Artificial insemination offers real hope for many couples seeking to become parents, with success rates reaching between 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 are unable to conceive after 12 months of trying. Additionally, being a painless and less invasive procedure than other fertility treatments, it represents an accessible and effective alternative for various situations, from ovulation problems to cases of unexplained infertility.
In this comprehensive guide, we will 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 pregnancy.
What is artificial insemination and when is it recommended?
Definition and basic concepts
Artificial insemination consists of depositing sperm in a non-natural 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 infertility. In cases of female sterility, it is recommended when there are:
- Cervical factor: alterations in the quality of cervical mucus
- Ovulatory dysfunction: irregularities in ovulation or polycystic ovary syndrome
- Mild or moderate endometriosis
- Vaginismus or problems that prevent the natural deposition of semen
On the other hand, in cases of male infertility, it is indicated when there are mild alterations in sperm quality or problems depositing semen naturally. Additionally, it is recommended in cases of unexplained sterility, 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, the woman should be under 35-37 years old, as ovarian reserve and the probability of pregnancy decrease significantly after this age. It is also essential that the fallopian tubes are patent and that there is ovulatory capacity, either naturally or through hormonal stimulation.
However, the technique is not limited to couples with fertility problems. It is also a viable option for single women who wish to become mothers or female couples, as long as they meet the mentioned requirements. In these cases, the age limit extends to 40 years.
The success rate varies between 15-25% per cycle when using partner sperm, while with donor sperm it can reach 20-30%. However, these probabilities significantly depend 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 partner. This procedure is particularly effective in cases of male impotence, vaginismus, and cervical alterations. It is also recommended for young couples who have not achieved pregnancy after a year of natural attempts.
IAH has an approximate success rate of 10% per cycle. However, the probabilities increase significantly to reach 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 transmitting hereditary diseases, or when the woman does not have a male partner.
IAD offers higher success rates, reaching between 20-25% per cycle. Additionally, it allows for up to six attempts to maximize the chances of pregnancy. Donors undergo rigorous medical and psychological screenings to ensure the quality of the sperm.
Differences between types of procedures
The main distinction between both procedures lies in the origin of the sperm used. However, the technical process is practically identical. In IAD, the semen must remain frozen for at least six months to conduct safety tests.
On the other hand, the selection of the donor in IAD follows specific criteria to maintain physical similarities with the recipient, including blood type, race, physical build, and characteristics such as eye and hair color. Spanish legislation guarantees the anonymity of the donor, allowing only access to non-identifying general 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 preliminary studies
Before starting treatment, it is essential to carry out a series of diagnostic tests. First, a transvaginal gynecological ultrasound is performed to assess ovarian reserve and detect possible pathologies. Subsequently, a baseline hormonal analysis is conducted between the first and third day of the menstrual cycle to evaluate ovarian reserve and possible hormonal alterations.
Additionally, it is necessary to verify the patency of the fallopian tubes through a hysterosalpingography or hysterosalpingosonography. This study confirms that there are no obstacles in the path of sperm to the egg.
The procedure in detail
The process begins with controlled ovarian stimulation, lasting between 10 and 12 days. During this period, small doses of gonadotropin hormones are administered to stimulate follicular development. The specialist monitors growth through ultrasounds until the follicles reach 16-18 millimeters.
On the day of insemination, the semen sample is obtained and processed. The laboratory performs sperm capacitation to select the most active and healthy sperm. Subsequently, using a thin and flexible cannula, the doctor deposits the prepared sample directly into the uterus.
Necessary post-procedure care
After the procedure, the patient should rest for 15 to 25 minutes. However, absolute rest is not necessary, as it has been shown that this does not increase the chances of success.
During the following 15 days, known as "beta wait," normal daily activities can be maintained. However, it is recommended to avoid intense physical exertion and maintain a healthy diet with adequate hydration.
It is important to note that during this period, symptoms such as abdominal bloating, abdominal pain, or brown spotting may occur, mainly related to the hormonal medication received. Finally, after 15 days, a pregnancy test is performed through a blood analysis (Beta-hCG) to confirm whether the treatment has been successful.
Success rates and determining factors
The results of artificial insemination vary significantly according to various factors, with the woman's age being the most determining.
Pregnancy statistics by age
Success rates show a clear pattern related to age. For women under 30 years, the probability of pregnancy reaches between 20% and 25% per cycle. Between 30 and 35 years, this percentage remains between 15% and 20%. However, for the group aged 35 to 40 years, the rate decreases to 11%, while for those over 40 years, it reduces to 4.7%.
Factors influencing the outcome
In addition to age, several elements directly impact the success of the treatment:
- The cause of infertility
- The quality and origin of the sperm
- The ovarian stimulation protocol applied
- The receptivity of the endometrium
On the other hand, when donor sperm is used, the probabilities increase considerably, reaching success rates of 54.8%. Additionally, in cases of polycystic ovary syndrome, rates range between 20% and 25% per cycle after three months of hormonal treatment.
Recommended number of attempts
The probability of pregnancy is cumulative, meaning it increases with each attempt made. After the fourth attempt, the cumulative rate reaches between 45% and 56.7%. However, specialists do not recommend performing more than four attempts before considering other treatment options.
However, there are exceptions for single women and same-sex female couples, who can perform up to six attempts of artificial insemination with a donor. In these cases, the cumulative rate can reach up to 84% in the sixth attempt.
It is important to mention that for women with infertility problems, achieving pregnancy becomes more difficult 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.
Costs and coverage of treatment
The costs associated with artificial insemination vary significantly depending on the type of procedure and the chosen medical center.
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 donor (IAD) has a higher cost, ranging from 1,000 to 1,700€. Additionally, it is essential to consider that the hormonal medication necessary for ovarian stimulation incurs an additional expense of between 300 and 600€.
What each procedure includes
The basic budget for artificial insemination generally includes:
- Monitoring during ovarian stimulation
- Processing of the semen
- Intrauterine insemination
- Pregnancy test through 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 the freezing of semen if necessary. Consequently, it is essential to request a detailed budget before starting treatment.
Available financing options
Currently, various entities offer specific financing programs for fertility treatments. For example, some financial institutions provide personalized loans without collateral, with amounts ranging from MXN 20,331.24 to MXN 711,593.54.
Additionally, certain clinics have developed flexible payment plans that allow financing the treatment for up to 12 months without interest or fees. These options include the possibility of covering both the procedure and the necessary medication.
Regarding health insurance coverage, it is important to note that it varies according to the contracted policy. Some private insurances cover assisted reproduction, although with certain limitations, such as waiting periods that can extend from 6 to 24 months and age limits, generally set at 40 years.
To access insurance coverage, it is usually required that both members of the couple are insured. Insurance companies often establish 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 service portfolio. However, waiting times and the number of covered attempts vary by Autonomous Community. Generally, it is 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 seeking to start a family. Certainly, although success rates vary according to various factors, especially the woman's age, this treatment offers promising results when performed under the right conditions.
Data shows that the chances of achieving a 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, allow adaptation to different situations and specific needs. Furthermore, thanks to advances in reproductive technology and the various financing options available, this treatment has become more accessible for those in need.
Finally, the success of the procedure depends not only on biological factors but also on adequate preparation and constant medical follow-up. For this reason, it is essential to choose a specialized center that offers comprehensive and personalized care throughout the process.
FAQs
What is the success rate of artificial insemination? The success rate varies according to several factors, mainly the woman's age. In general, the probability 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 according to the type of procedure. Conjugal artificial insemination (IAC) ranges from 700 to 1,100€, while artificial insemination with donor (IAD) costs between 1,000 and 1,700€. Additionally, the cost of hormonal medication, which can be between 300 and 600€, should be considered.
Who are the ideal candidates for artificial insemination? Ideal candidates are women under 35-37 years old with patent fallopian tubes and ovulatory capacity. It is also an option for single women or female couples up to 40 years old. The technique is recommended in cases of mild or unexplained infertility.
How many attempts of artificial insemination are recommended? Generally, specialists recommend not performing more than four attempts before considering other treatment options. However, for single women and same-sex female couples, up to six attempts with a donor can be made.
What types of artificial insemination exist? There are two main types: homologous artificial insemination (IAH), which uses the partner's sperm, and heterologous artificial insemination (IAD), which employs sperm from an anonymous donor. The choice depends on the cause of infertility and the specific circumstances of each case.
