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About Artificial Insemination
and Sperm Specimen Types

About artificial insemination methods

Artificial insemination is one of several reproductive procedures described below.

Intracervical Insemination (ICI), also known as vaginal insemination, is the placement of sperm in a woman's vagina, close to her cervix. It is best to do vaginal inseminations at home, rather than at a clinic, so you can lie down after placing the sperm in your vagina and allow the sperm to swim up into your uterus. Pregnancy rates with vaginal insemination are around 5% per cycle.

Intrauterine Insemination (IUI) is a procedure in which sperm is placed directly in a woman's uterus. It is not safe to perform an IUI unless the sperm has first been washed, to remove the proteins found in whole semen, as unwashed sperm can cause severe cramping or even shock. Pregnancy rates with IUI are generally 14% to 18% per cycle . IUI can be done at our PRS medical offices in San Francisco or Pasadena, California, or at your own clinician's.

In-Vitro Fertilization (IVF) is the insemination of a woman's egg with sperm in a laboratory dish (the term "in-vitro" means outside the body). Fertilization occurs when the sperm has entered the egg. IVF is a major fertility treatment performed in fertility centers and is typically used when other, less expensive and less invasive methods have failed. The process involves the use of fertility drugs, followed by removing mature eggs from a woman's ovaries and combining them with treated sperm. Pregnancy rates with IVF range from less than 30% and up to 50% per cycle, depending upon the woman's age.

About PRS sperm specimen types

The use of frozen semen or sperm in artificial insemination requires specific preparation for each type of procedure.

ICI (Intracervical) specimens contain whole semen, which was frozen after addition of a protective medium. It is safe to place ICI specimens in a woman's vagina, but can cause severe cramping and even shock if placed in a woman's uterus without first being "washed" (see below). PRS (and most fertility specialists) perform sperm washes on-site immediately prior to the IUI.

When to order ICI specimens:

• If you are doing a vaginal insemination at home
• If you are having an IUI at PRS
• If you are having In-Vitro Fertilization
• If you are having an IUI with a fertility specialist, check with them first

IUI (intrauterine) prepared specimens have been "washed" before being frozen (a laboratory process that separates the sperm cells from the seminal plasma). It is safe to place IUI prepared specimens in a woman's uterus or vagina. You will need IUI specimens if you are planning an IUI and your clinician does not do sperm washing. Most OB/Gyn and Primary Care clinicians do not have the laboratory materials necessary to perform a sperm wash, therefore it is best to order IUI ready specimens if you are having an intrauterine inseminatio with these clinicians.

When to order IUI specimens:
• If you are having an IUI by a Primary care or OB/GYN clinician

Note: If you are having an IUI by a Fertility Specialist, ask them which specimen type to order.

ART (Assisted Reproductive Technologies) specimens are for In-Vitro Fertilization (IVF) only, and should be used only when ICSI (intracytoplasmic sperm injection) is done as part of the IVF procedure. ICSI is a specialized procedure that involves injecting a single sperm directly into a woman's egg in a laboratory dish. Because ART specimens do not have as many motile sperm per dose, they do not have an adequate motile sperm count for traditional IVF (non-ICSI), nor for intrauterine or vaginal insemination.

If you are having an IVF (ICSI) procedure: We strongly recommend that you order 2 ART specimens for IVF (ICSI) procedures, even though your fertility doctor will probably need only one. In the unlikely event that one of your specimens is found to be compromised at the time of your procedure, your cycle may have to be cancelled if there is no back-up specimen. Considering the significant costs and medical treatments you will have undertaken by the day of your procedure, it is well worth having the insurance of an extra vial of sperm, should it be needed.

Important: How Your Sperm Is Prepared By Your Sperm Bank or Clinic Matters

Sperm can be easily damaged and rendered infertile when improperly handled.

While many sperm banks and clinics perform sperm washes, some types of sperm wash methods actually harm the sperm. Known as a simple wash, used by some clinics and some sperm banks, the semen is centrifuged without the proper laboratory equipment and reagents that best protect and clean the specimen of dead cells and debris that are toxic to the sperm.

The density gradient wash is a gentle method of separating sperm from semen and is accepted as the state of the art technology by reproductive specialists and scientists. This type of sperm wash requires specialized training and laboratory equipment, but produces sperm that have a better fertilization capacity and are free of harmful dead sperm and debris.

PRS always uses the density gradient wash method, both before freezing our IUI ready specimens and also to prepare ICI specimens immediately prior to performing an IUI.

Be sure to ask your clinic and sperm bank about their sperm preparation methods.