IUI

Artificial insemination is a means of attaining pregnancy not involving sexual intercourse. A couple having trouble getting pregnant can benefit from the exact timing and placement of the sperm. It can overcome instances where a woman's immune system can reject her partner's sperm as invading molecules. In the case of an impotent male, donor sperm may be used. It is also a means for a woman to conceive when two women wish to parent a child, or a single woman does not have a male partner, when she does not want a male partner, or when a male partner's physical limitation impedes his ability to impregnate her by sexual intercourse. Women who have issues with the cervix such as cervical scarring, cervical blockage from endometriosis, or thick cervical mucus may also benefit from artificial insemination since the sperm must pass through the cervix to result in fertilization. This method is often used for same-sex couples who wish to have a biological child. Lesbian(females) couples have a sperm donor. Gay(male) couples have an egg donor and a surrogate mother (similar to a birth mother).

Preparations
A woman needing artificial insemination to achieve pregnancy can obtain a sperm sample from her male partner or sperm from sperm donation may be used if, for example, the woman's partner produces too few motile sperm, or if he carries a genetic disorder, or if the woman has no male partner. Sperm is usually obtained through masturbation or the use of an electrical stimulator, although a special condom, known as a collection condom, may be used to collect the semen during intercourse.
Sperm provided by a sperm bank will always be produced by a donor attending at the sperm bank's premises in order to ascertain the donor's identity on every occasion. The donor masturbates to provide an ejaculate in a small container. The contents of the container are usually extended with chemicals in order to provide a number of vials for insemination. The sperm is frozen and quarantined for a period of usually six months and the donor re-tested prior to the sperm being used for artificial insemination.
A sperm donor is usually advised not to ejaculate for two to three days before providing the sample, to increase the sperm count.
A woman's menstrual cycle is closely observed, by tracking basal body temperature and changes in vaginal mucus, or using ovulation kits, ultrasounds or blood tests.
When using intrauterine insemination (IUI), the sperm must have been “washed” in a laboratory and concentrated in Hams F10 media without L-glutamine, warmed to 37C. The process of “washing” the sperm increases the chances of fertilization and removes any mucus and non-motile sperm in the semen. Pre and post concentration of motile sperm is counted.
Sperm from a sperm bank will be frozen and quarantined for a particular period and the donor will be tested before and after production of the sample to ensure that he does not carry a transmissible disease. Sperm samples donated in this way are commonly produced through masturbation by the sperm donor at the sperm bank. A chemical known as a cryoprotectant is added to the sperm to aid the freezing and thawing process. Further chemicals may be added which separate the most active sperm in the sample as well as extending or diluting the sample so that vials for a number of inseminations are produced. For fresh shipping, a semen extender is used. If sperm is provided by a private donor, either directly or through a sperm agency, it is usually supplied fresh, not frozen, and it will not be quarantined. Donor sperm provided in this way may be given directly to the recipient woman or her partner, or it may be transported in specially insulated containers. Some donors have their own freezing apparatus to freeze and store their sperm. Private donor sperm is usually produced through masturbation, but some donors use a collection condom to obtain the sperm when having sexual intercourse with their own partners.

Procedure
When an ovum is released, semen provided by the woman's male partner, or by a sperm donor, is introduced into the woman's vagina or uterus. The semen may be fresh or it may be frozen semen which has been thawed. Where donor sperm is supplied by a sperm bank, it will always be quarantined and frozen and will need to be thawed before use.
For vaginal artificial insemination, semen is usually placed in the vagina using a needleless syringe. A longer tube, called a tom cat, may be attached to the end of the syringe to facilitate deposit of the semen deeper into the vagina. The woman is generally advised to lie still for a half hour or so after the insemination to prevent seepage and to allow fertilization to take place.
A more efficient method of artificial insemination is to insert semen directly into the woman's uterus. Where this method is employed it is important that only 'washed' semen be used and this is inserted into the uterus by means of a catheter. Sperm banks and fertility clinics usually offer 'washed' semen for this purpose, but if partner sperm is used it must also be 'washed' by a medical practitioner to eliminate the risk of cramping.
Semen is occasionally inserted twice within a 'treatment cycle'. A double intrauterine insemination has been theorized to increase pregnancy rates by decreasing the risk of missing the fertile window during ovulation. However, a randomized trial of insemination after ovarian hyperstimulation found no difference in live birth rate between single and double intrauterine insemination.
An alternative method to the use of a needleless syringe or a catheter involves the placing of partner or donor sperm in the woman's vagina using a specially designed cervical cap, a conception device or conception cap. This holds the semen in place near to the entrance to the cervix for a period of time, usually for several hours, to allow fertilization to take place. Using this method, a woman may go about her usual activities while the cervical cap holds the semen in the vagina. One advantage with the conception device is that fresh, non-liquified semen may be used.
If the procedure is successful, the woman will conceive and carry to term a baby. The baby will be the woman's biological child, and the biological child of the man whose sperm was used to inseminate her, whether he is the woman's partner or a donor. A pregnancy resulting from artificial insemination will be no different from a pregnancy achieved by sexual intercourse. However, there may be a slight increased likelihood of multiple births if drugs are used by the woman for a 'stimulated' cycle.

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