The chances of pregnancy depend on many factors, the principle ones being the female partner's age, the cause of infertility and the duration of infertility.

The chances of pregnancy are high the younger the patients and are approximately 15% per treatment cycle until 35 years. It then drops to 10% until 40 and drops further afterwards. These results are relevant to patients without gynecologic problems who ovulate regularly.

IVF raises the chance of achieving pregnancy by a few % per cycle but treatment is more complex, requires higher dosages of drugs, has more side effects and entails higher risks, as well as an invasive procedure under general anesthesia.

Is insemination painful?

Insemination is a simple procedure, similar to a pelvic examination for PAP screening. Beyond simple discomfort, it is sometimes accompanied by mild uterine contractions (similar to menstrual pain), light staining and increased secretions.

What is the purpose of follow up at the institute? Could we use ovulation detection kits instead?

Since insemination needs to be coordinated with ovulation (a "window of opportunity" of 24 hours), the time of ovulation in a given cycle needs to be reliably detected. This is done using technology, such as ultrasound follow-up of the development of follicles and blood tests for estrogen and progesterone levels. The combination of these pieces of information allows us to determine the time of ovulation and appropriate time for IUI. For the detection of ovulation in a natural cycle (without ovulation induction medications), commercial ovulation detection kits may be considered reliable.

Can we have intercourse during the month of treatment?

When a couple comes in for insemination treatments, there is no problem with having intercourse as usual during the treatment cycle. You may be asked to avoid intercourse approximately two days before the presumed day of ovulation.

When a female patient requires donor insemination, having intercourse with a fertile male close to the time of ovulation may create confusion as to the identity of the father.

Is a single insemination performed? At what time intervals are inseminations performed?

Since the time of ovulation is not always precisely determined, and sometimes a 24 hour window is established, it is customary to perform two insemination procedures 24 hours apart around the time of ovulation. If the treatment includes ovulation induction, inseminations are performed 12 hours and 36 hours after the ovulation injection. The rationale of the first insemination is to preempt the possibility of premature ovulation.

Why are ovulation inducing drugs necessary even in women who ovulate spontaneously?

It is customary to begin treatment without ovulation induction drugs based on spontaneous ovulation timing. If pregnancy is not achieved after a trial period, it is generally recommended to begin combining superovulation inducing drugs. The idea is to create a surplus of ova and increase the chances of fertilization. The treatment is usually graduated, that is: we begin with oral treatment (ikaclomin pills) that are easier to use and go on to injection treatment if unsuccessful.

Does insemination treatment entail any health risks for the child?

A pregnancy achieved by insemination treatment is like any other normal pregnancy. Risks and potential complications are identical to those in the general population within a similar age group. The performance of insemination does not raise any risks.

Is there any association between hormonal treatment and the risk of cancer?

This question comes up often and has been widely discussed in the media over the past years. Most studied published in the professional literature indicate no direct association between the various fertility drugs in use and the development of malignant diseases (such as breast cancer, ovarian cancer, GI tract cancer or melanoma). However, several studies did indicate such an association although we should point out that the infertility and its various causes may also be associated with cancer, explaining the findings. The matter is now under investigation and scrutiny, and there is no way to definitely rule out a future finding of such an association.

Does using cryopreserved sperm impair the chances of success? Does it affect the child's health risks?

In the process of cryopreservation and thawing, some sperm are lost.

If sperm quality is excellent (such as sperm donor samples) - the number of viable sperm after cryopreservation should be sufficient to achieve pregnancy.

At any rate, each sperm sample is evaluated before use and used only if parameters meet minimal quality criteria.

There are no reports in the literature indicating a health risk to the embryo in using cryopreserved sperm.

What happens on weekends?

The hospital clinics do not operate on Saturdays only. Treatments are performed on Fridays and on Sundays. If ovulation is determined to occur on a Saturday, insemination is performed on Friday and sometimes on Sunday as well. It is important to understand that sperm survives in a woman's body for 72 hours, so an insemination procedure performed on a Friday will enable a couple to achieve pregnancy if ovulation occurs on Saturday.

If I need more information on treatment procedures, drugs, side effects etc., where can I find it?

There is a large amount of literature on the subject including popular literature available in commercial bookstores and various internet sites dealing with fertility, women's health and family planning.