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A method of fertility treatment, artificial insemination is the placement of sperm into a woman’s reproductive tract by means other than sexual intercourse. The procedure can be performed using either a sexual partner’s sperm (husband insemination) or a donor’s sperm (donor insemination).

The two most common types of artificial insemination procedures include intracervical insemination (ICI) and intrauterine insemination (IUI). ICI involves placing especially prepared (or “washed”) semen inside the cervix. During IUI, sperm is injected directly into a woman’s uterus. This allows the sperm to bypass the cervix enabling more sperm to successfully reach the uterine cavity and fallopian tubes where fertilization usually takes place. Both procedures are typically performed at the time of ovulation.

Less common techniques include intrafallopian insemination and intraperitoneal insemination. During these procedures sperm is placed near the mouth of the fallopian tubes and ovaries. Intravaginal insemination is also used on rare occasions. This method places sperm into the vagina.

Couples with infertility issues may benefit from artificial insemination if their problems are related to factors that make it difficult or impossible for the man’s sperm to reach the woman’s uterus. This may be due to issues with the man’s sperm or conditions that prevent the sperm from entering the uterus from the vagina. Artificial insemination may be recommended when the couple or one partner is diagnosed with:

• Unexplained infertility
  
  
• Impotence
  
  
• Premature ejaculation
  
  
• Low sperm count
  
  
• Decreased sperm motility (decreased ability to move)
  
  
• Abnormal sperm morphology (abnormal shape and structure)
  
  
• Sperm antibodies (antibodies produced by the body to destroy the sperm)
  
  
• Hypospadias (a condition in which the urethra opens on the underside of the penis)
  
  
• Drug-induced erectile dysfunction
  
  
• Poor interaction between sperm and cervical mucus
  
  
• Cervix disorders
  
  
• Mild endometriosis
  
  
• Retrograde ejaculation (a condition that causes semen to be released backward into the bladder at male climax)

Artificial insemination may improve the chances of fertilization in couples with these fertility issues. For women undergoing ovulation induction (a form of fertility treatment), the chances are greatly increased because timing the insemination procedure with ovulation is essential.   

Women may also undergo artificial insemination using sperm from a man other than their partner. The donor may be a friend, non-blood relative or an anonymous stranger. Known as donor insemination, this procedure may be recommended for a number of situations, including:

• Male partner infertility (e.g., azoospermia, severe oligospermia or other severe semen abnormalities resulting in infertility).
  
  
• One or both partners carry a heritable disorder. A couple may choose donor insemination when there is potential for hereditary disease in their offspring.
  
  
• Male partner has a sexually transmissible viral infection. Men who have a sexually transmissible viral infection, such as human immunodeficiency virus (HIV) and some forms of hepatitis, risk transmitting the infection to their partner through their semen.
  
  
• Absence of a male partner. Single women and lesbian couples can achieve pregnancy through donor insemination.
  
  
• Failed assisted reproductive technology (ART). Donor insemination may be recommended when ART methods, such as in vitro fertilization (IVF), have failed to result in pregnancy. 

Artificial insemination is not recommended for women who are less fertile because of tubal factors, uterine malformations, active pelvic infection or anovulation (failure or absence of ovulation).