Couples with an unfulfilled desire to have children can use modern reproductive medicine to help them get their family off to a good start. Insemination plays a major role as a method of artificial insemination. There is a great need for information before undergoing such treatment.
Find out here how insemination can increase the probability of pregnancy compared to natural fertilization through the targeted introduction ofprepared sperm into the uterus.
Insemination (sperm transfer) is a method of artificial insemination in cases of an unfulfilled desire to have children. The treating doctor inserts sperm (sperm cells) into the woman's uterus using a small catheter. This makes successful fertilization and thus pregnancy more likely compared to natural fertilization.
Mild hormonal stimulation can lead to the maturation of several follicles. This results in an increased probability of a multiple pregnancy. In the rare case that significantly more than 2 follicles are present in the preceding ultrasound checks, the cycle is aborted and insemination cannot take place. Overstimulation syndrome is very unlikely to occur during mild hormonal stimulation.
The beginning of a pregnancy: The sperm meets a female egg cell © Kateryna_Kon / Fotolia
There are various reasons for difficulties with natural fertilization, which can be present in both the woman and the man.
These cases of sperm transfer using the patient's own prepared sperm are also known as homologous insemination.
If sperm from a sperm donor is used, this is called heterologous insemination. This method of artificial insemination can also help single or homosexual women who wish to have children with family planning.
Depending on where the sperm cells are injected and the origin of the sperm, a distinction can be made between different forms of this treatment, which is usually carried out by reproductive physicians:
Theprerequisites for successful sperm transfer are healthy (patency) fallopian tubes and a sufficient number and motility of sperm capable of fertilization.
The anatomy of the female reproductive organs(vagina, cervix, uterus and ovaries) is clarified in advance in a gynecological examination and a transvaginal ultrasound to rule out anatomical causes of infertility.
The fallopian tubes cannot normally be visualized by ultrasound. To check the patency of the fallopian tubes , a further examination or operation can be discussed with the patient if necessary, for example a sonographic examination of the patency of the fallopian tubes with contrast medium or a laparoscopy with chromopertubation and uterine endoscopy.
The woman's hormone status is also determined by blood tests. In men, a laboratory examination of the sperm, the spermiogram, must first check the characteristics of the sperm quality (concentration, motility, shape of the sperm).
If the fallopian tubes are blocked or the cervix is inflamed, insemination should not be carried out.
Before the insemination itself, mild hormonal stimulation of the woman is usually planned. This stimulates 1-2 egg cells to mature in the ovaries, but this is associated with an increased probability of a multiple pregnancy. For this reason, regular ultrasound examinations are carried out to determine the number and size of the stimulated follicles (follicles with egg cells).
After ovulation has been induced with medication, the laboratory-prepared sperm (enrichment of motile, fertilizable sperm cells) are transferred into the uterus or cervix using a catheter.
The success of the treatment can be checked after around 14 days using a pregnancy test. The first proof of pregnancy is only possible 3 weeks after insemination.
With insemination to the desired child © AK-DigiArt / Fotolia
Very few women become pregnant after the first treatment. In most cases, three or four attempts are necessary before this artificial insemination has led to the desired success. However, for one in five women, this method remains unsuccessful in the longer term. These couples then have the option of undergoing IVF (in vitro fertilization) or ICSI therapy.
However, there are also risks. If the woman has undergone stimulation, the probability of a multiple pregnancy is increased.
In extremely rare cases, overstimulation syndrome with abdominal pain, nausea and shortness of breath can also occur. In this case, the patient should see a doctor immediately.
However, this does not usually occur with mild hormonal stimulation, as is common with inseminations. Overstimulation syndromes are typical of hormonal stimulation for IVF and ICSI therapy.
The cost of insemination - per treatment and cycle - is around 200 euros. Added to this are the costs for medication. Statutory health insurance companies cover 50% of the costs for up to three inseminations with stimulation and up to eight inseminations without stimulation.
Thelegal requirements of the statutory health insurance funds for sperm transfer in Germany are
Insemination specialists are usually specialists in reproductive medicine. In addition, specialists in gynecology and urology can also be consulted on questions relating to the desire to have children.
Inseminations are carried out at reproductive medicine centers at university women's clinics and in private fertility centers.
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