But the price of artificial insemination can sometimes be a deterrent. Insemination cycles can cost between $300 and $4000, depending on factors like sperm source, medication, or insurance coverage, says Michelle Ottey, PhD, consulting lab director at Fairfax Cryobank in Fairfax, Virginia. If you have fresh sperm from a donor and no known fertility issues, it can be cheaper to try insemination at home, says Marea Goodman, licensed professional midwife and author of “Babymaking for Everybody, A Guide for LGBTQ+ and Solo Parents.” But for many folks, at-home insemination is not just about cost savings. Compared to a clinical lab setting, at-home insemination can be more comfortable—and it’s simpler than you might think. “There’s a misconception that you have to go to a fertility clinic,” says Goodman. “But at-home insemination can be super low-tech.” COVID-19 has made at-home insemination a particularly popular option in the last few years, Dr. Ottey notes, citing early pandemic pauses on elective medical procedures. But in Dr. Ottey’s experience, the majority of people inquiring and pursuing home insemination have historically been same-sex female couples. We turned to the experts to find out what you need to know about artificial insemination and the pros and cons of attempting the procedure at home.
What Is At-Home Artificial Insemination?
In a clinical setting, sperm is prepared in a lab, concentrated to a very small volume, and placed at the top of the uterus with a catheter bypassing the cervix, says Brian Levine, MD, a board-certified reproductive endocrinologist, Verywell Family Review Board member, and founding partner and practice director of the fertility treatment center CCRM. This process is known as intrauterine insemination (IUI). At home, a sperm sample is inserted into the vagina and placed at the cervix via a procedure known as intracervical insemination (ICI). The semen is typically not concentrated beforehand, and the cervix is simply “bathed” via a cervical cap, or with a reservoir of semen via a syringe. Essential equipment for this process at home includes ovulation test strips and/or a basal body thermometer to determine when you’re ovulating. “Fertility apps won’t necessarily tell you when you’ll ovulate, so I recommend using test strips and other signs like cervical mucus and temperature to figure out when ovulation will occur, in order to optimize your chances of getting pregnant,” Goodman says. Once you nail the timing, you’ll need a menstrual cup or needleless syringe, which may be provided by a sperm bank, or purchased online.
How to Do Artificial Insemination at Home
When using fresh sperm from a known donor, Goodman recommends starting out with a contract that requires STD testing and an agreement around safer sex practices throughout the donation period. On average, it takes people with no known fertility issues more than one insemination to get pregnant, Goodman points out.
Timing and Logistics
Timing is particularly key. Because donors need 48 hours to replenish sperm between ejaculations and sperm can last several days inside the body, you’ll ideally want to perform insemination two days before estimated ovulation, and again when you receive a positive ovulation test. If possible, another insemination 48 hours later can be helpful, but not always necessary. When using frozen donor sperm, which is shipped in a temperature-controlled tank that can be kept for about a week, you’ll want to time delivery to coincide with ovulation, Dr. Ottey says. Then, remove the sample from the tank about 20 minutes before you’re ready to use it.
Insertion Approaches
Once the sperm is in your possession, there are several various ways to proceed. The sperm can be processed and inserted through a catheter into the uterus (IUI) by a professional. Here, the sperm will bypass the cervix where it would otherwise encounter mucus that separates it from seminal fluid, Goodman says. For this reason, it first needs to be processed in a portable centrifuge, which can take about 30 minutes. Afterward, the professional will use a speculum and sterile catheter to insert the sperm into the uterus. “Placement of the speculum is usually the most uncomfortable part,” Goodman says, adding that most people don’t feel anything, although some might experience cramps or spotting as sperm goes inside. Alternatively, unprocessed sperm can be inserted into the vagina with a needleless syringe, or placed in a menstrual cup and inserted into the vagina at the level of the cervix. You or your partner can do this safely on your own, assuming all equipment has been cleaned.When placing sperm in the cervix (or intra-vaginally using a shorter syringe), a fresh sperm sample can be used; no processing is necessary. Sperm banks sell frozen, unprocessed samples, Goodman notes, although some sperm won’t survive the freezing process. “Try to feel your cervix with your fingers before inserting the syringe,” Goodman suggests. You’ll get a more tactile sense of what you’re doing before you put the sperm in. “If you or your partner has never felt your cervix before, you’re looking for something with the consistency of the tip of your nose that [has a round shape] with a dimple in the middle.” If you need a visual, you’ll find plenty at BeautifulCervix.com. If the syringe method isn’t for you, you can place a fresh or frozen sperm sample in a menstrual cup, then insert it and elevate your hips while lying on your back.
After Insemination
Regardless of your technique, most experts recommend lying on your back with a firm pillow under your sacrum to elevate the hips for at least 15 minutes after insemination, although the jury is out on whether this actually improves pregnancy rates. If you’re going with the syringe route, Goodman says you can also use a cervical cap or diaphragm to help hold the sperm and seminal fluid in place. Alternatively, some experts also recommend flipping over every 20 to 30 minutes for up to two hours. “It can help the sperm wash over the cervix and swim through the uterus,” Dr. Ottey says. If you’re using a menstrual cup or syringe to deposit sperm into the vagina or cervix, an orgasm can be helpful afterward, since it causes contractions that can help bring the sperm into the uterus, Goodman says. With IUI, no orgasm is needed, since the sperm goes directly into the uterus.
Risks of At-Home Insemination
Goodman says the risks associated with at-home insemination are low. “Really, you’re just mimicking heterosexual intercourse, which puts sperm up by the cervix,” she says. “[Sex] is not something that has to happen in a sterile environment, so there’s no need to complicate it.” That said, there are various risks to be aware of.
Infectious Disease
When an IUI is done under the supervision of a medical professional, the sperm can be screened for infectious diseases. However, in informal home settings, at-home insemination doesn’t typically include sperm testing for conditions like hepatitis, gonorrhea, syphilis, and other STIs, explains Dr. Levine. Therein lies the greatest risk. As such, at-home insemination might not be the best approach for couples where one partner is infected with HIV or another infectious disease, adds Dr. Levine. Because there can be a three to six-month lag between HIV infection and detection, clinics typically “quarantine” sperm by freezing and holding it for a number of months before retesting the donor. If you have identified your own dedicated donor, you can use a sperm bank to freeze and quarantine the sample. But you really don’t want to skip this step for cost savings, Dr. Levine urges.
Low Success Rates for Certain Individuals
Those with cervical factor infertility should make sure a medical professional is present during an at-home insemination, Dr. Levine says. Only IUI bypasses the cervix, so a medical professional is needed regardless of your preferred setting for the procedure.
Infection
When you undergo an IUI, there’s a small risk of infection, but a trained provider can help keep things sterile to reduce that risk, Goodman says. “I would never recommend a layperson does the IUI since you have to use sterile techniques, and sperm has to be washed correctly,” Goodman says. If you intend to reuse the same syringe, you should wash it with hot soapy water between uses to prevent any issues, Goodman adds.
Painful Contractions
Unprocessed semen in the uterus can cause painful contractions, notes Dr. Levine. Even when conducting an ICI, he recommends washing the sperm with a centrifuge, which concentrates it.
Legal Issues
At-home insemination can be a cost-saving approach. “[However], there’s a real concern that there is no legal structure protecting the intended parent or the donor,” Dr. Levine says. When you go to a clinic, all legal paperwork will be completed so that parental rights are reassigned. You can certainly complete this paperwork on your own with the help of a boilerplate agreement found online or better yet, a lawyer.
Unexpected Costs
While at-home insemination might seem like a cost-saver, sperm can sometimes cost more than the procedure itself, Dr. Levine notes. This is especially true if you’re purchasing sperm from a bank and your at-home insemination goes wrong, which could result in wasted sperm.
A Word From Verywell
At-home insemination doesn’t have to be “artificial” or very medical and can be a great alternative to attending a fertility clinic for some people. “If your cycle is regular and you’re interested in a more home-y experience, you can try to do your insemination yourself, or with the help of a midwife or nurse practitioner,” Goodman says. “If you have an irregular cycle, I recommend going to a fertility clinic to get medication that can help regulate your cycle, which can increase your chance of conception.” As with any other medical issue or procedure, if you have questions about at-home artificial insemination, you should speak with your OB/GYN or healthcare provider for more information.