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PubMed1989

[Intrauterine insemination in fertility disorders].

The success of intrauterine insemination with in HAM-F10 washed spermatozoa was evaluated during a clinical study of two years, in 32 couples with male infertility, male and female infertility and unexplained infertility. Six women of the 16 treated couples with male infertility achieved pregnancy. In this group no spontaneous pregnancies occurred. In couples with male and female and unexplained infertility the usefulness of the treatment is not proven. Further careful evaluation is needed.

Adult↗
PubMed1986

[Genetic aspects of artificial insemination. Choice of donors].

Artificial insemination with donors has genetic repercussions which increase with its impact on demography. Genetic control of semen donors offers a possibility of preventing the main genetic handicaps. The French Federation of Human Semen Study and Preservation Centres (CECOS) is currently organizing such a control system. The reasons for this and the modalities of the system are given in this article.

Female↗
PubMedDate not supplied

Immunological usefulness of semen manipulation for artificial insemination homologous (AIH) in subjects with antisperm antibodies bound to sperm surface.

The authors report trials carried out in the preparation of semen for homologous artificial insemination in subjects with antisperm autoantibodies. The tests have demonstrated that swim-up is not able to select spermatozoa free of antibodies bound to the sperm surface. All the experiments of migration, dilution, antigenic competition and cryoconservation, carried out to evaluate the theoretical possibility of a better recovery of non "immunologically compromised" spermatozoa, have confirmed such negative results both with the Immunobead Test and Cytofluorimetric analysis.

Autoantibodies↗
PubMedDate not supplied

Artificial insemination using fresh donor semen.

Four hundred and forty couples were treated by artificial insemination using fresh donor semen. The main indication was azoospermia. The overall pregnancy rate was 84.9% resulting in 287 take-home babies. The rate of ectopic pregnancies, perinatal deaths and spontaneous abortions were comparable to the general population. The accumulating pregnancy rate within 5 months was 86.8. Women older than 35 years had similar pregnancy rates than younger patients. Socioeconomic class, length of infertility and ovulatory disturbances either before or during treatment affected significantly the pregnancy rates.

Adult↗
PubMedDate not supplied

Direct intraperitoneal insemination (DIPI) for the treatment of refractory infertility unrelated to female organic pelvic disease.

344 couples with infertility unrelated to female organic pelvic disease underwent Direct Intraperitoneal Insemination (DIPI) for a total of a 429 DIPI cycles. Pregnancy per couple was 16.5% and per DIPI cycle 13.2%. DIPI was particularly effective in cases of infertility due to cervical mucus insufficiency and unexplained infertility with results respectively of 33.7% and 30.4% per couple and 30.7% and 28.7% per DIPI cycle. On the contrary, the results regarding male subfertility were 12.5% per couple and 10.5% per DIPI cycle. A significant difference was found (X2 A = 16.48, p less than 0.001) between these results and those of the group composed of cases of cervical mucus insufficiency and unexplained infertility. In cases of antisperm iso- and autoimmunization the results were on the whole poor, and were in any case influenced by corticosteroid pretreatment. The Pellet Swim-up Test (PST) proved to be a good prognostic sign for success of DIPI, since a significant difference was found between the PST group greater than or equal to 1.5 X 10(6)/ml (pregnancy per couple was 19.7% and per DIPI cycle 17.2%) and PST group less than 1.5 X 10(6)/ml (pregnancy per couple was 6.8% and per DIPI cycle was 4.5%) (X2 = 11.4. P less than 0.001).

Autoimmune Diseases↗
PubMed1988

Simplified sperm washing techniques and intrauterine insemination.

Sperm washing followed by intrauterine insemination of the husband's semen has emerged as a useful therapy. Several drawbacks restrict wider availability of this technique. The present study compared the pregnancy rate of a more complicated laboratory protocol with that of a simplified washing protocol in 42 patients. Eighteen pregnancies resulted, for an overall rate of 43%; eight occurred with the complicated protocol in 93 attempts and ten with the simplified protocol in 108 attempts, rates that do not differ significantly. We conclude that sperm washing protocols can be simplified without affecting efficacy, making the technique suitable for office settings.

Female↗
PubMed1988

[Donor artificial insemination. Psychological survey of 830 couples].

830 couples who had asked for Artificial Insemination by Donor (AID) were questioned using separate questionnaires for the husband and for the wife. The questions were directed to the reactions that followed in succession to discovery of the sterility, the psychological conditions that led to choosing AID, their attitude as far as secrecy was concerned and finally their contribution to finding donors of sperm. Overall the husband-wife replies corresponded to one another. Frequently the reaction to the news that the man is sterile is a depressive one and to a lesser degree followed by troubles in sexual performance. The choice of AID is usually a decision of both members of the couple. Most couples express themselves as hesitant about adoption. Most of them said that secrecy about the procedure was an essential condition. It appears that, above all, male sterility had to be hidden from the circle in which they associated and from the child. It is this position as far as secrecy is concerned that makes it difficult for the couples to help in recruiting sperm donors.

Attitude↗
PubMed1988

The screening of donors enrolled in an artificial insemination program.

Artificial insemination is currently offered in Ontario to couples when infertility arises from a male factor. The majority of practitioners are using fresh sperm, but because of the threat of transmitted infection, a change to the use of frozen semen, which can be screened concurrently, is anticipated. Screening can prevent the transmission of both genetic and infectious disease and the principles of a possible program are outlined below. Elements of screening include a genetic history, blood count, selected biochemical and serological assays, and a semen analysis and culture. Because of the high cost and the few cases of genetic disease that will be prevented, routine karyotyping is not recommended. It remains to be seen whether changing the donor pool from an unscreened group of medical personnel to a screened sperm bank derived from the general population will provide increased protection for the mother and child.

Anemia, Sickle Cell↗
PubMedDate not supplied

Birth after direct intraperitoneal insemination with frozen semen of donor.

For the first time, as least as far we known, a pregnancy and a normal baby obtained with DII with frozen semen of donor are reported. Our experience not only shows DII with frozen semen may be used successfully in AID but that it poses interesting hypotheses, to be verified in future, of its use in association with, or as an alternative to, GIFT and IVF/ET in cases of AID failure and as a first approach to an insemination technique in AID in general.

Adult↗
PubMed1986

The impact of AIDS on artificial insemination by donor.

Artificial insemination by donor (AID) provides a necessary service to a significant number of infertile couples. Its practice has been well controlled in Australia by careful donor screening and selection of suitable recipients. The potential for transmission of several infectious diseases has demanded a vigorous protocol for donor assessment and a strong movement away from the use of fresh semen. The description of human immunodeficiency virus (HIV) transmission by AID has increased the need for vigilance and has mandated, both by common sense and by Health Department Requirement (in Australia), the universal use of frozen donations. Antibody testing for HIV is not fail safe and must be supported by a carefully constructed lifestyle declaration form and a drive to recruit monogamous donors. The recruitment of sufficient donors has always been a problem and the advent of the HIV has not helped. Whilst transmission to laboratory staff appears to represent an extremely low risk, this possibility has required the development of safety protocols and appropriate staff training. This review outlines the current problems of running an AID programme given the knowledge that the HIV can be maintained in liquid nitrogen and transmitted atraumatically to a recipient.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Ethical and legal aspects of in-vitro fertilization and artificial insemination by donor.

All areas of medical practice are shaped by ethical and legal mandates. When a physician provides infertility services, however, ethical and legal concerns reach an even greater prominence. The infertility specialist is in the awesome role of facilitating the creation of new life. A task of that level of importance brings with it responsibilities of an equal magnitude. Clinicians performing in-vitro fertilization and artificial insemination should be especially sensitive to the ethical and legal concerns raised by the selection of patients and donors, the informed consent process, and record-keeping. As reproductive technologies such as these develop, the clinician not only has a duty to monitor their safety and efficacy, but also to provide extensive information to the participants and to society at large to make possible informed decisions about how best to enhance the benefits and avoid the risks of these new technologies.

Confidentiality↗
PubMed1987

[Artificial intrauterine insemination with washed prepared spermatozoa of the husband].

Intra-uterine insemination with washed spermatozoa of the husband was evaluated in 42 infertile couples during 103 treatment cycles. A pregnancy rate of 47.3% was obtained after an average of 2 treatment cycles in a group of patients in whom hostile cervical mucus was the only known cause of infertility. A pregnancy rate of 21.7% was obtained after an average of 2.6 treatment cycles in a group of patients in whom low sperm morphology was the only known cause of infertility. The overall conception rate of 33.3% compares favourably with that in other published series.

Female↗
PubMedDate not supplied

Cervical cap homologous artificial insemination (AIH): the University of Florence experience.

We report our experience with artificial insemination with husband's semen (AIH) using cervical cap. Forty-four couples were admitted to our AIH program over a two-year period. In 4 couples, AIH was performed due to impotence or hypospadia, while in the remaining 40 couples indications for AIH were abnormal semen, poor post-coital test, anti-sperm antibodies, poor cervical mucus. Overall, six pregnancies were obtained (pregnancy rate = 15%) in the latter group; in particular, AIH was able to elicit pregnancy in 5 out of the 25 cases of abnormal semen (20%). Our data emphasize the importance of female factors associated with infertility since significantly higher pregnancy rates (45.4% versus 0%) were observed in subjects in whom these factors were absent.

Adult↗
PubMedDate not supplied

Treatment of infertile couples by intrauterine artificial insemination homologous (AIH) of motile sperm collected by swim-up in human serum.

Twenty six couples with long standing infertility were treated by intrauterine AIH. Seminal and/or cervical factors were responsible for negative or poor coital test (PCT); retrograde ejaculation occurred in one case. A highly concentrated motile sperm suspension was obtained by swim-up procedure into fasting human serum and utilized for intrauterine insemination. Timing of ovulation was checked with the aid of ultrasound monitoring of follicular development. Totally, 120 cycles were treated. The pregnancy rate was 23.3%. Intrauterine AIH with motile sperm recovered by swim-up in human serum appears a valuable approach in the treatment of infertile couples with poor PCT as well as in cases of retrograde ejaculation.

Cell Separation↗
PubMed1985

Artificial insemination by donor at Groote Schuur Hospital.

An artificial insemination by donor (AID) service was started in the Infertility Clinic at Groote Schuur Hospital, Cape Town, in response to repeated requests by patients, doctors and social workers. The methods, results of treatment, and reasons for reorganizing the work of the clinic are presented. Future management at the clinic is also outlined. The clinic has been reorganized and work on semen cryopreservation is being carried out by the Andrology Service at Groote Schuur Hospital. A semen bank has also been established. The ethical, religious, legal and genetic aspects of AID are reviewed.

Adult↗
PubMed1985

[Artificial insemination by donor as an alternative for childless couples in South Africa. A pilot study].

Data obtained during 1981-1983 from an investigation of artificial insemination by donor (AID) as an alternative for childless couples in which 93 gynaecologists participated undeniably proved that AID, although operating on a relatively small scale, is already firmly established in South Africa. General practitioners appear to be well informed as to which gynaecologists couples can be referred to for AID. Gynaecologists who practice AID do not necessarily prefer AID to adoption. With the exception of a few, the majority of gynaecologists are in favour of a counselling service for childless couples where they can freely discuss their feelings of loss and evaluate various alternatives, such as remaining childless, adoption or AID. Despite the fact that selection of couples for AID in terms of the important psychosocial parameters is primarily a non-medical activity, it appears that by far the majority of gynaecologists carry out this selection themselves without necessarily being trained for such a task.

Adoption↗
PubMed1979

Therapeutic donor insemination: results and causes of nonfertilization.

The results of therapeutic donor insemination (AID) in 108 women are presented. Of the 108 women, 65 (60%) achieved a pregnancy. Eighty-five per cent of the pregnancies occurred with six AIDs or less, and 80% resulted in live births. The reasons why 43 women did not conceive are analyzed. The most common cause of failure was discontinuing the AID program. Of the original 108 women, 34 (32%) had dropped out of the program by the time they had received 6 AIDs or less. Reproductive abnormalities in the wife, and irregular ovulatory patterns, were the next most common causes of failure, and were often associated with discontinuation of the program. Advice regarding 2 days of sexual abstinence prior to AID was considered to improve the pregnancy rate. Fresh semen was shown to be superior to frozen samples in achieving pregnancies.

Abortion, Spontaneous↗
PubMed1979

[The results of two years of artificial insemination (author's transl)].

Artificial insemination donor (AID) is the solution for the sterility of many couples where the man is irreversibly sterile. We present the results of AID using frozen sperm in the two first years of work at the Centre d'Etudes et de Conservation du Sperme (C.E.C.O.S.), which is situated in the Midi-Pyrénées region of France. The results that have been obtained are satisfactory and prove the value of this method, but the means at present at the disposal of the Center do not always meet the demands made on it.

Adult↗