Artificial insemination consists of introducing into the uterus, on the day of ovulation, previously prepared spermatozoa. There are two types of artificial insemination: artificial insemination with sperm sperm (IAC) and artificial insemination with donated sperm (IAD).

The IAC can be offered to the couple in different situations:

• unexplained infertility. Artificial insemination then makes it possible to optimize the chances of fertilization by playing on various factors: the quality of the sperm, the passage of the cervix, the quality of ovulation, the timing of the meeting between the oocytes and the sperm.
• ovulation disorders, after failure of simple ovarian stimulation
• an obstacle at the level of the cervix (abnormality of the cervix, cervical mucus)
• moderate endometriosis (provided the tubes are healthy)
• moderate male infertility
• ejaculation disorders
• a viral risk (HIV, hepatitis B and C)

In all cases, artificial insemination requires in women:

• normal levels of the hormones FSH, estradiol and AMH
• a sufficient number of antral follicles (between 5 and 9 mm in size)
• one or two permeable tubes.

In men: at least 500 to 000 million motile and normal spermatozoa (1).

Artificial insemination with sperm donation is proposed in the event of male infertility or hereditary disease in the spouse.

Artificial insemination takes place in several stages:

• ovarian stimulation is not compulsory, but frequent. The administration of hormones by oral or injectable way makes it possible to obtain a follicular development and a quality ovulation with often two follicles, even three, against only one for a spontaneous cycle, which thus optimizes the chances of fertilization. Throughout the stimulation phase, follicular development is closely monitored using ultrasound scans and hormone assays to avoid ovarian hyperstimulation and multiple pregnancy.
• the onset of ovulation: when the ultrasound shows one to two (or even 3) mature follicles (diameter between 14 and 20 mm2), an endometrium of satisfactory thickness (for a good implantation of the embryo) and a With adequate estradiol, ovulation is triggered with a hormone injection.
• collection and preparation of sperm: the spouse’s sperm is collected after abstinence for 2 to 3 days. It is then prepared in the laboratory in order to separate the sperm from the seminal fluid and to keep only the most motile normal sperm. The best pregnancy rates are obtained when the number of inseminated progressive motile sperm (NSMI) is between 1 and 10 million3.
• insemination: 36 hours after the onset of ovulation, the actual insemination takes place. Using a thin catheter, the doctor deposits the sperm inside the uterus (intra-uterine insemination). -uterine), more rarely in the cervix (intra-cervical insemination). This gesture does not require anesthesia or hospitalization.

• in 2003, 52560 artificial inseminations with the partner’s sperm were performed, resulting in the birth of 5792 children.
• 3833 artificial inseminations with sperm donation (intra-cervical or intra-uterine) were performed; 743 children were born.
• among the 23 children born from ART, 651% (28 children) were conceived by intrauterine insemination
• the delivery rate is 10% after artificial insemination with partner’s sperm, 18,4% after intrauterine insemination with donated sperm and 12,6% after intra-cervical insemination with donated sperm.