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Better postcoital test for oligospermic patients using split ejaculate artificial insemination.

In 25 oligospermic patients who had negative postcoital tests, artificial inseminations were performed with the whole semen and split ejaculates. After 30 minutes, a sample of cervical mucus was obtained and examined microscopically for the presence of motile spermatozoa. There was a significant improvement of 64% using the split ejaculate, as compared with 44% using whole semen. We found a significantly higher sperm count and progressive motility in the split ejaculate (18 patients, 72%).

Cell Count↗

Artificial insemination with donor semen: the necessity of frequent donor screening.

Artificial insemination with donor semen has become a well established alternative for couples with untreatable male factor infertility. Because of the widespread use of donor insemination, and the increasing awareness and prevalence of sexually transmitted diseases, the American Fertility Society recently redrafted procedural guidelines for the use of donor screening for insemination. Our series of donor screenings is reported to emphasize the necessity of donor evaluations at frequent intervals. From June 1986 through August 1987, 48 healthy male volunteers presented as potential semen donors for our donor program. Each was evaluated with a careful medical history, physical examination and 2 semen analyses for evidence of sexually transmitted disease. On initial evaluation, no donor presented with a positive human immunodeficiency virus antibody, abnormal karyotype, elevated serum glutamic oxaloacetic transaminase, rapid plasma reagent, or positive cultures for Chlamydia or Mycoplasma. One potential donor was excluded because of a positive hepatitis B-core antibody and 1 because of a positive IgM test for cytomegalovirus. At initial examination 3 potential donors had a positive culture for Ureaplasma; all 3 were treated with 3 weeks of tetracycline, and repeat cultures were all negative. Routine followup screening was performed on all donors at 3-month intervals for all sexually transmitted diseases. During this 14-month period cultures converted to positive for Ureaplasma in 4 donors. Furthermore, 1 donor at 6 months contracted gonorrhea. He was treated but no longer used as a donor. Since initiation of the outlined protocol more than 800 inseminations have been performed using fresh semen with no case of sexually transmitted diseases reported from our recipients. We conclude that careful sexual history, and frequent donor and semen evaluation are necessary for prevention of diseases that might be transmitted sexually. If these precautions are strictly observed use of donor semen is safe and effective.

Acquired Immunodeficiency Syndrome↗

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↗

Clomiphene-regulated ovulation for donor artificial insemination.

Seventeen couples with male-caused infertility requested donor artificial insemination between January 1, 1973, and December 31, 1974. All of the women were evaluated prior to the inseminations and were found to be ovulatory. They were treated with clomiphene, citrate 50 mg/day for 5 days beginning on day 4,5, or 6 of a menstrual cycle, and scheduled for two inseminations on the 5th and 7th days after completion of the clomiphene regimen. Fresh semen placed in cervical cups was used for the inseminations. The procedure was repeated in the following months until conception occurred.

Clomiphene↗

An improved method for preparation of semen for artificial insemination by husband.

An improved method of semen preparation for artificial insemination, which involves filtration on an albumin column followed by resuspension in fasting blood serum, is described. The proportion of motile sperms, the quality of motility, motility index, and life span of the sperms in vitro are improved. Six pregnancies have resulted from the use of this method.

Female↗

Human artificial insemination: some social and legal issues.

The demand for human artificial insemination (AI) is increasing as a function of declining numbers of babies available for adoption and greater community awareness. This paper reviews some of the social and legal issues associated with the practice of AI: prevalence of marital infertility; demand for AI; moral objections; effect on marriage; legality of practice; legal position of all the parties to the practice; legislation proposed to regulate the practice; and payment of medical benefits.

Australia↗

Artificial insemination: a comparison of pregnancy rates with intrauterine versus cervical insemination and washed sperm versus serum swim-up sperm preparations.

A four-cycle artificial insemination protocol was undertaken, with luteinizing hormone (LH) timing, to compare washed sperm and serum swim-up sperm preparations and cervical and intrauterine insemination. Of the 75 patients entered into the protocol series, 63 finished all 4 cycles. During the treatment period, 24 patients became pregnant, 20 of whom were donor (AID) pregnancies (out of 52 patients) and 4 were husband (AIH) pregnancies (out of 11 patients). Seventy-five percent of the pregnancies were intrauterine, whereas only 25% were from cervical inseminations. Sixty-two percent of the pregnancies were due to serum swim-up sperm preparations, and 38% were due to washed sperm preparations. The data indicate substantially higher pregnancy rates can be obtained with intrauterine insemination and suggest that additional studies are necessary to determine if the method of sperm preparation significantly influences pregnancy rates.

Cervix Uteri↗

Current practice of artificial insemination by donor in the United States.

Of 711 physicians likely to perform artificial insemination by donor surveyed to determine their current practices, 471 responded, of whom 379 reported that they performed this procedure. They accounted for approximately 3576 births by this means in 1977. In addition to treating infertility, 26 per cent of these physicians used the procedure to prevent transmission of a genetic disease, and 10 per cent used if for single women. Donors of semen were primarily from universities, were only superficially screened for genetic diseases, and were then matched phenotypically to the recipient's husband. Most recipients were inseminated twice per cycle. Only 17 per cent of physicians used the same donor for a given recipient, and 32 per cent used multiple donors within a single cycle. Only 37 per cent kept records on children, and only 30 per cent on donors. The identity of donors usually was carefully guarded to ensure privacy and to avoid legal complications.

Confidentiality↗

Genetic screening of donors for artificial insemination.

A routine has been established for genetic screening of donors in an artificial insemination and frozen sperm bank program. This report is a summary and analysis of the information obtained on the first 168 donor applicants and 89 recipients who were genetically screened. The specific forms for screening, family information obtained, characteristics of the donor and recipient groups, and guidelines for acceptance or rejection of donors are discussed. The donor and recipient often failed to perceive that the disorders in the family were genetic. The simple question of whether or not there were genetic or hereditary problems in the family was ineffective, even when the donor or recipient had formal medical training.

Age Factors↗