What is artificial insemination?

Artificial insemination is a fertility treatment method used to deliver sperm directly to the cervix or uterus in the hopes of getting pregnant. Sometimes, these sperm are washed or “prepared” to increase the likelihood a woman will get pregnant.

Two chief approaches to artificial insemination exist: intrauterine insemination (IUI) and intracervical insemination (ICI). Some women may also take medications to stimulate ovarian follicle growth and increase conception chances.

What is the process?

Conceiving requires a man’s sperm to travel up the vagina, through the cervix, into the uterus, and into a fallopian tube where an egg is fertilized. However, sometimes a man’s sperm isn’t mobile enough to make this trip. Other times, a woman’s cervix may not be favorable to allow sperm to travel into the uterus. In these instances and other situations, artificial insemination may help a woman conceive.

A doctor may recommend a couple pursue artificial insemination:

  • after six months of having unprotected sex if a woman is older than age 35
  • after a year of having unprotected sex if a woman is younger than age 35

ICI

ICI is a type of artificial insemination that involves inserting sperm into the cervix. This is the passageway just outside the uterus. This approach can be used in a doctor’s office or at home. The steps for this process include:

  • A woman will monitor her ovulation cycle using a calendar method, ultrasound, by taking her temperature regularly, or a combination of these. Sometimes, a doctor may prescribe medications to induce ovulation and increase the likelihood a woman will release multiple eggs. Clomid is one commonly prescribed medication.
  • A woman’s partner will donate sperm for use or a woman will obtain a sperm sample from a donor.
  • A doctor will insert sperm into the vagina using a special syringe. Another option is to place the sperm in a cervical cap that’s inserted into the cervix and stays for a designated amount of time.
  • A woman will typically be instructed to lie down for 15 to 30 minutes. This ideally allows the sperm to move up from the cervix into the uterus.
  • A woman can return to her regular activities after this time. In about two weeks or slightly longer, she’ll take a pregnancy test to determine if the insemination process was successful.

IUI

IUI is a procedure that involves inserting sperm past the cervix and directly into the uterus. The steps for this process are similar to that of ICI, but are usually performed at a doctor’s office and with specially prepared sperm. Additional steps include:

  • The semen is prepared or “washed” to remove potential proteins that could affect fertilization. This also makes the sperm more concentrated. Ideally, this will increase the likelihood a woman will conceive.
  • A doctor will use a special instrument called a speculum to make the uterus easier to access. They’ll use a special, thin instrument inserted through the vagina and place the sperm into the uterus.

What are the side effects?

Some women may experience some cramping or light bleeding following the procedure. Others may not experience any residual effects at all.

When the procedure is performed in a sterile fashion, the risks for infection are minimal. However, it’s possible that a woman could experience a pelvic infection or inflammation after the procedure.

There’s another side effect that’s important to consider. Taking fertility medications along with artificial insemination increases the likelihood for multiple children, such as twins or triplets.

A common misconception about artificial insemination and taking fertility medications is that they’re associated with a greater risk for birth defects. This isn’t true, according to the American Society for Reproductive Medicine.

How successful is it?

The success of artificial insemination depends on more than the approach taken. Factors include:

  • a woman’s age
  • use of fertility medications
  • underlying fertility concerns

Success rates for ICI

According to a research study published in the journal Human Reproduction, the pregnancy rate for ICI is 37.9 percent after six treatment cycles.

Success rates for IUI

The same study found a 40.5 percent success rate for IUI after six treatments.

According to an article in the Journal of Andrology, pregnancy success rates for IUI are higher after six cycles of IUI compared with the same amount of ICI cycles. This is likely due to the more direct placement and preparation of highly concentrated sperm. According to the University of Wisconsin Hospitals and Clinics, preparing a sperm sample in a laboratory increases the concentration of sperm by 20 times.

What are the benefits?

Artificial insemination can be a beneficial and successful treatment for some couples who have trouble conceiving. Some of the conditions a doctor may recommend artificial insemination for include:

  • couples where a man may have a genetic defect and using donor sperm is preferred
  • men with a low sperm count
  • men with low sperm motility
  • women whose cervical mucus may be unfavorable to getting pregnant
  • women with a history of endometriosis

Artificial insemination also provides the benefit that a single woman or a same-sex couple can get pregnant using donated sperm.

How much does it cost?

According to the University of Wisconsin Hospitals and Clinics, IUI can cost anywhere from $460 to $1,500. This cost doesn’t include prices for fertility medications.

However, there may be other costs prior to the insemination itself. This can include consultation, semen testing, and ultrasound monitoring.

Sometimes, an insurance company will cover a portion of the costs related to artificial insemination. IUI tends to be more expensive than ICI because:

  • it’s more invasive
  • performed at a doctor’s office
  • usually involves sending the sperm to a laboratory

Can it be done at home?

Some women may choose a home insemination. Most commonly, home inseminations are ICI procedures.

Some of the benefits of an at-home artificial insemination is that a woman can be in the privacy of her own home. Most commonly, a practitioner such as a midwife will use an unwashed specimen that’s obtained directly and immediately from a man.

At-home inseminations aren’t as regulated as they are at a medical office. For this reason, it’s important that a woman or couple thoroughly discuss the procedure and its risks and benefits with the person performing the insemination. A home environment increases risk of infection over a clinical environment.

People can also purchase at-home insemination kits. These kits come with containers for semen and syringes to collect the semen and insert it through the vagina. While the procedure is fairly straightforward, it may be difficult for a woman to perform on herself. It can take several attempts before successful conception.

Alternatives to artificial insemination

If a woman hasn’t gotten pregnant after six cycles of artificial insemination, she may wish to evaluate her additional fertility options with her doctor. Also, some women may be unable to do artificial insemination due to underlying fertility problems that make conception unlikely. For example, a woman who’s had both fallopian tubes removed won’t be able to get pregnant via artificial insemination.

In these instances, a doctor may recommend an additional fertility treatment called in vitro fertilization (IVF). This treatment involves extracting eggs from a woman and sperm from a man. These are sent to a laboratory, where sperm are used to fertilize an egg in a laboratory setting. The fertilized eggs are allowed to grow as embryos. A doctor will then transfer an embryo or embryos into a woman’s uterus in the hopes an embryo will implant and a successful pregnancy will occur.

What’s the outlook?

Artificial insemination is a treatment that’s providing many couples, including same-sex couples and single women across the country, the chance to get pregnant after having difficulty conceiving. If a woman has had difficulty getting pregnant or wishes to receive assistance in conceiving, she should talk to her doctor about fertility treatment options.