How much do you know about the process of artificial insemination and who it is suitable for?

At the beginning of 2021, the shocking news of female celebrities' surrogacy in the entertainment industry brought artificial insemination into everyone's attention. So what exactly is artificial insemination, what kind of families are suitable for artificial insemination, and what is the process of artificial insemination? Let me explain them to you one by one.

Artificial insemination, as the name suggests, refers to a reproductive technology that collects semen from the husband or sperm donor and injects it directly or after washing into the female reproductive tract during the female ovulation period. Generally speaking, normal men and women can complete insemination in the body in a normal way, but with the serious environmental pollution, changes in diet structure, mood swings, diseases and other factors, the incidence of infertility among married couples is increasing year by year.

When infertility occurs, artificial insemination is needed.

Artificial insemination can be divided into two types according to the method of sperm provision: artificial insemination with husband's semen and artificial insemination with donor's semen.

According to the different sites of insemination, it is divided into 6 types: intravaginal artificial insemination, intracervical artificial insemination, intrauterine artificial insemination, intraperitoneal artificial insemination, intrafollicular artificial insemination, and transvaginal intrafallopian artificial insemination.

According to the length of artificial insemination storage time, it can be divided into two categories: fresh sperm artificial insemination, which means that the semen is processed as soon as possible after leaving the body and artificial insemination is performed. The advantages are that it is relatively simple and has a relatively high success rate, but the disadvantage is that there is a possibility of infectious diseases. It is mainly used for artificial insemination of husband's semen. The second type is frozen sperm artificial insemination, which means that semen is ultra-low temperature frozen and stored in a special way after leaving the body. It is generally stored in a -170℃ liquid nitrogen tank. When needed, the frozen semen is thawed and artificial insemination is performed. The disadvantages are that the success rate is low and more complex instruments and equipment are required; the advantages are that it is safe and there is no possibility of infectious diseases.

Which couples are suitable for artificial insemination? The man has oligospermia, asthenospermia, teratozoospermia, hypospadias, severe premature ejaculation, impotence, or a serious genetic defect that can cause premature miscarriage or even fetal malformation. The woman has vaginal spasm or anatomical abnormalities that prevent semen from entering the vagina.

The female's cervical factors hinder sperm from entering the uterus, such as cervical stenosis, thick cervical mucus, etc.; the female's ovulation disorder; the female has mild to moderate endometriosis; some immune factors, such as positive anti-sperm antibodies in male semen and positive anti-sperm antibodies in female cervical mucus; unexplained infertility. Such families can consider artificial insemination. So what kind of families cannot perform artificial insemination? One of the couple suffers from acute infection of the reproductive and urinary system or sexually transmitted diseases; or suffers from serious genetic, physical or mental diseases; is exposed to teratogenic doses of radiation, poisons or drugs and is in the period of action; has serious bad habits such as drug abuse; vas deferens recanalization fails; The above situations show that both men and women are not physically or mentally capable of welcoming a new life, so artificial insemination is prohibited.

The process of artificial insemination is relatively complicated. When deciding on artificial insemination, the couple must first prepare their marriage certificate and ID card. After the doctor assesses that both men and women are suitable for artificial insemination, they will be informed of all the problems and risks related to artificial insemination. Signing the informed consent form is the first step.

The second step is to conduct a routine physical examination, which is different for men and women. The man will have a blood test, which often requires fasting, six endocrine tests, four eugenics tests, liver function, kidney function, blood routine, blood type, four coagulation tests, hepatitis series, chromosomes, syphilis, AIDS, anti-sperm antibodies, etc. Semen examination: routine and deformity rate, mycoplasma chlamydia, etc. Women are also required to have a fasting blood test: six sex tests, four eugenics tests, liver function, kidney function, blood routine, blood type, four coagulation tests, hepatitis series, chromosomes, syphilis, AIDS, anti-sperm antibodies, anti-endometrial antibodies, thyroid function, etc. Leucorrhea examination: leucorrhea routine, mycoplasma chlamydia test, TCT, etc. Other examinations include chest X-ray, electrocardiogram, breast color ultrasound, liver, gallbladder and spleen color ultrasound (fasting), vaginal B-ultrasound, hysterosalpingography, etc.

The doctor will then customize a plan for each couple based on the results of the examination. Common plans include artificial insemination during the natural cycle and artificial insemination during the ovulation induction cycle. If a woman has regular menstruation and normal ovulation, the natural cycle plan is usually chosen. For women with ovulation disorders or poor follicular development and poor corpus luteum function, drugs can be used for ovulation induction treatment. Women in the ovulation induction cycle usually start using ovulation induction drugs 3-5 days after menstruation.

The third step is follicle monitoring, which is to determine the date of female ovulation and the time of artificial insemination. Follicle monitoring usually starts on the 10th day of a woman's menstruation. The size of the follicles and hormone levels are observed through B-ultrasound or blood draw to determine the development of the follicles. The next monitoring time is determined based on the examination results. When the follicles grow to the size of nearly mature follicles, the doctor will inject the patient with a follicle maturation injection according to the patient's condition and prepare for artificial insemination. At this time, men are required to abstain from sex.

The fourth step is the actual implementation of artificial insemination. The artificial insemination operation will be performed once before and after the female ovulation. On the day of the operation, the man needs to take out the semen in advance, and after optimization, inject it directly into the female's uterine cavity. The whole operation takes about 5 minutes, and the woman needs to lie flat for about half an hour after the operation.

The fifth step is to observe whether the woman is pregnant. If she is, luteal support is recommended, and progesterone drugs are used to maintain pregnancy. HCG is checked in the blood 14-16 days after the operation to confirm whether she is pregnant. If she is pregnant, luteal support is continued. If it is not successful, preparations should be made for the next artificial insemination.

References:

[1] Sun Yingpu, Wang Fang. Selection of assisted reproductive technology methods[J]. Chinese Journal of Practical Gynecology and Obstetrics, 2010, 26(10):735-738.

[2] Yin Wenyan. Things about artificial insemination[J]. Rural Knowledge, 2018(08):52-54.