Knowing your options can help you make the right decisions on your fertility journey. This is why at-home insemination worked for us.
My wife and I always knew we’d have to find sperm some day.
When we were eventually ready to have kids, we balked at how much of our savings meant for our future kids would end up being spent on creating those kids. That’s part of what sent us down the path of using a friend as a sperm donor for DIY insemination at home.
Of course, as with any DIY project, there were questions to research and methods to understand.
How do we get the semen from our donor into one of us? How long can it survive outside a body? Are there any infection risks? What are the success rates? What can we do to boost the chance of pregnancy?
Without using a clinic, we didn’t have anywhere to turn with these questions except the internet.
Thankfully we found our answers and achieved three pregnancies at home without any clinic.
An insemination is any time sperm is put into another body, intercourse included. Artificial insemination is when sperm is put into another body without intercourse.
An at-home or home insemination is when this is done outside a clinic. There are a few different ways this can be done, which I’ll get into below.
Folks who are using inseminations to get pregnant are often not in that situation as their preferred way to make a baby. Maybe their reproductive organs don’t match up for reproduction (like a couple with two uteruses and no sperm) or they’re experiencing infertility.
People may choose to make the insemination process more personal and less medical by trying to get pregnant at home, avoiding the sterile setting at a clinic where strangers are involved in the intimate process.
In-clinic inseminations also come with extra costs because of the staff and facilities involved, so trying at home can save a significant amount of money.
One woman told me that she liked the increased flexibility of home inseminations as opposed to having doctor’s appointments at certain times that might be hard to schedule around her work hours.
In a world changed by COVID-19, home insemination can be the “perfect option,” according to Fredrik Andreasson, CEO of Seattle Sperm Bank.
He said clinics are hearing from clients that they want to continue with their monthly tries at home even when a clinic closes due to being “nonessential.”
For his own bank, Andreasson shares that while requests for sperm shipments to clinics decreased by 50 percent since the COVID-19 outbreak in the United States, their shipments to residences haven’t gone down at all.
There are two types of artificial insemination that can be done at home:
- intracervical insemination (ICI), which involves putting sperm into the vagina, as would happen with intercourse
- intrauterine insemination (IUI), which involves putting sperm directly into the uterus using a tube that goes through the cervix
IUI is almost always performed by a medical professional. However, that doesn’t mean IUI can’t happen at home. Some trained midwives make house calls for this procedure.
Regarding success rates of at-home versus clinic insemination success rates, as well as ICI versus IUI, here’s what we know:
older 1988 studyshowed no statistical difference in pregnancy rates between 53 infertile women trying artificial insemination at home versus a clinic.
2001 studyof 62 women over 189 cycles found that IUI had higher monthly success rates than ICI (15 percent versus 9 percent).
- A 2015 study of 1,843 women found pregnancy rates over six cycles were only slightly higher for IUI (40.5 percent) versus ICI (37.9 percent), with researchers noting “no substantial benefit of IUI over ICI.”
2017 studyof three different groups of couples (ages 20 to 33 years, 33 to 36 years, and 36 and up) found at home insemination an effective way of achieving pregnancy, with success rates of 69 percent, 43 percent, and 25 percent in the three different groups over six cycles.
The most important factors for success rates are nailing the perfect timing of the insemination, the quality and quantity of the sperm sample, and the age and the hormones in the body being inseminated — not necessarily the building where the insemination happens.
If you like, you can visit with a fertility specialist and ask questions about insemination processes up front. Going to a doctor doesn’t mean you’re automatically signing up for anything or committing to an in-clinic procedure. You’re simply getting the facts, and you can still choose to do the procedure at home.
What you need for an insemination at home will again depend on whether you’re doing ICI and which of the two sperm options you’re using:
- fresh sperm (recently ejaculated)
- frozen sperm (ordered through a sperm bank)
When doing a home insemination, you should also consider:
- legal considerations or parental rights when using a friend versus a sperm bank
- whether you and/or your partner want testing done, for instance genetic testing or testing for sexually transmitted infections (STI) — these would need to be done in a clinic setting
Fresh sperm ICI method
With fresh sperm, you’ll need a receptacle for the sperm and a way to get it into the vagina.
Sometimes the donor ejaculates into a cup. This can be a sterile specimen collection cup you buy… or just a clean container from the kitchen! The other popular option for collection is a soft cup.
Online forums that discuss home inseminations are abuzz with touting the “soft cup method.” This approach is when you use a menstrual cup or disc to keep the sperm up by the cervix. So a sperm-filled soft cup would be inserted into the vagina and left there by the person being inseminated or a partner/helper.
The idea is that the sperm are kept up by the cervix instead of dripping down the vaginal walls. They’ll stay there for as long as you leave the cup in, so if you want to give the swimmers an hour or more to get up there, you can. (Just don’t leave it in for more than a day because you’d risk infection.)
No matter the receptacle you’re asking a donor to ejaculate into, coach them to aim carefully!
“D,” a mom in western Massachusetts, shared a funny-in-retrospect story with me: “On the very first try [my wife and I] walked around the block until [our known donor] said he was done. He basically ‘missed’ the vessel. So we count it as a try, but really there was nothing to work with when we got home!”
If you’re not using a soft cup for vaginal insertion, you’ll need another way to get the sperm from the receptacle into the vagina. Most people use a needleless syringe for this, the kind you would use for giving liquid medicine to a pet or child.
The Mosie syringe has been specifically designed for home inseminations, but any will do. You simply use the syringe to suck the sperm up into it, and then push it out into the vagina.
A midwife told me before my wife and I started trying we should try to aim to coat the cervix (so, aim up and back).
Frozen sperm ICI method
With frozen sperm, you’d order through a sperm bank. Andreasson of Seattle Sperm Bank told me the shipping fee is $100 to $180 and that it arrives with instructions and everything you need to perform the insemination including the syringe.
The kit will tell you to thaw the frozen vial in a cup of room temperature water for about 15 minutes first.
The vial will be stable for 14 days (much longer than a fertile window) so he recommends scheduling your shipment to arrive a few days before you think you’ll need it.
With frozen sperm, there are yet another two types:
This doesn’t have anything to do with cleanliness, but “washed” means the semen has gone through a process of separating the sperm from the rest of the ejaculate. You can use either washed or unwashed for ICI.
Frozen sperm IUI method
As mentioned, IUI involves piping sperm directly into the uterus through the cervix and should be done by a medical professional like a midwife or physician.
With intercourse or ICI, the sperm itself naturally separates from the rest of the ejaculate in the vaginal canal and only the swimmers themselves go on to the uterus. With IUI, you’re skipping the swimming step. This is why you should only use washed sperm if your plans involve IUI. Make sure you order correctly!
While there’s no data available on how common home inseminations are, they’re a wonderful choice for many people trying to conceive.
My wife and I loved the significant financial savings, the flexibility, the control we had over steering the process ourselves, and the intimacy of being naked on a bed instead of being under a paper gown in stirrups with professionals around.
Especially when this was some people’s only option during the pandemic, it’s good to know there’s a way to keep going safely through clinic closures.
Sarah Prager’s writing has appeared in The Atlantic, HuffPost, SheKnows, NewNowNext, JSTOR Daily, Bustle, The Advocate, Motherfigure, and many other outlets. She’s the author of two books for youth about LGBTQ+ heroes of history, both Junior Library Guild selections published by HarperCollins. “Queer, There, and Everywhere: 23 People Who Changed the World” is for ages 12 and up, and “Rainbow Revolutionaries: 50 LGBTQ+ People Who Made History” is for ages 8 and up. Sarah has spoken to over 150 audiences across 5 countries on LGBTQ+ history at venues from the U.S. Embassy in Mexico City to Twitter’s headquarters to Harvard Business School. She lives in Massachusetts with her wife and their two children. Learn more about Sarah here.