Methods of artificial insemination. Artificial insemination. List of tests for artificial insemination

Differences between IVF and artificial insemination

Currently, with the help of new reproductive technologies, the process of artificial conception gives many childless couples diagnosed with infertility hope to become parents.

How is conception

AI is a technology that is used to deliver a baby to women suffering from various types of infertility. Today it is widely used 2 most popular methods of fertilization, each of which has its own specifics:

• artificial insemination
• in vitro fertilization

IVF involves creating conditions for conception outside the body of a woman, while artificial insemination occurs directly inside it.

intrauterine insemination method

The essence of the method is the introduction of the male seed into the female body, bypassing many different obstacles. The main condition is the patency of the fallopian tubes. The fact is that, despite the guaranteed “landing” in the uterine cavity, the sperm must themselves get to the egg. But they can do this only through the fallopian tubes. If there are problems with patency, this method is not recommended.

Before entering the sperm, it is subjected to a special treatment, during which only healthy spermatozoa are left. Thus, not only the quality of sperm is increased, but the risk of having a child with pathological changes is also reduced.

IVF - a laboratory way of the origin of life

Among the scientific achievements of the twentieth century, the method of in vitro fertilization is perhaps one of the most outstanding. With the help of this method, the problem of infertility was almost completely solved.

IVF is a technology that allows you to reproduce the necessary conditions for conception outside the human body. As a rule, this procedure is resorted to by people who, for several years, have failed to conceive a child, and the treatment has been ineffective.

To date, there are about five million IVF children on earth, many of whom have already become parents themselves. At present, we can safely say that children conceived in the laboratory do not have any differences from babies conceived naturally.

IVF technology involves the passage of several stages, during which patients are under the constant supervision of doctors.

1. The first phase involves taking hormonal drugs, with the help of which ovulation is stimulated. This procedure is necessary for the maturation of a large number of eggs.
2. The second stage involves a transvaginal puncture of the follicles, during which mature eggs are extracted.
3. Then comes the third phase. The so-called cultivation of embryos: the resulting egg and sperm are subjected to special treatment, after which they merge (fertilization). Then the embryos must reach a certain stage of development.
4. At the final stage, the embryos are transferred into the uterine cavity for their further development.

As a rule, several embryos are placed in the uterus at once to increase the likelihood of a favorable outcome.

The cost of the procedure and statistics

It should be noted that no one can guarantee a 100% result that will follow after artificial conception. Some women manage to get pregnant in this way after the first attempt, while others get a negative result after several procedures.

In the case of artificial insemination, the probability of a positive result is about 30%. The cost of the procedure ranges from 15 to 30 thousand rubles..

When using in vitro fertilization, the probability of getting pregnant will be about 40%. The price for IVF varies from 115 to 200 thousand rubles.

If you fail to conceive a child naturally, this does not mean at all that you will not be able to become the genetic parents of your child. Modern medicine really works miracles. The main thing is not to lose hope and move only forward.

When it comes to artificial insemination, most often patients are offered the IVF procedure. However, reproductive medicine has other methods that are more effective in certain cases. Each artificial insemination has its own characteristics, indications and contraindications.

Conventionally, the methods of assisted reproductive medicine are divided into insemination and injections. Inseminations are not expensive, but the chances of successful conception are less, and the list of indications is shorter. In vitro conception is more expensive, but more effective and possible even in severe cases of female and male infertility.

Artificial insemination has long become familiar and normal. People can constantly debate the ethics of such a conception, but one thing cannot be denied - a medical procedure is often the only way to have children of your own.

Artificial insemination allows you to control and regulate the process of fusion of germ cells. Usually this phrase refers to the IVF procedure, although there are other methods of assisted reproductive medicine. There are three methods that combine all varieties: IVF, and insemination. All of them lead to the fusion of the egg and sperm, but under different conditions.

Artificial insemination is possible only if the woman is potentially capable of carrying and giving birth to a child. Cardinal measures are usually recommended after 1.5-2 years of infertility therapy (except in cases that are not amenable to treatment).

Artificial insemination is legal in Russia. Official registration of marriage is not required, but if it is, confirmation of the spouse is required. Patients must be over 18 years of age. There are donor cell banks in every country.

Women under 38 years of age before artificial insemination must receive official confirmation of the diagnosis and treatment failure (usually 1.5-2 years). Women older than this age can undergo the procedure immediately and without prior treatment.

If the examination reveals any diseases that may interfere with any of the stages of artificial insemination, pregnancy or childbirth, the procedure is postponed. Patients are prescribed treatment and manipulations are carried out only when the condition is stable.

All methods of artificial insemination are short and normally tolerated by patients. Therefore, it is possible to repeat the procedure without long interruptions.

IVF and its modifications, ICSI, IISM and IISD, donor programs and surrogacy are classified as assisted reproductive technologies. They are resorted to in cases where there is no chance of pregnancy occurring naturally or the probability is less than with the use of reproductive technologies. All methods of artificial insemination can be divided into two groups: artificial insemination and intracytoplasmic injections. Insemination implies the fertilization of the egg in the conditions of the female body, and with IVF and ICSI - outside the body.

Donor programs and surrogacy

In cases where partners have problems directly with germ cells, it is possible to use donor material. All donors undergo a complete medical genetic examination, which eliminates the risk of inheriting dangerous diseases.

Women who are unable to bear a child can turn to. Donor sperm is used only after its double examination with an interval of three months. Before IVF, preimplantation genetic diagnosis is carried out, which reveals genetic pathologies, abnormalities in chromosomes, and possible developmental anomalies.

Intracytoplasmic injections

The injection method is more complicated than insemination, it requires the fulfillment of certain conditions and is divided into several stages. First, a woman is prescribed hormonal drugs to stabilize the endocrine system and prepare the body for ovulation and fertilization. The doctor regularly checks the maturation of the eggs. Stimulation helps to grow some good eggs.

After retrieving the eggs and combining them with sperm, the cells are placed in an incubator at a certain temperature that will promote conception. This process takes several days. Artificial insemination can be carried out using the ICSI or IVF method.

in vitro fertilization

IVF procedure is the most popular method of artificial insemination. In this case, conception occurs outside the woman's body in artificially created conditions. IVF is a fairly young method, which nevertheless has already become the gold standard of reproductive medicine. The procedure was first performed in 1978 in England. According to statistics, IVF reduces the risk of fetal pathologies.

In vitro fertilization is considered the most effective and reliable method of assisted reproductive medicine. The egg is removed from the woman's body and fertilized "in vitro" using the husband's or a donor's sperm. After cell fusion, the embryo is placed in the uterus. Subsequent pregnancy is no different from pregnancy after natural conception. Children born in this way do not suffer from any specific diseases and do not have abnormalities.

Indications for IVF

• endocrine disorders;
• complete obstruction of the fallopian tubes;
• absence of fallopian tubes;
• endometriosis;
• unexplained causes of infertility.

Doctors control the process of egg maturation by controlling the level of hormones. During this period, a woman can lead a normal life, but taking into account the recommendations of doctors on nutrition, physical activity and emotional state.

After hormonal therapy, the stimulation of egg maturation is carried out, then they are removed from the ovaries using puncture and ultrasound scanning. At this time, the partner donates sperm, it is processed and prepared. Then, under special conditions, the materials of the spouses are mixed and placed in an incubator so that a natural combination of cells occurs.

After fertilization, the embryologist analyzes the development of the embryos. The most viable are transferred to the uterus. Usually, several fertilized cells are used to increase the chances of attaching at least one. Therefore, after IVF, twins and triplets are often born. The resulting embryos can be cryopreserved to be used in the future or in the absence of pregnancy after the procedure. In the case of engraftment of several embryos, a part can be removed, but the woman must make such a decision.

Contraindications for IVF

• psychical deviations;
• deformation of the uterus;
• inability to bear a child;
• ovarian tumor;
• benign formation in the uterus;
• malignant pathologies;
• acute inflammation.

If the patient has serious problems with egg maturation, donor cells can be used. In vitro fertilization is much more effective than insemination. The first procedure is successful in 33% of cases. The disadvantages of IVF are long-term hormone therapy and high cost. Prices start from 80 thousand rubles, but on average an IVF procedure costs 120-200 thousand rubles. The final figure is determined by the complexity of the chosen technique, the degree of stimulation, the need to use donor sperm and additional services in each particular clinic.

Injection of the sperm into the egg

The ICSI procedure is the fertilization of the egg by intraplasmic infection of the spermatozoon. Usually, the method is recommended for male infertility, caused by a violation of the quantity and quality of the composition of sperm. This method is a real lifesaver for many patients as it requires only one sperm cell. The doctor selects the most mobile and viable and injects it into the egg. After a few weeks, the uterus and the attachment of the embryo are checked by ultrasound. Often, during artificial insemination, a woman is prescribed hormonal drugs to maintain pregnancy.

ICSI is recommended when IVF and other methods have failed. The procedure is indicated for female and male infertility, even in the most severe cases. According to statistics, as a result of ICSI, pregnancy occurs in every third woman (60-70% of the probability of successful fertilization).

Compared to IVF, the procedure is more delicate: one sperm is selected, which is injected into one egg using an ultra-thin glass needle. ICSI gives hope even in the most severe cases of infertility, especially in males. After a few days, the doctor selects the most viable embryos.

Stimulation of folliculogenesis

The purpose of this event is to form several normal eggs so that doctors have a choice. Hormone regimens are called protocols. They differ for different methods of artificial insemination, are selected and adjusted individually for each patient. All protocols are divided into short and long.

Usually, before stimulation, a course of oral contraceptives is prescribed for 1-2 weeks to suppress the secretion of sex hormones. This is necessary to prevent natural ovulation when one cell matures.

The protocol is usually started on days 1-2 of the menstrual cycle. The patient is prescribed follicle-stimulating drugs, human chorionic gonadotropin, gonadotropin-releasing hormone agonists or antagonists. A woman is given injections of follicle-stimulating hormone (Gonal or Puregon) and gonadotropin-releasing hormone (Buserelin, Goserelin, Diferelin). The drugs are administered daily. Every few days, a blood test is performed to determine the concentration of estrogen, and an ultrasound to measure the follicles.

Follicle-stimulating hormone is canceled at an E2 estrogen concentration of 50 mg / l and a follicle size of 16-20 mm. Typically, such indicators are available on the 12-15th day of stimulation. On this day, injections of human chorionic gonadotropin are added. Gonadotropin-releasing is canceled the day before hCG is cancelled. The doctor determines the duration of the course according to the results of ultrasound. 36 hours after the abolition of hCG, cells are collected.

The short protocol also starts on the second day of the cycle. A woman is injected with all three drugs every day, analyzing the growth of follicles every 2-3 days. In the presence of three follicles of 18-20 mm, the drugs are canceled (hCG is administered for another 1-2 days). Eggs are collected 35-36 hours after the last injection.

Sex cells are obtained using a needle that is inserted into the ovaries through the peritoneum or vagina. The woman is under anesthesia, so she does not experience discomfort. The procedure takes up to 30 minutes. Sperm is obtained by masturbation. If there are difficulties, male germ cells are taken through similar manipulations.

insemination

Insemination methods involve the introduction of sperm into the uterine cavity using a catheter. Conception occurs in much the same way as with natural fertilization. For artificial insemination, the sperm of a partner or a donor is used.

Indications for insemination

• absence of a partner;
• vaginismus (spasm of the vaginal walls, in which sexual intercourse is impossible);
• potency disorders;
• ejaculation disorders;
• insufficient number of active spermatozoa;
• cervicitis, which is not treatable;
• immunological incompatibility of spouses (presence of antisperm antibodies in the cervical mucus).

Before insemination, both partners need to undergo a complete examination and identify the causes of infertility. Preparation for the procedure includes a consultation with a therapist and a gynecologist, a blood test (HIV, viral hepatitis, syphilis and other infections), a smear test. It is necessary to determine the blood type and Rh factor of partners and evaluate their compatibility. A man must pass a sample for a spermogram, and a woman determines the time of ovulation, examines the uterus and fallopian tubes.

If no contraindications are identified, preparation can begin. According to indications, doctors can prescribe drug stimulation of ovulation. Sperm is taken in advance (2-3 hours). When donor material is selected, frozen sperm is used.

Sperm is processed, spermatozoa are separated from seminal fluid. The resulting mixture is injected into the uterus through a catheter. The procedure takes a few minutes and does not cause discomfort to the patient.

Contraindications for insemination

• uterine pathologies that make childbearing impossible;
• ovarian tumor;
• malignant pathologies;
• acute inflammation;
• psychical deviations.

On average, artificial insemination costs from 30 thousand rubles when using partner sperm and from 40 thousand when using donor sperm.

Artificial insemination with husband's sperm

The IIMS procedure is recommended in the case when the woman's reproductive system was not subject to pathological changes, there are no adhesions, erosions, convolutions, and the fallopian tubes are passable, but the partner's sperm has insufficient characteristics for natural conception. For sperm, they are processed and endowed with the properties necessary for fertilization. During the procedure, the partner's processed sperm is artificially injected into the uterus.

IISM can be prescribed in case of incompatibility of partners. The reasons for this phenomenon are different, but usually this is an aggressive effect of the flora of the vagina or uterus on spermatozoa. The introduction of sperm directly into the uterus eliminates the contact of the seed with the microflora of the vagina, which greatly increases the chances of successful fertilization. The injection procedure is painless, the embryos are passed through a thin catheter.

For one menstrual cycle, intrauterine insemination can be carried out 2-4 times. It is necessary to undergo an examination and pass tests in order to calculate the most favorable time.

Artificial insemination with donor sperm

The IISD procedure is recommended in the presence of poor indicators of the partner's spermogram. Donor sperm should also be used in the case when the reason for the incompatibility of the spouses is not clear, there is a high risk of a blood conflict or there were dangerous hereditary pathologies in the family. IISD is carried out only with the joint consent of the partners.

The procedure itself is not much different from insemination with the husband's sperm. IISD and IISM are similar procedures that are carried out under the same conditions. You can also repeat 2-4 times per cycle, but the effectiveness of the procedure is 30% more (according to statistics, with ISIS, the chances of success are 40%).

Methods IISM and IISD are recommended for male infertility, sexual disorders, immunological conflict. During preparation, the patient should visit the clinic regularly to monitor the number of maturing follicles and the growth of the endometrium in the uterus.

Transplantation of germ cells into the fallopian tubes

GIFT (gamete intrafallopian transfer) is a procedure for transplanting egg and sperm gametes into fallopian corpses. Artificial insemination by this method requires special training and the fulfillment of certain conditions. You can place gametes only in passable fallopian tubes and at a strictly selected time. Since only one ovulation occurs per menstrual cycle, GIFT can only be done once a month.

ZIPT (zygote intrafallopian transfer) is a procedure for transplanting a zygote into the fallopian tubes. In this case, the fertilization of the egg is carried out outside the body, after which the embryo is placed in the fallopian tubes.

GIFT and ZIFT procedures are carried out in a hospital. The doctor uses a laparoscope and an ultrasound scan. If, during the placement of gametes, the mixture is injected from the side of the peritoneum through a small puncture, then the embryo is implanted through the cervix. The ZIPT procedure is carried out after ovulation and hormonal preparation of the uterus. The methods of GIFT and ZIFT are extremely rarely used in reproductive clinics in Russia, since they are inferior in efficiency to standard IVF.

When it comes to artificial insemination, many people think of IVF as the most common way. Despite the fact that its effectiveness has been proven by time, fertility doctors also use other methods.

This article will tell you in detail about what ART is for infertility and what types of insemination modern medicine uses, as well as whether it is possible to perform them at home.

What is ART for infertility?

ART for infertility is an assisted reproductive technology that helps a woman get pregnant. The purpose of the procedure is to obtain healthy offspring from infertile couples.

The indication for ART is tubal infertility with obstruction of the fallopian tubes or their absence, immunological forms of infertility, male infertility, endometriosis, infertility of unknown origin, as well as infertility that is not amenable to therapy.

ART means:

• intrauterine injection of partner's sperm;
• use of donor sperm.

The artificial introduction of spermatozoa into a woman's uterus means that they pass through the cervix without the risk of dying during an attempted natural conception. This significantly increases the chances of spouses to conceive a child with cervical infertility factor.

Other indications for ART:

• ejaculatory dysfunction;
• oligoastenozoospermia;
• immunological infertility;
• infertility of unknown etiology.

Artificial insemination has an efficiency of about 30% in one attempt.

There are several types of insemination. They are divided according to the place of replanting and are divided into:

1. vaginal;
2. uterine;
3. pipe;
4. cervical;
5. follicular.

Kinds

There are about 10 methods used in medicine, which are used as assisted reproductive technologies. Below we consider the most popular of them.

ECO

IVF or in vitro fertilization is currently the most popular method of assisted reproductive technology used in case of infertility. It is also known as "in vitro fertilization".

The egg is removed from the woman's body and artificially fertilized. The resulting embryo is kept in an incubator for 2-5 days, after which it is transferred back to the uterine cavity. Further development takes place in the body of a woman.

We offer you to watch a video about what is in vitro fertilization:

ICSI

ICSI is the artificial introduction of sperm into the cytoplasm. The method is used in cases of various pathologies of spermatozoa, for example, a decrease in their number in semen or poor mobility.

ICSI is an auxiliary IVF method. With the help of a microneedle, a spermatozoon is injected into the egg, and after that it is planted in a woman.

We offer you to watch a video about what is the artificial introduction of sperm into the cytoplasm:

ISM

ISM is artificial insemination with husband's sperm. It is used in cases where the woman's reproductive system is working normally, and the partner has problems associated with a decrease in the ability of sperm to conceive.

Artificial insemination with the husband's sperm is used when the couple is incompatible.

The method consists in creating favorable conditions for conception and introducing spermatozoa into the uterine cavity.

To increase the chances of conception in one menstrual cycle, it is permissible to carry out up to four manipulations. The chance of getting pregnant with this method of fertilization is 20-40%.

Lately the method is often used to overcome the immunological aggression of the cervical mucus. In this case, the transplanted spermatozoa artificially pass through the destructive environment, immediately ending up in the uterine cavity. The effectiveness of the method in this pathology is up to 27.7%.

ISD

ISD is artificial insemination with donor sperm. It is used in the case when male sperm is of poor quality or there is an insurmountable barrier of incompatibility of partners. These include the diagnoses of aspermia, grade 3 oligospermia, and azoospermia. Also, the method is used for general severe diseases of the spouse.

ISM and ISD techniques are the same, however, the probability of a successful pregnancy when fertilized with donor sperm is higher and amounts to 50-80%. The maximum number of cycles during which it is advisable to attempt artificial insemination is 4 times.

ZIFT

ZIPT - transplantation of the future embryo (zygote) into the fallopian tube. A zygote is formed by the fusion of germ cells with a specific set of chromosomes.

Several germ cells are taken from both partners and injected as zygotes into the woman's fallopian tube. At the same time, the integrity of the fallopian tubes and their functions must be preserved. Indications for the procedure are cervical factor of infertility or problems with immunological incompatibility of partners.

Unlike the following method, already fertilized eggs are transferred to the reproductive organs of a woman at an early stage of development. Accordingly, the probability of pregnancy is higher than with GIFT.

GIFT

GIFT is the transplantation of an egg and sperm (gametes) into the fallopian tube. The essence of the method is to take several eggs from the future mother, and sperm from the future father. After they are mixed, they are planted in the woman's uterus.

The success of the procedure depends on the full operation of the fallopian tubes and the timely transplantation.

Indications for this artificial insemination: incompatibility of partners or male infertility. The effectiveness of GIFT and ZIFT methods reaches 30%.

Carrying out the procedure at home

Of all existing types of artificial insemination only vaginal insemination can be done at home. It does not require special preparation from a man and a woman. Since the process practically does not differ from sexual intercourse, it makes sense to carry it out only if a woman is trying to get pregnant from donor sperm and does not suffer from infertility.

For the treatment of infertility, other methods of insemination are used, which are carried out exclusively in the clinic.

Doctors insist on professional participation in the process of artificial insemination and do not recommend performing the procedure at home, however, some women prefer to do it on their own, trying to save money on going to specialists. Doing so is not always wise.

For the procedure, there is a kit for intravaginal insemination on sale. Procedure sequence:

1. The first step is to prepare donor sperm. It must be placed in a special container and wait 15-20 minutes. It should not be forgotten that spermatozoa show viability only the first 2-3 hours after ejaculation.
2. Using a special syringe from the kit, a woman needs to inject sperm into the vagina. You can do it yourself or ask for help. Sperm must be released at the base of the cervix, in no case by inserting the tip into the uterus itself, as this is fraught with injury.
3. After that, the woman should lie down with a raised pelvis for 30 minutes. It should be ensured that the sperm does not flow out of the vagina - this will increase the chances of becoming pregnant.

It is necessary to carry out intravaginal insemination during the period of ovulation.. The effectiveness of the process can be determined by a pregnancy test.

It is important to keep the room and tools clean during the procedure at home, and also not to use the insemination kit twice.

The use of lubricants or saliva should be avoided in order not to harm the viability of the spermatozoa. Before masturbation, a man should thoroughly wash his genitals.

You can not inject sperm with a syringe into the cervix - this can lead to pain shock, infection, and even an anaphylactic reaction on the part of the woman.

Contraindications:

• inflammatory diseases of the uterus, appendages or ovaries;
• absence of fallopian tubes;
• tubal occlusion;
• oncology of the pelvic organs;
• exacerbation of infectious diseases, for example, SARS;
• the presence of STDs;
• lack of ovulation;
• endocrine disorders;
• any other diseases associated with the problem of miscarriage.

Do not perform home insemination without the knowledge of the spouse or donor. This can lead not only to misunderstandings, but also to problems with the law. Insemination can be carried out only when the donor gives his consent.

Even 10 years ago, only scientists involved in research knew about the methods listed in the article. Today, these procedures are available to all clients of reproductive centers not only on a commercial basis, but also on a budgetary basis.

It should be remembered that all methods of insemination must be carried out in a clinical setting, since during the procedure, it is necessary to maintain the sterility of the room and instruments as well as special training.

Assisted reproductive technologies are used only after a thorough examination of both partners. Only in this way will a woman experiencing problems with conception be able to endure and give birth to a healthy child.

Unfortunately, in our time, up to 20% of couples face the problem of infertility. If a diagnosis has been made, and the cause of the disease cannot be eliminated, then artificial insemination by IVF comes to the rescue. It is carried out when the spouses cannot conceive a child for several years.

What it is

If a couple fails to conceive a child naturally, it is worth paying attention to artificial methods.

What is artificial insemination often called? The abbreviation IVF is commonly used, which means in vitro conception. It is used in the presence of various pathologies in women and men. This is a procedure that has overcome infertility.

Fertilization occurs by introducing sperm into the uterus (insemination) or extracorporeally (in vitro - in vitro, outside the body).

Perform the procedure in clinics that specialize in this.

The efficiency is about 35%.

Kinds

There are 2 types of fertilization. In each case, the type is selected individually, taking into account medical indications. Types of artificial insemination are represented by sperm insemination (partner - IISM or donor - IISD); ECO:

1. During insemination, sperm is introduced into the uterine cavity with a catheter. Thus, the protective mucus of the cervix, the acidic environment of the vagina does not interfere with the sperm, it is directly transported to its destination without barriers. Further, the spermatozoa themselves move to the tubes, where the natural fertilization of the egg occurs. Both "live" and frozen sperm are used. First it is purified, then concentrated. This method is recommended if a woman has an increased acidity of the vaginal environment, high viscosity of cervical mucus. For men, such indications of this method: with a small number of motile spermatozoa, erectile dysfunction, high semen viscosity. The procedure is carried out without anesthesia. Upon completion, the patient should lie down for 20 minutes.
2. IVF artificial insemination. The resulting eggs and sperm are combined in a test tube. A few days later they are transplanted into the uterus. There is further development. A variation of this method is ICSI. Used for male infertility. Only here the doctor, using a powerful microscope, places the most fertile sperm in the egg. After a couple of days, it is introduced into the uterus.

Description of the method

How artificial insemination takes place is the essence of the method: spermatozoa in a test tube are placed in an egg. When they merge, the material is introduced into the female uterus. With a successful procedure, several embryos can take root. After all, they use not one egg, but several.

Classical are IVF, IVF together with ICSI.

The ICSI method is auxiliary. This method is used for help when the sperm of a man is of poor quality (improper structure of spermatozoa, low mobility). Having selected viable spermatozoa, they are injected into the egg using a microscope, special. surgical instruments.

Fertilization methods also include:

• Gift. For fusion in a natural way, both male and female germ cells are introduced into the uterus.
• Insemination inside the uterus. Artificial insemination is carried out directly in the fallopian tubes.

Important! If the family wants one child, then the rest of the implanted embryos can be removed (reduction). But sometimes it provokes a miscarriage.

Indications, contraindications

The main indication is infertility, not amenable to treatment. For women, this is:

1. bilateral tubal infertility;
2. operations on them after 30 years (plastic);
3. long-term treatment of tubal obstruction;
4. unknown cause of infertility;
5. endometriosis (when a natural pregnancy does not occur within a year);
6. reduced work of the reproductive female system;
7. age infertility;
8. anovulation.

Indications for men for an additional ICSI method:

• varicose veins of the spermatic cord;
• azoospermia (absence of ducts or blocked ducts that do not release sperm).

In such cases, an operation is performed or a puncture is taken to obtain sperm. Having selected healthy cells, they are connected to the egg.

Note! Bad habits, low immunity, physical inactivity, excess weight are also contraindications.

There are absolute contraindications (either they do not perform the procedure at all, or they are carried out under the strictest control, with high caution, with constant supervision) for both sides, these are:

1. tuberculosis (active form);
2. syphilis;
3. HIV, AIDS (allowed if the form is subclinical or in remission);
4. acute hepatitis of any form, chronic exacerbations of hepatitis B, C;
5. malignant formations;
6. benign formations of female reproductive organs;
7. leukemia (acute form);
8. various anemias;
9. diabetes;
10. kidney failure;
11. serious mental disorders;
12. severe movement disorders;
13. heart diseases;
14. rheumatoid arthritis and many other diseases that the doctor will acquaint you with.

Training

Geneticists have performed artificial insemination of pigs before, and continue to do so now. The method has been used on women for over 100 years.

Perform the procedure in specialized honey. clinics, after a complete examination of a couple planning a pregnancy. It is important to exclude contraindications. It is necessary to pass a bunch of tests, pass a lot of tests. A woman must:

• check the uterus and its tubes (X-ray with a contrast agent);
• or do a laparoscopy to make sure the reproductive tract is patent.

To get eggs, a few weeks of hormones stimulate ovulation. When maturing, the eggs are removed by a reproductive specialist and placed in a test tube.

An important advantage of IVF is the genetic diagnosis of the embryo (detection of deviations, possible diseases, developmental anomalies).

You can check all chromosomes, choose only healthy embryos.

Process

This process is quite labor intensive. How artificial insemination is done - let's get acquainted in stages:

1. Preparatory. Couple diagnostics, diagnosis. Detection of diseases that do not have the best effect on fertilization. If necessary, carry out treatment. The preparation lasts up to 3 months. The main thing is that the main indicators of health are normal for both.
2. Stimulation for superovulation. Hormones stimulate the production of eggs. There is a clear schedule for taking medications. During this period, they constantly check the blood, do an ultrasound. Obtaining high-quality material directly depends on the correct completion of all preparatory procedures. The doctor prescribes the necessary drugs, determines the method of artificial insemination.
3. Sperm collection, follicle. The man just donates sperm. A woman is given a transvaginal follicle puncture with a thin needle. Lasts 15 minutes, monitored by ultrasound. The resulting liquid is sent to the laboratory, the eggs are selected. The woman remains under observation for several hours. She has another ultrasound before going home.
4. Embryo formation. Make a solution as close as possible to the environment of the uterus. Eggs are placed there, later they will be fertilized. The quality of sperm affects the method of fertilization. For example, the in vitro method - the sperm is injected into the solution, and it itself penetrates the egg. ICSI - introduction with the help of instruments. The doctor observes all stages, fixes the features of the development of the embryo.
5. Introduction. The embryo is injected after its fertilization from day 2. It happens quickly and doesn't hurt. According to the law of the Russian Federation, 1-2 embryos can be injected. Rarely more is administered (there must be solid evidence for this, the woman's written consent).
6. Loop support. definition of pregnancy. Over the next 2 weeks, the embryo should attach inside the uterus. The doctor prescribes hormone therapy. A woman is entitled to sick leave. Recommended physical rest, emotional calm. It is better to stay at home, reduce contacts, adhere to bed rest.
7. Diagnostics. After 2 weeks, a diagnosis is made to determine pregnancy. Pass tests (urine for hCG, blood). An ultrasound will give an accurate answer about the presence of pregnancy in another week. Then the number and position of the embryos will already be clearly defined.
8. Pregnancy. Matches natural.

Choice of clinic

Having decided on a serious procedure, you should only contact professionals who have been practicing artificial insemination of women for more than one year.

Feel free to contact the clinic if:

• there are specialists of a narrow profile (genetics, embryologists, reproductologists, andrologists);
• drugs, materials are used only high quality, original;
• specialists form individual programs after a thorough study of the couple (age, health, illness);
• doctors use hormones for stimulation in minimal amounts (thus they take care of the health of their patients, preventing hyperstimulation);
• no more than 2 embryos are transplanted (to exclude multiple pregnancies);
• the clinic has only modern medical equipment;
• all sperm analyzes are performed in the same clinic by embryologists (they will accurately assess fertility, morphology);
• it is better if the chosen clinic cooperates with a laboratory that has international standards (the quality of analyzes is extremely important at all stages of the procedure);
• it is important that, starting from the consultation and until the end of the manipulation, the patient is led by the same reproductologist;
• it is imperative to keep in touch with the doctor (telephone, mail), to clarify issues, in case of various situations;
• it is great if pregnancy can be observed at the same clinic.

Price

Since 2015, the IVF procedure has been free in Russia. For this you need:

1. presence of evidence;
2. compulsory medical insurance policy;
3. age from 22 to 39;
4. conclusion of the doctoral commission, referral to the procedure according to the quota;
5. no contraindications.

Spouses, partners and single women can choose a clinic from the presented list of the federal program.

Under the terms, it is allowed to make a non-fixed number of fertilization attempts, until the result is obtained.

Insurers give about 100 thousand rubles for each procedure. The rest, if necessary, is paid by customers.

Standing in line for IVF, they draw up a compulsory medical insurance policy (a passport is presented, an examination is carried out, a diagnosis is made, they are sent to a commission, a clinic is selected, paperwork is processed).

Worth noticing! The insurance does not cover the ICSI procedure if the infertility is male (unsuitable sperm). You will have to make the payment yourself (the average cost is 15 thousand rubles).

Also, you can always make a paid procedure. Prices are different. They must be immediately clarified with the manager of the clinic, and find out what is included in the price.

Artificial insemination- this is a real miracle for those couples who cannot conceive a child themselves.

If many years of unsuccessful attempts lead to a zero result, then the spouses experience despair. In this case, artificial insemination becomes the only way out.

The achievements of modern medicine make it possible to make dreams of children a reality. Nowadays, no one is surprised to hear about IVF.

What do you need to know?

If you want to use artificial insemination, then you need to familiarize yourself with its basic principles. Feedback from people who have gone through this procedure is always a good help.

According to statistics, most infertile couples prefer artificial insemination. This procedure is affordable. It is done in many Russian clinics.

average price for artificial insemination (artificial insemination) fluctuates between 15,000 rubles.

The advantage of this procedure- it does not require separation from the usual life. That is, immediately after the session, a woman can start her work.

Reviews about this procedure usually positive. Here we must understand that success depends not only on the skills of doctors. The health status of spouses is the most important factor A that specifies the outcome of the session.

Concerning in vitro fertilization, then sometimes this procedure is the only way out. Judging by the reviews, women who have gone through IVF recommend a thorough approach to choosing a clinic.

It is important to determine what medical equipment the center is equipped with. It is equally important to find out the skill level of embryologists.

If the embryology of the clinic is at a low level, the procedures may fail. In this version, the treatment turns into a banal pumping of money from an infertile couple.

But IVF performed by professionals works wonders. There are excellent specialists in Russia who have helped many people become happy parents. Therefore, choose a medical center need for recommendations rather than the cost of services.

Methods and types of artificial insemination

under artificial insemination understand a whole range of special methods of infertility treatment.

This includes in vitro fertilization with transplantation into the uterus of crushing embryos and fertilization by artificial insemination.

What is artificial insemination?

This method is also called insemination. In this variant, sperm is injected into the lumen of the fallopian tubes or into the uterine cavity.

Artificial insemination is used in the following cases:

• with some diseases of a man (impotence, hypospadias, lack of ejaculation, etc.);
• anatomical changes in the cervix;
• vaginismus that does not respond to treatment;
• if antisperm antibodies are found in the cervical mucus of a woman.

Before the procedure experts examine the sperm of a man. They find out the cause of infertility.

Insemination is carried out 2-3 times during one cycle. The procedure is repeated for at least 3 cycles.

If the examination reveals that the husband's sperm has pathological changes (a decrease in the number of sperm or none at all), then we are talking about the donor's sperm.

Sometimes the reason for using donor sperm becomes, which is not treatable, as well as genetic diseases in the next of kin of the husband.

Thus, the seed of a man is introduced into the female genital tract, bypassing the barriers that are detrimental to him. The mechanism of the procedure is as follows: spermatozoa are placed in the genital tract or in the uterine cavity.

Further one of them fertilizes a mature egg (artificial insemination). After that, it is implanted to the wall of the uterus, and the embryo continues to develop. With this fertilization there is no problem of "extra" embryos.

The positive result of the procedure largely depends on the diseases that the couple has. Sometimes a woman may not have a period, although the pregnancy has not occurred. Therefore, you can only know for sure about conception with the help of.

If ovarian stimulation is not performed, then insemination can be performed several times.

Usually, after insemination with donor sperm, pregnancy occurs in 80% of cases. Women who have gone through artificial insemination are under the supervision of a specialist from the antenatal clinic.

Usually pregnancy and childbirth proceed without complications. Anomalies in the development of the fetus in such cases occur no more often than in other pregnant women.

You can get tested for hormones or buy.

If you want to carry out insemination on your own, then keep in mind that sperm retains its activity for no more than 2 hours. It cannot be properly frozen and stored at home.

That is, it will not work to completely imitate the conditions of the clinic. Therefore, semen should be used immediately after ejaculation.

Procedure in progress using a syringe without a needle. To collect the semen, you will need a sterile and dry container. You can use a vaginal dilator.

After receiving sperm from a donor, wait for it to liquefy (no more than 20 minutes). Thereafter semen is collected in a syringe and squirt it into the vagina.

Wherein strictly prohibited inject sperm into the uterine cavity. Independent manipulations should not affect the sterile cavity. This can lead to infection or injury.

If home insemination is successful, pregnancy will be the result.

Despite the fact that artificial insemination does not always end in conception, do not despair. Persistent attempts, patience and professional approach of specialists are important success factors.

The reward for your work will be the long-awaited baby.

ECO. School of Dr. Komarovsky.