Artificial InseminationArtificial insemination (AI) places sperm directly in the cervix (called intra cervical insemination) or uterus (called intrauterine insemination or IUI). It is useful for women who have structural problems, when the cervical mucus is unreceptive, when donor sperm are required, when the male partner’s semen contains very low numbers of sperm, or when unexplained infertility exists in both partners. In order to prepare for AI, a woman usually takes fertility drugs in advance. The man must produce sperm at the time the woman is ovulating. The sperm are subjected to certain so–called “Washing” procedures and are then inserted into the uterine cavity through a long, thin catheter.
Assisted Reproductive Technologies (ART)
General GuidelinesAssisted reproductive technologies (ART) are procedures that either use donated eggs or employ techniques that retrieve eggs from the ovary and re implant them. Fertilization may occur either in the laboratory or in the uterus. The most common procedure is in vitro fertilization (IVF). More recent ART procedures include gamete intra fallopian transfer (GIFT), zygote intra fallopian transfer (ZIFT), and intra cytoplasmic sperm injection (ICSI).
Success RatesThe success rates of ART procedures are now approaching that of normal couples in appropriate candidates. Many women, however, are not good candidates for GIFT and ZIFT. These procedures are also more invasive than IVF. It should be noted that even women who become pregnant may require more than one fertility cycle.
In general, the success rates with ART are lower for older women and those with uterine abnormalities as the primary cause of infertility. The chances of success are also greater with the clinic’s own success rate, if eggs are the women’s own, or if a previous pregnancy was successful. Age, however, is the most important determinant when a woman uses her own eggs. Rates for ART are relatively high for both pregnancies and live births among women in their 20s but they decline after 30 and go sharply downward toward the end of the decade and afterward. The use of donor eggs has made it possible for many older women, even some who are postmenopausal, to bear a child. (Success rates using donor eggs depend on the age of the donor, not the age of the recipient.) Freezing eggs allows them to remain viable for long periods, after thawing, about half are able to be fertilized.