Artificial insemination improves birth statistics

In vitro fertilization (IVF), colloquially referred to as "artificial fertilization", can help infertile couples to give birth. Since the birth of Louise Brown, the first person to be born in a bowl of nutrient solution, exactly 30 years ago, the method has been continuously refined and expanded. In the case of poor sperm quality, reproductive medicine can even insert a single sperm cell directly into the egg cell (intracytoplasmic sperm injection, ICSI).

According to the German IVF registry, artificial insemination in this country has a probability of around 20 percent per treatment cycle, i.e. the birth of a baby. IVF children are twice as likely to be born with birth defects as naturally born, according to a recent case study from the American Centers of Disease Control and Prevention. Overall, however, the rate is so low that a connection with the techniques of reproductive medicine cannot be clearly demonstrated. It is more likely that the malformations can be traced back to the same causes underlying the infertility.

The German IVF registry has been keeping statistics on children born in this way since 1997. Their number rose steadily from around 4,000 at that time to almost 19,000 in 2003, and their share in the total number of children born in Germany every year grew from half a percent in 1997 to 2.6 percent in 2003. Until then, the statutory health insurance companies had a maximum of four treatment cycles fully reimbursed. The health care reform of 2004, however, charged couples with unfulfilled desire to have children half of the costs for a maximum of three treatment cycles, one of which costs an average of 3,200 euros.

Since then, the average age at which women go to a fertility clinic has increased from 33.1 to 35 years because, according to Klaus Bühler, chairman of the German IVF register: "The couples have to save longer." With increasing age, however, not only does natural fertility decrease, the chances of success of artificial insemination also diminish.

Reproductive medicine therefore makes a not insignificant contribution to demographic development. How much it contributes obviously depends on how infertility treatment is funded. Denmark, where three IVF treatments are fully paid for in a public clinic, has the highest proportion of children born outside the body of the total number of newborns in Europe, at around four percent.

According to the data that the Berlin Institute for Population and Development had in 2007 as part of the "Unintentionally childless" study by the Allensbach Institute for Demoscopy, there are about two million adults in Germany over the age of 25 who wish to have children or to expand the existing family remains unfulfilled despite "trying". These include around 1.4 million who have tried unsuccessfully for at least a year and are therefore likely to have medical or biological causes.

Insemination is the transfer of semen into the female genital tract. Usually this happens during sexual intercourse. Insemination usually refers to artificial insemination. This is usually done by the doctor, but sometimes at home. Here's how an artificial semen transfer works and what the chances of success are.

Basically, artificial insemination is an assisted type of fertilization. This procedure is also known as artificial insemination or semen transfer.

There are various options for this, either with or without medical help. IUI, the intrauterine insemination, the transmission directly into the uterus (uterus). If the sperm of one's partner is used, it is a homologous insemination. If donor sperm is used (in hereditary diseases, inadequate spermiogram, lesbian couples)it is a heterologous or donogenic insemination.

When the time comes, the doctor injects the previously prepared sperm directly into the uterus using a thin catheter. If you take the insemination yourself, you will need to purchase some remedies beforehand. You can do the home session with an insemination cap, funnel, beaker or insemination syringe. In principle, you transport the sperm to the vaginal entrance (intravaginal insemination) in this way. The semen sample must be fresh for this because the sperm in the seminal fluid can only survive for a limited time.

If you lie down afterwards, this can improve the chances of getting pregnant.

Regardless of whether you choose an IUI or a home insemination, women and sperm donors must meet the following physical requirements:

  • continuous functional fallopian tubes
  • well constructed uterine mucus for implantation
  • ovulation must take place
  • fertile and motile sperm
  • sufficient sperm count

In principle, semen transfer is recommended for couples without a serious cause of childlessness (idiopathic sterility) or if direct sexual contact is not possible or should be avoided (HIV infection).

Artificial insemination at home is a possibility for single women, who are denied access to artificial insemination in Germany, to fulfill their desire to have children even without a permanent partner. Provided you find a private sperm donor. Of course, this also applies to lesbian couples who want to do a home insemination. Since homosexual couples largely have to bear the costs of artificial insemination themselves, this method is a cheaper alternative.

Even heterosexual couples who have problems getting pregnant naturally can help a little with self-insemination. If the woman is HIV positive, a home insemination may restrict a virus transfer to the partner. If the man is affected, however, the sperm must be examined. In principle, couples with HIV infection should definitely seek medical advice before insemination.

The chances of getting pregnant are between 15 and 40 percent for the IUI, depending on how many cycles are passed. The age of the mother and the hormonal stimulation decide whether the insemination is successful.

Basically, the success rate with the IUI is higher than with the home insemination, as the semen sample is injected directly into the uterus. In self-insemination, the sperm only land at the entrance to the vagina and have to make it to the ovum itself. So a lot can go wrong. In addition, the ejaculate is processed during the medically assisted intrauterine insemination and the cell count is optimized, which further increases the chances of success.

Advantages and disadvantages of insemination

No matter if IUI or home insemination: The actual semen transfer is relatively uncomplicated and painless. Also, the financial expenses are limited. However, the cycle must be closely monitored until the upcoming ovulation.

It can be distressing when the woman undergoes hormone therapy to promote the maturation of oocytes. Overstimulation, including ovarian hyperstimulation syndrome, or multiple pregnancy can lead to complications.

Basically, insemination in the spontaneous cycle is the least risky of all assisted reproduction methods.

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