Intrauterine insemination is the simplest and most physiologically sound method of medically assisted procreation. It involves depositing a preparation of sorted spermatozoa in the uterine cavity, bringing them closer to the site of fertilization at the moment of ovulation.
OVARIAN STIMULATION
In the vast majority of cases, intrauterine insemination is preceded by ovarian stimulation to bring one or two follicles to maturity.
This treatment requires ultrasound and biological monitoring to ensure proper development of the follicle(s) and their number, and to determine the most propitious moment for triggering ovulation, followed by insemination.
In patients with very regular cycles, follicular development is simply accompanied by a few days of gonadotropin injections.
Intrauterine insemination can also be performed in a spontaneous cycle, i.e. with only the natural development of the dominant follicle being monitored. This very “minimalist” approach offers the advantage of avoiding the risk of multiple pregnancies, which are sometimes totally contraindicated (uterine malformation, history of cervical amputation, cervical gap, chronic general illness). However, pregnancy rates per cycle are lower than those observed for cycles with ovulation stimulation.
Patients with ovulation disorders will require conventional ovulation stimulation, with identical monitoring.
OVULATION INDUCTION
Ovulation induction is used to program the insemination procedure. It involves subcutaneous injection of recombinant hCG. Ovulation occurs 36 to 40 hours after the injection.
SPERM COLLECTION AND PREPARATION
Sperm is collected from the partner on the morning of insemination. It is preferable for the patient to have observed a short abstinence of around 48 hours..
It is essential to bring proof of identity with you, otherwise no collection will be possible.
Once the patient’s identity has been verified, he or she is placed in a cabin in the AMP center, where sperm is collected by masturbation. The sample is then sent to the laboratory for preparation.
INSEMINATION PROCEDURE
Intrauterine insemination is a simple, quick and painless procedure. It is carried out on the premises of the MPA center, using sterile, single-use equipment.
After her identity has been checked by the gynecologist and biologist, the patient is placed on the gynecological examination table.
The cervix is exposed with a speculum inserted into the vagina, and vaginal secretions are wiped away with a sterile compress soaked in saline solution.
The sperm preparation is contained in a small syringe mounted on a flexible catheter. The volume of the preparation is of the order of a few milliliters.
The tip of the catheter is inserted into the cervical canal and then into the uterine cavity. The sperm preparation is then deposited in the uterine cavity.
There is no need to rest after insemination, as this does not increase the chances of pregnancy.
AFTER INSEMINATION
There are no specific recommendations to follow after intrauterine insemination. Sports activities, travel and sexual relations are all permitted.
A blood pregnancy test will be carried out 15 days after intrauterine insemination. If positive, the growth of hCG will be monitored by repeated measurements, as this is the only way to ensure that the early stages of pregnancy are progressing well.
The first pregnancy ultrasound will be scheduled 5 weeks after insemination, at which point it is possible to see a gestational sac and an embryo in the uterus.
If the pregnancy test is negative, you can immediately start a new cycle of treatment for a new insemination, as there is no benefit in pausing cycles.
