Intrauterine Insemination

Requirements for future mothers

• Before family planning in Austria, there are some bureaucratic steps that must be taken in accordance with the clear legal situation . A notarized partnership and a notarial deed for the foreign sperm are prerequisites for sperm donation. These documents serve as permission to use the semen and do not make a marriage or registered partnership mandatory. However, it is important to note that single women will still not be able to receive sperm or egg donations.
• Couples from abroad also have the opportunity to be treated in our fertility clinic. This is because residence and nationality play an important role in the notarized documents required to fulfill the desire to have children. For example, Germans living in Austria should find out early on which notary can help them with the necessary steps, as German law is different from Austrian law.

Insemination – Couples who want to have children

• Sperm transfer is possible for heterosexual and lesbian couples and offers a gentle way to fulfill the desire to have children.
• We distinguish between homologous insemination (from a partner) and heterologous insemination (from a donor). Success depends on the optimal time in the cycle: natural or hormonal stimulation. We clarify the patency of the fallopian tubes. Fresh or cryopreserved sperm cells are used, either from the partner or from a sperm bank. Discreet extraction in our clinic is possible. The sperm cells are prepared in the laboratory and the most mobile ones are selected. The transmission takes place through the vagina by means of a catheter.
• About three weeks later, a pregnancy test is used to determine whether pregnancy has occurred. Another three weeks later, the child’s heartbeat can already be detected on ultrasound.

• Depending on the procedure, we distinguish:

  1. Natural insemination as part of the menstrual cycle. We closely monitor your cycle and determine the time of ovulation using ultrasound scans to determine the optimal time for sperm transfer.
  2. Insemination with hormonal stimulation. To increase the chances of pregnancy success, we occasionally perform hormonal stimulation on the woman in order to achieve increased maturation of the eggs in the ovaries. After the eggs reach the right size, ovulation is triggered, followed by sperm transfer.

The right time of insemination is crucial for the chances of success. Therefore, couples considering insemination should be flexible in terms of time. A fundamental requirement for any insemination is that the fallopian tubes are permeable, which is clarified by our diagnosis.

For whom is insemination suitable?

Sperm transfer is suitable for couples in who, after thorough examinations, no serious causes of childlessness can be found (idiopathic sterility).

In women, menstrual cycle disorders, endometriosis, anatomical changes in the cervix or impermeable cervical mucus can make fertilization difficult. In men, a low sperm count, slow sperm or a lack of ejaculation can be the problem.

Sometimes it is also necessary to avoid direct sexual contact, such as in couples with HIV infection. Even in such cases, intrauterine insemination can fulfill the desire to have children.

Preconditions

Both men and women must meet certain organic requirements:

For the woman:

• Continuous, functional fallopian tubes (tubal function)
• Sufficiently built up uterine lining for implantation
• Ovulation, spontaneous or hormonally induced

For men:

• Fertile (potent) and motile spermatozoa
• Sufficient sperm count on the spermiogram (otherwise an intracytoplasmic sperm injection, ICSI, may be more useful)

Chances of success of intrauterine insemination

• The success rate of intrauterine insemination is between about seven and 15 percent per treatment cycle and with hormonal stimulation of the woman. After several treatment cycles, even up to 40 percent can be achieved, but only up to the age of about 35. For older women, the chance of pregnancy drops to about four percent per cycle using IUI.

  The medication used for hormonal stimulation and the number of stimulated follicles also play a role. In order to be successful with IUI, it is essential to have stimulated follicles. However, if more than two follicles mature, the risk of a multiple pregnancy increases, which is why doctors advise against insemination in this case.

  Studies have shown that multiple inseminations within one cycle do not provide any additional benefit. Therefore, multiple inseminations are not used today.

  The number of attempts to get pregnant using IUI also depends on the age of the woman. In about 80 percent of couples, pregnancy occurs after three to four cycles. Younger women can give themselves and their partner a little more time and make up to six attempts. However, women over 35 may want to consider other assisted reproduction methods after the first unsuccessful cycles, such as in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), which may be more promising.