What Injection Code To You Use For Lower Back L1-L2 Cervical Conception Cap Insemination

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Cervical Conception Cap Insemination

Many infertile couples find that there are few satisfactory therapeutic options between ovulation timing and IVF. There is another lesser-known treatment category that couples can consider; cervical cap insemination. To use this technique, the sperm is collected and placed in a small cap, which is placed in the vagina and on the cervix, the opening of the uterus. The sperm are next to the cervical mucus, while they are protected from the vaginal environment. Without this protection, sperm will die within minutes of intercourse. Sealing the sperm on the cervix allows all available sperm to swim up to the uterus and fallopian tubes, where the egg will be. Cervical caps can be used to treat low sperm count, low sperm motility, tilted cervix and other common conditions.

The cervical cap has been used by gynecologists and urologists for decades and has been documented in the medical literature since the first edition of Fertility and Sterility in 1950. At the time, Dr MJ Whitelaw wrote about the insemination technique “using a plastic cervical cap”. filled with the husband’s sperm, which was placed on the cervix for 24 hours.” (1) This was done to treat oligospermia, i.e., low sperm count. At the time, other obstetricians and gynecologists also performed cervical cap insemination, but with a heavier, surgical steel cup, the women undergoing treatment had to lie in a medical examination room with their hips elevated for six hours.

Cervical insemination was widely used in the 1970s and 1980s. Effective in the treatment of low sperm count and tilted cervix, it has also been used in unexplained infertility. In 1983, Dr. Michael Diamond and colleagues found that women with primary infertility who had never been pregnant had a 43% pregnancy rate in the first six months of using a cervical cap. In women with secondary infertility who had a history of at least one pregnancy, the rate in the first six months of pregnancy was 67%. (2) Their method was a cervical cap that the patient placed on the cervix and then filled with sperm using a catheter that fits into a small opening in the cap. Couples treated in this study generally had low sperm counts and/or poor postcoital test results, but the female was assessed as normal. Doctors in the study also offered insemination to couples who did not complete a full evaluation, which at the time included a diagnostic laparoscopy. This allowed patients to continue trying to get pregnant and have all their cycles while still considering advanced options.

Finally, with the advent of in vitro fertilization (IVF) and then intracytoplasmic sperm injection (ICSI), cervical cap fertilization was left behind. During the economic boom of the 1990s, with more discretionary income, couples had access to many tests and procedures, even if their insurance did not cover them. Tests such as hamster egg penetration, hypoosmotic swelling test, and antibody test, which were popular a few years ago, are not ordered as often by doctors today, citing the value of the results obtained compared to the money spent. ICSI, which was developed to treat low sperm count, is now most often used by IVF clinicians. According to the most recent data collected, The Society for Assisted Reproductive Technology (SART) reported that in 2006, 62% of all IVF cycles used ICSI. In 2007, a study published in the New England Journal of Medicine showed that over a decade, the rate of ICSI use increased fivefold, although sperm quality parameters remained essentially unchanged over the same period.

While the cost and use of high-tech treatments have skyrocketed in recent years, the cervical cap and home insemination are quietly making a comeback. Couples interested in more cost-effective, natural methods are looking for other options for conception. At-home cervical cap insemination is a treatment option that fits into several places in a couple’s fertility planning. For couples just starting their fertility journey, home insemination can be used as a first step, especially if one or both partners are reluctant to spend a lot of time in the doctor’s office. For those who are trying to conceive over several cycles and may be taking fertility drugs to boost ovulation, a cervical cap can add another valuable tool to your treatment plan. Finally, couples undergoing an IVF cycle or who have had IVF in the past may want to try a home fertilization method during their cycles away from more aggressive treatments. This technique is also beneficial for single mothers of choice as an alternative insemination system.

Cervical caps, also used for contraception to prevent pregnancy, are part of the Code of Federal Regulations (CFR). The current name for the cervical cap devices used for insemination is the conception cap. Cervical caps currently available for home insemination are a modern update of the old rigid plastic or metal caps. The newer version is made of soft, implantable silicone and has flanges on the inner rim, so it doesn’t have to be custom fitted in one size. It can be worn during normal activities, leaving women free to go about their normal daily routine.

The 2007 FDA-approved clinical trial was designed to include couples diagnosed with infertility; most have tried other methods, such as IVF and IUI. According to the results, 84% of patients found the cervical cap easy to place on the cervix and 92% of patients found the instructions easy to understand. 24% of patients in the clinical trial became pregnant within the first month, including couples who had failed IVF and IUI attempts. (3)

The use of the cervical cap has shown positive results in the past and may make a significant contribution to the future of reproductive medicine. With medical costs beyond the average consumer’s ability to pay, home IVF can be an attractive option to continue family building during tough economic times.

Footnotes

1. Whitelaw MJ. 1950. Use of the cervical cap to increase fertility in oligospermia. Fertility and sterility. 1:33 a.m.

2. Diamond, MP, Christianson C, Daniell JF, Wentz AC. Pregnancy after using the cervical cup for artificial insemination at home with homologous sperm. Fertility and sterility. April 1983; Article 39, paragraph 4; 480-4.

3. Conception Kit clinical trials, Conceivex. 2006-2007

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