Looking for a pregnancy and not getting it can be a difficult time in the life of a couple (or a single person).
The advantage today is that if there are difficulties conceiving, there are many assisted reproduction techniques with a very high degree of success.
The reality is that we have the feeling that it is more common every day: we know of cases around us, there are many more twins than before (the result of artificial inseminations and fertilizations in vitro), and people often talk about their fertility treatments in a (slightly) more open way.
But... although it may seem like it, fertility aid techniques are nothing new. First in animals and then in humans, since ancient times attempts have been made, with the difficulties of each era, to help overcome obstacles between couples when it comes to conceiving.
History of assisted reproduction
A well-known and documented case of Artificial Insemination, a prelude to a civil war, already took place during the time of the Catholic Monarchs.
A Jewish doctor introduced the semen of King Henry IV of Castile, called "The Impotent" into the body of his wife, Queen Joan of Portugal, through a gold cannula.
The queen finally had a daughter, Princess Juana, but doubts about the technique became evident, since the monarch had no more offspring either with another wife or with lovers.
Evil tongues said that she was not the daughter of the king, but of one of his trusted men: Beltrán de la Cueva, which caused the young woman to receive the nickname "la Beltraneja."
Furthermore, due to this fact, she was not recognized as her father's heir by half of the population.
First cases of fertilization in vitro
The first fertilization in vitro World Cup was in 1977, but although there was fertilization and implantation, the embryo did not survive and was lost after a few weeks.
The first child born by fertilization in vitro It was a year later, in 1978, in England, it was a girl, Louise Brown.
In Spain, the first case was in 1984 in private healthcare, and in 1985 in public healthcare.
It was not until July 1987 that the first case of birth after freezing and thawing embryos occurred and, a year later, in 1988, the first successes in oocyte donation. In 2007, the first positive case was achieved in Spain after oocyte vitrification.
What is assisted reproduction for?
Today, assisted reproduction techniques allow many couples around the world to overcome physical and physiological obstacles, both male and female.
Assisted reproduction for problems in men
Assisted reproduction helps men who have problems with sperm quality and quantity, retrograde ejaculation or erection problems, among others.
Assisted reproduction for problems in women
In the case of women, the different assisted reproduction techniques can help with alterations in ovulation, problems with patency of the fallopian tubes, cases of endometriosis or vaginismus.
Assisted reproduction for problems in men and women
Furthermore, the different types of assisted reproduction allow us to solve problems that can occur in both men and women: immunological or hereditary problems.
What are the technical differences between Artificial Insemination and IVF?
Both techniques are used to increase women's chances of pregnancy.
And, although there are nuances and variants, these two techniques continue to be the two main tools within fertility aid or assisted reproduction programs.
But let's look at the differences that exist between both techniques.
Place of fertilization
The main difference between artificial insemination and fertilization in vitro is he place where fertilization occurs It is yes, that is, the place where the union between the woman's egg and the man's sperm occurs.
In the case of artificial insemination (INS), this process occurs inside the woman. On the one hand, the route that the sperm have to take to reach the egg is artificially shortened and, on the other, the optimal moment for this encounter to occur inside the woman is monitored.
In the case of fertilization in vitro (IVF), the meeting between the egg and the sperm occurs outside the woman's body, in a test tube. The process is more controlled. As soon as fertilization has occurred, the fertilized egg or eggs are introduced into the woman's body for implantation to occur.
Degree of interventionism
The artificial insemination process is less directed and somewhat more natural (although hormonal processes are involved) and fertilization in vitro It's more controlled.
Egg donation and sperm donation options
fertilization in vitro, for its part, offers more options to help fertility in the sense that both the egg and the sperm could be from a donor, if necessary.
In artificial insemination, only the sperm could be from a donor. The woman must have a good baseline ovarian reserve.
Ovarian stimulation of women
On the other hand, although in both processes hormonal stimulation is caused in the woman, in Artificial Insemination this stimulation is very mild.
Nowadays, it would not make sense to stimulate a woman too much so that she could become pregnant naturally from a multiple pregnancy, with the risks that entails.
At fertilization in vitroOn the other hand, the stimulation is stronger voluntarily. The objective is for the woman to generate more eggs than normal, so that these can be extracted, fertilized in the laboratory and the desired embryos can be transferred to the woman. The rest of the fertilized embryos can be frozen for future occasions.
There is also the possibility of carrying out what is known as Mini IVF: a fertilization in vitro with lower hormonal load, lower stimulation and lower number of final follicles available for fertilization.
Necessary surgical intervention
In the case of fertilization in vitro A small surgical intervention is necessary for the woman to extract her own oocytes, while in artificial insemination this step does not exist.
Extra IVF alternatives
Finally, IVF also allows two modalities that help overcome some particular circumstances.
For fertilization, in the same test tube the egg and sperm can be placed close to each other so that it is expected that they will naturally find each other. This technique has its defenders and its detractors.
On the one hand, it is believed that in this way the best sperm is the one that manages to arrive. On the other hand, there is a greater risk that fertilization may not take place.
The other, opposite technique, forces fertilization by making a puncture in the membrane of the egg and thus directly introducing the sperm. This technique, known as intracytoplasmic sperm microinjection (ICSI), is not always necessary, but there are couples for whom this technique allows them to finally achieve pregnancy.
Final price of the treatment
Finally, another important difference is the price of the treatment. Being more complex and controlled, fertilization in vitro It is worth more money than artificial insemination.
We have seen that there are numerous differences between fertilization in vitro and artificial insemination, although both aim to achieve pregnancy in cases where the positive result is not achieved naturally.
In the next post I tell you who each technique is aimed at and how to choose it according to the situation, as well as the success rates.
It may interest you:
- Natural therapies in assisted reproduction processes
- How to choose the best assisted reproduction clinic
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