How is the time of insemination decided?
It is essential that the timing of insemination is correct, as close prior
to ovulation as possible. The time of insemination can be predicted to a
reasonable extent based on clinical experience, laboratory data, and
examination.
Does your physician check the quality of semen prior to insemination?
On occasion, even in the best cryobank, freezing might not preserve the sperm as
well as expected and the sample could be unsatisfactory. The quality of semen
should be checked prior to insemination, since using a poor quality specimen is
a waste of time, money and effort.
How is a decision made to choose between regular cervical and intrauterine
inseminations?
Intrauterine insemination became very fashionable and frequently is used without
true need of it. In order to prepare a semen sample for intrauterine
insemination, it has to be washed and spun in a centrifuge for a considerable
length of time. If this is not necessary, possible harm to the sperm might
actually hinder the result of insemination.
Is your physician equipped and willing to perform the penetration test?
The penetration test examines the sperm survival in the cervical mucus.
It verifies the ability of the sperm to invade the mucus or survive within that
mucus for a number of hours. A poor penetration and survival might be seen in
situations where the cervical mucus is not favorable or the semen may not have
the ability to invade the mucus or survive within that mucus for a number of
hours.
In case of intrauterine insemination, what effect has the washing of sperm on
the numbers and motility?
Not all specimens favorably tolerate sperm washing and centrifuging necessary
prior to intrauterine insemination. During natural conception, the sperm
is not washed nor spun in a centrifuge. Thus, both these processes are
artificial and can have a serious impact on the quality and effectiveness of the
sperm.
Is the treating physician ready and willing to proceed with a detailed
work-up after 3-4 cycles of unsuccessful inseminations?
As a rule of thumb one would expect most of the inseminations to be successful
within 3-4 cycles. If they are not, physicians should start looking into
possible reasons to understand why pregnancy has not happened and rule out the
most common infertility problems.
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