I do not have a partner but I would like to be a mother

Artificial Insemination involves placing the previously prepared sperm inside the uterus or the cervical channel of the woman. The menstrual cycle of the patient has to be monitored in order to find out exactly when ovulation takes place. With this treatment the semen sample is provided by an anonymous donor who is selected according to the characteristics of the woman requiring AID.

AID is carried out in two stages. First of all the follicular growth is stimulated in order to obtain a small number of mature follicles (vesicles containing eggs in the ovaries). That is why the patients have to undergo hormone treatment (with FSH) and a series of ultrasound scans is taken.

At the second stage, when the size of the follicles is adequate, the ovulation is triggered with a special medicine (chorionic gonadotropin). The insemination is carried out between 36 and 40 hours later. The semen sample has to be prepared in advance (normally it is thawed and warmed in the incubator at +37ºC with 5% of CO2).

ARTIFICIAL INSEMINATION WITH DONOR SPERM IN SINGLE WOMEN

Spanish Law considers it the single woman’s right to undergo Assisted Reproduction treatment in order to have a child. Some of the Assisted Reproduction centres help patients without a male partner to become mothers.

Artificial Insemination with sperm from an anonymous donor is recommended to the patient when she does not suffer from any pathology that might cause infertility (for example, tubal obstruction). Otherwise, a more complex procedure such as In Vitro fertilisation has to be considered.

The sperm issued from the semen bank is donated by healthy men and is previously checked in order to guarantee the complete absence of any infectious or hereditary diseases.

ADDITIONAL NECESSARY TESTS

Sometimes a series of additional analysis and tests are required before undertaking the treatment:

Gynaecological check with a recent cytology which is usually taken at the first appointment.

Blood tests are required for precise pre-conception evaluation. They consist of a complete hemogram, hepatic and renal biochemical tests, serologies (HBsAg, anti-HBs, anti-HC, rubella, toxoplasmosis, lues, HIV), blood group and Rh. The test results have to be updated only if they were taken more than six months ago.

Hormone analysis is taken on the third day of the menstrual cycle (FSH, LH and 17 β-Estradiol). If this falls on a holiday it can be taken between the second and the fifth day of the cycle. This test is necessary when an endocrine alteration is suspected.

Hysterosalpingography is carried out between the eighth and the twelfth day of the cycle if a tubal obstruction is suspected. It is a contrast x-ray which shows the outline of the uterus and the Fallopian tubes.

Basal temperature normally provides very useful information. It is preferably taken using the rectal method every day starting on the first day of the menstrual cycle and for the duration of approximately two cycles. There are specific graphs to record the given temperature. However, this test is not always necessary.

REQUIREMENTS

The woman has to be in good health in order to undergo this treatment. According to Spanish Law the patient has to sign a consent form and fill it in providing the information about her physical characteristics and blood group so that a suitable donor can be selected.

PROCEDURE

First appointment
The first appointment is specially focused on the discussion of the chosen technique. It is recommended for the woman to schedule the visit when she is not menstruating and can undergo a gynaecological check-up. During this appointment the doctor will evaluate the patient’s case and plan its follow-up.

Taking into account the available results and the information received at the first appointment, the doctor will point out the additional tests to run, if necessary, in order to complete the case study and programme the following appointments.

If any anomaly is detected as a result of the study the case will be evaluated in more depth in order to confirm that Artificial Insemination is the appropriate action for the patient.

If all the requirements applicable to the case are met and no additional tests are needed, the doctor will provide a detailed explanation about the hormone treatment to follow in order to induce ovulation.

Second and following appointments

When it has been decided to begin the treatment, or when the case study has been completed, the woman calls EUGIN on the first of second day of her period in order to confirm the procedure and the dosage to follow. As a rule, the treatment begins on the third day after the menstrual cycle starts.

At the same time the second appointment at the clinic is scheduled so that she can see the doctor after having followed the hormone treatment for seven days. With this appointment an ultrasound scan via the vagina is carried out in order to check the ovarian response and, according to the results, another follicular control is scheduled. Normally two or three visits are necessary.

When the follicular controls show the expected ovarian response, the ovulation is induced and the Artificial Insemination treatment is programmed. It will take place two days after the last ultrasound scan.

When the semen sample is ready the insemination takes place. Fifteen days later a pregnancy blood test is taken.

ARTIFICIAL INSEMINATION WITH DONOR SPERM IN WOMEN NOT RESIDING IN BARCELONA

PROCEDURE

If the woman does not live in Barcelona and prefers not to leave her home during the treatment, a protocol for non-residents can be applied. In this case AID is carried out by means of coordination between the gynaecologist or the ultrasound professional in the woman’s home town and EUGIN.

A. Technique choice and planning

An appointment is scheduled in Barcelona in order to evaluate the patient’s case and confirm the technique to apply.

1. It is recommended to bring all the tests and analysis available such as ultrasound scans etc.

2. When the woman confirms her decision to undergo AID, the suitable semen sample will be selected so that it can be used for the insemination.

B. Pharmacological stimulation of the cycle

In order to guarantee the availability of a follicle on the day of the insemination, the patient has to undergo a pharmacological stimulation cycle. The stimulation will begin when the EUGIN specialist considers it appropriate. At this moment it is recommended to start planning the trip to Barcelona where the insemination will take place.

The treatment procedure has to be coordinated via emails, telephone or fax. Therefore, the clinic should be informed about the results of the follicular controls taking place in the patient’s hometown so that the treatment can be supervised from Barcelona. Normally only two controls are needed.

Depending on the results of the treatment and in order to be able to plan a visit to EUGIN, the woman is informed about the estimated date of the insemination which will be confirmed two days in advance.

Artificial Insemination with donor sperm

Artificial Insemination takes place in Barcelona, in EUGIN clinic. Intrauterine insemination technique with previously selected donor sperm issued from the semen bank is carried out. The patient can return home immediately after the procedure.

PROCEDURE

There are several Assisted Reproduction centres but few of them have the experience and protocols that can help patients who do not live in the city where the clinic is. In Barcelona, EUGINE has been a pioneering centre in developing and applying distance treatment coordination. The process consists of using new communication technologies for regulated procedures.

Even if the final stage of the Assisted Reproduction treatment – in this particular case Artificial Insemination – always takes place in Barcelona, normally the larger part of the study and hormone preparation of the woman can be effectively carried out in her home town or area.

This procedure is coordinated via the Internet or phone which allows many non-resident women to take advantage of Assisted Reproduction Techniques in a more comfortable and effective way as well as to reduce the cost of the treatment as they do not have to travel to the clinic more than is absolutely necessary.

NECESSARY ADDITIONAL TESTS

These results can be obtained in the patient’s home town in collaboration with her GP or a specialist.

Gynaecological check with a recent cytology which is taken in Barcelona at the first appointment.

Blood tests which can be brought from the patient’s hometown and have to be updated only if they were taken more than six months ago.

Hormone analysis is necessary only when an endocrine alteration is suspected and can be taken in the patient’s hometown or area.

Hysterosalpingography can be carried out in the patient’s hometown or area.

Basal temperature is recommended as this information is very useful for the treatment.

GENERAL PROCEDURE COORDINATION

First appointment

The first appointment takes place in Barcelona. It is recommended that the woman is not menstruating and can undergo a gynaecological check-up. During this appointment the case of the patient will be evaluated and its follow-up will be planned.

Depending on the available results and the interview, the specialist will suggest the additional tests to be taken, if necessary, in order to complete the case study and to programme the future appointments. If all the case requirements are met and no additional analysis is needed, the patient will be provided with a detailed explanation about the procedure to follow in order to induce the ovulation. The necessary consent form will be signed.

Second appointment

If as a result of the case study an anomaly is found, the patient’s case will be studied in more depth in order to make sure that the chosen treatment is appropriate. This study can be coordinated by the woman’s specialist (gynaecologist, ultrasound professional) who can effectively communicate with the clinic using the Internet in order to send their comments. The woman herself can inform the clinic about the results of the tests. When the case study is finished or the decision to start the treatment is taken, the patient should phone EUGIN on the first or second day of her menstrual cycle in order to confirm the procedure and the dosage of the hormone treatment to follow. Normally it has to begin on the third day of the cycle.

At the same time the patient should make an appointment with the gynaecologist or ultrasound professional in her hometown or area. It has to be scheduled approximately on the seventh day of the hormone treatment. An ultrasound scan via the vagina will be carried out during this visit in order to check the ovarian response and, depending on its result, another control will be scheduled. To do so the patient can contact the clinic on the phone or via email.

When the controls confirm the appropriate ovarian response, Artificial Insemination will be programmed. It will take place in Barcelona two days after the last ultrasound scan. As soon as the prepared semen sample is ready the procedure is carried out and the patient can return home immediately. Fifteen days later the patient should take a pregnancy test.

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