In general, Artificial Insemination (AI) involves placing sperm directly in the female reproductive tract of an infertile patient whose ovaries may or may not be stimulated with hormones. Intra-Uterine Insemination (IUI) and ovarian stimulation with exogenous hormones is the alternative with the highest probability of pregnancy for couples with infertility associated with specific diagnoses-directed treatments and those with unexplained infertility. However, since there are several alternatives and acronyms to describe them, depending on the specific clinical conditions of the couple, it may be difficult for the patient to distinguish one from another. The form of AI will be influenced by the effective sperm count, ovarian stimulation, sperm source (spouse or donor) and deposition of sperm in the female reproductive tract among others. Therefore, we intend to give a brief but general explanation of the different modalities associated with Artificial Insemination (AI), the clinical significance and the probability of pregnancy.

What is needed before AI?

Before AI is offered it is important to determine the cause(s) of infertility and a series of tests should be conducted to determine if the couple is a candidate for the procedure. A detailed medical history and physical examination should be conducted initially. The male partner will have two or more semen analysis and a few other tests conducted to estimate the fertilizing ability of his sperm. It is recommended that both be tested for HIV, hepatitis B and C, syphilis, gonorrhea, and chlamydia. In addition, the female partner should be evaluated for rubella titer. Also, it is necessary to determine the time and frequency of ovulation using LH surge kits, basal body temperature (BBT) charts and cervical mucus examination in addition to an endometrial biopsy to determine if there is adequate ovarian hormone production. Some physicians may recommend a Post-coital Test but not much information can be gained from it. Some patients may need a hysterosalpingogram, hysteroscopy or laparoscopy prior to insemination to determine the status of the fallopian tubes, absence of severe adhesions in the pelvic cavity and a reproductive tract free of problems interfering with conception and pregnancy. If your medical history and pelvic exam suggests previous pelvic inflammatory diseases, infections, tubal damage, or endometriosis you will need at least one of those procedures.