Artificial insemination (AI) is the least complicated assisted reproductive technology. Its low complexity makes it a fertility treatment of first choice when pregnancy is not achieved through natural conception.
It involves placing a small semen sample inside the woman’s uterine cavity through the cervical canal. The semen sample is previously capacitated, which is to say, washed so that it is able to reach the egg and fertilize it.
Requirements for being inseminated
For a woman to have the highest chances of achieving pregnancy through artificial insemination, she should meet the following requirements:
- Tubal patency: both Fallopian tubes should be permeable, since that is the location where the egg-sperm binding takes place.
- Semen quality: it must be high-quality sperm, especially in terms of sperm morphology, sperm motility, and sperm concentration.
- Good ovarian reserve: it is necessary for a woman to present a good ovarian reserve with regular ovulation periods, i.e. the egg is capable of being released from the follicle and meet the sperm in the tubes.
- Woman’s age: normally, artificial insemination is not indicated for women aged 35 or more.
As for sperm quality, usually a motile sperm concentration (MSC) of between 3 and 5 million sperms per milliliter is required. If the intended father’s sperm quality is not as good as expected, the Cypriot law allows using donor sperm.
Also when there is no male partner (as in the case of single women and lesbian couples), donor insemination would be the treatment of choice.
Artificial insemination by donor
The Law governing medically assisted reproduction in Cyprus 69(I) of 2015 defines artificial insemination by donor as the use of a semen sample collected from a man other than the patient’s husband/partner.
Conversely, by artificial insemination by husband we mean the use of the husband’s or partner’s sperm.
As for sperm donation, Cypriot regulations put special emphasis on the fact that candidates should be anonymous men who are willing to donate their sperm in an act of solidarity. This means the fertility clinic where the woman undergoes this treatment is the one responsible for selecting and allocating a donor to a recipient. Thus, neither the donor nor the recipient knows about each other’s identity.
The first step involves taking hormone medications for ovulation induction. It is nothing but just a mild stimulation, as the purpose is to trigger the development of just one or two follicles.
As the woman self-administers these medications, she will have the development of follicle growth monitored through ultrasound scan and blood tests. When at least a single follicle is observed to have reached a 16 to 18 mm size, the insemination date will be scheduled.
Thirty-six hours before being inseminated, women have to take hCG hormone shots with the purpose of ensuring the eggs produced are fully mature, as well as triggering ovulation.
Just before carrying out the insemination, the donor’s semen sample will be thawed and washed. Sperm washing or capacitation involves the elimination of seminal plasma and non-viable sperms in order to obtain a sample containing only the best spermatozoa.
The capacitated semen sample is aspirated and placed on the cannula, which is inserted through the cervical canal with the purpose of placing the semen inside the vagina.
After just resting for 20 minutes, the woman can continue with her normal lifestyle up until the moment when she can take a pregnancy test, around 15 days later.
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