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.
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 an anonymous sperm bank are used.
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
It is important that the procedure takes place shortly before ovulation or on the day of ovulation. The moment of ovulation can be determined very accurately by the doctor using ultrasound scans and hormone checks.
When the day arrives, fresh or cryopreserved (frozen) sperm are required. If fresh sperm and homologous insemination are used, the partner must provide a sperm sample on the day of the procedure. The seminal fluid is then taken to the laboratory and prepared there. This involves filtering out as many motile sperm as possible.
The doctor then inserts the prepared seminal fluid directly into the woman’s uterine cavity using a soft catheter. This is referred to as intrauterine insemination (IUI). The treatment takes only a few minutes.
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.
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.
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.
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.