Artificial Insemination (AI) is defined as the placement of a laboratory processed seminal sample in the female reproductive tract, in order to achieve gestation. Depending on the origin of the seminal sample, we can differentiate between artificial insemination by conjugal or homologous insemination (AIH) or artificial insemination with donor sperm (AI with donor sperm).
The main advantages of this technique are its low cost and easy application, so that it can be performed in any gynecological office.
At the time of performing an AI, the following indications should be taken into account:
- Tube permeability.
- Age of the woman less than 38 years old.
- Not had more than 4 previous cycles.
- Less than 3 years history of infertility.
- Post-capacitation sperm motility test of greater than 2 millon.
- Absence of severe teratozoospermia.
Based on these indications, cryptozoospermic semen is not suitable for AI treatment.
The World Health Organization (WHO) defines cryptozoospermia as the absence of sperm in the ejaculate on initial analysis and the presence of sperm after centrifugation.
Taking into account this definition developed by the WHO, it will not be recommended to perform an AIH on a woman whose partner has been diagnosed with cryptozoospermic samples, since we cannot meet the criterion of having more than 2 million motile spermatozoa after performing sperm capacitation, so the probability of success of the technique is greatly compromised.
In these cases, the most indicated technique in the laboratory will be intracytoplasmic sperm injection, also known as ICSI, whereby the embryologist selects a motile sperm with normal morphology (if possible) and microinjects it into the oocyte.