Instituto Bernabeu · Fertilidad y Ginecología



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The Husband Intrauterine Insemination (I.U.I.), is a procedure widely used for the treatment of diverse reproductive disorders. We must not confuse it with In Vitro Fertilization (I.V.F.). Insemination consists on achieving the fertilization in a natural manner inside the Fallopian tubes, where it usually takes place. It does not oblige to suspend daily activities or to rest. It does not oblige to suspend daily activities or to rest. According to effective legislation, before starting, the couple must formalize an informative consent authorizing to carry out the intervention, as well as to make analysis, that allow discarding the presence of hazardous virus for the health of the future child (hepatitis B, hepatitis C, AIDS Virus). It consists of different stages: 1. Stimulation of Ovulation Every month, the ovary initiates the development of hundreds of oocytes (the cell, fertilized by the spermatozoon, gives rise to the embryo). Only one, or rarely two, mature, taking place ovulation or liberation of them on the part of the ovary. At that time, the Fallopian tube, embraces the ovary and collects the oocyte. The spermatozoon, deposited at the vaginal vault during intercourse, must reach the oocyte at the Fallopian tube. The ovarian stimulation tries that the oocytes are developed optimally and synchronizes the ovulation with the moment of insemination. In order to achieve this, the patient will receive a treatment that has several characteristics: Medication must be adjusted in a correct form to your particular response: each woman responds in a different way and each cycle of the same patient can even need different doses. It is essential to carry out an ovarian control, to obtain the optimal response. This control, is made by means of vaginal sound scanners and occasional blood analysis. In this way, we make sure that the dose is the correct one. Insufficient doses, are followed with poor answers. On the other hand overdoses can produce multiple ovulations, bringing the consequence of multiple pregnancies. Normally, two to four visits are needed throughout the cycle. These controls, also allow prediction of the moment of ovulation in order to carry out insemination correctly. If the ovarian answer is not the expected one, for example, in the case of fearing multiple ovulations, the insemination would not be carried out. 2. Sperm Improvement The correct day for the insemination, the man contributes, following the instructions given, with a sample of his ejaculation. In the laboratory, the best spermatozoa are separated from the rest in order to increase its fertilizing capacity by incubating them in suitable means of culture. This procedure requires between two to four hours. After this, the insemination will be made. 3. Insemination It consists of placing in the inner uterus the sample of previously improved sperm. There will be only one deposit, because of previous controls, we know the exact moment for it. It is a fast, completely painless technique, and uses a fine, soft plastic catheter, that allow us to place sperm next to the opening of the Fallopian tube. Therefore if we recall: We induce ovulation of mature oocytes. We improve sperm. We get them near. It is easy to deduce that we remarkably increase the chances that the two cells encounter and fuse, beginning pregnancy. After the insemination, the patient can resume calmly her daily activities. We must consider: The cycle success rate is estimated between a 14%-20%. We rarely advise more than three or four treatment cycles, since most pregnancies that are achieved by means of artificial insemination are obtain in the first cycles. If gestation is not accomplished, an appointment is arranged with the couple to gather the advice of our Reproductive Medicine Committee, where the facultative team meets to evaluate the clinical case and to indicate the steps to follow. The possibility of gestating is the same one in each cycle. The rate of multiple pregnancy is reduced with a correct control in an 8%. Published by our team in May, 2004. Fertility and Sterility Official Magazine of American Society of Reproductive Medicine. Once pregnancy is obtained, it will evolve in the same way as one obtained by an spontaneous cycle.