How is insemination performed?

1. The Surrogate Mother usually is given medication to stimulate mutiple egg development and the insemination is timed to coincide with ovulation.

2. A semen specimen is either produced at home or in the office by masturbation after 2-5 days of abstinence from ejaculation.

3. The semen is "washed" in the laboratory (called sperm processing or sperm washing). By this process, the sperm is separated from the other components of the semen and concentrated in a much smaller volume. Various media and techniques can be used to perform the washing and separation, depending on the specifics of the individual case and preferences of the fertility doctor and laboratory. The sperm processing takes about 20-60 minutes, depending on the technique utilized.

4. A speculum is placed in the vagina and the cervical area is gently cleaned.

5. Then the separated and washed specimen consisting of a purified fraction of highly motile sperm is placed either in the cervix (intracervical insemination) or higher in to the uterine cavity (intrauterine insemination, IUI) using a sterile, thin and soft catheter. Intrauterine insemination has a better success rate than intracervical insemination. Therefore, it is the preferred method at the large majority of fertility centers.

Most programs offer to let the Surrogate remain lying down on the exam table for a few minutes following the IUI procedure, although this has not been shown in studies to improve pregnancy rates. Since the sperm is above the level of the vagina and cervix, it will not leak out when she stands up.

The intrauterine insemination procedure, if done properly, should seem similar to a pap smear for the Surrogate. There should be little or no discomfort.