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PubMed1989

The health experience of single women who have children through artificial donor insemination.

Little is known about the health care needs of single women who decide to have children through artificial insemination. An exploratory qualitative research study was conducted to investigate this health experience. A case study design was used, consisting of two single women who had children through artificial donor insemination. Results suggested that the decision to have donor insemination was made after a lengthy process of considering multiple factors. The subjects' relationships and roles were affected, as were future goals and aspirations. Personal perspectives of self-enhancement were evident and feelings of aloneness and vulnerability. Health care needs that can be met by the clinical specialist were identified with emphasis on the decision counseling, direct care, educative, and leadership aspects of this nursing role. Directions for future research were proposed.

Adult↗
PubMedDate not supplied

Treatment of infertile patients by intrauterine insemination of washed spermatozoa.

Thirty-five couples with a variety of infertility problems were treated by a sperm-washing and intrauterine-insemination method. The husband's semen was washed with a modified Biggers, Whitten, and Whittingham's medium to obtain a seminal plasma-free, highly concentrated sperm suspension for intrauterine insemination. Couples receiving these inseminations were evaluated by semen analysis, zona-free hamster egg penetration test (EPT), post-coital test (PCT), antisperm antibody test (ASAT), and other appropriate infertility tests to determine the possible cause of infertility. The pregnancy rate as a group was 17%, while the spontaneous rate was found to be only 7%. Patients with a poor PCT result had a good success rate (25%) especially if the male's fertilizing ability appeared normal in the EPT (50% success). This treatment did not help men with poor EPT results or reduced sperm concentration (5% and 0% success). By excluding unsuccessful patients attempting less than three months, the calculated conception rate for this treatment is 33%. No infection or other serious complications were reported. It is concluded that this method is an uncomplicated and effective treatment for certain infertility patients. The patients most likely to be assisted by this method can be identified by using the EPT, PCT, and ASAT, and these patients should be treated for a minimum of three cycles.

Animals↗
PubMedDate not supplied

The role of the nurse practitioner in artificial insemination.

The nurse practitioner caring for the couple requesting artificial insemination is able to provide comprehensive care as a teacher, counselor, and technician. An artificial insemination program is described, in which the nurse practitioner assesses the couple's emotional status relative to infertility, counsels them if indicated, describes the legal ramifications of the procedure, performs the insemination, and assists in interviewing donors for the program.

Counseling↗
PubMed1988

Seasonal distribution in conceptions achieved by artificial insemination by donor.

The distribution of conceptions after artificial insemination from a donor was studied in 259 conceptions at an artificial insemination clinic and found to be seasonal. Conception was not influenced by the number of donors or patients attending the clinic, the frequency of inseminations, or medical skill. Conception was more common from early winter until early spring (October to March) with a peak in November. As variables such as frequency of intercourse and ovulation were irrelevant in these women and highest sperm counts occur from February to March these results suggested a seasonal variation in the quality of the ovulated egg or endometrial receptivity. The waste of eggs after ovulation (or preimplantation conceptuses) at specific times of the year has implications in the treatment of infertility, particularly for in vitro fertilisation and gamete intrafallopian transfer.

England↗
PubMed1977

Control of ovulation and fixed time insemination in heifers following cloprostenol.

The time of ovulation was determined in heifers following two injections 11 days apart of 500 microgram of cloprostenol by recovery of reproductive tracts at slaughter. Ovulation had not begun by 72 hours while 31%, 61% and 95% had ovulated by 78, 92 and 96 hours respectively after the second injection of cloprostenol. Injection of synthetic LH-releasing factor (GnRH) given 48 hours after cloprostenol significantly hastened the time of ovulation in animals slaughtered at 78 hours after the second cloprostenol injection. Insemination of heifers at 48, 60 or 72 hours resulted in lower fertility than two inseminations at 60 and 72 hours or at 48 and 72 hours after treatment. Controlling the time of ovulation with GnRH did not increase the fertility following a single insemination 71 hours after the treatment with cloprostenol.

Animals↗
PubMed1986

Ultrasound in the timing of artificial insemination with frozen donor semen.

Ultrasonography was performed to time ovulation in 30 patients participating in program for artificial insemination with donor semen (AID). During this study (10 months) 61 scans were carried out where one or more follicles were visible. The mean number of treatment cycles per patient was 2.8. Insemination with frozen donor semen was performed if a clear and mature follicle was detectable. The mean follicular diameter in successful inseminations was 20.1 +/- 0.8 mm, ranging from 16 to 23 mm. Twelve patients became pregnant, 9 (75%) of them after three treatment cycles. The mean time to conception was 2.75 cycles and the most successful day of the menstrual cycle was day 13. Ovulation was induced in 8 (56.7%) patients who conceived. Ultrasound is a noninvasive, quick and reliable method in the detection and timing of ovulation in most AID patients.

Adult↗
PubMed1983

Pregnancy rate after homologous insemination of pathological ejaculate both with and without the addition of kallikrein.

As part of a gynecological-andrological cooperation programme for the treatment of infertile marriages made by the 1st Department of Obstetrics and Gynecology and the Department of Urology, University of Vienna Medical School, the pregnancy rates achieved through 1,269 homologous inseminations of pathological ejaculates (according to Elliason's classification) both with and without addition of kallikrein was analysed retrospectively. In the case of 131 married couples, only 5 pregnancies occurred without the addition of kallikrein, and where kallikrein was used, there were also 5 pregnancies in 75 couples (6.66%). No conception occurred when cryoejaculate was used in addition. There were altogether 11 cases of spontaneous pregnancies. Conception could only be induced if an ejaculate of relatively high quality with a spermatozoa count of more than 12 million/ml and a 2-hour motility of more than 28% was used for insemination. The problems associated with homologous insemination with pathological ejaculate are being discussed.

Cold Temperature↗
PubMed1980

Couples' reactions to male infertility and donor insemination.

The author interviewed 16 couples after the husband had been diagnosed as infertile. Eleven husbands experienced a period of impotency. Fourteen of the women experienced anger toward the husband, psychiatric symptoms, and/or dreams about their concern for the husband, a wish to be rid of him, and guilt over this wish. Ten couples had decided to pursue donor insemination; 6 had delayed 1 3/4 to 4 years after the diagnosis of infertility and had a better adjustment than 3 of the 4 couples who did not. The author believes that the total secrecy involved in donor insemination inhibits the working through of conflicts about infertility and donor insemination itself.

Adaptation, Psychological↗
PubMed1989

Artificial insemination with husband's sperm (AIH): techniques for sperm selection.

Artificial insemination with husband's sperm (AIH) attempts to treat infertile couples by solving their particular infertility problems. This review is concerned with detailing and evaluating the experiences of different authors with AIH in infertile couples, types of insemination, and indications for insemination, with emphasis on techniques for sperm selection and separation: glass-wool filtration, separation on albumin columns, washed sperm, swim-up method, and spermatozoa selection in Percoll gradients.

Female↗
PubMed1990

Artificial insemination with fresh donor semen.

A review is given of the use of fresh donor semen for therapeutic artificial insemination. This includes a section on the legal, ethical, and psychological aspects as seen from the point of view of various cultures. Topics covered are the indications for donor insemination, the selection of donors, and the techniques in common use. The success rate is described together with the sex ratio of the neonates. Short mention is made of short-term office semen preservation and the obsolete technique of mixed husband-donor insemination.

Ethics↗
PubMed1990

Therapeutic donor insemination with frozen semen.

Although it is now accepted that cryopreserved semen must, on ethical and medicolegal grounds, be used for donor insemination many clinicians still believe that it has an unacceptably reduced fecundability rate as compared with fresh semen. We studied the outcome of 81 recipients who started therapeutic donor insemination (TDI) treatment during 1986 in a program that used exclusively cryopreserved semen; 55 had never undergone TDI and were receiving the first series (six cycles), 6 were receiving the second series (also six cycles), and 20 had achieved pregnancy through TDI previously and were starting the treatment again. Insemination with semen stored in 0.5-ml French straws was performed daily during the periovulatory period while the modified Insler score was 10 or greater out of 15. A total of 42 (52%) of the recipients became pregnant within six TDI cycles; 4 (10%) had a spontaneous abortion. An average of 4.8 straws were used per cycle among those who became pregnant and 5.1 per cycle among those who did not. On average 2.6 cycles were required to achieve pregnancy. The overall fecundability rate was 14.6%. We conclude that a TDI program involving exclusively frozen semen can be operated with a success rate comparable to rates achieved with fresh semen if a simple, established cryopreservation method and an uncomplicated clinical management protocol are used.

Adult↗
PubMedDate not supplied

A controlled trial of intrauterine insemination for cervical factor and male factor: a preliminary report.

In a prospective, randomized, controlled trial, we evaluated the efficacy of intrauterine insemination (IUI) in 54 couples with cervical factor (CF) infertility and in 19 couples with male factor (MF) infertility. The diagnoses were confirmed by strict criteria and all other etiologies of infertility were ruled out prior to entry. Patients served as their own controls with alternating cycles of washed sperm IUI and whole-ejaculate intracervical insemination (ICI). In 113 paired cycles (mean 2.1 pairs/patient; range 1-7 paired cycles), 13% (n = 7) of CF patients became pregnant by IUI, 7% (n = 4) by ICI, and 6% (n = 3) by intercourse after missing inseminations. Seventy-one percent of IUI pregnancies occurred in the first 2 months. In 45 paired cycles for MF patients (mean 2.4 pairs/patient; range 1-6 paired cycles), two patients conceived, both in the first IUI cycle. These data suggest that pregnancies resulting from IUI occur during early treatment cycles.

Adult↗
PubMed1988

[A case of a complete paraplegic fathering a girl following artificial insemination after an intrathecal neostigmine injection].

A case of a 32-year-old paraplegic male who fathered a girl following artificial insemination after an intrathecal neostigmine injection is described. The patient became a complete paraplegic after injury to the spinal cord caused by a traffic accident in 1971, resulting in ejaculatory disturbance. In June, 1984 the first intrathecal neostigmine injection was tried and 2.7 ml of semen was collected and offered to artificial insemination. However, the first to ninth attempt did not result in fertilization. The tenth attempt was made in March 7, 1986, and 3 ml of semen presenting 240 X 10(6) spermatozoa per ml with 5% of motile sperms was collected. This resulted in pregnancy, and the patient's wife delivered a healthy girl weighing 2552 g by cesarean section on November 19, 1986. This is the fourth case of a paraplegic who fathered a child following artificial insemination after an intrathecal neostigmine injection in the Japanese literature.

Adult↗
PubMed1986

Insemination with fresh donor semen.

Factors influencing the probability of conception after artificial insemination with donor semen were investigated in a series of 80 infertile couples. Overall, 46 pregnancies were achieved for a crude pregnancy rate of 58%. Life table analysis showed a cumulative probability of conception of 97.1% at the end of 12 cycles and an average fecundability of 15.1%. These results were achieved using a single insemination per cycle and individualizing the day of insemination based on the woman's basal body temperature. Women who had been pregnant previously had a significantly better fecundability than nulligravid women (P less than .05). The overall rates of conception in those women who required therapy for ovulatory dysfunction were the same as normal women although the fecundability was somewhat lower. Women who had abdominal pathology had an overall conception rate of 23%.

Cervix Mucus↗
PubMed1987

Transmission of hepatitis B virus by artificial insemination.

Although the capacity for transmission of hepatitis B infection by semen is well recognized, the potential for transmission by artificial insemination remains theoretical. Currently, screening of semen donors for hepatitis B virus infection is not standard practice. We saw a case of acute viral hepatitis B in a woman following artificial insemination with semen from a donor subsequently found to be positive for hepatitis B surface antigen (HBsAg). Both the donor serum and semen contained HBsAg and hepatitis B e antigen, and the HBsAg subtype was identical to that of the patient. Documentation of hepatitis B virus transmission by artificial insemination indicates that HBsAg screening of semen donors should be routine practice.

Adult↗
PubMed1979

Homologous insemination with the addition of pancreatic kallikrein.

Hog pancreatic kallikrein does improve sperm motility and sperm migration in vitro. Kallikrein can be used for artificial insemination to improve cervical mucus sperm penetration ability of spermatozoa with reduced motility. Homologous insemination in 52 couples during a period of one year yields a conception rate of 38.5%. Insemination with kallikrein showed no side effects. Abortion rate with 15% was within the normal range. All delivered babies were healthy and showed no abnormalities.

Animals↗
PubMed1979

[Artificial marital (homologous) insemination of women with sterility and retroflexion of uterus (author's transl)].

Successful use of artificial marital (homologous) insemination is described in this paper by examples of eight sterility patients (women aged 31 on average) with mobile retroflexion of uterus and procreative husbands. After an average period of 4.7 years had elapsed with desires for children unaccomplished in spite of special treatment, the above approach led to positive success in al cases. Five women turned pregnant in the first insemination cycle, one in the second, and two in the third. There were five spontaneous births of six intact infants, while two patients still are pregnant. Laparotomy was necessary in one case for ectopic gravidity. The authors are inclined to conclude from their own experience that homologous insemination may be used as one of the therapies applicable to childlessness, if no causative factors are detectable in addition to mobile retorflexion of uterus.

Adult↗
PubMed1984

[Use of ultrasonic folliculometry and LH determination in artificial insemination with donor semen].

The results of ultrasonic determinations of follicular growth and determinations of serum LH-levels were analysed in 34 patients who were artificially inseminated using cryopreserved donor semen (AID). 22 of them became pregnant. The ultrasonic findings had contributed to perform AID optimally, where as the determinations of LH did not surely indicate ovulation in each case. Frequency of inseminations per cycle was reduced by means of ultrasonic observations of follicle. The chance of success of artificial insemination using cryopreserved spermatozoa was decreased by delay of maturity of follicle. A peak of LH-concentration in serum was not detectable in 27 per cent of patients by one estimation daily.

Adult↗