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Artificial insemination

Saturday, November 10th 2012. | Pregnancy, Baby & Child
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General

Artificial insemination for couples can qualify, which childrenwant, but for different reasons, in the natural way, ie through sexual intercourse can not get.

Remains a desire to have childrenby natural means unfulfilled, are initially counseling and medical examinations necessary to find out the reasons for infertility. These can be found in men and women in roughly equal parts. If it is not possible, the causes of infertility or to correct infertility, in some cases, is an artificial insemination question.The precise sequence varies from case to case.

Basically, an artificial insemination is that the doctor of the woman – sometimes after previous hormonal stimulation – ova and / or the man takes sperm, these processed and together again. Usually in such cases, medical intervention is necessary.

For artificial insemination are different methods available, for example, are universally known as in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). In the IVF doctor removes the eggs and fertilizes them with sperm outside the body of the man. Successful fertilization, the doctor transfers the fertilized egg or the embryo by using a thin, flexible catheter through the vagina into the uterus. Regular check-ups are used to monitor the growth of the embryo.

Artificial insemination can sometimes be rather stressful – so it is important that couples consider this before and with her gynecologist to discuss in detail . How promising is the artificial insemination (ie how high the chances are, a pregnancy induce) depends on several factors – such as the methods used and the age of the woman.

The costs incurred for artificial insemination cost health insurance usually carries proportionally, but certain conditions must be met: For example, before a medical consultation is required and the partners may not exceed a defined age.

Artificial insemination 300x169 Artificial insemination

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Methods of artificial insemination

By artificial insemination is often achieved a fertility despite infertility meet or infertility. As artificial insemination are colloquially all proceedings in which a child by sexual intercourse occurs. Artificial insemination can be accomplished by various methods, such as:

  • AIH
  • Heterologous insemination
  • GIFT :. engl Intrafallopian gamete transfer (gamete intra)
  • IVF : In Vitro Fertilization
  • IVM : In Vitro Maturation
  • ICSI : intracytoplasmic sperm injection

Preparation

Hormone stimulation

Thus, in vitro fertilization is possible, but in some cases to prepare one hormonal stimulation of the woman may be necessary: If the hormone levels of women in the imbalance, it may be useful to the ovaries to stimulate by hormonal treatment in the form of hormone pills or hormone injections (stimulating) . The hormones cause the ovaries have several follicles mature simultaneously. This increases the probability that multiple fertilizable ova arise.

To hormonal stimulation prior to IVF are various hormones, singly or combined, are suitable:

  • FSH (follicle stimulating hormone) hormone by the pituitary gland that stimulates the ovaries to increased oocyte maturation.
  • HMG (human menopausal gonadotropin) also acts directly on the ovaries.
  • Clomiphene : triggers the release of the ovulation-enhancing hormones FSH and LH (luteinizing hormone). Clomiphene is available as a tablet.
  • GnRH agonist and GnRH antagonist : reduce the body’s hormones. They are used to control the oocyte maturation and ovulation better.
  • HCG (human chorionic gonadotropin): solves the ovulation from.

Semen Collection

As for artificial insemination, the sperm of the male is necessary for the preparation of artificial insemination is also the semen. The seed of the man usually wins itself (through masturbation ). Then a preparation in the laboratory of the seminal fluid, in order to increase the chances of fertilization.

MESA and TESE

May need to semen for artificial insemination are the MESA and TESE procedure is used:

  • MESA stands for microsurgical epididymal sperm aspiration
  • TESE stands for testicular sperm extraction

These methods of semen come only considered if the man was not in a position to win the seeds, followed by masturbation ejaculation, or if the man does not ejaculate sperm are (eg vas deferens occlusion). When the doctor takes MESA sperm for artificial insemination from the epididymis , the TESE from the testicular tissue .

Cryopreservation

If artificial insemination is planned at a later date, may be their preparation in a cryopreservation: This one freezes eggs one at the pronuclear stage in order to artificially inseminate later and then into the uterus use. In Germany, people keep the frozen eggs for up to two years on an artificial insemination. The statutory health insurance cover the costs of cryopreservation is not.

Insemination

Artificial insemination can be done in different ways. A method of artificial insemination is called insemination: where do you get the male sperm artificially in the female sex organ ( “insemination”means “insertion of sperm”). Fertilization of the egg thus takes place in the woman’s body. When insemination different approaches are possible:

  • Intracervicale insemination (ICI): The doctor injects the sperm into the cervix.
  • Intrauterine insemination (IUI): The doctor uses the previously prepared in the laboratory sperm directly into the uterus one.
  • Intratubale insemination (ITI): The doctor uses the previously in the laboratory prepared sperm directly into the fallopian tubesone.

The insemination is used in particular for artificial insemination considered if the semen of a man with too few sperm or the sperm are not mobile enough to achieve normal fertilization. The advantage of artificial insemination is that more sperm get to the egg faster than with intercourse.

AIH

By artificial insemination homologous insemination means that the artificially introduced into the body of the woman seed from their own dates partners. In a homologous insemination, the child is the biological child of both partners. By artificial insemination homologous insemination results in about 5 to 10 percent of cases, the desired results.

Heterologous insemination

If the artificial fertilization of the egg with the sperm of a strange man is procreating, it is called heterologous insemination. This method can be used when the generative power of the partner of the woman is not enough to fertilize the egg. Here, the child is not the biological child of the partner, but only the mother.

The heterologous insemination has a success rate of about 20 percent. Health insurance must bear the cost of an artificial insemination by heterologous insemination itself, since this method is not provided by statutory health insurance.

IVF (in vitro fertilization)

Artificial insemination may be done by the so-called IVF (in vitro fertilization). “In vitro fertilization” means “fertilization in glass”: In this method, the egg is fertilized outside the body . After IVF is the transmission (transfer) of the fertilized ovum or instead of the embryo.

1978 in Great Britain was the first conceived through IVF (in vitro fertilization) child into the world: Louise Brown. In a Petri dish blended together one egg and sperm, the fertilized egg then a set of mother of Louise.

With in vitro fertilization through IVF expect those affected following expiration : The doctor removes the woman under ultrasound guidance through the vagina and some eggs can fertilize them outside her body with her partner’s sperm or a strange man. It takes the sperm fertilization itself, so to speak – that is, they come in in vitro fertilization does not have a shot, but by itself into the egg. Approximately 48 hours after fertilization, the fertilized egg planted the doctor (or up to three) in the uterus of the female one.

The IVF is if, inter alia for the in vitro fertilization be considered if the fallopian tubes (tubes) of women are not sufficiently consistent. The success rate, or the so-called baby-take-home rate of in-vitro fertilization is about 18 percent.

GIFT (gamete Intrafallopian transfer, gamete intra)

If using artificial insemination as the GIFT (English: Gamete Intrafallopian transfer ) or gamete intra- designated method, fertilization of the egg cell in the body instead. The egg is obtained previously by puncture from the ovaries of women. Together with the sperm of the man she then flushes the doctor in the fallopian tube , either through the abdomen or through a thin catheter through the cervix. Egg and sperm can then merge in the body of the woman.Before artificial insemination by POISON it is necessary to the maturation of oocytes by a hormone treatment to stimulate.

Requirement for artificial insemination by POISON, is that at least one fallopian tube of the woman in all cases (not restrictive).

IVM (in vitro maturation)

Artificial insemination is also possible by the relatively new IVM (in vitro maturation). This method completes the process of IVF (in vitro fertilization): The IVM removes one immature oocytes from (unlike IVF) previously only slightly or not stimulated with hormones ovaries of women. Instead, the mature oocytes in vitro only one to two days by the addition of natural hormones FSH (follicle stimulating hormone) and hCG (human chorionic gonadotropin). Until fertilization takes place the cells with the male sperm. After two more days, the doctor places the fertilized eggs then into the uterus one.

That the IVM as opposed to IVF is no previous high-dose treatment with hormones, has many advantages: For example, the artificial insemination is by in vitro maturation suitable for example for women who can not tolerate hormonal treatment or not the result of a cancer one chemotherapy need.

Artificial insemination by IVM is not provided by statutory health insurance.

ICSI (intracytoplasmic sperm injection)

Since the year 1994 for artificial insemination in Germany is theICSI (intracytoplasmic sperm injection), and microinjection called, are available: This method is then used for artificial insemination, if fertilization does not in oviduct can still succeed under laboratory conditions. This is for example the case when the sperm of the man have too small a number and / or are restricted in their mobility.

Artificial insemination by ICSI has the following sequence : The doctor removes the eggs by the woman vagina and then sprayed each sperm cell using a micropipette directly into the cytoplasm of the egg of the woman. The transmission (transfer) of the thus fertilized cells into the uterus takes place two days later.

Artificial insemination by intracytoplasmic sperm injection leads to an average of about 20 percent of attempts to success. What ICSI success rate (ie, the prospects, a pregnancy induce) are dependent, inter alia, to a large extent on the age of the mother.

Risks and Complications

Artificial insemination is a substantial interference with the woman’s body, which may be connected depending on the sequence with various risks and complications. Above all, a hormone treatment can cause undesirable side effects and adverse reactions that may be uncomfortable to life threatening. Is it necessary to prepare for the artificial insemination, the ovaries with hormones to stimulate, can this hormone stimulation nausea , malaise, shortness of breath and pain occur. In severe cases of the disorder are bleeding and fluid retention ( edema ) possible. Rarely, when the hormone treatment to severe hyperstimulation of the ovaries (known as ovarian hyperstimulation syndrome, for example, come after ICSI ).Here, the ovaries enlarge very strong and the follicles form many hormones.

If the artificial insemination includes a hormone to stimulate the ovaries, is also the likelihood of multiple births increased (eg twins or triplets). Such multiple pregnancies go basically associated with higher risks than simple pregnancies. Therefore, in case of over-stimulation is sexual intercourse inadvisable. In the IVF (in vitro fertilization), the chance of a multiple pregnancy is generally increased because the doctor usually several (up to three) embryos into the uterus planting to ensure the success of artificial insemination.

In general, the risk of being early miscarriage or a pregnancy outside of the uterus (called ectopic pregnancy ) by artificial insemination when compared to a natural generation increased slightly.

With a collection of ova for their artificial insemination outside the body, it may also lead to complications such as infections of the ovaries and fallopian tubes. Through the puncture, the doctor organs such as the bladder and bowel and blood vessel injury.

Even in men, artificial insemination is associated with complications: If the removal of sperm from testisor epididymis by biopsy or puncture is made, the doctor may thereby injure blood vessels, for example.

Reimbursement

How much does an in vitro fertilization? This varies from case to case, because: The artificial insemination is connected depending on the method (eg, insemination, IVF, ICSI) with different costs. Reimbursement is governed by law: the statutory health insurance (GKV) takes proportionately in certain circumstances the cost of medical measures to achieve a pregnancy in infertility.These conditions are:

  • The couple must be married.
  • The woman must be between 25 and 40 years old and be a man between 25 and 50
  • The couple must have been previously subjected to a consulting an independent physician.
  • The measures of in vitro fertilization are required after medical observation and promise a reasonable prospect of success.
  • It is only the use of ova and spermatozoa of spouses allowed (AIH).
  • Only certain doctors and institutions to which the competent national authority has granted a permit may make the artificial insemination.

The statutory health insurance 50 percent of the costs for in vitro fertilization by up to 3 inseminations occur with or up to 8 inseminations without hormonal support. There will also be a guarantee of payment held by the public health insurance for up to 3 attempts, if an artificial insemination by IVF or ICSI is medically indicated.

Privately insured people have a right to reimbursement of expenses incurred for artificial insemination costs, if the person responsible for the infertility conception or infertility is due to illness.

 

 

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