ARTIFICIAL INSEMINATION - BY DR. SUNIL DUCHANIA

1.  By Dr Sunil
duchania

2. Art and science of getting gametes together
May be done by artificial or partially artificial means
May or may not involve third party

3.  ICMR(National guidelines for accreditation,
supervision and regulation of ART clinics in
India,2005-NG,2005.
 No punishment have been mentioned .

4.  Artificial insemination
 Conventional in- vitro fertilization and embryo
transfer (IVF-ET,TEST TUBE BABES)
 Surrogate motherhood
 Embryo donation
 Gamete intrafallopian transfer (GIFT)
 Intracytoplasmic sperm injection(ICSI)
 Zygote intrafallopian transfer(ZIFT)

6.  TYPES
 Artificial insemination homologous (AIH)
 Artificial insemination donor(AID)
 Artificial insemination homologous and donor
(AIHD)

7.  AIH-male factors
 Impotence, physical anomaly, posthumous
assisted reproduction
 -female factors
 AID-sterility, wife is isoimmune to husband’s
sperm, HIV or HEP b infection, lesbian couples,
 AIHD-oligozoospermia

8.  Consent of donor ,recipient and their spouses
 Donor
 Couple should be psychologically fit and
emotionally stable.
 Delivery should not be done by the physician who
performed AI.

9. Female reproductive system

11. Normal Fertilization

12. Hormonal
treatment
Female
Harvest
the ovum
Mix in a test tube
Natural
ejaculation
Collect semen
Mature Ova
Motile sperms
Keep to
develop
embryo
Transfer
to mother
Male
Basic Principle of IVF

14. Fig 1

17. Gamete intrafallopian transfer (GIFT): GIFT is similar to IVF. It is used when a
woman has at least one normal fallopian tube. Eggs are placed in this tube
along with a man’s sperm to fertilize there.
Zygote intrafallopian transfer (ZIFT): ZIFT is tubal embryo transfer in which a
woman’s eggs are taken from her ovaries, fertilized in the laboratory, and put
back in the fallopian tubes rather than the uterus.
Assisted fertilization techniques when not enough sperm are available or sperm
quality is not sufficient to fertilize include the following:
• Partial zona dissection
• Subzonal sperm injection
• Intracytoplasmic sperm injection
• Embryo cryopreservation (frozen fertilized egg and sperm)
Alternates of IVF

18. ICSI
Stands for intracytoplasmic sperm injection. This process is used to inject
a single sperm into each egg before the fertilized eggs are put back into the
woman's body. The procedure may be used if the male has a low sperm
count.

19. Normal results
Success rates vary widely between clinics and between physicians performing the
procedure and implantation does not guarantee pregnancy. Therefore, the procedure
may have to be repeated more than once to achieve pregnancy. However, success rates
have improved in recent years, up from 20% in 1995 to 27% in 2001.
Abnormal results
An ectopic or multiple pregnancy may abort spontaneously or may require termination if
the health of the mother is at risk. The number of multiple pregnancies has decreased in
recent years as technical advances and professional guidelines have led to implanting of
fewer embryos per attempt.

20. • Bypassing the natural method of conception.
• Fertilization of more embryos than will be needed.
• Unnatural environment for embryos.
• Not affordable for many.
• Exposure of embryos to unnatural substances.
• Potential to create embryos for medical purposes.
• Potential to modify embryos.
• Financial rewards for IVF doctors dissuade them from recommending
other methods to couples.
• Infertility is treated as a disease and not as a symptom of underlying
medical problems.
Ethics

22.  No law on Artificial Insemination applicable in the
entire country.
 The Delhi Artificial Insemination (human) Act 1995
is applicable only in Delhi .

23.  Passed to regulate of donation,sale,and supply of
human semen and ovum
 Main provisions
 All semen banks in Delhi would have to be duly
registered.
 Renewal of registration every year.
 Certification by DHS ,Govt. of NCT Delhi.
 Running without registration –fine of 5000 and for
subsequent offences fine of 5000 or 3 months
imprisonment

24. Duties of qualifies medical practitioner
(s.14)
Keep complete record of bio data.
Written consent
No segregation of XX and XY chromosomes
Maintain secrecy about the identity
Test for HIV 1,2 Before donation

25.  ADULTERY-AID without husband’s consent can
however be a ground for divorce or judicial
separation.(S.3.16.2)
 CONFIDENTIALITY-(S.3.2.3,NG2005)
 CONSUMMATION OF MARRIAGE (S.3.16.3)
 DAMAGES
 INCEST
 LEGITIMACY(S.3.12.1,NG2005)

26. CHILD BORN THROUGH ART –(S.3.12,NG2005)
UNMARRIED WOMAN OPTING FOR AID
MINIMUM AGE FOR ART (S.3.14.1,NG 2005)
POSTHUMOUS AIH(S.3.12.5,NG 2005)

27. Under consideration in the dept. of health
research ,Ministry of Health and Family
Welfare,GOI.
For proper regulation and supervision of ART clinics
and banks in India.

28.  To establish the National Advisory Board, the
State Advisory Boards and the National Registry
for the accreditation ,regulation and supervision of
ART clinics .
 Prevention of misuse of assisted reproductive
technologies.

29. Thank you