Insemination

If it is not possible to get pregnant by conventional means, a doctor can perform a semen transfer (insemination). This involves a simple medical procedure to insert the man’s sperm into the woman’s uterus. This facilitates or eliminates the travel of the sperm from the vagina up through the cervix.

Homologous and heterologous insemination

There are two different types of artificial insemination: homologous and heterologous. In homologous insemination, the sperm come from the woman’s partner. In heterologous insemination, donor sperm from a sperm bank are used.

When is insemination useful?

Homologous insemination can be used if:

• The man’s sperm quality is only mildly impaired, i.e. there are too few sperm in the ejaculate or the sperm are not motile enough

• The couple cannot have sex

• There are organic causes in the woman, such as a constricted cervix

Heterologous insemination, on the other hand, is worth considering if:

• The man is infertile, i.e. he does not have any sperm cells

• He has a severe hereditary disease

Hormonal stimulation

Artificial insemination can be carried out in the woman’s so-called spontaneous cycle, that is, during her natural cycle. However, the chances of success are somewhat improved if the maturation of the eggs is assisted by low-dose hormone preparations and ovulation is specifically triggered. 

What are the chances of success?

The individual chances of successful insemination depend on several factors, such as the woman’s age, her physical condition, the partner’s sperm quality, and the accompanying hormone treatment.

Few women become pregnant during the first treatment. The likelihood of success is between 5 and 12% in the case of homologous insemination. Several attempts are usually required. 

Are there any risks or side effects?

The risks of artificial insemination without hormone stimulation are very low. By using ultra-soft and very flexible catheters, it is virtually always possible to avoid injuring the uterus during insemination.

If hormone treatment is performed before the procedure, it is possible that a multiple pregnancy may occur. However, thanks to the ultrasound scan carried out before insemination, the number and size of the egg follicles can be easily detected and the risk of multiple pregnancy can therefore be estimated relatively reliably. If there are several large follicles, the patient is informed about this, and the cycle is terminated if necessary to avoid a higher risk of multiple pregnancy. 

Furthermore, the hormone preparations can also put a strain on the body. In very rare cases, hyperstimulation syndrome can occur. This can cause nausea, severe abdominal pain, shortness of breath or fluid accumulation in the abdomen, for example. These complications are rare – the doctor will individually explain the treatment to you along with any possible risks and side effects during your consultation before the treatment.

Costs: What does the health insurance pay?

The statutory health insurance funds in Germany usually cover 50% of the costs for the procedure. However, only under very special conditions and for a limited number of attempts. These conditions vary from country to country.