Artificial insemination by husband and wife (AIH) is a type of artificial insemination in which the husband's or partner's semen is used.
AIH is one of the simplest and least invasives assisted reproduction techniques available and, therefore, its cost is low. Each IAH cycle has an approximate price of 1000-1700$.
Their success rate is not very high, around 10% calving rate per cycle. However, the cumulative rate of AIH can increase to approximately 50% after four attempts have been made.
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Requirements indications
In general, spousal artificial insemination is recommended for young couples with a mild cause of infertility who, after one year of unprotected sexual intercourse, have not yet achieved pregnancy.
For the treatment to be successful, it is recommended that the woman is not older than 36 years and that her ovarian reserve is good. In addition, it is imperative that:
- The woman has patent fallopian tubes.
- The male presents semen with acceptable quality.
If these requirements are met, AIH could be the reproductive solution for patients.
The most common indications for AIH are discussed below:
- Women with alterations in the menstrual cycle.
- Anovulation problems, as in polycystic ovary syndrome (PCOS).
- Mild or moderate endometriosis.
- Female infertility due to cervical factor.
- Inability to deposit semen in the vagina: vaginismus, erectile dysfunction, retrograde ejaculation, etc.
- Mild male factor: oligozoospermia, asthenozoospermia, etc.
- Immunological sterility: antisperm antibodies, semen allergy, etc.
- Infertility of unknown origin.
- Serodiscordant couples.
You can read more about it here: Basic requirements for intrauterine artificial insemination.
How is the AIH process?
As we have already mentioned, the artificial insemination procedure is very simple and consists of the different steps:
- Controlled ovarian stimulation
- a gentle stimulation is performed so that only one or two ovarian follicles develop.
- Semen training
- the man gives a semen sample obtained by masturbation on the day of the artificial insemination. This semen sample is processed in the laboratory to remove the seminal plasma and keep only the progressive motile sperm.
- Artificial insemination
- about 36 hours before insemination, the woman is administered a drug to induce ovulation. Then, on the day of insemination, the partner's capacitated semen is introduced into the woman's uterus with an insemination cannula.
If you want more detailed information on the steps of artificial insemination, you can consult this article: How is artificial insemination performed step by step?
Percentage of success
Since it is one of the simplest assisted reproduction treatments, the success rates of artificial insemination are also not very high. According to the latest report published by the Spanish Fertility Society (SEF) with the results of Spanish assisted reproduction centers in 2019, the success rates of AIH were as follows:
- Pregnancy rate
- 15.3% (insemination pregnancies)
- Delivery rate
- 11.9% (insemination births)
- Single birth rate
- 91.4% (single deliveries per total number of deliveries).
- Multiple birth rate
- 8.6% (multiple births per total number of births)
- Abortion rate
- 22.1% (miscarriages per number of pregnancies).
One of the most important factors determining the success of artificial insemination is the age of the woman. The younger the woman, the higher the pregnancy rate and delivery rate.
In case of a negative result with the first cycle of AIH, it is advisable to perform another cycle to increase the probability of success, as AIH has a cumulative pregnancy rate of 50-60% after 4 attempts.
According to Dr. Gorka Barrenetxea:
In artificial inseminations there is a cumulative success rate, it can be 60% in conjugal inseminations, it can be 80% in donor sperm inseminations, after 4 or 6 attempts.
Logically, the cumulative rate is the information that we must give to the woman when she starts an insemination treatment. Look, we are going to do this treatment that consists of this procedure, your chances of pregnancy per cycle are so many, but in 4 attempts this is the chance of pregnancy that you have. You should know that some get pregnant on the first try, others get pregnant on the fourth, and a percentage do not get pregnant even after 4 attempts.
In the case of AIH, a fifth insemination cycle is not recommended because pregnancy rates no longer increase. These couples will have to resort to in vitro fertilization (IVF) to have a better chance of becoming parents.
If you need more information about IAC success rates, you can consult this article: Artificial insemination results.
How much does it cost?
AIH is the most economical assisted reproductive technique compared to the rest. Its price varies between 1.000 and 1.700$, although this depends on the clinic and the specific state.
It should also be noted that the price of medication for ovarian stimulation and endometrial preparation is not usually included in the AIH budget. This may involve an additional cost of about €100-600, depending on what kind of fertility drugs are used per cycle.
Therefore, it is very important to compare several quotes between clinics and resolve all possible doubts before starting any treatment. Some clinics offer discounts after the second attempt or other promotions.
Assisted procreation, as any other medical treatment, requires that you rely on the professionalism of the doctors and staff of the clinic you choose. Obviously, each clinic is different. Get now your Fertility Report, which will select several clinics for you out of the pool of clinics that meet our strict quality criteria. Moreover, it will offer you a comparison between the fees and conditions each clinic offers in order for you to make a well informed choice.
On the other hand, in the case of artificial insemination by Social Security, it is essential to comply with all the requirements demanded by the public system. Normally, the criteria for access to fertility treatment covered by insurance are usually an age under 40 years and no previous children with the same partner. However, each insurance company has its own particular requirements.
FAQs from users
Is artificial insemination by husband the same in serodiscordant couples and in healthy couples?
Due to advances in sperm washing techniques and large medical studies, HIV serodiscordant couples can be offered IUI (intrauterine insemination) provided the semen sample from a HIV positive man is prepared in a reproductive laboratory capable of appropriate preparation of the specimen in order to maximize the reduction of HIV transmission to the woman and baby.
What are the main steps in the AI process?
The processes of conjugal and donor artificial insemination are practically the same. The main steps are as follows:
- Gentle ovarian stimulation
- Ovulation induction
- Thawing of the donor semen sample and sperm capacitation (if it was not already capacitated). Donor samples are usually frozen already capacitated.
- Insemination (semen sample introduction)
- Pregnancy test
Can I undergo artificial insemination without husband's consent?
No, it is not possible. When a woman is married or in a civil relationship, the clinic needs her consent and her husband's approval to proceed with the fertility treatment of choice, either AI or IVF. In case of divorce, consent would be required as well.
It is possible, however, if the couple is divorced or separated and the woman wants to get pregnant through IUI with donor sperm, as the man would not be considered to be the legal father of the child, that is, he would have no legal right or responsibility to the baby.
What tests does the husband have to pass in order to do the AIH?
The previous studies to be performed by the male for the performance of an artificial insemination are the following: Negative serologies for HCV, HBV (HBsAg, HBsAc, HBcAc), HIV 1 and 2, RPR.
In addition, a normozoospermia result in the seminal sample of the male with a motile sperm recovery higher than 5 million in previous seminograms.
Recommended readings
If you want to continue reading more about artificial insemination treatment, we recommend you to access the following post: Advantages and disadvantages of artificial insemination.
You may have some doubts about the choice of the most appropriate treatment. For this reason, we recommend the reading you will find here: Differences between artificial insemination and in vitro fertilization.
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References
Ibérico G, Vioque J, Ariza N, Lozano JM, Roca M, Llàcer J, Bernabeu R (2004). Analysis of factors influencing pregnancy rates in homologous intrauterine insemination. Fertil Steril;81:1308 – 1313.
Sociedad Española de Fertilidad. Registro Nacional de Actividad 2019-Registro SEF (see)
The ESHRE Capri Workshop Group (2009). Intrauterine insemination. Human Reproduction Update; 15 (3): 265–277.64
FAQs from users: 'Is artificial insemination by husband the same in serodiscordant couples and in healthy couples?', 'What are the main steps in the AI process?', 'Can I undergo artificial insemination without husband's consent?', 'What tests does the husband have to pass in order to do the AIH?', 'Can I undergo artificial insemination with my husband's sperm if he is dead?', 'AIH vs. AID, what's the difference?', 'Can I get started with IUI even though my husband's traveling?' and 'What are the benefits of using your husband's sperm cells to get pregnant?'.
Authors and contributors
More information about Cristina Algarra Goosman
Hi, we have done two AI’s with both my eggs and my husband’s sperm which, in principle, we have no problem with. Is it normal that it did not work or should we do something else?
Hello Olivia,
According to statistics, after the 4 cycles of artificial insemination, the cumulative pregnancy rate no longer increases so it is usually referred to as another reproductive treatment.
In your case, you have had two AI cycles so the probability of pregnancy may still increase in the next two AI cycles.
If after 4 cycles of AI pregnancy does not occur, I recommend that you talk to your doctor to explain the possibility of resorting to in vitro fertilization.
I hope I have helped you,
Best regards
I got my tubes tied 5 years ago. Now I’m in a stable relationship and the biological clock kicks in. Am I still eligible for artificial insemination or is it too late and I can’t get pregnant anymore?
Hi Aishe,
I’m sorry to say that in your case artificial insemination is not possible anymore. The indicated treatment in your case would be IVF.
Read more about your pregnancy possibilites with tubal legation here: I got my tubes tied. Can I still get pregnant?
Hope this helps,
Wish you all the best!
We’ve already had five inseminations and I haven’t had a positive one. All the tests appear to be normal and both my partner and I are 30 years old. Should you make another attempt or move on to IVF? Thanks for answering.
Hi!
as statistics show, the probability of a pregnancy after four AIH cycles doesn’t increase anymore, which is why we recommend a different fertility treatment in order to have a positive pregnancy test result. One of the recommended treatments would be in vitro fertilization.
Here you’ll find all information you need: What does IVF consist of?
Wish you all the best!