What Is Artificial Insemination?

Artificial insemination (AI) refers to an assisted reproductive technology (ART) that uses non-sexual methods to deliver sperm to the female reproductive tract to achieve the purpose of fertilizing a woman. It refers to an assisted reproductive technology (ART) that uses non-sexual methods to deliver sperm to the female reproductive tract to achieve the purpose of fertilizing a woman. According to its sperm source, AI can be divided into artificial insemination (AIH) from husband sperm and artificial insemination (AID) from third-party sperm. According to different insemination sites, such as vaginal, cervical canal, uterine cavity, fallopian tube and abdominal cavity insemination, they are called intravaginal artificial insemination (IVI), intrauterine insemination (ICI), intrauterine insemination (IUI) and intrafallopian tube Artificial insemination (IFI). The implementation process shall be in accordance with the "Administrative Measures for the Assisted Reproductive Technology of Human Beings" promulgated by the Ministry of Health (Ministerial Order No. 14 of the Ministry of Health in 2001), and the "Notice of the Ministry of Health on Revising the Related Standards, Basic Standards and Ethical Principles of Assisted Reproductive Technology and Human Sperm Banks" "(Health Science Education [[2003]; No. 176)" and "Implementation Rules of the Ministry of Health on the Implementation of Human Assisted Reproductive Technology and Human Sperm Bank Calibration" (Health Science Education [2006] No. 44) and other regulations.

Basic Information

English name

artificialinsemination

Visiting department

Obstetrics and Gynecology

Common causes

Infertility

Contagious

no

IUI Intrauterine Insemination (IUI)

Indication

Male factors: sexual dysfunction, mild azoospermia; ovulation disorders; infertility of unknown cause; endometriosis (mild to moderate); cervical infertility.

Contraindication

Acute and chronic systemic diseases and inflammation of the reproductive tract; the woman's sperm and egg combination disorder due to fallopian tube factors; the woman has a genetic disease, a serious physical disease, and a mental and psychological disorder; has a birth history of a congenital defect baby and is confirmed to be caused by the woman's factor; The woman is exposed to teratogenic radiation, poisons, and drugs and is in the action period; the woman has bad habits such as alcohol and drug abuse.

3. Men's Weak Spermia Can IUI Semen Conditions

Sperm density 15 million / ml, forward motile sperm (a + b) 15%; conditions for IUI after semen treatment: upstream a-grade sperm 70%, sperm 20 per HPF, at least one fallopian tube is unobstructed .

4. Diagnosis and treatment process

(1) Preparation by the woman Natural cycle IUI: Those who have regular menstruation can have natural cycle IUI. The patient started monitoring follicular growth on days 8-10 of the menstrual cycle. Ovulation-promoting cycle IUI: For those with ovulation disorders, ovulation-promoting is required. The patient returned to the clinic on the 2nd to 3rd day of the menstrual cycle to rule out pregnancy. Except for ovarian cysts on B-ultrasound, ovulation-promoting drugs can be given. When the dominant follicle reaches 1.4 cm, establish an IUIB ultra-monitoring form, complete the monitoring form completely, and clearly indicate the IUI indications. Review the "three certificates". Tell the patient that B does not need to retrieve the medical records during this period. IUI timing: IUI is performed one day after the appearance of LH peak; IUI on ovulation day; HCG is injected when at least one follicle reaches 18-20 mm in diameter, and IUI is performed 24 to 36 hours after HCG injection. When the ovulation-promoting cycle has> 3 dominant follicles, the IUI of the cycle is abandoned. Progesterone support: Oral progesterone can be given for 14 days from the third day after ovulation, and urine and blood HCG can be checked for pregnancy 16 days after the operation.

(2) The man prepares the man to masturbate once on the 8th day of the menstrual cycle. On the day of IUI, the man masturbated to obtain sperm, and the number of sperm in the forward movement injected by the husband's semen artificial insemination was more than 1 million.

5. IUI frequency per cycle

IUI is 1-2 times per cycle. A meta-analysis with more than 1,000 IUI cycles showed that two IUIs can slightly increase fertility compared to a single IUI, but the statistical difference was not significant (14.9%, 11.4%).

6.IUI cycle number

IUI has the highest pregnancy rate in 3 to 4 cycles. After 3 to 6 cycles of IUI, its cumulative pregnancy rate enters the plateau stage.

Artificial insemination

Indication

Testicular azoospermia, obstructive azoospermia, severe oligozoospermia, asthenozoospermia, and teratozoospermia; failure to reintegrate vas deferens; ejaculation disorders; men and / or families with severe hereditary diseases that are not fertile; Infant blood group incompatibility does not result in a viable newborn. Among them, in addition to testicular azoospermia, other patients who need to use artificial insemination technology, medical staff must explain to them that they can obtain their blood offspring through the intracytoplasmic sperm microinjection technology (ICSI).

Contraindication

The woman suffers from acute genitourinary infection or sexually transmitted diseases; the woman suffers from severe genetic, physical or mental illness; the woman is exposed to teratogenic radiation, poisons, drugs and is in the action period; the woman has bad habits such as drug abuse.

3. Commonly used sites for insemination and artificial insemination

Including artificial insemination in the vagina, artificial insemination in the cervix, artificial insemination in the uterine cavity, generally used artificial insemination in the cervix.

4. Artificial insemination methods and timing

Can be carried out in the natural cycle or ovulation-promoting cycle, the specific timing of artificial insemination with the husband's sperm.

5.AID semen requirements

According to the technical specifications of the original Ministry of Health, when thawed semen is used for intrauterine insemination, the total number of forward-moving sperm after resuscitation must not be less than 10 × 106 / ml, and the percentage of forward movement must not be less than 35% .

6. Institutions implementing insemination and artificial insemination technology should establish strict confidentiality measures to ensure the privacy of patients; establish a practical follow-up mechanism to ensure timely and accurate feedback of pregnancy and offspring to the sperm bank; and establish a reliable operating mechanism In cooperation with the computer-aided management system, the frozen semen of each donor can only be controlled to conceive up to 5 women.

References:

1. Decree No. 14 of the Ministry of Health of the People's Republic of China, "Administrative Measures on Human Assisted Reproductive Technology".

2. Zhang Lizhu, chief editor. Clinical Reproductive Endocrinology and Infertility Second Edition: Science Press, 2006.