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Insemination (IUI)

While there are various applications of artificial insemination, in practice, when we talk about artificial insemination, it usually refers to the process of collecting and preparing a sperm sample from the male and then placing it into the woman’s uterus. The goal of artificial insemination is to facilitate the meeting of sperm and the egg during ovulation in young and healthy couples to achieve pregnancy. Therefore, selecting the right patient and ensuring proper preparation of the woman’s ovaries and uterus are crucial.

Who is Suitable for Artificial Insemination (IUI)?

In artificial insemination, since both the egg and sperm will come together within the female reproductive system, it is necessary for ovulation to occur naturally or be induced with medications. Additionally, even if there is a mild decrease in sperm parameters, the sperm should still have sufficient quality, and the fallopian tubes and uterine environment should be healthy. The success of artificial insemination is generally higher in young couples.

Unexplained infertility in women with ovulation problems or irregular menstrual cycles (such as those with polycystic ovaries) or couples with mild male factor infertility (mild decreases in sperm count, motility, or morphology) and or situations where regular sexual intercourse is not possible. IUI treatment can be explored.

How is the Preparation for Artificial Insemination Done?

For artificial insemination, ovulation needs to occur either naturally or with the help of medications. Oral medications or low-dose injections administered through the abdomen can be used to stimulate egg development. Follicle growth is monitored with ultrasound, and when the follicle reaches 18-20 mm in size, a trigger injection (hCG) is administered, and artificial insemination is scheduled for approximately 36 hours later. Your partner should abstain from ejaculation for 2 to 4 days. On the day of the procedure, your partner’s sperm will be prepared in the laboratory (sometimes subjected to special washing procedures to concentrate the most motile sperm), so you will need to be at the clinic about 1 hour before the insemination procedure. It is advisable to have a partially full bladder to make the procedure more comfortable.

Is Artificial Insemination Painful? How is the Procedure Done?

The procedure is generally painless and can be performed without the need for anaesthesia in women who have had sexual intercourse. In cases where conditions like vaginismus hinder vaginal examinations, short-term sedation anesthesia called sedation may be applied. The artificial insemination procedure is done on a gynaecological examination table. A speculum, a small instrument, is placed in the vagina to visualize the cervix. If there is mucus or debris in the cervix, it is cleaned. The prepared sperm sample, which is about 0.5-1 cc, is introduced into the uterus through a thin catheter. Ultrasound may be used during the procedure for monitoring.

What Should I Pay Attention to After Artificial Insemination?

There is no specific waiting period required after artificial insemination. However, in practical terms, patients are often advised to rest for about 5-10 minutes on the examination table after the procedure and then to rest for half an hour. After the procedure, you can continue with your normal daily activities.

Will I Need Any Medication After Artificial Insemination?

You can continue taking your vitamins and any other necessary medications that you are already using. There is usually no specific medication required after artificial insemination. However, in some cases, additional progesterone supplementation may be recommended. It’s worth noting that the body can often produce the necessary progesterone for pregnancy after successful ovulation induction.

What is the Success Rate of Artificial Insemination?

Artificial insemination is essentially an attempt to achieve pregnancy using mechanisms similar to natural sexual intercourse. In young couples, the success rate of artificial insemination ranges from approximately 15-20%.

Is There an Ideal Sperm Count for Successful Artificial Insemination? In couples where the total motile sperm count after processing is 9 million or higher, artificial insemination can achieve a success rate of 15-20% (ASRM 2015). However, in cases where the total motile sperm count is less than 9 million, the chances of success are lower.

How Many Times Can I Have Artificial Insemination?

In young couples, artificial insemination can be performed before resorting to in vitro fertilization (IVF). While technically up to 3 attempts can be made, the success rate of repeated inseminations decreases with each subsequent attempt. Therefore, in practice, trying it 2 times is often sufficient.

Is it Mandatory to Have Artificial Insemination Before in Vitro Fertilization (IVF)?

Technically, there is no such requirement. However, due to the relatively easy preparation process and lower cost, artificial insemination is often preferred, except in cases where treatment outside of IVF is not possible. Additionally, for couples using their health insurance to undergo IVF treatment, there may be a requirement to have a certain number of artificial insemination attempts before proceeding to IVF.