Infertility and New

Reproductive Technologies
ARTIFICIAL INSEMINATION
(therapeutic option)
By: Honeylette M. Brotonel
Conjugal Love

 Procreative
 Unitive
 Child is conceived
 out of love
 for love

 To “create” a child
outside conjugal love
is considered
immoral.
 Artificial Insemination
 Sperm is placed in a woman’s
reproductive tract by means other than
sexual intercourse
 Sperm
 From spouse: Artificial Insemination by
Husband (AIH)
 From a donor: Artificial Insemination by Donor
(AID)
 History
 ???? - First artificial insemination attempt on Juana, wife of King Henry
IV of Castile.
 1677 - Anton Von Leeuwenhoek visualized spermatozoa under the
microscope.
 1780 - Spallanzani’s experiment proved that physical contact between
the male and female gamete is required for successful embryo
development.
 1899 - Russia works towards development of Artificial
Insemination methods.
 1922 - Reports of successful insemination experiments in horses
published.
 1939 - G. W. Salisbury pioneers research in animal breeding and artificial
insemination.
 1940 - Technical improvement in freezing and thawing of sperm
preparations.
 1950’s - Cornell suggests idea of adding anti-biotic to the sperm preparation
media.
 1953 - The first successful artificial insemination with frozen human
semen was achieved.
 1970, 1980’s - Enhancement in the sperm collection techniques.
 Commonly Used for Infertility
Associated with:

 Endrometriosis
 Disease state in which the endometrial tissue
has spread elsewhere (ovaries)
 Commonly Used for Infertility
Associated with:
 The hormones that stimulate egg
development must be made in the
brain and pituitary and be released
 Unexplained
properly Fertility
 The egg must be of sufficient  Idiopathic infertility
quality and be chromosomally
normalThe egg must develop to  Cases are those in
maturity which standard infertility
 The brain must release a sufficient testing has not found a
surge of the LH hormone to cause for failure to
stimulate final maturation of the conceive
eggThe follicle (eggs develop in
structures called follicles in the  A weak link anywhere
ovaries) must rupture and release
the follicular fluid and the egg in this chain can cause
 The tube must "pick up" the failure to conceive
eggThe sperm must survive their
brief visit to the vagina, enter the
cervical mucous, swim to the
fallopian tube and "find" the egg
shell (zona pellucida) of the egg
Commonly Used for Infertility
Associated with:
 Anovulatory Infertility
 Women who do not
properly develop and
release egg every
month

 Polycystic ovarian
syndrome (common
cause)
Commonly Used for Infertility
Associated with:
 Mild degree of male
factor infertility

 Picture of human sperm in

a counting chamber
(hemocytometer); tool used
in determination of sperm
counts
 Commonly Used for Infertility
Associated with:

 Cervical Infertility

 Immunologic
Abnormalities
 Donor Variation
 Indication for artificial insemination with
husband’s sperm (AIH) include:

 Male problems that prevent normal

deposition of sperm into the vagina
 Premature ejaculation
 Impotence
 Retrograde ejaculation
 Donor Variation
 Problems with the woman that prevent normal
deposition of sperm into the vagina.
 painful intercourse
 physical deformities
 Cervical factors.
 narrowed cervix
 absent, abnormally thick or acidic cervical
mucus
 Donor Variation
 Suboptimal semen quality.
 Artificial insemination can ensure that most of the
sperm in an ejaculate of low volume will get past the
vagina into the upper reproductive tract of the woman
 Use of frozen husband's sperm.
 Donor Variation
 Indication for artificial insemination with
donor’s sperm (AID) include:
 Azoospermia - the absence of sperm
 Oligo-astheno-teratospermia - sperm that are
of low supply, having poor quality motion
and/or abnormally shaped
 Avoidance of transmission of genetic
abnormalities.
 Reproduction by single or lesbian women.
 Selection and Screening of the
Donor
 21-35 years old
 Excluded:
 sexually transmitted disease
 Hepatitis or acquired immune deficiency
syndrome
 Genetically transmittable disease in the
donor’s family
 Use of recreational drugs
 Excessive alcohol
 Site of Insemination
 Depends on the type of infertility

Intracervical Insemination
Intrautrauterine Insemination
 Technique
1. Woman is stimulated with medication.
2. Semen specimen is produced.
Abstinence from ejaculation (2-5 days)
3. The semen is “washed” in the laboratory.
 20-60 minutes
4. The specimen is placed above the level
of vagina using a catheter.
 Technique
 Single insemination is planned for the expected
day of ovulation each cycle.

 The day of insemination(s) may be determined

by several means. Some woman will utilize a kit
that detects the LH surge in her urine. Ovulation
is most likely to occur on the day after the LH
surge is first appreciated.
 Ultrasound evaluation of follicle growth
 Blood testing
 Technique
 There is also the administration of an injection of
human chorionic gonadotropin (hCG) to some
patients (who are usually receiving other fertility
drugs) in order to "trigger" ovulation.
 artificial insemination will usually be scheduled for 36-
44 hours after the hCG injection when a single
insemination is planned or at approximately 24 and 48
hours after the hCG injection when two inseminations
are to be done.
Complications
 Rare

 Infection or allergic
reaction to sperm
 Fever, chills, and
lower abdominal pain

 Multiple pregnancy
Ethical Issues: Heterologous
Artificial Insemination
 Fusion of gametes of at
least 1 donor other than
the spouse
 Respect for the unity of
marriage and for conjugal
fidelity demands that the
child be conceived in
marriage; the bond
existing between
husband and wife
accords the spouses, in
an objective and
inalienable manner, the
exclusive right to become
father and mother solely
through each other.
 Ethical Issues: Heterologous
Artificial Insemination
 Heterologous artificial
fertilization violates the
rights of the child.
 It offends the common
vocation of the spouses
who are called to
fatherhood and
motherhood: it objectively
deprives conjugal
fruitfulness of its unity
and integrity; it brings
about and manifests a
rupture between genetic
parenthood, gestational
parenthood and
responsibility for
upbringing.
 Ethical Issues: Homologous
Artificial Insemination

 Artificial insemination as a substitute for the conjugal act

is prohibited by reason of the voluntarily achieved
dissociation of the two meanings of the conjugal act.
Masturbation, through which the sperm is normally
obtained, is another sign of this dissociation: even when
it is done for the purpose of procreation, the act remains
deprived of its unitive meaning: "It lacks the sexual
relationship called for by the moral order, namely the
relationship which realizes 'the full sense of mutual self-
giving and human procreation in the context of true love.
 VIRTUES OF A CATHOLIC
HEALTH CARE GIVER
 FIDELITY
 HONESTY
 HUMILITY
FIDELITY
 Faithfulness to trust
and promise
 Trust: basis of
patient-healthcare
professional
relationship
 Keep the patient’s
best interest first in
mind
FIDELITY
 Providing competent care
 Avoid: using the patient
as means to advance
one’s power or exploiting
a patient in research
 Respect the dignity of
man
 Provide the truth
 Obtaining the free and
informed consent
 HONESTY
 Truthfulness and
integrity

 Convey the truth

 Telling the patient the

truth about the illness,
benefits and burdens
of alternative actions
 HUMILITY
 Recognizing one’s
capabilities and
limitations

 Recognizing the
patient as one who
knows and should
decide what is best
for one