Assisted Reproduction Treatment Conjugal Artificial Insemination (IAC)

The Conjugal Artificial Insemination (IAC) is an easy treatment that can be followed and it’s not very disconcerting. If there is no contra-indication, it is the first treatment option.

The Conjugal Artificial Insemination is a human reproduction treatment that introduces the sperm of the couple (which is “improved” beforehand) in the uterus of the woman at the time of ovulation.

The conditions required for Artificial Insemination are:

  • For the woman: gynecological report, hysterosalpingogram and sonohysterography to show the permeability of at least one tube and blood analysis.
  • For the man: sperm analysis or REM test with the detection of a severe male factor, blood analysis.
  • Their consent to the Conjugal Artificial Insemination, after making an informed decision.

The Artificial Insemination is prescribed in the following cases:

  • Male factor: light/moderate alteration of the number or mobility of sperms.
  • Failure of planned sexual activities or Clomiphene Citrate.
  • Sterility of Unknown Origin (SUO).
  • Female factor: patients suffering from anovulation (for instance, Polycystic Ovary Disorder).
  • HIV or CHV positive men: in this case, we perform the artificial insemination after washing the sperm.

We do not perform an Artificial Insemination in the following cases:

  • Bilateral tubal occlusion.
  • High tubal adhesion.
  • Severe endometriosis.
  • Severe male factor.

The Artificial Insemination Technique:

  • Ovulation induction: from the 3rd day of the gonadotropin cycle (FSH hormone), they undergo a subcutaneous administration on a daily basis in order to stimulate the follicle growth. An ultrasound then helps evaluate the follicle development. When the follicles are ready, we apply another treatment (HCG hormone) to provoke the ovulation.
  • Sperm capacity: on the day of ovulation, the sperm of the couple is treated in order to improve its quality (particularly its mobility). After this improvement, we can proceed to the artificial insemination.
  • Artificial Insemination: in the cabinet, and in a practically painless way, we inject the sperms in the uterine cavity via an insemination catheter. From there, they go up to the tube where they fertilize the egg.

After artificial insemination, the patient can lead her normal routine in peace, without needing to rest. The success rate per cycle is around 20-24%, with an accumulative rate over 3 cycles reaching 65%. We recommend using this technique over a period from 3 to 6 cycles, which may be consecutive, because a rest between each cycle is not required. The multiple pregnancy rate is between 8 and 20%.

Last Update: 02/09/2014
References:
– Merviel P, Heraud MH, Grenier N, Lourdel E, Sanguinet P, Copin H. Predictive factors for pregnancy after intrauterine insemination (IUI): an analysis of 1038 cycles and a review of the literature. Fertil Steril. 2010; 93(1): 79-88.
– Cooper TG, Noonan E, von Eckardstein S, Auger J, Baker HW, Behre HM, et al. World Health Organization reference values for human semen characteristics. Hum Reprod Update. 2010; 16(3): 231-45.
– Intrauterine insemination. Hum Reprod Update. 2009; 15(3): 265-77.
– Polyzos NP, Tzioras S, Mauri D, Tatsioni A. Double versus single intrauterine insemination for unexplained infertility: a meta-analysis of randomized trials. Fertil Steril. 2010; 94(4): 1261- 6.
– Hughes EG. The effectiveness of ovulation induction and intrauterine insemination in the treatment of persistent infertility: a meta-analysis. Hum Reprod 1997;12:1865-72.