In recent years, unfortunately, there has been an increase in the percentage of women who cannot become pregnant naturally. The reason for this is the deteriorating environmental situation, various inflammations of the female genital organs and many other factors. The union of a man and a woman is considered to be fruitless in the case when partners have an active sexual life without the use of contraceptives for 1-2 years, but the long-awaited pregnancy does not occur. This problem is diagnosed in about one in five married couples. In such situations, methods of artificial insemination of the female egg come to the rescue.

Methods of artificial insemination

In modern medicine, today there are several methods of artificial insemination, which have been successfully used for many years. Every couple who decides to resort to one of the artificial insemination methods should know how artificial insemination is done and what to expect during this procedure. In this article we will try to answer the most interesting questions regarding such a difficult topic. In our time, it is possible to become a full-fledged family, conceive and give birth to a healthy baby using methods such as:

• In vitro fertilization (IVF) - the fusion of male and female cells is performed in a laboratory in a sterile test tube, after which the developing embryo is transferred to the uterus of an infertile woman.
• Intracytoplasmic sperm injection into the egg (ICSI) - the technique of this procedure is almost identical to the previous one, however, in the case of ICSI, fertilization occurs using purified prepared male sperm (the patient's spouse or a donor).
• Artificial insemination (AI) - this type of artificial insemination is resorted to in cases where reproductive problems have been identified in a man (insufficient sperm activity, abnormalities in the functioning of sexual functions, the presence of any other diseases).
• Donation of male genetic material.
• Conception using an egg from a professional or individual donor.

Important! If you have been unsuccessfully trying to become parents for many years and have already used all the methods of conception available for this, you should not despair - every couple has the opportunity to resort to the services of a surrogate mother. However, if you are unable or unwilling to use this method, you can always adopt a child who is left without parents.

Understanding the Mystery of Conception

Fertilization itself represents the initial stage of the birth of a new life. Its beginning is considered the moment of connection of the female and male germ cells. From that moment on, the sex of the child is already randomly determined in advance. We know that a sperm cell and an egg contain 23 chromosomes each, one of which is responsible for the sex of the unborn baby. When an egg meets a male sperm with an X chromosome, the couple has a girl, if with a Y chromosome, you can soon be congratulated on the birth of a boy.

As a rule, 12-14 days after the onset of menstruation, almost every representative of the weaker sex begins ovulation - the release of an egg from the follicle, which is ready for fertilization. Through the fallopian tubes, she gradually moves inward, where she will languish for some time from waiting for a meeting with a spermatozoon. The egg remains fertile for approximately 24 hours from the moment it leaves the follicle. Thousands of sperm enter the woman's vagina along with seminal fluid and begin their long and difficult journey.

It takes 3-4 hours for the spermatozoa to cover this short distance. On their way there are a lot of obstacles, and most of them die. Only the most high-quality and mobile of them reach the cherished goal. In order for conception to occur, about 10 million male cells are required, but only one of them can merge with the egg, which will be able to penetrate the dense protective shell. The moment of their merging is considered the moment of fertilization.

Two merged cells eventually turn into a zygote, and then into an embryo - a prototype of the future little man. Pregnancy occurs when the fertilized egg reaches the uterus and attaches to the inner lining of the uterus, the endometrium. This happens around 7-10 days. After that, a special hormone responsible for pregnancy (hCG) begins to be produced in the woman's body, which allows you to diagnose pregnancy at home - you just need to purchase a special test at the pharmacy. After nine months, a new person is born.

Artificial conception and its types

If a woman or her partner has been diagnosed with infertility, then in this case they resort to the procedure of artificial insemination. But one should not be afraid of the word "artificial", because babies conceived in this way are absolutely no different from children who were born naturally.

The most accessible and simple method of artificial insemination is considered to be artificial insemination. During this manipulation, the male sperm is placed directly into the uterine cavity through a special catheter, where the spermatozoa independently find the egg and merge with it. Of course, the sperm is pre-cleaned and prepared, only the highest quality and most mobile spermatozoa are selected.

On the eve of the manipulation, the couple must undergo a complete examination of the body, pass the necessary tests. The woman is checked for patency of the fallopian tubes, the man takes a spermogram analysis, both partners pass tests for the presence of genital infections. Often, if necessary, ovulation in a woman is stimulated with the help of special hormonal injections.

This type of artificial insemination is used in cases where:

• a woman does not ovulate;
• fallopian tubes are impassable or absent altogether;
• a woman experiences spasms and muscle contractions during intercourse;
• the woman's body produces antisperm bodies that deprive sperm of the viability;
• a man is diagnosed with impotence or other disorders in the genital area;
• age factor;
• a woman has endometriosis or other diseases in the genital area;
• spermogram analysis has an unsatisfactory result.

With primary infertility (infertility of the 1st degree), married couples prefer this particular method of artificial insemination.

Important! The effectiveness of this type of artificial insemination is approximately 25%. However, the degree of effectiveness is also determined by a number of factors: the age of the partners, the degree and duration of infertility, the quality of the ejaculate, and some others.

In vitro fertilization (IVF) is a more expensive, complicated and time-consuming procedure. It is resorted to in situations where there are many unsuccessful attempts to conceive naturally and artificially, but the long-awaited pregnancy did not happen. The couple together must pass a series of tests, the woman is given an ultrasound diagnosis, the fallopian tubes are checked for patency, and the man takes a spermogram. After a long preparatory stage, they go directly to the process of artificial conception.

Male biomaterial is pre-processed and cleaned, after which it is placed in a favorable nutrient medium in an incubator. In a sterile test tube, the most active and high-quality spermatozoa are mixed with female cells. After about a day, it can be ascertained whether fertilization has occurred. And after 2-3 days, the developing embryos are transferred to the uterus of an infertile patient for further development.

During IVF, several embryos are usually placed in the uterus at once, in order to increase the effectiveness of the procedure. If desired, the couple can freeze the remaining embryos so that they do not go through all the previous stages of IVF in the future. The chance of pregnancy when using this method is approximately 20-30%.

Itroplasmic sperm injection (ICSI) is usually used in cases of male infertility. In most cases, the reason for this is insufficient sperm motility, or their complete absence in the ejaculate. The procedure is quite simple - the selected spermatozoon is delivered directly into the egg using a very thin needle. This happens not in the body of a woman, but in a laboratory using a pre-extracted and processed egg. The course of manipulation is controlled by a microscope.

Preparation for ICSI is about the same as for IVF. The only difference is that during IVF, spermatozoa are given the opportunity to independently reach the egg, and with ICSI, this task is taken on by an experienced specialist. The chance of pregnancy with this artificial insemination technique is approximately 30%. To be more precise and turn to statistics, the probability also depends on the age of the woman:

• the chance of getting pregnant with IVF in women under 35 is approximately 40%;
• at the age of 35 to 37 - 30%;
• at the age of 38-40 years - 20%;
• women over 40 years old are given about 10%, and at 45 years old - about 1%.

Alternative methods of conception

It should be noted that in especially severe cases, there are also ways for childless couples to become happy parents:

• using the services of a surrogate mother (your unborn child is being carried and given birth by another woman);
• in vitro fertilization using donor biomaterials;
• use of frozen embryos;
• adoption of a child without real parents.

Curious facts

There is an opinion that artificially conceived children develop several times more actively than their peers, but at the same time they are more susceptible to various diseases. However, these are just assumptions, and in fact, test-tube babies are no different from naturally conceived babies. Perhaps such opinions are based on the fact that usually a child conceived with the help of IVF is born to elderly parents, thereby becoming even more desirable, long-awaited and loved. In addition, the opportunity to carry out this procedure is mainly available to people whose financial component is quite reliable and stable, and such parents in the future are able to give their child a decent education and excellent living conditions.

Difficulties of choice

In the vast majority of cases, almost any form of both female and male infertility can be successfully treated, and the couple manages to finally know the joy of having a child. However, sometimes it happens that the cause of infertility has been established, but it is not possible to eliminate it either with the help of medications or by surgery.

What is the method of artificial insemination to choose? There is no definite answer to this question. Each of them has its own merits and demerits. For example, the artificial insemination procedure is financially accessible to almost everyone and easy to perform. But you can not vouch for its very high efficiency. While in vitro fertilization has a rather high price, and its implementation can take more than one year, but the probability of obtaining the desired result is quite high.

For couples with similar difficulties, artificial insemination techniques come to the rescue, which have been successfully carried out for several years by Dr. Alexander Pavlovich Lazarev, PhD, author of more than 30 scientific papers in the field of various forms of infertility. Remember that without exception, all couples who managed to get pregnant and give birth to a long-awaited baby with the help of modern advances in the field of reproduction experience great parental happiness. The same cannot be said about infertile men and women who still have doubts and have not yet been able to make this decision. However, it should be borne in mind that after thirty years, it is much more difficult for any woman to become a mother, even with the help of artificial insemination. Weigh all the pros and cons, make the right decision and experience the joy of having a baby!

Many couples, for one reason or another, cannot conceive a child naturally. Such a situation today is not a verdict, modern reproductive assistive techniques come to the aid of spouses. Fertilization methods are different, some are as close to natural as possible, others are carried out outside the female body. The choice depends on the pathology that caused infertility, the health of the woman and the man, and some other circumstances. Only a reproductologist can advise which methods of fertilization are suitable for a particular couple.

Fertilization methods - artificial insemination

Artificial insemination with sperm is one of the simplest, affordable, and at the same time quite effective methods. It has its positive and negative sides. The advantages include a rather high percentage of pregnancies, relative ease of implementation, safety, and the possibility of using it without additional ovarian stimulation. Conception during insemination takes place almost naturally. The disadvantages include a fairly large number of restrictions. Not all forms of infertility can be corrected by this method of fertilization.

Indications for artificial insemination on the part of a woman are the presence of antisperm antibodies, increased acidity of the vagina, which leads to a decrease in sperm activity, pathology of the structure of the cervix, features of cervical mucus that cause immobilization of male germ cells. On the part of a man, indications may be a slight decrease in the number of spermatozoa and the sperm itself, increased viscosity of the ejaculate, erection problems, retrograde ejaculation into the bladder cavity. Contraindications to the procedure are obstruction of the fallopian tubes, several unsuccessful attempts to use this method of fertilization, the inability to obtain a sufficient number of active sperm from the husband and the refusal to use donor sperm, oncological diseases and benign tumors, genital tract infections, operations on the pelvic organs, hormonal disorders, preventing egg maturation.

Methods of fertilization by artificial insemination are different. The most common and effective is the intrauterine injection of spermatozoa. Also, the material can be injected into the vagina, cervical canal, tubes, directly into the follicles. There is a method of abdominal insemination, when sperm is injected into the abdominal cavity. For artificial insemination, the spermatozoa of the husband or donor are used. They are subject to special treatment to increase the chance of fertilization.

They do artificial insemination with or without preliminary stimulation of egg maturation. In the second case, the chance of getting pregnant is reduced by 2-3 times. The procedure is performed on an outpatient basis. A woman, through a special catheter, is injected into the uterine cavity with processed spermatozoa. After that, it is recommended to lie down for at least half an hour. At the first attempt, the chance of getting pregnant is 12-15%, in the future it increases slightly. Approximately 87% of women get pregnant during three cycles, in the fourth cycle the chances decrease to 6%. Therefore, artificial insemination is not recommended to be used more than 4 times. If pregnancy does not occur, other methods of fertilization are used.

IVF fertilization methods

In vitro fertilization is the most common and effective method of infertility correction. It has been used for over forty years and leads to pregnancy in a third of cases, some clinics give even 50% results. Such methods of fertilization are shown in the following situations:

• Fallopian tube obstruction
• Poor sperm quality in men
• Unexplained causes of infertility
• High chance of hereditary diseases
• Failure of other fertilization methods

IVF consists of several stages. But before applying any methods of fertilization, the couple must undergo a thorough examination. If certain pathologies, infectious diseases are detected, a course of therapy is prescribed. Only after its completion, you can go directly to IVF.

First stage is ovarian stimulation. It is carried out according to a short or long protocol. With a short one, only drugs with an analogue of the follicle-stimulating hormone are used. Start stimulation on day 2-3 of the cycle. With a long protocol, they first block the production of their own hormones in the pituitary gland. This allows you to better control the process of further stimulation. Start taking drugs on the 21st day of the cycle and continue until 2-3 days of the next menstruation. Then they move on to ovarian stimulation. After exposure to drugs, it matures from one to 7-8 eggs.

Second phase- oocyte retrieval. It is carried out by transvaginal puncture of the ovaries. The resulting cells can be subjected to genetic analysis if there is a high chance of hereditary pathologies.

At the third stage fertilization methods are different. You can simply add purified sperm to the environment with eggs, fertilization takes place almost the same as in natural conditions. There is a more advanced technique in which the sperm is artificially introduced into the female germ cell. A fertilized egg is placed in a substrate for growing embryos, then incubated for 2-5 days in a thermostat.

Fourth stage- transfer of embryos to the uterus. It is carried out 2-5 days after egg retrieval. Fertilization methods do not greatly affect the terms of transplantation, the number of eggs and embryos received, the number of previous IVF attempts, the age and health of the woman, and the readiness of the endometrium to accept the embryo are of greater importance. The transfer is done in the operating room, the patient is placed in a gynecological chair, anesthesia is not done, sedative and antispasmodic drugs can be used. Embryos are introduced into the uterus using a special plastic catheter. The whole procedure takes no more than 7-10 minutes. After it, progesterone preparations are prescribed to maintain implantation and subsequent pregnancy.

Final stage- control of the onset of pregnancy. Whether fertilization methods were successful can only be said 14 days after the embryo transfer. Approximately on day 5-7, the doctor may advise you to take a progesterone test. But its level does not indicate either the success of the procedure or its failure. The study is done to correct hormone therapy. In the second week, the patient is tested for hCG, only a change in its level can tell whether pregnancy has occurred or not. If necessary, an ultrasound is done, but a more revealing study will be 20-21 days after the embryo transfer.

Assisted fertilization methods ICSI

ICSI fertilization methods are used for male infertility. Indications may be the low quality of the ejaculate, up to the complete absence of spermatozoa in it, vasectomy, congenital pathologies of the vas deferens, problems with erection and ejaculation, a high risk of hereditary pathologies. ICSI fertilization methods make it possible for a man to become a father even when he manages to obtain single spermatozoa with low motility. Often they are found only in the tissue of the testicles. Conception using ICSI occurs in approximately 30-80% of cases. These methods of fertilization do not affect the frequency of implantation of embryos in the uterus and the onset of a full-fledged pregnancy.

The essence of ICSI is that the sperm is injected directly into the cytoplasm of the egg. This is done using a special microscopic needle under a microscope. Spermatozoa suitable for fertilization are preliminarily selected. If necessary, they can be genetically analyzed to exclude hereditary pathology. If there is a high probability of occurrence of genetic diseases associated with sex, cells with X or Y chromosomes can be selected. In other situations, it is not allowed to use fertilization methods to plan the sex of the child. After conception, the cultivation and replanting of embryos occurs in the same way as in conventional IVF. You can perform IVF, IVF with ICSI, artificial insemination at the clinic "IVF Center" Volgograd.

Fertilization methods ZIFT and GIFT

Fertilization methods such as GIFT and ZIFT are now rarely used, although 15 years ago they could compete with IVF. Their effectiveness is slightly lower than with IVF, but not much inferior and amounts to 25-29%. Indications for the use of methods are infertility of unknown etiology, pathology of the cervix and cervical mucus, endometriosis of the tubes, the presence of antibodies to male sperm in a woman, and unsuccessful attempts at intrauterine artificial insemination. These methods of fertilization can also be used for male factor infertility, but in such a situation ZIFT will be more effective than GIFT.

The methods of fertilization GIFT and ZIFT can be used only if there is one, and preferably two passable pipes. The essence of GIFT is that an egg mixed with specially processed sperm is transferred into the fallopian tube. Conception occurs already in the tube, as in natural conditions. Transfer is carried out by laparoscopy, under general anesthesia. Punctures are made on the front wall of the abdomen, then a laparoscope is inserted, the end of the fallopian tube is captured, and an egg is injected there using a catheter. Control the onset of pregnancy three weeks after the procedure.

ZIPT and IVF are very similar methods of fertilization. Unlike GIFT, conception with ZIPT occurs outside the female body. Embryo transfer is carried out on the first day, not into the uterine cavity, but into the fallopian tube. The transfer technique is the same as for GIFT, by transabdominal laparoscopy. Previous attempts have been made to transfer the zygote into the tube through the cervical canal and uterus. But the chances of getting pregnant decreased.

The methods of fertilization GIFT and ZIFT are now a thing of the past, despite their effectiveness. Very few fertility clinics provide this service. This situation is connected with the fact that the methods involve an invasive procedure, which increases the risk of complications. Unlike IVF, very little scientific development is currently underway to improve GIFT and ZIFT. Therefore, over time, their effectiveness, compared with classical IVF, can significantly decrease, which will make these fertilization methods even less popular.

The statistics are disappointing - every year the number of infertile couples only increases, and how many of them want children! Thanks to the latest technologies and progressive methods of treatment, babies are born, although it would seem that this is impossible. Artificial insemination is a procedure that allows a woman diagnosed with infertility to become a mother with the help of donor sperm. What is the essence of the technology, to whom it is contraindicated, and how great are the chances of giving birth to a child - more on that later.

What is artificial insemination

Being one of the methods of artificial insemination, insemination helps parents to find a long-awaited child. The procedure significantly increases the likelihood of conception, since it is preceded by a careful selection of material for the operation. Among spermatozoa, the most active ones are selected, and the weak ones are removed. The protein components of the ejaculate are removed, because they can be perceived by the female body as foreign.

Intrauterine insemination is not a panacea for infertility, but only one of the ways to get pregnant artificially. According to studies, the positive effect is estimated at a maximum of 30-40 percent. A single session does not guarantee the development of pregnancy, so the operation is performed up to 3 times per monthly cycle. If conception does not occur after several procedures, it is recommended to turn to other methods of artificial insemination. The very same pregnancy with intrauterine insemination is no different from the usual.

Why is artificial insemination possible?

It would seem why women cannot become pregnant, and with the artificial introduction of ejaculate, fertilization occurs. One of the features lies in the female body. The fact is that antibodies to male sperm are produced in the cervical mucus. It turns out that it simply kills the spermatozoa, and does not contribute to their penetration to the egg. The procedure helps to deliver the processed material directly to the uterus, bypassing the cervical canal. In this way, even if the spermatozoa are immobile, the chance of getting pregnant increases.

Indications

As can be seen from the above, the main indication for artificial intrauterine insemination is the immunological incompatibility of partners. In fact, there are much more individual reasons for resorting to the procedure, so it is worth considering them in more detail. The main problems in women are considered to be inflammatory processes in the cervical canal. The disease prevents the passage of sperm into the uterus, preventing a woman from becoming pregnant.

Artificial insemination is used for vaginismus - a problem when sexual intercourse is not possible due to spasms and pain. Injuries and pathologies of the genital organ that prevent pregnancy, anomalies in the position of the uterus, infertility of an obscure nest, surgical interventions on the cervix are another of the many reasons to go to the clinic for an insemination procedure.

Until recently, the cause of female infertility was sought only in the weaker sex, but, as studies have shown, male problems are often dominant in this matter. Low motility and a small number of spermatozoa, which are difficult to reach the end point, and azoospermia are one of the main diseases due to which artificial insemination is prescribed if the previous treatment has not given any results. Disorders with potency and ejaculation can also become an indication for the procedure.

Genetic diseases, due to which there is a risk of the birth of a patient or with the psychophysical characteristics of a baby, is another reason why artificial insemination is prescribed. True, then the procedure is performed with the donor's sperm, to which the husband (and the future official father) gives written consent. Fertilization with seminal fluid from the base of the clinic is also carried out for single women who want to get pregnant.

Advantages

Intrauterine insemination is the first of the methods that is used for problems with conception. The main advantage is the absence of great harm to the female body. Artificial insemination can be carried out even if the exact cause of infertility has not been established. The procedure does not require long preparation, and its implementation does not take much time. The main advantage of using this method is its low cost.

Preparation

Like any operation, and medically intrauterine insemination is such, the procedure requires preparation. One desire to do artificial insemination is not enough, you need to come to an appointment with a doctor who will prescribe an action plan after compiling a family history and a thorough analysis of the situation during the conversation. Then it is necessary to sign certain papers confirming the consent of the spouses to carry out the conception. If it is necessary to use donor sperm, the number of documents for approval increases significantly.

Tests before insemination

Previously, in order to find out the preparedness for the artificial insemination procedure, the couple is tested:

• HIV AIDS);
• torch infections;
• hepatitis;
• passive hemagglutination reaction (RPHA).

After a 3-5 day period of abstinence, a man gives a spermogram, which determines the mobility of spermatozoa. In women, the patency of the fallopian tubes is checked, with the help of hysterosalpingography, the uterus is examined. An ultrasound scan detects ovulation. If there are problems, then hormones stimulate the production of an egg. Sowing of microflora is carried out to determine the presence of papillomavirus, ureplasma, group B streptococcus, which can cause the impossibility of bearing a fetus.

Semen preparation

Immediately before the insemination procedure, seminal fluid is artificially surrendered, after which it is examined and processed. There are 2 ways to prepare cells: centrifugation and flotation. The first option is preferable because it increases the chances of conception. Preparation of sperm consists in removing acrosin from it, a substance that inhibits sperm motility. To do this, portions are poured into cups and left to liquefy, and after 2-3 hours they are activated with special preparations or passed through a centrifuge.

What day is insemination done

According to doctors specializing in these issues of gynecology, the best option for artificial insemination is the introduction of spermatozoa into the uterus three times:

• 1-2 days before ovulation;
• On the day of ovulation;
• After 1-2 days in the presence of several maturing follicles.

How is the procedure

Artificial insemination can be carried out independently or directly with the participation of a specialist in the clinic. To do this, the woman is placed on a gynecological chair, using a mirror, access to the cervix is ​​​​opened. The doctor inserts a catheter, and biological material is collected into a syringe connected to it. Then there is a gradual introduction of spermatozoa into the uterine cavity. After insemination, the woman should remain motionless for about 30-40 minutes.

Insemination with donor sperm

If serious diseases are detected in a woman's partner, such as hepatitis, HIV and other potentially dangerous diseases, including genetic ones, then donor sperm is used, which is stored frozen at a temperature of -197 ° C. Data about a person is not declassified, but a woman can always bring with her a person who has the right to donate seminal fluid for subsequent artificial insemination of the patient.

Husband's cum

When using the biological material of the spouse, sperm sampling takes place on the day of the insemination procedure. To do this, the spouses come to the clinic, where biological material is donated. After that, the seminal fluid is analyzed and prepared for use. It is important to understand that before donating sperm, a man must refrain from sexual intercourse for at least 3 days in order to improve the quality of spermatozoa.

Artificial insemination at home

Artificial insemination is allowed at home, although according to doctors, its effectiveness is considered minimal, however, judging by the reviews, successful attempts have been recorded. In the pharmacy, you can buy a special kit for manipulation at home. The algorithm differs from that carried out in the clinic in that the sperm is injected into the vagina, and not into the uterus. When carrying out insemination on your own, you cannot reuse the kit, it is forbidden to lubricate the labia with saliva or cream, and also to inject sperm directly into the cervix.

Method efficiency

A positive result in the procedure of intrauterine artificial insemination is achieved less frequently than in in vitro fertilization (IVF) and ranges from 3 to 49% (these are the most positive data). In practice, the number of attempts is limited to 3-4, since a larger number of attempts is considered ineffective. After that, it is necessary to conduct additional studies or correction of treatment. If there is no pregnancy, you should resort to another method of artificial conception or change the sperm donor.

Risks and possible complications

As such, intrauterine insemination does not cause complications, women are more at risk due to taking drugs that cause ovulation, so it is imperative to test for the possibility of allergies. In addition, the risk of having twins increases, less often triplets, due to the fact that several attempts are made to introduce sperm and stimulate the formation of more than one follicle.

Contraindications

Although artificial intrauterine insemination is a simple procedure with little or no consequences, there are still some restrictions on which it can be refused. Among them, there are problems with ovulation itself, which occurs with violations, tubal infertility (it is necessary that at least one intrauterine labor is capable), inflammation of the appendages and uterus, hormonal disruptions, infectious and viral diseases.

Price

It is impossible to say for sure how much artificial insemination costs, since prices will differ in each clinic in Moscow. It is important to understand that the procedure consists of several stages, including consultation, tests, treatment. It is necessary to take into account the price of the medicines that will have to be taken. If donor sperm is used, then it is worth adding to the price and its cost. To date, according to information provided on the Internet, the following figures can be named:

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Attention! The information presented in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment based on the individual characteristics of a particular patient.

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Artificial insemination

Artificial insemination

Artificial insemination is the process of fertilization, which is carried out by introducing sperm directly into the uterus (artificial insemination) or by the in vitro method (outside the body, "in vitro"), i.e. extracorporeal (IVF).

Types of artificial insemination:

1. artificial insemination with husband's or donor's sperm (IISM/IISD);
2. in vitro fertilization (IVF).

Depending on the testimony of a woman, an artificial insemination program is selected.

1. Intrauterine insemination is the introduction of specially prepared sperm using a special catheter directly into the uterine cavity.

   Thus, the sperm does not pass through the barriers of the acidic environment of the vagina and the dense protective mucus of the cervix, and immediately enters the neutral environment of the uterine cavity.

   After that, the spermatozoa independently move to the fallopian tubes and the egg is fertilized in the same way as during natural sexual contact.

   According to the literature, artificial insemination of a woman as a treatment for infertility has been used for more than 100 years. This procedure is carried out only in specialized medical clinics, subject to a complete examination of a man and a woman.

   It is mandatory to study the condition of the uterus and fallopian tubes - hysterosalpingography (X-ray examination using a contrast agent) or laparoscopy (examination of the uterus using an optical device - a laparoscope) to make sure that the reproductive tract is patent.

   For insemination, both native ("live") and cryopreserved sperm (previously thawed) can be used. Sperm before artificial insemination is cleaned and concentrated.

   Artificial insemination is recommended for women with increased viscosity of cervical mucus or acidity of the vaginal environment. On the part of the partner, there may be indications such as erectile dysfunction, a decrease in the number of motile spermatozoa, or increased sperm viscosity, etc.

   The procedure is carried out in the operating room of the clinic, on a gynecological chair with a special syringe with a catheter, through which the sperm is introduced into the uterine cavity. After this procedure, you must lie down for 15-20 minutes. The procedure does not require anesthesia.

2. IVF - in vitro fertilization - is a method of artificial insemination, in which male spermatozoa and female eggs (previously extracted from the ovaries) are combined outside the body, in vitro (in "glass", i.e. in a laboratory test tube).

   There, self-fertilization takes place, and the resulting embryos (1 or 2) after a few days are transferred to the woman's uterus, where one or both are implanted in the endometrium (the mucous membrane of the uterine cavity) and develop for 9 months.

   To obtain eggs for 2-3 weeks, ovulation is stimulated with hormonal drugs. After several eggs mature at once, the reproductologist removes them from the ovaries (performs a puncture of the follicles) and transfers them to the embryological laboratory.

   Artificial insemination by ICSI- This is one of the varieties of IVF. In this case, the embryologist, using special instruments under a strong magnification of the microscope, injects the most fertile spermatozoon into the egg.

   The embryo obtained after such fertilization is no different from the embryos conceived naturally, and also, after a few days, it is transferred to the woman's uterus and develops for 9 months. This method has been successfully used in patients with male factor infertility when there are abnormal sperm counts or after TESA biopsy for azoospermia.

Donor programs for artificial insemination

If one of the spouses does not have their own healthy sex cells, IVF can also be carried out with donor sperm, a donor egg. The donor undergoes a thorough medical and genetic examination before donating his germ cells. Artificial insemination with donor sperm is carried out only after a double examination with an interval of 3 months.

For couples where it is contraindicated for a woman to bear a child (for example, with severe heart disease) or it is physically impossible (due to the absence of a uterus), IVF is used with a surrogate mother.

Another great advantage of IVF is that during the cultivation of embryos in the embryological laboratory there is the possibility of preimplantation genetic diagnosis of the embryo. This method allows you to identify (if any) genetic diseases, chromosomal abnormalities, developmental anomalies (malformations). Unlike many other clinics, VitroClinic performs PGD on the entire set of human chromosomes (that is, on all 46 chromosomes). After such an analysis, only healthy embryos will be transferred to the uterus.

Before any artificial insemination program, the couple undergoes a thorough medical examination to identify possible contraindications. The list of such examinations is regulated by the Order of the Ministry of Health and is strictly observed in our clinic.

Where to do artificial insemination?

Before consulting a doctor about overcoming infertility, any married couple asks the question: “Where can artificial insemination be done at a high professional level?”

Before choosing such a clinic, adhere to the following recommendations:

• The clinic should employ narrow specialists specifically in the treatment of infertility: gynecologists-reproductologists, urologists-andrologists, embryologists and geneticists.
• The artificial insemination center should use in its work only high-quality and original medicines and consumables for IVF.
• True professional reproductive specialists work with each couple individually, i.e. the choice of method, stimulation schemes and support for early pregnancy is selected by a specialist only after a thorough study of the anamnesis of the spouses, past IVF experience (if any), age, current health status, and many others.
• Experienced reproductologists use sparing hormonal stimulation schemes, taking care of the health of their patients and avoiding hyperstimulation.
• To exclude multiple pregnancy, the reproductologist should transfer only one or two embryos (according to indications). Three or more is not allowed.
• The specialists of the clinic you have chosen must be proficient in all the most modern techniques in reproductive medicine: ICSI, PICSI, assisted hatching, genetic diagnostics of the embryo, etc.
• Semen analyzes should be carried out in the laboratory of the clinic itself by specialist embryologists who evaluate not only the morphology of the spermatozoa, but also their fertility.
• Choose a clinic that cooperates with an ISO-certified clinical diagnostic laboratory. The quality of the analyzes performed plays a crucial role in the preparation for IVF.
• Make sure in advance that from the initial consultation to the end of the entire IVF or artificial insemination program, you will be led by the same reproductologist (except for force majeure situations). This indicates the responsibility and focus of the doctor and the clinic on a positive result.
• Give preference to those clinics where doctors leave their contacts to patients for communication. You will have the opportunity to call or e-mail your doctor if you need any clarification or have questions.
• It is good if in the same clinic where you will do IVF there is an opportunity to stay to observe the pregnancy. Doctors, knowing all the nuances of your pregnancy, and having continuity among themselves, will do everything to bring it to the end - the birth of a healthy child.
• The price in Moscow for artificial insemination programs in different clinics can vary significantly. Be sure to check with the manager how much artificial insemination costs and what exactly is included in each program you are interested in, whether it is possible to add some additional services there, for example, ICSI or hatching, whether there are options with donor cells and embryos. A wide range of different programs is a big plus for the clinic. This means that in this artificial insemination center, doctors are proficient in all modern ART techniques and can afford to choose any program for each couple.

Artificial insemination is not a method of treating infertility, but a method of overcoming infertility. Thus, it overcomes obstacles to achieve pregnancy. Currently, artificial insemination is used to overcome almost any cause of infertility and allows you to bypass many problems with conception.

Question 1. What is fertilization?

Question 2. What types of fertilization do you know?

There are two main types of fertilization.

External fertilization - sex cells merge outside the body of the female. This type of fertilization exists in many fish, amphibians, mollusks and some worms. During external fertilization, organisms form a large number of both female and male germ cells (for example, moonfish spawn up to 30 million eggs).

Internal fertilization - the meeting and fusion of gametes - occurs in the female genital tract. In this case, the probability of fertilization and survival of the zygote is much higher, so germ cells (especially eggs) are formed much less. Internal fertilization is inherent in many aquatic organisms, and on land it becomes the only reliable way to ensure the fusion of gametes. With internal fertilization, the zygote gets the opportunity to develop while remaining in the mother's body.

Question 3. What is the process of double fertilization?

Double fertilization is typical for flowering plants. In their ovary, an embryo sac with eight haploid nuclei is formed. Two of them fuse to form a diploid cell; one, separating, turns into an egg; the other five are auxiliary.

When pollen hits the stigma of the pistil, the haploid cell of the pollen grain divides, forming two immobile sperm and a special, so-called vegetative cell. The vegetative cell, germinating, forms a pollen tube that carries sperm to the ovary.

Once in the ovary, one of the sperm merges with the egg, forming a diploid zygote, from which the seed embryo develops later. The second sperm fuses with the diploid ovary cell, forming a triploid cell, from which the nutrient tissue of the seed (endosperm) is then formed.

Question 4. What is the importance of artificial insemination in crop and livestock production?

Using artificial insemination in crop production, it is possible to carry out a certain, pre-planned crossing, to obtain plant varieties with the necessary properties. In addition, you can maintain the properties of the variety, producing self-pollination.

In animal husbandry, artificial insemination makes it possible to obtain numerous offspring from one sire, i.e., to raise a large number of animals with the desired traits in a short time. Modern technologies make it possible to preserve the gametes of promising individuals for a long time and transport them over long distances, which also expands the capabilities of livestock breeders and breeders.