How is artificial insemination done? IUD Own semen, IUD donor from international bank.
Artificial insemination is a relatively simple procedure, ideal for women who want to be single mothers, same-sex couples or couples in which the woman is fertile but the man does not produce sperm or they are of very poor quality.
Our catalog of national, international and super donors offers flexibility and a wide range of options. Remember that #SaberEsPoder and Dr. Otto Paredes, together with Biologist Fernanda Hernández, explain in detail the process to perform artificial insemination with your own semen (IUI) or with donor semen (IUD).
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Introduction
Hello! Today we are going to perform two intrauterine insemination procedures… We have seen that we do not have much information or many videos about this technique but it is something very interesting, remember that knowledge is success.
Steps of artificial insemination
Today we are going to review two cases or care for 2 patients who are going to an insemination cycle with bank semen. Why with bank semen? Particularly the case of these patients are women who want to be single mothers by decision, they do not have a male partner, they decided to be mothers and went to the clinic. How is an insemination cycle carried out?
First of all we proceed to perform ovarian stimulation. We stimulated their ovaries to mature 2 or 3 eggs, both patients reacted in this case with 3 follicles.
The day we have the eggs prepared, we proceed to prepare the semen sample that they have previously selected, then in our sperm bank we have several options, they are going to review the catalog of the options they have to make the decision of which one they want to use.
The biologist is in charge of thawing the sample and preparing it.
Later we go to the office here, you will see that it is a very quick and simple procedure and we proceed to inseminate.
In this way we would be coordinating the placement of the semen already prepared in the laboratory with the moment in which she is ovulating and in this way we offer the opportunity to achieve pregnancy in a very simple way.
Defrosting and improving the semen sample
Hello! Well today I am going to show you how we are going to thaw a semen sample, this semen sample belongs to a donor, that is, to a person who wanted to voluntarily, altruistically, donate his sample for couples who we know have had any problem; that there are no sperm in the ejaculate or it is difficult for them to take their sample or even for women who do not have a male partner, this type of donor is used and here at Creafam we have a program that has quality management for these donors.
The first thing we are going to do is remove the sample from our nitrogen tank, which is at -196 °C, and then we are going to defrost it at 37 °C. This is distilled water at 37 degrees specifically in this heater so that we can defrost it. There are other ways to defrost, however for us this is the optimal one, the one that gives us the best results because the survival of sperm also has to be adequate. Let’s remember that a fresh sample will always be better, however, as an additional option it is good to freeze them.
It has 2.5 ml in volume and for each milliliter we have 120 to 130 million. If you notice, we have a lot of mobility, some agglutinations, this can happen because the sample is a little viscous, etc. In terms of concentration we have no problems, there are quite a few and that is very good, the minimum is 15 million, we are tripling the amount. In this case we are going to see how much movement we have in each sperm.
Ok, the bell rang. What does this mean? In terms of movement of that amount of 120 to 130 million, we have 56% of a very good movement, that is, like those who move around here that advance quite quickly. Option B that we have, they do move but maybe they don’t advance as fast and their movement is a little more intermittent, like for example this one here.
They advance very quickly, sometimes it is difficult to see it but with the clinical eye that we develop it is easier for us through experience, and those that do not move, like this one for example. Many times, due to metabolic and energetic issues of the sperm itself, the sperm do not move… That does not mean that they are dead, for that reason a test called vitality is done. It is very different when they are dead, which is called necrozoospermia, than when they do not have movement, which in that case is called asthenozoospermia.
Sperm donor catalog
We have a semen catalog. What does it mean? That we subject our donors to a series of interviews and very specific tests in order to have very good quality management regarding the samples. If you notice a while ago we thawed a sample in a cryovial, here is the cryovial where we put what number it is, fully identified with the donor and the date because it is very important to know what date it was frozen and the status. In the information of our donors we collect everything according to how they live, their date of birth, age, physical characteristics, we even do some psychological tests.
We also have a catalog of international foreign semen and also a catalog of super donors. What does super donors mean? It’s good that its fertility has already been proven before.
Commonly, many patients or many couples ask us about the confidentiality of data, both of our donors and of you as couples and well, in that regard I want to leave you in peace since all that information is completely anonymous. There is no exchange between donors and patients, each one has a confidentiality letter, in addition to the fact that our donors, as I said before, come to do so voluntarily. They accept and sign legal consents, etc.
Here is the compilation of all the information, if at any time you would like to have access you can have it, we even have photographs when they were infants so that you can see some characteristics, it is also detected if there was any type of problem at the genetic level, any mental illness, who do not have any type of metabolic, muscular, neurological, respiratory, etc. medical problem.
In addition to the normal test that is done to detect any low quality of semen, which is the seminogram as many already know it, we also perform freezing and prior thawing tests, we do sperm DNA fragmentation, in some cases sperm Fish to prevent have some type of genetic disease or a high probability of it, we also do karyotype tests to see that they are chromosomally good and the process is really to give them the best quality samples.
Once we have carried out a centrifugation wash with a nutrient medium, we are going to place it in gradients. What do gradients mean? Well, they are substances that have silica particles that filter out the best sperm. If you noticed on the screen, in a fresh sample there will not only be live sperm, there may also be some dead ones, some immobile, some with poor movement or other cells such as some leukocytes or white blood cells. We are going to filter those sperm, we are going to remove all those cells so that we can obtain those that move much better and have better morphological characteristics.
There it is trained, if you notice there are very few sperm that still do not move, that is completely normal, remember that in a previous explanation we mentioned that some that do not move does not mean that they are dead but that their movement is not yet the appropriate one, because remember that it must be a temperature of 37 °C as we are inside the organism and here are the ones that move.
We are going to evaluate motility, movement itself, which has to be much greater in a trained sample. Ok, we have a percentage of 64% movement, if you realize it is much more than with a fresh sample, here is the grid.
Artificial Insemination (IUD or IUI)
If you see the images on the screen, the ultrasound image is clearly seen when the cannula passes and a glow appears inside the uterus. We call it a flush because it is a shine that appears at that moment, when we do in vitro foundation we have mentioned in other videos the appearance of this signal and it is much smaller.
Because? Because when we do in vitro fertilization and transfer embryos, it is a drop of culture medium with the embryos, in the case of insemination we are transferring half a milliliter of culture medium with the sperm, so yes, the volume of liquid is greater and This is what gives us a different image than the ultrasound, it is also important because it allows us to confirm that we are inside the uterus, that we are indeed leaving the sample inside the cavity. Once it is there, the sperm, just as happens naturally, will proceed to swim or move towards the uterine tubes to seek to meet the egg.
Ok, after performing an insemination the recommendations we give to patients are: Continue your usual life, your usual lifestyle; they can work, they can drive, they can walk; For those girls who do physical exercise, we recommend lowering the intensity a little, particularly exercises such as jumping or running or high-impact exercises, for some who do activities such as swimming or weights, there would be no major inconvenience.
The important thing is not to have much impact from the previous stimulation they had on the ovaries and, well, they may feel a little uncomfortable, but there is no really important change in their lifestyle.
After performing the insemination we apply or indicate luteal phase support with progesterone, to slightly reinforce the endocrinological conditions in favor of pregnancy and in 15 days we are waiting to perform the pregnancy test. Once we have the result, we will confirm what happened and 10 or 15 days later the first ultrasound to verify the implantation.
Conclusions
Ok, so, if for example we have a couple who has a seminal study and you are not very sure if, let’s say what type of treatment you need, if you need to go to an in vitro, if you can opt for insemination, remember that on our page website, at creafam.com/en/semen there are many more videos giving information on this topic and there is also the semen quality calculator that with more objective data can guide you on which is the best assisted reproduction treatment that you can access.
Reproductive medicine and gynecological endocrinology
Instituto Valenciano de Infertilidad, Spain.