Surrogacy
Refers to the process of assisted reproduction in which an ova (egg) is transferred from an intended mother and fertilized using a sperm of the intended father with the aim of helping intended parents have children when they would otherwise not have. The fertilized embryo is then transferred to the surrogate mother who willingly or through agreement accepts to carry the baby until the due date. The process may also involves the fertilization of a donor egg using the sperm of the intended father or another donor sperm and transfer the resulting embryo to the surrogate mother.
Artificial insemination
Is a fertilization procedure which involves the placement of sperms artificially into the cervix or uterus of a woman. During the process, the woman's cervix is monitored through blood tests, ovarian kits, and ultrasounds to ensure that the female environment is able to carry the fertilized ovum. Similarly, the sperm is also 'washed' in the laboratory to enhance its chances of performing successful fertilization for conception.
Intrauterine insemination
This refers to the type of artificial insemination in which the sperm is placed in a female's uterus to facilitate fertilization of the ovum. The main aim of intrauterine insemination is to increase chances of fertilization as the number of sperms reaching the fallopian tube increases. The process is always adopted in cases where there is: unexplained infertility, cervical mucus problems, dysfunctional ejaculation, and cervical scar tissue which may hinder the entrance of sperms into the uterus.
The process of intrauterine insemination
The procedure for intrauterine insemination begins with taking fertility drugs and monitoring of the ovulation cycle. The patient starts frequent visit to the fertility specialist for a pre-insemination workup in which the doctor checks whether the female is in a good health condition to enable successful process (Thijssen et al., 2017). First, the doctor assesses the hormone levels to check if they are in the normal expected range that can support fertilization and also survey if the uterus is able to support implantation. The doctor may also start the patient on the ovulation drugs as series of ultrasound and blood testing are done; this process aims at confirming whether the female produces healthy eggs that would warrant fertilization (Thijssen et al., 2017). The common injection drugs used by doctors include gonadotropin and Clomid ills which stimulate ovulation by nurturing the follicles to grow. The process will also enable the doctor determine the best timing to inject the sperm.
The doctor monitors the drug treatment until the day of the insemination to measure follicle growth as well as control the dosage of drugs based on the patient capabilities. Since the drugs are able to produce several eggs, the process of monitoring is important in reducing cases of multiple births (Hurst, Merriam, Marshburn, Matthews, " Usadi¸ 2016). The doctor performs blood tests to measure the estrogen which also facilitates follicular growth. When the patient has two to three mature follicles, then the doctor would be compelled to inject the hCG hormone, also referred to as Ovidrelæ for preparation of insemination (Thijssen et al., 2017).
The second step
Involves the provision of a sperm sample by the intended father or donor, which is 'washed' for the insemination process. The intended father gives a sperm sample which is prepared in the laboratory through 'washing' (Hurst, Merriam, Marshburn, Matthews, " Usadi¸ 2016). The purpose of this procedure is to ensure that all potential toxic chemicals are eliminated and ensure that only the sperm that is able to fertilize the egg remains for insemination. The removed chemicals may cause allergic reaction to the intended mother, thus, hindering fertilization. Washing also enhances the volume of sperm concentration which increases the chance of healthy insemination process.
The last step
Entails the injection of the sperm into the intended uterus. This process is very fast as it may take between one and two hours. The female recipient is made to lie down on a table as usually done for any pelvic examination (Hurst, Merriam, Marshburn, Matthews, " Usadi¸ 2016). The doctor then inserts a small, flexible, and think catheter into the cervix then injects the washed sperm into the uterus. Although most inseminations are done by a single insemination, the doctor may opt for two inseminations depending on the health of the intended mother. After the procedure, the intended mother has to see a doctor within a week to check the progesterone levels (Thijssen et al., 2017). The doctor also checks the uterine lining using an ultrasound as well as hormonal changes to confirm if the process was successful. The simple process may take between 45 minutes to 1 hour.
Intrauterine insemination is viewed variable by different stakeholders. The patients and doctors believe that it offers parents the opportunity to have children in cases where it would otherwise be impossible. This is particularly true to couples or partners with temporary infertility who may have limited chances of getting pregnant by natural fertilization. Manufacturers of the injection drugs have always proven that the medications for intrauterine insemination are safe as long as applied in the prescribed dosage. As such, they advocate for the process which enhances the wellbeing of patients who are committed to having children.
References
Hurst, B. S., Merriam, K., Marshburn, P., Matthews, M., " Usadi, R. S. (2016). Optimal timing for intrauterine insemination (IUI) after administering HCG in ovulation induction IUI cycles. Fertility and Sterility, 106(3), e305-e306.
Thijssen, A., Creemers, A., Van der Elst, W., Creemers, E., Vandormael, E., Dhont, N., " Ombelet, W. (2017). Predictive factors influencing pregnancy rates after intrauterine insemination with frozen donor semen: a prospective cohort study. Reproductive biomedicine online, 34(6), 590-597.
