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7 - Cervical factor, unexplained subfertility and artificial insemination with husband sperm

Published online by Cambridge University Press:  06 July 2010

Gabor T. Kovacs
Affiliation:
Monash University, Victoria
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Summary

The first recorded AIH in the human was allegedly performed by Doctor John Hunter during the late 18th century. His nephew, Sir Everard Home, reported a normal pregnancy and delivery as a result of the procedure in the wife of a London linen merchant (Finegold, 1980).

A new wave of scientific interest in AIH emerged during the 1970s. This was probably stimulated by the emerging attention paid to subfertility, and the inability of any preparations consistently to improve semen quality in subfertile men. In 1978, the First International Symposium on Artificial Insemination Homologous and Male Subfertility was held in Bordeaux, France, and was attended by many distinguished clinicians from all over the world (Emperarire and Audebert, 1978). Subsequently, the indications for AIH have been classified into five groups.

  1. Mechanical problems in the male, i.e. impotence, hypospadias, premature ejaculation, or retrograde ejaculation.

  2. Mechanical problems in the female such as vaginismus or prolapse.

  3. ‘Cervical hostility’.

  4. Impaired semen quality – of volume, concentration, motility, morphology or the presence of antibodies.

  5. Unexplained subfertility.

Mechanical problems in the male

If there is inability by the male to deposit semen at the top of the vagina, conception is unlikely to occur. By artificially depositing semen at the exocervix during the fertile phase, the problem is easily overcome and pregnancy results. In the case of retrograde ejaculation, the semen needs to be recovered from the urine after ejaculation and, to prevent acid damage, the urine needs to be alkalinized in advance (Mahadevan, Leeton and Trounson, 1981).

Type
Chapter
Information
The Subfertility Handbook
A Clinician's Guide
, pp. 83 - 87
Publisher: Cambridge University Press
Print publication year: 1997

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