Artificial Insemination in South Africa

Semen used in insemination can be fresh, raw or frozen. If the donor sperm is supplied by a sperm bank, it will be quarantined and frozen and will need to be thawed before use. When an ovum has been released by the female, semen is introduced into the female’s vagina, uterus or cervix. This is determined by the method being used.

• Heterosexual couples suffering from male fertility problems
• Lesbian couples
• Single women
• If unable to have vaginal sex due to a disability or psychosexual problem
• People with medical conditions that require specific help to conceive

Your doctor will confirm that you are ovulating by use of ovulation kits, ultrasound, or blood tests. Your partner will provide a sample of his semen. To make sure sperm count is high, the doctor may ask him to avoid sex 2-5 days prior to the procedure.

The sperm is then washed in a laboratory. Washing the sperm removes chemicals in the semen which may cause discomfort to the woman as well as increase the chances of getting pregnant.

• Intracervical insemination (ICI): This involves injecting raw (unwashed) semen into the cervix with a needleless syringe. If fresh semen is used, it must be allowed to liquefy before inserting it into the syringe. Alternatively, the syringe may be back loaded. Frozen semen which has been thawed can also be used. Enclosed air is removed from the syringe by pressing the plunger forward before the syringe is inserted into the vagina. A vaginal speculum may be used to hold the vagina open so that the syringe is inserted more accurately. The plunger is then pushed forward and the semen in the syringe is emptied deep into the vagina. The syringe may be left in place for a few minutes and the woman is advised to lie still to improve the success rate.

• ICI is the most common artificial insemination technique. The process closely replicates natural insemination as fresh semen is directly deposited onto the neck of the cervix. A conception cap may be inserted into the vagina after insemination. It may be left in place for several hours. Using the conception cap allows a woman to perform her regular activities while the cervical cap holds the semen in the vagina. Using the conception device allows for fresh unliquefied semen to be used.
• Intrauterine insemination(IUI): It involves injecting washed sperm into the uterus by using a catheter. Unwashed semen is not used because it may cause uterine cramping, expel the semen and cause pain. The woman should lie down on the table for 15 minutes after IUI for optimal results.
• Intrauterine tuboperitoneal insemination(IUTPI): It involves injecting washed sperm into both the fallopian tubes and uterus. The cervix is then clamped. This is to prevent leakage to the vagina and is usually done with a specially designed double nut bivalve(DNB) speculum.
• Intratubal insemination(ITI): It involves injecting washed sperm into the fallopian tube.