Definition Artificial insemination, or AI, is a procedure that is used to help a woman who is infertile become pregnant. Infertility is a disorder in which a woman is unable to become pregnant through sexual intercourse. In AI, sperm from a man is injected into a woman's cervix, uterus, fallopian tube, or ovarian follicle.
Who is a candidate for the procedure? Artificial insemination is recommended when a woman has been unable to conceive for more than a year. Artificial insemination may be used if:
the woman's cervical mucous does not allow for the sperm to be mobile
sperm are not able to survive in the cervix because the mucous "attacks" the sperm
there are problems with the shape and structure of the woman's body, making it difficult to conceive
there are problems with the sperm. This includes a low sperm count or low motility, the speed at which the sperm move toward the uterus.
To be a candidate for this procedure, a woman must have fallopian tubes that are in good condition and working properly. The tubes should be free of any disease and should not be blocked.
How is the procedure performed? AI involves several steps before, during, and after the actual procedure. Before the AI procedure, a fertility medication may be used to stimulate the production and maturation of the eggs. This also helps prepare the reproductive system for fertilisation. The fertility medications are often taken for about 7 days before the woman normally ovulates.
The woman will be monitored carefully while she is taking fertility medications. This includes ultrasound scans and blood tests to monitor her hormone levels. Using fertility medications also increases the chance of having a multiple pregnancy (twins, triplets, or more), making a higher risk pregnancy.
The doctor will help the woman figure out when she ovulates. A woman can do this by measuring her body temperature every day and noting any vaginal discharge. Ultrasound can also help determine when a woman is ovulating.
There are several types of AI, including:
intratubal, in which the sperm is injected into the fallopian tubes
intrauterine, in which the sperm is injected into the uterus
intrafollicular, in which the sperm is injected into the ovarian follicle
intracervical, in which the sperm is injected at the cervix, which is the opening to the uterus
The cause of the infertility determines which location for sperm injection.
The AI procedure is done in a doctor's office or clinic several days before the woman begins to ovulate. Sperm from the woman's partner or sperm from a donor is used. The sperm is collected on the day of the procedure. Depending on the type of AI being done, the sperm may undergo a special "washing." This prepares it for injection into the body. This also makes it more concentrated for fertilisation.
A woman is positioned as for a pelvic exam, with her feet up. A speculum will be inserted into the vagina, as in a pelvic examination. Next, the sperm will be drawn into a plastic syringe. A catheter, or thin tube, is attached to the syringe and is moved into the appropriate location. The sperm is then injected into the cervix, uterus, fallopian tube, or ovarian follicle. This procedure is usually painless. The entire procedure may take anywhere from 45 minutes to a few hours.
What happens right after the procedure? Usually the doctor will have the woman lay still for about 30 to 45 minutes with her legs elevated. Often a cervical cap will be put over the cervix to hold the sperm in place for several hours. The cap is then removed later that day. Next, the woman can usually go home and resume normal activities. Pregnancy testing will be done. If conception has occurred, the pregnancy will be monitored closely.
What are the potential complications after the procedure? A possible complication of AI is a risk of having a multiple pregnancy. A multiple pregnancy may increase the risk of miscarriage or low-birth-weight babies. When too high a dose of fertility medication is used, the ovaries can become over stimulated and cause abdominal pain.
Author: Eileen McLaughlin, RN, BSN Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
