Artificial insemination offers real hope for many couples seeking to become parents, with success rates ranging from 15-25% per cycle with partner sperm and up to 30% with donor sperm. In fact, when four cycles are performed, the chances of achieving a pregnancy increase significantly, reaching 60-70%.
For this reason, artificial insemination has become the first recommended option for couples who fail to conceive after 12 months of trying. In addition, being a painless and less invasive procedure than other fertility treatments, it represents an accessible and effective alternative for different situations, from ovulation problems to cases of unexplained infertility.
In this comprehensive guide, we'll explain in detail what artificial insemination is, how the procedure works, its different types, success rates, and associated costs. We will also address the factors that determine its effectiveness and the situations in which this treatment may be the best option for achieving a pregnancy.
What is artificial insemination and when is it recommended?
Definition and basic concepts
Artificial insemination consists of placing sperm in an unnatural way directly into the woman's uterus using specialized instruments. This procedure is performed during the ovulatory period to maximize the chances of fertilization, which occurs in the fallopian tubes.
Main medical indications
The medical indications for artificial insemination vary depending on the origin of the infertility. In cases of female sterility, it is recommended when there are:
- Cervical factor: alterations in the quality of the mucus of the uterine cervix
- Ovulatory dysfunction: ovulation irregularities or polycystic ovary syndrome
- Mild or moderate endometriosis
- Vaginismus or problems that prevent the natural deposit of semen
On the other hand, in cases of male infertility, it is indicated when there are mild alterations in sperm quality or problems to deposit semen naturally. In addition, it is recommended in cases of infertility of unknown origin, when fertility tests show normal results but pregnancy is not achieved.
Ideal candidates for treatment
Ideal candidates for artificial insemination must meet certain specific requirements. First of all, the woman must be under 35-37 years old, since the ovarian reserve and the likelihood of pregnancy decrease significantly after this age. It is also essential that the fallopian tubes are permeable and that there is an ovulatory capacity, either naturally or through hormonal stimulation.
However, the technique isn't just limited to couples with fertility problems. It is also a viable option for single women who want to become mothers or partners of women, as long as they meet the above requirements. In these cases, the age limit is extended to 40 years.
The success rate ranges from 15-25% per cycle when using partner sperm, while with donor sperm it can reach 20-30%. However, these odds are significantly dependent on factors such as the woman's age and the specific cause of infertility.
Types of artificial insemination available
There are two main types of artificial insemination, each adapted to different medical needs and circumstances.
Homologous artificial insemination (IAH)
Homologous artificial insemination, also known as IAH or conjugal, uses the sperm of the woman's own partner. This procedure is especially effective in cases of male impotence, vaginismus and cervical disorders. It is also recommended for young couples who have not achieved pregnancy after a year of natural attempts.
The IAH has an approximate success rate of 10% per cycle. However, the odds increase significantly to 50% after four attempts. The cost of each cycle ranges from 600 to 1,000 euros.
Heterologous artificial insemination (IAD)
Heterologous artificial insemination or IAD uses sperm from an anonymous donor. This modality is mainly indicated in three situations: when there is severe male sterility, when there is a risk of transmission of hereditary diseases, or when the woman has no male partner.
IAD offers higher success rates, reaching between 20-25% per cycle. In addition, it allows up to six attempts to maximize the chances of pregnancy. Donors undergo rigorous medical and psychological checks to ensure sperm quality.
Differences between types of procedures
The main distinction between the two procedures lies in the origin of the sperm used. However, the technical process is practically identical. In IAD, semen must remain frozen for at least six months for safety testing.
On the other hand, donor selection in IAD follows specific criteria to maintain physical similarities with the recipient, including blood group, race, physical build, and characteristics such as eye and hair color. Spanish legislation guarantees the anonymity of the donor, allowing only access to general, non-identifying data.
Step-by-step process of artificial insemination
The artificial insemination process requires careful preparation and several specific steps to maximize the chances of success.
Preparation and previous studies
Before starting treatment, it is essential to perform a series of diagnostic tests. First, a transvaginal gynecological ultrasound is performed to evaluate the ovarian reserve and detect possible pathologies. Subsequently, a baseline hormonal analysis is performed between the first and third day of the menstrual cycle to assess ovarian reserve and possible hormonal alterations.
In addition, it is necessary to verify the patency of the fallopian tubes using hysterosalpingography or hysterosalpingosonography. This study confirms that there are no obstacles on the path of sperm to the egg.
The procedure in detail
The process begins with controlled ovarian stimulation, which lasts 10 to 12 days. During this period, small doses of gonadotropin hormones are administered to stimulate follicular development. The specialist monitors growth using ultrasound until the follicles reach 16-18 millimeters.
On the day of insemination, the semen sample is obtained and processed. The laboratory performs sperm training to select the most active and healthy sperm cells. Then, using a thin, flexible cannula, the doctor deposits the prepared sample directly into the uterus.
Necessary aftercare
After the procedure, the patient should rest for 15 to 25 minutes. However, it is not necessary to keep absolute rest, as this has been proven to not increase the chances of success.
For the next 15 days, known as “beta waiting”, normal daily activities can be maintained. However, it is recommended to avoid intense physical exertion and to maintain a healthy diet with adequate hydration.
It is important to note that during this period symptoms such as belly bloating, abdominal pain or brown spotting may occur, mainly related to the hormonal medication received. Finally, after 15 days, a pregnancy test is performed using blood tests (beta-hCG) to confirm if the treatment has been successful.
Success Rates and Determining Factors
The results of artificial insemination vary significantly depending on several factors, with the woman's age being the most decisive.
Pregnancy statistics by age
Success rates show a clear age-related pattern. For women under 30, the probability of pregnancy reaches between 20% and 25% per cycle. Between 30 and 35 years old, this percentage remains between 15% and 20%. However, for the 35-40 age group, the rate decreases to 11%, while in those over 40 it drops to 4.7%.
Factors that influence the result
In addition to age, several factors have a direct impact on the success of treatment:
- The cause of infertility
- The quality and origin of sperm
- The applied ovarian stimulation protocol
- The receptivity of the endometrium
On the other hand, when donor semen is used, the odds increase considerably, achieving success rates of 54.8%. In addition, in cases of polycystic ovary syndrome, rates range from 20% to 25% per cycle after three months of hormonal treatment.
Recommended number of attempts
The chance of pregnancy is cumulative, meaning that it increases with each attempt made. After the fourth attempt, the cumulative rate reaches between 45% and 56.7%. However, specialists do not recommend more than four attempts before considering other treatment options.
However, there are exceptions for single women and couples of homosexual women, who can perform up to six attempts at artificial insemination with a donor. In these cases, the cumulative rate can reach up to 84% on the sixth attempt.
It is important to mention that for women with infertility problems, it is more difficult to achieve pregnancy after the fourth attempt. For this reason, doctors carefully evaluate each case to determine whether to continue with more cycles or consider alternatives such as in vitro fertilization.
Treatment Costs and Coverage
The costs associated with artificial insemination vary significantly depending on the type of procedure and the medical facility chosen.
Updated prices in Spain
Conjugal artificial insemination (IAC) represents the most economical option, with prices ranging from 700 to 1,100€. On the other hand, artificial insemination with a donor (IAD) has a higher cost, ranging from 1,000 to 1,700€. In addition, it is essential to consider that the hormonal medication needed for ovarian stimulation involves an additional cost of between 300 and 600€.
What each procedure includes
The basic budget for artificial insemination generally includes:
- Controls during ovarian stimulation
- Semen processing
- Intrauterine insemination
- Pregnancy test using beta-hCG analysis
However, there are additional services that are not usually included in the initial price, such as diagnostic tests prior to treatment and freezing of semen if necessary. Consequently, it is essential to request a detailed quote before starting treatment.
Available Funding Options
Currently, several entities offer specific funding programs for fertility treatments. For example, some financial institutions provide personalized unsecured loans, with amounts ranging from MXN 20,331.24 to MXN 711,593.54.
In addition, certain clinics have developed flexible payment plans that allow treatment to be financed for up to 12 months without interest or commissions. These options include the possibility of covering both the procedure and the necessary medication.
As for health insurance coverage, it is important to note that it varies depending on the policy taken out. Some private insurance covers assisted reproduction, although with certain limitations, such as grace periods that can last from 6 to 24 months and age limits, generally set at 40 years.
To access insurance coverage, both members of the couple are usually required to be insured. Insurance companies usually set a maximum number of covered attempts and may require specific requirements for treatment approval.
In the Spanish public health system, artificial insemination is included in the portfolio of services. However, waiting times and the number of attempts covered vary depending on the Autonomous Community. It is usually limited to 3 or 4 cycles, and waiting periods can range from 3 to 4 months.
Conclusion
Artificial insemination represents a hopeful option for many couples looking to start a family. Certainly, although success rates vary depending on several factors, especially the woman's age, this treatment offers promising results when performed under the right conditions.
Data shows that the chances of achieving pregnancy increase significantly with each attempt, reaching up to 56.7% after four cycles. However, it is essential to consider that each case is unique and requires a personalized evaluation by the medical team.
The available options, both homologous and heterologous artificial insemination, can be adapted to different situations and specific needs. In addition, thanks to advances in reproductive technology and the various existing funding options, this treatment has become more accessible to those who need it.
Finally, the success of the procedure depends not only on biological factors but also on adequate preparation and constant medical monitoring. For this reason, it is essential to choose a specialized center that offers comprehensive and personalized attention throughout the process.
FAQs
What is the success rate of artificial insemination? The success rate varies depending on several factors, primarily the woman's age. In general, the chance of pregnancy is 15-25% per cycle. After four attempts, the cumulative rate can reach between 45-56.7%.
How much does artificial insemination treatment cost in Spain? The cost varies depending on the type of procedure. Conjugal artificial insemination (IAC) ranges from 700 to 1,100€, while artificial insemination with a donor (IAD) costs between 1,000 and 1,700€. In addition, we must consider the additional cost of hormonal medication, which can be 300 to 600€.
Who are the ideal candidates for artificial insemination? Ideal candidates are women younger than 35-37 years of age with permeable fallopian tubes and ovulatory capacity. It's also an option for single women or couples of women up to the age of 40. The technique is recommended in cases of mild or unexplained infertility.
How many attempts at artificial insemination are recommended? Specialists generally recommend no more than four attempts before considering other treatment options. However, for single women and couples of gay women, up to six attempts can be made with a donor.
What types of artificial insemination are there? There are two main types: homologous artificial insemination (IAH), which uses the partner's sperm, and heterologous artificial insemination (IAD), which uses sperm from an anonymous donor. The choice depends on the cause of infertility and the specific circumstances of each case.