Types of Insemination
Types of Assisted Reproduction Technologies (ART)
The most familiar ART procedures are intrauterine insemination (IUI) - known as artificial insemination - and in vitro fertilization (IVF). However, there are in fact several types of artificial insemination, each of which tries to help a woman conceive (without sexual intercourse) by placing sperm directly into a woman's reproductive tract. The goal is to help sperm 'artificially' reach a woman's egg with the hope for fertilization and ensuing pregnancy.
Types of Artificial Insemination
There are four types of insemination procedures, each involving the placement of sperm into a different area of the female reproductive tract. Artificial insemination can be performed in: the cervix (intracervical insemination); the uterus (intrauterine insemination or IUI); the vagina (intravaginal insemination); the fallopian tubes (intratubal insemination).
Intracervical Insemination (ICI): A semen sample from a woman's partner or from a sperm donor is placed directly into a woman's cervix. ICI is popular due to its non-invasive, painless nature, and its relatively inexpensive cost compared to the IUI procedure. For example, a single ICI cycle ranges from $200-$350, as opposed to approximately $800 for a single cycle of IUI. With the difference in price, couples can afford more treatment cycles.
Intrauterine Insemination (IUI): Sperm from a woman's partner or a sperm donor is "washed," or separated in a lab from the semen sample, and then placed directly into the uterus. While more expensive than ICI, the success rates of IUI are much higher since sperm are placed much closer to the fallopian tubes. It is said that the chances that a woman will become pregnant with IUI are almost double those of ICI.
Furthermore, IUI is often combined with fertility drugs in order to increase success rates. In a process called ovarian stimulation, fertility medications are used to simulate the ovaries to produce more eggs, thereby increasing the likelihood that fertilization will occur. Couples and their fertility specialist have the option of using oral Clomid (clomiphene citrate) tablets or using injectable gonadotropins (Follistim, Gonal-F, Bravelle, Menopur) in conjunction with IUI.
Intravaginal Insemination: This type of insemination is also known as 'self-insemination,' wherein couples try to become pregnant on their own. Through the use of a syringe, the semen sample is placed inside the vaginal canal near the cervix. The advantages of self-insemination are the obviously low costs and having the procedure carried out in privacy of one's own home.
Intratubal Insemination: There are two types of this intervention, known as intra-fallopian insemination (IFI) and intraperitoneal inseminations (IPI). However, intratubal insemination is rare since it is significantly more invasive and its success rates no higher than that of its IUI counterpart.
In IFI, washed sperm are injected into a fallopian tube. In IPI, washed sperm are injected via the top of the vagina into the peritoneal cavity near the entrance to the fallopian tubes. The latter is often carried out with the guidance of an ultrasound.
In all artificial inseminations, timing is the key to success. Artificial insemination must be performed adjacent to the time when a woman is ovulating - that is, the time in the menstrual cycle when an egg is released and women are most fertile. For women with regular periods, this is often around day 14 of their cycle. In order to time inseminations properly, blood tests or urine tests are used to check levels of luteinizing hormone (LH), since a surge in LH indicates ovulation. Other means of detecting ovulation are changes in vaginal discharge or a drop in basal body temperature.