Insemination
The insemination method is generally unsuitable for women aged 40 or above, due to the poor success rate with this age group. The expected rate of pregnancy during the first attempt with partner sperm is 15% (up to 20-30 %) and slightly more with donor sperm (30-35%).If pregnancy is not achieved after 3-4 well-monitored and well-implemented treatments, the couple should consider test-tube treatment.
There are several insemination methods, but we supplement them all with hormone stimulation for the woman, as described under "Hormone stimulation".
Intrauterine insemination (insemination in the uterus).
The purified sperm is transferred to the uterus while ovulation is managed through stimulation treatment. IUI (Intra Uterine Insemination) is the most popular method of treating childlessness.The treatment can be carried out without stimulation treatment, but the chance of pregnancy is considerably lower than with combined stimulation and insemination treatment. This is also the case if the woman receives only stimulation treatment, i.e. without insemination but with natural intercourse.
Insemination
FER Frozen Embryo Replacement)
Extraction of sperm cells from the epididymes
Partner's sperm or donor sperm. Insemination can be achieved with the partner's sperm or with sperm from an anonymous donor.
The results are better with donor sperm than with the partner's sperm, as insemination with donor sperm rules out bad sperm samples that are often a direct reason for choosing insemination treatment.
The sperm is purified in a laboratory, and the isolated and concentrated sperm cells are transferred to the uterus at the right time in the woman's planned and managed ovulation cycle.
The methods
FSP (Fallopian Sperm Perfusion) is the equivalent to insemination in the uterus, except that a larger volume of liquid is used (nourishment medium). Instead of inseminating with ½ ml fluid, 2-6 ml of fluid containing purified sperm cells is transferred to the uterus and “flushed” into the Fallopian tubes.
This method has proven to result in considerably more pregnancies without increased discomfort for the woman or increasing the number of pregnancies outside the uterus. FSP is suitable for all women who have at least one normal Fallopian tube and, as stated earlier, is a routine procedure at the clinic.
The method requires that the sperm is purified very carefully in a laboratory with very good sterile technology, and all protein must be removed from the seminal fluid.
VITI (Vaginal Intra Tubal Insemination). Insemination with a double catheter inserted gently in the Fallopian tubes. This method requires both extensive experience in insemination treatment and good sterile technology.
VITI is only carried out in certain circumstances, primarily when insemination is desired in only one of the Fallopian tubes. With conventional IUI or FSP it is impossible to decide which Fallopian tube the sperm enters.
The method is also used if the man has very poor quality sperm and the couple does not want testtube treatment for some reason.
VITI follows the principles of IUI and is carried out with a double catheter with a thin, inner catheter that is very gently inserted 2-5 cm into the Fallopian tube. The purified sperm cells are then flushed into it. Very little fluid is used (0.2-0.3 ml).
As a rule, only very light discomfort resembling menstrual pains occur on the side where insemination is performed. Very rarely, the insemination process is painful enough to require a local anaesthetic. Due to the simultaneous hormone treatment, the chance of multiple pregnancies and overstimulation is slightly increased. The risk of infection in the uterus caused by this technique is very low – less than 0.5 %.
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