, and to avoid the need to keep a male at all (such as for small numbers of females or in species whose fertile males may be difficult to manage).
Semen is collected, extended, then cooled or frozen. It can be used on site or shipped to the female's location. If frozen, the small plastic tube holding the semen is referred to as a straw. To allow the sperm to remain viable during the time before and after it is frozen, the semen is mixed with a solution containing glycerol or other cryoprotectants. An extender is a solution that allows the semen from a donor to impregnate more females by making insemination possible with fewer sperm. Antibiotics, such as streptomycin, are sometimes added to the sperm to control some bacterial venereal diseases. Before the actual insemination, estrus may be induced through the use of progestogen and another hormone
Hormone
A hormone is a chemical released by a cell or a gland in one part of the body that sends out messages that affect cells in other parts of the organism. Only a small amount of hormone is required to alter cell metabolism. In essence, it is a chemical messenger that transports a signal from one...
(usually PMSG
Equine chorionic gonadotropin
Equine chorionic gonadotropin is a gonadotropic hormone produced in the chorion of pregnant mares. Most commonly called pregnant mare's serum gonadotropin in the past, the hormone is commonly used in concert with progestogen to induce ovulation in livestock prior to artificial...
or Prostaglandin F2α).
Artificial insemination of farm animals is very common in today's agriculture industry in the developed world, especially for breeding dairy cattle. (75% of all inseminations) Swine are also bred using this method (up to 85% of all inseminations). It provides an economical means for a livestock
Livestock
Livestock refers to one or more domesticated animals raised in an agricultural setting to produce commodities such as food, fiber and labor. The term "livestock" as used in this article does not include poultry or farmed fish; however the inclusion of these, especially poultry, within the meaning...
breeder to improve their herds utilizing males having very desirable traits.
Although common with cattle and swine, AI is not as widely practised in the breeding of horses. A small number of equine associations in North America accept only horses that have been conceived by "natural cover" or "natural service" – the actual physical mating of a mare
Mare
Female horses are called mares.Mare is the Latin word for "sea".The word may also refer to:-People:* Ahmed Marzooq, also known as Mare, a footballer and Secretary General of Maldives Olympic Committee* Mare Winningham, American actress and singer...
to a stallion
Stallion
A Stallion is a male horse.Stallion may also refer to:* Stallion , an American pop rock group* Stallion , a figure in the Gobot toyline* Stallion , a character in the console role-playing game series...
. The Jockey Club
Jockey Club
The Jockey Club is the largest commercial organisation in British horseracing. Although no longer responsible for the governance and regulation of the sport, it owns 14 of Britain's famous racecourses, including Aintree, Cheltenham and Newmarket, amongst other concerns such as the National Stud and...
being the most notable of these - no AI is allowed in Thoroughbred
Thoroughbred
The Thoroughbred is a horse breed best known for its use in horse racing. Although the word thoroughbred is sometimes used to refer to any breed of purebred horse, it technically refers only to the Thoroughbred breed...
breeding. Other registries such as the AQHA and warmblood
Warmblood
Warmbloods are a group of middle-weight horse types and breeds, primarily originating in Europe, registered with organizations that are characterized by open studbook policy, studbook selection, and the aim of breeding for equestrian sport...
registries allow registration of foals created through AI, and the process is widely used allowing the breeding of mares to stallions not resident at the same facility - or even in the same country - through the use of transported frozen or cooled semen.
Modern Artificial Insemination was pioneered by Dr. John O. Almquist of the Pennsylvania State University. His improvement of breeding efficiency by the use of antibiotics (first proven with penicillin in 1946) to control bacterial growth, decreasing embrionic mortality and increase fertiilty, and various new techniques for processing, freezing and thawing of frozen semen significantly enhanced the practical utilization of AI in the livestock industry, and earned him the 1981 Wolf Foundation Prize in Agriculture. Many techniques developed by him have since been applied to other species, including that of the human male.
The, John O. Almquist Dairy Breeding Research Center, at Penn State University, is a unique facility for research on reproduction in farm animals. It is one of only three centers worldwide providing substantial housing for mature bulls. The Center has a long-standing working relationship with the artificial insemination industry. Today we have a new methodology named "Barceló Method for Artificial Insemination" patented by Carlos Alberto Barceló Rojas from Villahermosa, Tabasco, México. It's a revolutionary method for impregnanting cows. Some cattleman are using it successfully in their farms located in the south of México with percentages over 90%. Patent Application WO/2011/034411
See also
- Semen extenderSemen extenderSemen extender is a liquid diluent which is added to semen to preserve its fertilizing ability. The extender allows the semen to be freighted to the female, rather than requiring the male and female to be near to each other...
- Embryo transferEmbryo transferEmbryo transfer refers to a step in the process of assisted reproduction in which embryos are placed into the uterus of a female with the intent to establish a pregnancy...
- Ex-situ conservationEx-situ conservationEx-situ conservation means literally, "off-site conservation". It is the process of protecting an endangered species of plant or animal outside of its natural habitat; for example, by removing part of the population from a threatened habitat and placing it in a new location, which may be a wild...
- Intracytoplasmic sperm injectionIntracytoplasmic sperm injectionIntracytoplasmic sperm injection is an in vitro fertilization procedure in which a single sperm is injected directly into an egg.-Indications:...
- Sperm bankSperm bankA sperm bank, semen bank or cryobank is a facility that collects and stores human sperm mainly from sperm donors, primarily for the purpose of achieving pregnancies through third party reproduction, notably by artificial insemination...
- Sperm donationSperm donationSperm donation is the provision by a man, , of his sperm, with the intention that it be used to impregnate a woman who is not usually the man's sexual partner, in order to produce a child....
- Accidental incestAccidental incestAccidental incest is incest that is committed by two partners who do not know they are biologically related. It can occur when two people who are unaware of their biological relationship become sexually intimate, or between siblings who share a room and partake in sexual exploration...
- Sperm sortingSperm sortingSperm sorting is a means of choosing what type of sperm cell is to fertilize the egg cell. It can be used to sort out sperm that are most healthy, as well as determination of more specific traits, such as sex selection in which spermatozoa are separated into X- and Y- chromosome bearing...
- Donor conceived peopleDonor conceived peopleA donor offspring, or donor conceived person, is conceived via the donation of sperm or ova , or both, either from two separate donors or from a couple...
- SurrogacySurrogacySurrogacy is an arrangement in which a woman carries and delivers a child for another couple or person. This woman may be the child's genetic mother , or she may carry the pregnancy to delivery after having an embryo, to which she has no genetic relationship whatsoever, transferred to her uterus...
- Frozen zooFrozen zooA frozen zoo is a storage facility in which genetic materials taken from animals are gathered and thereafter stored at very low temperatures for optimal preservation over a long period of time...
- WildlifeWildlifeWildlife includes all non-domesticated plants, animals and other organisms. Domesticating wild plant and animal species for human benefit has occurred many times all over the planet, and has a major impact on the environment, both positive and negative....
- Conception deviceConception deviceA conception device is a medical device which is used to assist in the achievement of a pregnancy, often, but not always, by means other than sexual intercourse or NI...
- EjaculationEjaculationEjaculation is the ejecting of semen from the male reproductory tract, and is usually accompanied by orgasm. It is usually the final stage and natural objective of male sexual stimulation, and an essential component of natural conception. In rare cases ejaculation occurs because of prostatic disease...
External links
- Detailed description of the different fertility treatment options available
- A history of artificial insemination
- What are the Ethical Considerations for Sperm Donation?
- United States state court rules sperm donor is not liable for children
- UK Sperm Donors Lose Anonymity
- AI technique in the equine
- IntraUterine TuboPeritoneal Insemination (IUTPI)
- The Hastings Center's Bioethics Briefing Book entry on assisted reproduction