Q&A: Is Artificial Insemination For You?by Bradley G. Goldberg, M.D.
Q My husband and I have been discussing artificial insemination to get pregnant, and I heard you perform this. I have tried for 10 plus years to get pregnant and no luck. I have had hormonal problems, etc... but still no luck getting pregnant.
A I am sorry to hear about your difficulties. Yes, I do perform inseminations at my office. It is a good procedure, and I have had several patients become pregnant this way. But, it is not for everyone.
The definition of infertility is "a couple who has been trying to become pregnant for at least one year without success." There are many causes of infertility, some male related and some female related. Before any treatment, such as insemination, is considered, a basic infertility evaluation should be performed.
This evaluation will include a male semen analysis, since this is the problem in up to 40% of cases. After this, several hormones should be checked in the woman, including tests of ovarian function, thyroid function, prolactin levels, as well as insulin level evaluations in patients who meet certain criteria. In addition, a test should be performed to confirm ovulation. Although it is not possible to completely confirm ovulation, tests such as progesterone levels at the appropriate point in a woman's cycle can help.
Once all these tests are performed, a cause will be identified in up to 80% of couples. The remaining 20% are diagnosed with "unexplained infertility."
Intrauterine insemination is a procedure performed for unexplained infertility or infertility due to mild endometriosis. For the procedure to be successful, the woman's fallopian tubes must be open. The insemination is done after treating the woman with hormones to help the egg develop. The patient is then followed closely with ultrasound, and when the egg is ready, a second hormone injection is used to help release the egg. The next day, the husband's semen is collected, washed with a special solution, and then concentrated in a centrifuge. This concentrate is then placed directly into the woman's uterus using a small plastic tube. This procedure usually does not cause any more discomfort than a PAP smear.
The procedure is more effective than using Clomid alone, and is much less expensive than "in vitro" fertilization ("test-tube babies"). It can increase a couples chance of pregnancy 2-3 fold, but still not all will be able to conceive this way. For those who can not, a consultation with a reproductive endocrinologist is usually necessary.
Best of luck to you and your husband with starting your family!
Bradley G. Goldberg, M.D.,
Chief of Staff, CRMC
Coffee Women's Center, P.C.
Click here to Ask Dr. Goldberg your pregnancy questions.
Dr. Bradley G Goldberg is a specialist in Obstetrics and Gynecology, Dr. Goldberg is certified by the American Board of Obstetrics and Gynecology. Dr. Goldberg is Chief of Staff of Coffee Regional Medical Center. Currently, he is serving as Director of the Department of Obstetrics and Gynecology, and he is the Chairman of the Perinatal Committee. Dr. Goldberg graduated from the University of Florida in 1989 as a member of The Phi Beta Kappa honor society. He received his medical degree from the University of Florida College of Medicine, and completed his internship and residency in Obstetrics and Gynecology at Georgia Baptist Medical Center in Atlanta.
Dr. Goldberg is a contributing author to OBGYN.net, the largest women's health site on the Internet. In addition, Dr. Goldberg is the author of an article on "Urethral Carcinoma," which is in press with the Journal of Urology, and he co-produced an instructional video on Norplant removal that he presented at the annual meeting of the American College of Obstetricians and Gynecologists.
Dr. Goldberg is a member of the American Medical Association, The American College of Obstetricians & Gynecologists, The Medical Association of Georgia, and The Atlanta Medical Association. Dr. Goldberg's wife Kimberly is a pediatric nurse. Together, they enjoy traveling and spending time with their family.
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