Artificial insemination

Artificial insemination (AI) is an assisted reproductive technology (ART) that USES non-sexual intercourse to deliver sperm to the female reproductive tract for the purpose of insemination. Assisted reproduction (ART) is the ART of delivering sperm to a woman's reproductive tract without intercourse for the purpose of impregnating her. According to the source of the sperm, AI can be divided into artificial insemination (AIH) from the husband's sperm and artificial insemination (AID) from the third party's sperm. According to different parts of insemination, such as vagina, cervical tube, intrauterine cavity, fallopian tube and abdominal cavity, insemination is respectively called intrauterine artificial insemination (IVI), intrauterine artificial insemination (ICI), intrauterine artificial insemination (IUI) and intrauterine artificial insemination (IFI). The implementation process shall be in accordance with the administrative measures on human assisted reproductive technology issued by the ministry of health (no. 14 ministerial order of the ministry of health in 2001), the notice of the ministry of health on the revision of related norms, basic standards and ethical principles of human assisted reproductive technology and human sperm bank (issued by the ministry of health science and education [; 2003]; (no.176) and the implementation rules for the verification of human assisted reproductive technology and human sperm bank of the ministry of health (issued by the ministry of health science and education [2006] no.44).

Intrauterine artificial insemination (IUI)
1. The indications
Male factors: sexual dysfunction, mild asthenospermia; Ovulatory disorder; Unexplained infertility; Endometriosis (mild to moderate); Cervical infertility.
2. Contraindicated
Acute and chronic systemic diseases and genital inflammation; Oviduct factors caused by the woman's sperm and egg binding disorders; The female suffers from genetic diseases, serious physical diseases and mental and psychological disorders; The birth history of a baby with congenital defects was confirmed to be caused by maternal factors; The woman is exposed to teratogenic rays, poisons and drugs and is in the action period; The woman has a drinking, drug and other bad habits.
3. Asthenospermia of the male partner may affect IUI semen conditions
Sperm density 15 million /ml, forward-moving sperm (a+b) 15%; Conditions for IUI after semen treatment: upstream, grade a sperm 70%, sperm 20 /HPF, at least one fallopian tube unobstructed.
4. Diagnosis and treatment procedures
(1) the woman prepared natural cycle IUI: menstrual cycle IUI can be regular. Follicular growth was monitored from day 8 to day 10 of the menstrual cycle. (2) promote ovulation cycle IUI: for the ovulation disorder, need to promote ovulation. The patient was returned to the hospital on the second to third day of the menstrual cycle, pregnancy was excluded, and b-mode ultrasound examination was performed to exclude ovarian cyst, and ovulation promoting drugs could be given. (3) when the dominant follicle reached 1.4cm, the IUIB ultrasonic monitoring form was established, and the monitoring form was completely filled in to clearly write the IUI indications. Review the "three certificates". Tell the patient that there is no need to extract the medical record for the period B overtime. (4) IUI timing: the day after LH peak appeared, IUI was conducted; Ovulation day IUI; When at least one follicle with a diameter of 18 ~ 20mm was injected with HCG, IUI was performed 24 ~ 36 hours after injection of HCG. (5) when promoting ovulation cycle has >3 advantage follicle, then give up this cycle IUI. 6 luteal support: the third day after ovulation can be given oral progesterone 14 days, 16 days after surgery for urine, blood HCG to confirm whether pregnant.
(2) the husband prepares to masturbate and ejaculate on the 8th day of the menstrual cycle. On the day of IUI, the man masturbated to extract sperm, and the number of forward-moving sperm injected into the artificial insemination of the husband's semen should be more than 1 million.
5. Frequency of IUI per cycle
Each period is feasible IUI1 ~ 2 times. A meta-analysis containing more than 1000 IUI cycles showed that 2 iuis could slightly improve fertility compared with a single IUI, but the difference was not statistically significant (14.9%, 11.4%).
6. IUI cycles
IUI has the highest pregnancy rate after 3-4 cycles, and IUI's cumulative pregnancy rate enters the plateau after 3-6 cycles.

Donor insemination
1. The indications
Testicular azoospermia, obstructive azoospermia, severe oligospermia, asthenospermia and teratospermia; Vas deferens recanalization failure; Ejaculation disorder; The husband and/or his family have a serious genetic disease which is infertile; A newborn whose mother and son are incompatible in blood type will not survive. In addition to testicular azoospermia, medical staff must explain to patients who need artificial insemination for sperm supply that they can obtain the offspring of their blood relatives through intracytoplasmic single sperm microinjection (ICSI).
2. Contraindicated
The woman suffers from acute infection of the genitourinary system or sexually transmitted diseases; The woman suffers from a serious genetic, physical or mental disorder; The woman is exposed to teratogenic rays, poisons and drugs and is in the action period; The woman has drug addiction and other bad habits.
3. Common parts for artificial insemination
Including vaginal artificial insemination, intrauterine artificial insemination, intrauterine artificial insemination, generally use intrauterine artificial insemination.
4. Methods and timing of artificial insemination for sperm supply
Can be carried out in natural cycle or promote oviposit cycle, specific opportunity is the same as intrauterine artificial insemination of husband sperm.
5. Semen AID requirements
According to the technical specifications of the original ministry of health, when the thawed semen is used for intrauterine artificial insemination treatment, the total number of semen moving forward after resuscitation should not be less than 10 106/ml, and the percentage of moving forward should not be less than 35%.
6. Institutions implementing artificial insemination for sperm supply shall establish strict confidentiality measures to ensure the personal privacy and security of patients; To establish a feasible follow-up mechanism to ensure timely and accurate feedback of pregnancy and offspring to the sperm bank; The establishment of a reliable operation mechanism, coupled with computer-aided management system, strictly control each donor's frozen semen can only make up to 5 women pregnant.