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Pregnancy following use of the cervical cup for home artificial insemination utilizing homologous semen.

Sixty-one couples with infertility from 1 to 11 years were instructed in the use of the cervical cup for artificial insemination using homologous semen in the privacy of their own homes. There have been 36 reported pregnancies in 32 of these couples. Among women with primary infertility, the pregnancy rate was 43%; it was 67% for those with secondary infertility and 53% overall. Sperm counts and percent motility, as well as postcoital test results, however, failed to be indicative of eventual ability to conceive. Regardless, among couples with documented infertility, this method provided over half of the couples with at least one pregnancy. Additionally, the technique is simple, inexpensive, without significant risk or discomfort, and can be carried out by a couple at their convenience and in privacy.

Female↗

Pregnancy outcome in 242 conceptions after artificial insemination with donor sperm and effects of maternal age on the prognosis for successful pregnancy.

Four hundred four treatment courses of artificial insemination with donor sperm were initiated in 330 couples. A treatment course was defined as completed if the patient conceived, failed to conceive after 12 cycles of artificial insemination with donor sperm, or dropped out of the program after at least one inseminated cycle. We have documented a 92.4% conception rate in patients who completed six treatment courses and 83.7% in those completing at least three treatment courses. Including all the patients who dropped out, 72.7% of all patients conceived. Spontaneous abortion occurred in 17.4%; three infants with major congenital defects were delivered and three indicated midtrimester abortions were performed. Our data demonstrate that the prognosis for successful artificial insemination with donor sperm is inversely related to advancing maternal age. Patients over age 35 had significantly lower conception rates; more insemination cycles were required per conception and the incidence of spontaneous abortion was related to the number of cycles required per conception.

Abortion, Spontaneous↗

Psychological and attitudinal profiles in donors for artificial insemination.

Few objective data are available concerning the psychological profiles and attitudes of sperm donors in artificial insemination programs. We studied 30 consecutive new volunteers and 45 established sperm donors using the Cattell 16PF personality profile and an attitudinal survey concerning motives for donation, attitudes toward uses of sperm, desire for knowledge of outcomes, and attitudes toward disclosures of identifying and nonidentifying information between the parties to artificial insemination. Donors differed from the population norms in 7 of 16 first-order and 1 of 4 second-order personality factors, and this difference appeared to reflect their self-selection as donors. The predominant motive for donation was altruism, but secondary motives were also common. Financial motivation was very low in this population with few students. Donors approved of all current and most hypothetical uses of sperm but were not in favor of disclosures of information to other participants in the program. Restriction of disclosures to nonidentifying details was more acceptable. Unmarried donors were more often motivated for nonaltruistic reasons and were more in favor of disclosures. Attitudes of sperm donors were mostly stable over at least 3 years, but an increasing minority with time envisaged circumstances that might lead to their withdrawal from the program.

Attitude↗

Pharmacologic induction of multiple follicular development improves the success rate of artificial insemination with husband's semen in couples with male-related or unexplained infertility.

The use of artificial insemination with husband's semen (AIH) as treatment for couples with male-related or unexplained infertility is often disappointing. The aim of the present study was to evaluate whether the induction of multiple ovulation can increase the pregnancy rates in couples treated with AIH. Multiple follicular development was induced by means of clomiphene citrate (CC) plus purified follicle-stimulating hormone (FSH) in 17 couples undergoing AIH for male-related or unexplained infertility. In spite of the long duration of infertility (greater than 6 years), 10 couples (58.8%) achieved pregnancy within 6 months of treatment. This figure was significantly higher than that obtained in 120 couples who underwent AIH either during spontaneous cycles or after induction of follicular development with CC alone. These results suggest that the availability of multiple mature oocytes increases the conception rate during each cycle, as reported for in vitro fertilization (IVF) programs. It is therefore suggested that a trial of induction of multiple follicular development be performed in couples with male-related or unexplained infertility before their inclusion in protocols for invasive procedures, such as IVF or gamete intrafallopian transfer.

Clomiphene↗

Semen abnormalities in artificial insemination donor candidates.

We screened 43 healthy adult male medical students as potential anonymous donors for the artificial insemination program at our university. Of the candidates 10 had varicoceles (5 bilaterally). Over-all, 34 men (79 per cent) had inadequate semen analyses by 1 or more criteria. Of the men with varicoceles 80 per cent also had abnormal findings. Three abnormalities were discovered most frequently in the semen of men with a normal physical examination and 5 deficiencies were found in those with a varicocele. Problems with semen quality were more common than those of sperm numbers.

Adult↗

[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↗

The effect of time of artificial insemination on fertilization status and embryo quality in superovulated cows.

Thirty nonlactating Holstein cows were superovulated to determine the effect of artificial insemination time on fertilization status and embryo quality. During the luteal phase of the estrous cycle, cows were administered 38 mg FSH-P in a 4-d descending dose regimen. Luteolysis was induced with two injections of prostaglandin on the last day of FSH-P treatment. All cows were continuously monitored for behavioral estrus using the HeatWatch estrus detection system. All cows were inseminated once with one .5-mL straw (50 x 10(6) sperm) at either 0 (n = 10), 12 (n = 10), or 24 h (n = 10) after the first standing event. The elapsed time (mean +/- SD) from the first prostaglandin dose to the first standing event was 39.4 h +/- 7.7 h. The (mean +/- SD) duration of behavioral estrus was 13.2 h +/- 4.1 h. The (mean +/- SD) number of standing events was 27 +/- 17. Five hundred twenty-nine embryos and ova were recovered nonsurgically 6 d after insemination. Fertilization rates were 29 (0 h), 60 (12 h), and 81% (24 h) (P < .01). Percentages of excellent and good, fair and poor, and degenerate embryos were not different (P > .05). Percentages of embryos with accessory sperm were 5 (0 h), 8 (12 h), and 41 (24 h) and differed between the 0 and 24 h and the 12 and 24 h inseminations (P < .01). Artificial insemination of superovulated, nonlactating Holstein cattle 24 h after onset of estrus increased fertilization rate and percentage of embryos with accessory sperm compared with insemination at 0 or 12 h after onset of estrus. Embryo quality was not affected by time of insemination.

Animals↗

Retrograde ejaculation: successful treatment with artificial insemination.

Between 1977 and 1987, 14 couples in whom the male partner had retrograde ejaculation were treated with artificial insemination using the husband's sperm (AIH). There were 6 pregnancies in 4 couples, giving a cumulative probability of pregnancy at 12 months of 72%. The success rate depended on a number of factors, including semen quality, methods of sperm extraction from the urine, timing of ovulation and other complicating fertility factors.

Adult↗

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↗

Artificial insemination with donor semen. Review of 252 patients.

The total three year experience with frozen sperm used with artificial insemination by donor (AID) at Prince Henry's Hospital. Melbourne is presented. During this period, 252 women have had one or more cycles of treatment, with life table pregnancy rates of 47.6 +/- 3.55 after six cycles and 62.8 +/- 4.00 after 12 cycles. There was no difference in outcome between patients with azoospermic or oligospermic husbands, but patients requiring ovulatory stimulants or who have tubal abnormalities have a much lower success rate.

Actuarial Analysis↗