Жас өнімділігі: In vivo ұрықтандыру арқылы жүктілік

Pregnancy through in vivo fertilization

Artificial insemination is the deliberate introduction of sperm into a female's cervix or uterine cavity for the purpose of achieving a pregnancy through in vivo fertilization by means other than sexual intercourse. It is a fertility treatment for humans, and is a common practice in animal breeding, including dairy cattle (see frozen bovine semen) and pigs. Artificial insemination may employ assisted reproductive technology, sperm donation and animal husbandry techniques. Artificial insemination techniques available include intracervical insemination (ICI) and intrauterine insemination (IUI). Where gametes from a third party are used, the procedure may be known as 'assisted insemination'.

The first recorded case of artificial insemination was John Hunter in 1790, who helped impregnate a linen draper's wife. The first reported case of artificial insemination by donor occurred in 1884: William H. Pancoast, a professor in Philadelphia, took sperm from his "best looking" student to inseminate an anesthetized woman without her knowledge. The case was reported 25 years later in a medical journal. The sperm bank was developed in Iowa starting in the 1950s in research conducted by University of Iowa medical school researchers Jerome K. Sherman and Raymond Bunge. In the United Kingdom, the British obstetrician Mary Barton founded one of the first fertility clinics to offer donor insemination in the 1930s, with her husband Bertold Wiesner fathering hundreds of offspring. In the 1980s, direct intraperitoneal insemination (DIPI) was occasionally used, where doctors injected sperm into the lower abdomen through a surgical hole or incision, with the intention of letting them find the oocyte at the ovary or after entering the genital tract through the ostium of the fallopian tube.

The sperm used in artificial insemination may be provided by either the woman's husband or partner (partner sperm) or by a known or anonymous sperm donor (see sperm donation (donor sperm)). The beneficiaries of artificial insemination are women who desire to give birth to their own child who may be single, women who are in a lesbian relationship or women who are in a heterosexual relationship but with a male partner who is infertile or who has a physical impairment which prevents full intercourse from taking place. Artificial insemination techniques were originally used mainly to assist heterosexual couples to conceive where they were having difficulties. With the advancement of techniques in this field, notably ICSI, the use of artificial insemination for such couples has largely been rendered unnecessary. However, there are still reasons why a couple would seek to use artificial insemination using the male partner's sperm. In the case of such couples, before artificial insemination is turned to as the solution, doctors will require an examination of both the male and female involved in order to remove any and all physical hindrances that are preventing them from naturally achieving a pregnancy including any factors which prevent the couple from having satisfactory sexual intercourse. The couple is also given a fertility test to determine the motility, number, and viability of the male's sperm and the success of the female's ovulation. From these tests, the doctor may or may not recommend a form of artificial insemination. The results of investigations may, for example, show that the woman's immune system may be rejecting her partner's sperm as invading molecules. Women who have issues with the cervix – such as cervical scarring, cervical blockage from endometriosis, or thick cervical mucus – may also benefit from artificial insemination, since the sperm must pass through the cervix to result in fertilization. Nowadays artificial insemination in humans is mainly used as a substitute for sexual intercourse for women without a male partner who wish to have their own children and who do so where sperm from a sperm donor is used. Donor sperm may be used in other ways, such as IVF and ICSI and a woman having a baby by a sperm donor will usually also have these methods available to her as alternatives to artificial insemination. Intracervical insemination is the easiest and most common insemination technique and can be used in the home for self insemination without medical practitioner assistance. Compared with natural insemination (i. e., insemination by sexual intercourse), artificial insemination can be more expensive and more invasive, and may require professional assistance. Some countries have laws which restrict and regulate who can donate sperm and who is able to receive artificial insemination, and the consequences of such insemination. Some women who live in a jurisdiction which does not permit artificial insemination in the circumstance in which she finds herself may travel to another jurisdiction which permits it. If the procedure is successful, the woman will conceive and carry a baby to term in the normal manner. A pregnancy resulting from artificial insemination is no different from a pregnancy achieved by sexual intercourse. In all cases of artificial insemination, the recipient woman will be the biological mother of any child produced, and the male whose sperm is used will be the biological father. There are multiple methods used to obtain the semen necessary for artificial insemination. Some methods require only men, while others require a combination of a male and female. Those that require only men to obtain semen are masturbation or the aspiration of sperm by means of a puncture of the testicle and epydidymus. Methods of collecting semen that involve a combination of a male and female include interrupted intercourse, intercourse with a 'collection condom', or the post coital aspiration of the semen from the vagina.

Timing is critical, as the window and opportunity for fertilization is little more than twelve hours from the release of the ovum. To increase the chance of success, the woman's menstrual cycle is closely observed, often using ovulation kits, ultrasounds or blood tests, such as basal body temperature tests over, noting the color and texture of the vaginal mucus, and the softness of the nose of her cervix. To improve the success rate of artificial insemination, drugs to create a stimulated cycle may be used, but the use of such drugs also results in an increased chance of a multiple birth. Sperm can be provided fresh or washed. Washed sperm is required in certain situations. Pre and post concentration of motile sperm is counted. Sperm from a sperm bank will be frozen and quarantined for a period, and the donor will be tested before and after production of the sample to ensure that he does not carry a transmissible disease. Sperm from a sperm bank will also be suspended in a semen extender which assists with freezing, storing and shipping. If sperm is provided by a private donor, either directly or through a sperm agency, it is usually supplied fresh, not frozen, and it will not be quarantined. Donor sperm provided in this way may be given directly to the recipient woman or her partner, or it may be transported in specially insulated containers. Some donors have their own freezing apparatus to freeze and store their sperm.

Semen used is either fresh, raw, or frozen. Where donor sperm is supplied by a sperm bank, it will always be quarantined and frozen, and will need to be thawed before use. The sperm is ideally donated after two or three days of abstinence, without lubrication as the lubricant can inhibit the sperm motility. It may also be performed privately by the woman, or, if she has a partner, in the presence of her partner, or by her partner. ICI was previously used in many fertility centers as a method of insemination, but its popularity in this context has waned as other, more reliable methods of insemination have become available. During ICI, air is expelled from a needleless syringe which is then filled with semen which has been allowed to liquify. A specially designed syringe, wider and with a more rounded end, may be used for this purpose. Any further enclosed air is removed by gently pressing the plunger forward. The woman lies on her back and the syringe is inserted into the vagina. Care is optimal when inserting the syringe, so that the tip is as close to the entrance to the cervix as possible. A vaginal speculum may be used for this purpose and a catheter may be attached to the tip of the syringe to ensure delivery of the semen as close to the entrance to the cervix as possible. The plunger is then slowly pushed forward and the semen in the syringe is gently emptied deep into the vagina. It is important that the syringe is emptied slowly for safety and for the best results, bearing in mind that the purpose of the procedure is to replicate as closely as possible a natural deposit of the semen in the vagina. The syringe (and catheter if used) may be left in place for several minutes before removal. The woman can bring herself to orgasm so that the cervix 'dips down' into the pool of semen, again replicating closely vaginal intercourse, and this may improve the success rate. Following insemination, fertile sperm will swim through the cervix into the uterus and from there to the fallopian tubes in a natural way as if the sperm had been deposited in the vagina through intercourse. The woman is therefore advised to lie still for about half an hour to assist conception. One insemination during a cycle is usually sufficient. Additional inseminations during the same cycle may not improve the chances of a pregnancy. Ordinary sexual lubricants should not be used in the process, but special fertility or 'sperm friendly' lubricants can be used for increased ease and comfort. When performed at home without the presence of a professional, aiming the sperm in the vagina at the neck of the cervix may be more difficult to achieve and the effect may be to 'flood' the vagina with semen, rather than to target it specifically at the entrance to the cervix. This procedure is sometimes referred to as 'intravaginal insemination' (IVI). Sperm supplied by a sperm bank will be frozen and must be allowed to thaw before insemination. The sealed end of the straw itself must be cut off and the open end of the straw is usually fixed straight on to the tip of the syringe, allowing the contents to be drawn into the syringe. Sperm from more than one straw can generally be used in the same syringe. Where fresh semen is used, this must be allowed to liquefy before inserting it into the syringe, or alternatively, the syringe may be back loaded. A conception cap, which is a form of conception device, may be inserted into the vagina following insemination and may be left in place for several hours. Using this method, a woman may go about her usual activities while the cervical cap holds the semen in the vagina close to the entrance to the cervix. Advocates of this method claim that it increases the chances of conception. One advantage with the conception device is that fresh, non liquefied semen may be used. The man may ejaculate straight into the cap so that his fresh semen can be inserted immediately into the vagina without waiting for it to liquefy, although a collection cup may also be used. Other methods may be used to insert semen into the vagina notably involving different uses of a conception cap. These include a specially designed conception cap with a tube attached which may be inserted empty into the vagina after which liquefied semen is poured into the tube. These methods are designed to ensure that semen is inseminated as close as possible to the cervix and that it is kept in place there to increase the chances of conception.

Intrauterine tuboperitoneal insemination (IUTPI) involves injection of washed sperm into both the uterus and fallopian tubes. The cervix is then clamped to prevent leakage to the vagina, best achieved with a specially designed double nut bivalve (DNB) speculum. The sperm is mixed to create a volume of 10 ml, sufficient to fill the uterine cavity, pass through the interstitial part of the tubes and the ampulla, finally reaching the peritoneal cavity and the Pouch of Douglas where it would be mixed with the peritoneal and follicular fluid. IUTPI can be useful in unexplained infertility, mild or moderate male infertility, and mild or moderate endometriosis. In non tubal sub fertility, fallopian tube sperm perfusion may be the preferred technique over intrauterine insemination.

Intratubal insemination (ITI) involves injection of washed sperm into the fallopian tube, although this procedure is no longer generally regarded as having any beneficial effect compared with IUI. ITI however, should not be confused with gamete intrafallopian transfer, where both eggs and sperm are mixed outside the woman's body and then immediately inserted into the fallopian tube where fertilization takes place.

Although many fertilization procedures, such as IUI are typically carried out in a medical setting, society is increasingly recognizing the important role that this plays in the lives of individuals who might otherwise not conceive through heterosexual penetrative sexual intercourse. Artificial insemination using a sperm donor for LGBTQ+ individuals and couples is one of the more cost effective avenues to parenting. While clinic based IUI may be open to many, it typically still includes hetero reproductive narratives which dates from the early days of fertilization procedures when these were often exclusively for married couples and when there was a resistance in many societies to extend these services to the LGBTQ+ community. Indeed, in the early days, there were very few fertility clinics which would provide services to single women and lesbian couples. In the UK, notable pioneers in this respect were the British Pregnancy Advisory Service (BPAS) and the Pregnancy Advisory Service (PAS), both of which operated before statutory control of fertility services in 1992, and the London Women's Clinic (LWC) which provided artificial insemination to single women and lesbians from 1998. Most donor insemination procedures undertaken in many countries today are for lesbian couples or single mainly lesbian women, yet much of their rhetoric and advertising is directed at heterosexual couples. Indeed, many sperm banks seem reluctant to inform donors that most of their donations will be used for lesbians and single women. To improve the way society talks about and carries out donor insemination inclusive language may be used. One way to do this is to bring LGBTQ narratives into this process, with a particular emphasis on this being a family centered process. Even in a medical setting, it is important to bring intimacy and family centeredness into this process, as this promotes connectedness and inclusiveness in what can be seen as a hostile and discriminatory environment. After a sperm donor is selected, a couple can proceed with donor sperm IUI. IUI is an economic option for same sex couples and can be done without the use of medication. According to a study from 2021, lesbian women undergoing IUI had an average clinical pregnancy rate of 13.2% per cycle and 42.2% success rate giving the average number of cycles at 3.6.

The rates of successful pregnancy for artificial insemination are 10 15% per menstrual cycle using ICI, and 15–20% per cycle for IUI. In IUI, about 60 to 70% have achieved pregnancy after 6 cycles. However, these pregnancy rates may be very misleading, since many factors have to be included to give a meaningful answer, e. g. definition of success and calculation of the total population. These rates can be influenced by age, overall reproductive health, and if the patient had an orgasm during the insemination. The literature is conflicting on immobilization after insemination has increasing the chances of pregnancy Previous data suggests that it is statistically significant for the patient to remain immobile for 15 minutes after insemination, while another review article claims that it is not. A point of consideration, is that it does cost the patient or healthcare system to remain immobile for 15 minutes if it does increase the chances. For couples with unexplained infertility, unstimulated IUI is no more effective than natural means of conception. The pregnancy rate also depends on the total sperm count, or, more specifically, the total motile sperm count (TMSC), used in a cycle. The success rate increases with increasing TMSC, but only up to a certain count, when other factors become limiting to success. The summed pregnancy rate of two cycles using a TMSC of 5 million (may be a TSC of ~10 million on graph) in each cycle is substantially higher than one single cycle using a TMSC of 10 million. However, although more cost efficient, using a lower TMSC also increases the average time taken to achieve pregnancy. Women whose age is becoming a major factor in fertility may not want to spend that extra time.

Artificial insemination is used for pets, livestock, endangered species, and animals in zoos or marine parks difficult to transport.

It may be used for many reasons, including to allow a male to inseminate a much larger number of females, to allow the use of genetic material from males separated by distance or time, to overcome physical breeding difficulties, to control the paternity of offspring, to synchronize births, to avoid injury incurred during natural mating, and to avoid the need to keep a male at all (such as for small numbers of females or in species whose fertile males may be difficult to manage). Artificial insemination is much more common than natural mating, as it allows several female animals to be impregnated from a single male. For instance, up to 30 40 female pigs can be impregnated from a single boar. Workers collect the semen by masturbating the boars, then insert it into the sows via a raised catheter known as a pork stork. Boars are still physically used to excite the females prior to insemination, but are prevented from actually mating. Semen is collected, extended, then cooled or frozen. It can be used on site or shipped to the female's location. If frozen, the small plastic tube holding the semen is referred to as a straw. To allow the sperm to remain viable during the time before and after it is frozen, the semen is mixed with a solution containing glycerol or other cryoprotectants. An extender is a solution that allows the semen from a donor to impregnate more females by making insemination possible with fewer sperm. Antibiotics, such as streptomycin, are sometimes added to the sperm to control some bacterial venereal diseases. Before the actual insemination, estrus may be induced through the use of progestogen and another hormone (usually PMSG or Prostaglandin F2α).

The first viviparous animal to be artificially fertilized was a dog. The experiment was conducted with success by the Italian Lazzaro Spallanzani in 1780. Another pioneer was the Russian Ilya Ivanov in 1899. In 1935, diluted semen from Suffolk sheep was flown from Cambridge in Britain to Kraków, Poland, as part of an international research project. The participants included Prawochenki (Poland), Milovanoff (USSR), Hammond and Walton (UK), and Thomasset (Uruguay). Modern artificial insemination was pioneered by John O. Almquist of Pennsylvania State University. He improved breeding efficiency by the use of antibiotics (first proven with penicillin in 1946) to control bacterial growth, decreasing embryonic mortality, and increase fertility. This, and various new techniques for processing, freezing, and thawing of frozen semen significantly enhanced the practical utilization of artificial insemination in the livestock industry and earned him the 1981 Wolf Foundation Prize in Agriculture. Many techniques developed by him have since been applied to other species, including humans.

Artificial insemination is used in many non human animals, including sheep, horses, cattle, pigs, dogs, pedigree animals generally, zoo animals, turkeys and creatures as tiny as honeybees and as massive as orcas (killer whales). Artificial insemination of farm animals is common in the developed world, especially for breeding dairy cattle (75% of all inseminations). Swine are also bred using this method (up to 85% of all inseminations). It is an economical means for a livestock breeder to improve their herds utilizing males having desirable traits. Although common with cattle and swine, artificial insemination is not as widely practiced in the breeding of horses. A small number of equine associations in North America accept only horses that have been conceived by "natural cover" or "natural service" – the actual physical mating of a mare to a stallion – the Jockey Club being the most notable of these, as no artificial insemination is allowed in Thoroughbred breeding. Other registries such as the AQHA and warmblood registries allow registration of foals created through artificial insemination, and the process is widely used allowing the breeding of mares to stallions not resident at the same facility – or even in the same country – through the use of transported frozen or cooled semen. In modern species conservation, semen collection and artificial insemination are used also in birds. In 2013 scientist of the Justus Liebig University of Giessen, Germany, from the working group of Michael Lierz, Clinic for birds, reptiles, amphibians, and fish, developed a novel technique for semen collection and artificial insemination in parrots producing the world's first macaw by assisted reproduction. Scientists working with captive orcas were able to pioneer the technique in the early 2000s, resulting in "the first successful conceptions, resulting in live offspring, using artificial insemination in any cetacean species". John Hargrove, a SeaWorld trainer, describes Kasatka as being the first orca to receive artificial insemination.

Artificial insemination on animals has been criticised as a violation of animal rights, with animal rights advocates equating it with rape and arguing it constitutes institutionalized bestiality. Artificial insemination of farm animals is condemned by animal rights campaigners such as People for the Ethical Treatment of Animals (PETA) and Joey Carbstrong, who identify the practice as a form of rape due to its sexual, involuntary and perceived painful nature. Animal rights organizations such as PETA and Mercy for Animals frequently write against the practice in their articles. Much of the meat production in the United States depends on artificial insemination, resulting in an explosive growth of the procedure over the past three decades. The state of Kansas makes no exceptions for artificial insemination under its bestiality law, thus making the procedure illegal.