Artificial insemination Spain

Artificial insemination is recommended for cases in which the woman is not over the age of 38, although this could be extended when it is not a sterility problem. Indications for artificial insemination are:

• No partner or female partner that requires the use donor sperm
• When the cause of sterility is unknown despite having performed the basic fertility evaluation
• When there is a mild male factor that can improve with sperm preparation in the laboratory
• When there is a severe male factor that recommends the use of donor sperm
• When there are ovulation abnormalities
• When a couple has difficulty having sexual intercourse

In all these cases, it is recommended that you go to an “artificial insemination clinic” specialising in assisted reproduction to achieve a pregnancy.

The recommended tests for performing artificial insemination are:

• Hormone test to examine the ovarian reserve. The Anti-Müllerian Hormone (AMH) value can be determined at any time during the cycle, and the FSH and Estradiol value on day 3 of the cycle.
• Semen analysis with motile sperm recovery (MSR) test to evaluate whether the partner’s sample is of sufficient quality to perform an insemination.
• Gynaecological ultrasound to rule out uterine and ovarian diseases. It is also used to evaluate the ovarian reserve by antral follicle count.
• Hysterosalpingography to evaluate tubal permeability. It consists of a contrast injection into the uterine neck while x-rays are being performed.
• Serologies to rule out the presence of transmissible infectious diseases.

As with natural cycles, inseminations can be repeated in each cycle. It is not necessary to have one month off to increase success rates.
The success rates for inseminations remain stable during the three first attempts. If no pregnancy is achieved after 3 inseminations, we recommend trying a different and more effective treatment.

The main risk of artificial insemination is a multiple pregnancy, which will depend on the number of follicles that develop during the stimulation phase. This risk is manageable with ultrasound monitoring during the treatment.

Controlled ovarian stimulation is performed by administering hormones through daily subcutaneous injections from the first few days of the cycle. The stimulation protocol will be individually adjusted according to the woman’s ovarian reserve. During stimulation, ovarian response should be monitored by serial ultrasounds until the development of 1 or 2 follicles is achieved. At this point, ovulation will be triggered to perform artificial insemination after 36-40 hours.

During the treatment, you will have to go to the clinic several times to check follicular development. Usually, no more than three ultrasound scans will be required to schedule the artificial insemination.

Ovarian stimulation is not essential for women that are producing eggs as normal. Nevertheless, it is recommended in all cases since it significantly improves the chances for success.

The sperm used for artificial insemination can come from the partner or a donor. In the event of using donor sperm, it will be chosen as set out by Law, maintaining the maximum physical similarity with the patients. The sperm concentration in donor samples is of the highest quality, greatly exceeding the established limits to ensure the highest chances for pregnancy.

On the day of insemination, the sperm sample will be prepared in the laboratory by sperm capacitation process, to select the progressively motile sperm suited for egg fertilisation.

It is recommended to take progesterone supplements for a few days after insemination, to encourage embryo implantation.

During treatment, the woman will not notice any significant difference to her natural cycle. Therefore, it is recommended to lead as normal a lifestyle as possible.

It is recommended to take a urine pregnancy test two weeks after insemination.