What is At-Home Insemination?

The process of artificial insemination is a method of fertility treatment that is used to deliver sperm directly into the uterus or cervix in hopes of increasing the chances of becoming pregnant. In fact, the process of insemination can be defined as any time when sperm is put inside another body, including through intercourse. The method of artificial insemination, though, does not involve intercourse.^{(1, 2, 3, 4)} An at-home or home insemination is when this process is performed outside of a clinic. Home insemination consists of the use of a needleless syringe or a cervical cap to place the semen directly on the cervix. At-home insemination has become a popular alternative to the many other artificial insemination methods available since it avoids the large medical bills that would follow if you get the process done in a hospital or clinic, and it also allows you to remain in the comfort and safety of your own home.^{(5, 6)}

There are many causes of infertility that face couples. Many people choose to make the insemination process more personal and less medical by trying to move the artificial insemination process at home and avoiding the sterile setting of the clinic where strangers are involved in this entire process. At the same time, in-clinic insemination also costs extra due to the facilities and staff involved in the process. This is why opting for at-home insemination can save a lot of money.⁽⁷⁾

Some women also prefer the increased flexibility of home inseminations as compared to having rigidly scheduled doctor’s appointments at certain times that may be difficult to reschedule around the preferred hours.

Many non-binary people prefer to opt for home insemination because they don’t want to deal with the many questions, mis-gendering, and stigma that they face at clinics and hospitals.⁽⁸⁾

At the same time, in the post-pandemic world that we live in after COVID-19, at-home insemination is often seen as the safer option. Even when clinics are closing due to being ‘non-essential’ during the global lockdowns, many choose to continue with their monthly attempts at getting pregnant at home itself. During the COVID-19 outbreak in the United States, requests for sperm shipments to fertility clinics went down by nearly 50 percent, though the shipments to residences did not go down at all.⁽⁹⁾

There are two methods of artificial insemination that can be performed at home. These include:

• Intrauterine insemination (IUI), a process that involves putting sperm directly into the uterus using a tube that goes through the cervix.^(10,11)
• Intracervical insemination (ICI), a process that involves putting the sperm into the vagina, as usually happens during sexual intercourse.^(12,13)

Intrauterine insemination is nearly always done by a medical professional. However, this is not to say that IUI cannot be done at home. There are some trained midwives who make house calls for performing this procedure.

However, when it comes to the success rates of clinic versus at-home insemination, including IYUI versus ICI, here’s what research shows:

• One of the older studies from 1988 carried out by the University of Amsterdam in The Netherlands found no statistical difference in rates of successful pregnancy amongst 53 infertile women trying the process of artificial insemination at home versus at a clinic.⁽¹⁴⁾
• A 2001 study done by the Fenway Community Health Center in Boston on 62 women over 189 cycles found that IUI had a higher monthly success rate than ICI. The rate of 15 percent success rate of IUI versus nine percent in ICI.⁽¹²⁾
• A 2015 study carried out on 1843 women participants found the pregnancy rates over six cycles to be only slightly higher for IUI (at 40.5 percent) as compared to ICI (at 37.9%), with researchers noting that there was no substantial benefit of IUI over ICI. ⁽¹⁵⁾
• A recent 2017 study published in the Journal of Human Reproductive Sciences of three different groups of couples (aged 20 to 33 years, 33 to 36 years, and 36 and upwards) found that at home insemination was an effective way of having a successful pregnancy, with a success rate of 69 percent, 43 percent, and 25 percent in the three age groups respectively over a period of six cycles.⁽¹⁶⁾

The most important factor to consider for success rate is getting the perfect timing of the insemination, the quantity and quality of the sperm sample, the age, and the hormones in the body being inseminated.

The exact items you need for at-home insemination again depend on whether you are undergoing an ICI procedure and which sperm option you are using. Sperm options include:

• Fresh sperm (freshly ejaculated)
• Frozen sperm (ordered through a sperm bank)

When undergoing an at-home insemination, you should also keep in mind the following:

Parental rights or legal consideration when using a friend versus using a sperm bank.

Whether you and/or your partner want to get, any testing done, including genetic testing or testing for any sexually transmitted infections (STIs). In such situations, the procedure would need to be done in a clinic setting.⁽¹⁷⁾

Here are the items you would need for an at-home insemination according to the procedure being used.

1. Fresh Sperm with ICI Technique

   When you are using fresh sperm, you will need to have a receptacle for the sperm and a way to get it into the vagina. In most cases, the donor ejaculates into a cup. This is usually a sterile specimen collection cup you buy, or you can even use a clean container from the kitchen.

   Another popular method for collection is a soft cup, and you will find many online forms supporting this soft cup method theory. This approach uses a menstrual cup or disc to keep the sperm up against the cervix for as long as possible. So the sperm-filled soft cup is inserted into the vagina and left there by the partner/helper or the person being inseminated. The idea behind using this is that sperm are kept close by the cervix instead of dropping down the vaginal walls. The sperm stays there for as long as you wish to leave the cup in. So if you want to give the sperm an hour or more to get up in there and maximize the chances of fertilization, you can easily do so. However, don’t leave it in for more than a day as this increases the risk of infection for yourself as well.⁽¹⁸⁾

   If you are not using a soft cup for the vaginal insertion of the sperm, you will have to find another way to get the sperm inside from the receptacle into the vagina. Most people use a needleless syringe for this purpose. You might be having it if you have ever given liquid medicine to a child or a pet.

   For example, the Mosie syringe has been specially designed for home inseminations, but you can also use any other needleless syringe.⁽¹⁹⁾ You use the syringe to suck up the sperm into it and then push it into the vagina.

2. Frozen Sperm ICI Method

   If you want to use frozen sperm, you will have to order it through a sperm bank. The shipping fee for this differs from state to state e but on average ranges between $100 to $200. It arrives with all the instructions and everything you will need to perform the insemination process, including the syringe as well.⁽²⁰⁾

   The kit will instruct you to thaw the frozen vial in a cup of water (room temperature) for around 15 minutes. This vial remains stable for around 14 days, which is much longer than what the average fertile window lasts for. This is why it is recommended to schedule your shipment to arrive just a few days before you think you will enter the fertile period.

   When using frozen sperm as well, there are two types – washed and unwashed.⁽²¹⁾ The term washed, and unwashed has nothing to do with the cleanliness of the sperm. Washed only means that the same has undergone a process of separating the sperm from the rest of the ejaculate. You can go ahead and use either washed or unwashed sperm samples for the ICI procedure.

3. Frozen Sperm with IUI Method

   IUI involves putting the sperm directly into the uterus through the cervix and should ideally be performed by a medical professional like a doctor or a midwife.⁽²²⁾

   In the process of ICI or during natural intercourse, the sperm is able to naturally separate out from the rest of the ejaculate in the vaginal canal, with only the swimmers moving onto the uterus. With the process of IUI, you are skipping this swimming step. This is why it is important to only use washed sperm if you plan to use IUI. So make sure to check and order correctly.

While there is no data available on how common at-home inseminations are, they are fast becoming a popular choice for many people trying to conceive and have a family. The benefits of at-home insemination include a significant financial savings, flexibility, having control over the process, and more intimacy than the sterile hospital or clinic setting. However, if you are attempting insemination through the process of IUI, it is better to take the help of a medical professional.

References: