Everything You Need to Know About Artificial Insemination

Conceiving requires sperm to travel up the vagina, through the cervix, into the uterus, and into a fallopian tube where an egg is fertilized.

However, sometimes the sperm isn’t mobile enough to make this trip, or there may be other fertility issues where artificial insemination can help, such as unexplained infertility, or a person may not have a partner with sperm, for instance in a same-sex couple.

Other times, the cervix may not be favorable to allow sperm to travel into the uterus. In these instances and other situations, artificial insemination may help a person conceive.

A doctor may recommend a couple pursue artificial insemination:

• after six months of having unprotected sex if the birthing parent is older than age 35
• after a year of having unprotected sex if the birthing parent is younger than age 35
• in cases of known male factor infertility
• for same sex couples

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:

• You will monitor your ovulation cycle using a calendar method, ultrasound, by taking your temperature regularly, or a combination of these. Sometimes, a doctor may prescribe medications to induce ovulation and increase the likelihood you will release multiple eggs. Clomid is one commonly prescribed medication.
• Your partner will donate sperm for use or you 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.
• You 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.
• You can return to her regular activities after this time. In about two weeks or slightly longer, you’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 you 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.

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

When the procedure is performed with sterile instruments, the risks for infection are minimal. However, it’s possible that you 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.

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

• age
• use of fertility medications
• underlying fertility concerns
• sperm count
• sperm motility

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.

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:

• your partner may have a genetic defect and using donor sperm is preferred
• your partner may have a low sperm count
• your partner may have low sperm motility
• your cervical mucus may be unfavorable to getting pregnant
• you may have a history of endometriosis

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

IUI can cost anywhere from $500 to $4000. This cost varies based on the type of medication used, monitoring and bloodwork, and the insemination itself.

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
• having the sperm processed in a laboratory

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

Some of the benefits of an at-home artificial insemination is that you can be in the privacy of your own home. Most commonly, a practitioner such as a midwife will use an unwashed specimen that’s obtained directly and immediately from your donor or partner, or couples may do this themselves.

At-home inseminations aren’t as regulated as they are at a medical office. For this reason, it’s important that you thoroughly discuss the procedure and its risks and benefits with the person performing the insemination.

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 you to perform on yourself. It can take several attempts before successful conception, or it may not work at all.

If you haven’t gotten pregnant after three cycles of artificial insemination, you may wish to evaluate your additional fertility options with your doctor.

Also, some prospective parents may be unable to do artificial insemination due to underlying fertility problems that make conception unlikely. For example, someone who’s had both fallopian tubes removed won’t be able to get pregnant via artificial insemination.

In these instances, a doctor may recommend a different fertility treatment called in vitro fertilization (IVF). This treatment involves extracting eggs from one parent and sperm from another. The sperm are then used to fertilize an egg in a clinical setting.

The fertilized eggs are allowed to grow as embryos. A doctor will then transfer an embryo or embryos into the uterus in the hopes an embryo will implant and a successful pregnancy will occur.

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 you have had difficulty getting pregnant or wishes to receive assistance in conceiving, you should talk to your doctor about fertility treatment options.