Safe Donor Sperm Insemination at Home
There are three types of insemination techniques: 1) vaginal (or peri-cervical), which uses a syringe (the kind used to give infants liquid medicine) to place sperm into a woman's vagina, near the cervix, 2) intracervical insemination (ICI), involves the use of a catheter or cannula, to place the sperm directly into the cervix, 3) intrauterine insemination (IUI) involves the use of a catheter, or cannula, to place the sperm directly into the uterus.
Some midwives and women's health experts teach the at-home method of vaginal insemination. But IUI or ICI need to be done by a medical provider, using sterile technique, since they involve introducing substances into the cervix and uterus, which are sterile environments. Medical providers who do ICIs and IUIs in their offices use sterile techniques to introduce the instrument into and through the cervix and into the uterus.
"If sterile technique were not used, bacteria could be introduced, causing a high risk of infection, which could develop into pelvic inflammatory disease and cause infertility, not to mention pain and fever," says Liz Coolidge, a licensed mental health counselor who runs the Alternative Insemination Program at Fenway Community Health Center in Boston. "[On the other hand] a woman really cannot hurt herself doing a home vaginal insemination."
Whether a woman is using ICI, IUI, or doing an at-home insemination, she must order either unwashed or washed sperm from the bank. specifying the method [preparation of the specimen]. "Washed" means the sperm is separated from semen. Most experts recommend against putting unwashed sperm (sperm unseparated from semen) into the uterus because it can cause a bad reaction, including nausea and vomiting.
"We won't do inseminations with fresh sperm in our office. We teach women how to use it for at-home insemination. But I counsel them about evaluating the risks of STDs," Coolidge says.
Kristin Kali, a licensed midwife who provides fertility consultations at Maia Midwifery and Preconception Services in the San Francisco Bay area, believes fresh sperm is preferable to frozen in many ways, assuming the important safety precautions are in place.
"Fresh sperm is more effective for achieving pregnancy than sperm that has been frozen and thawed," she says. "Many women don't realize that the quantity of semen they are receiving from a bank is only 0.5cc, while the normal volume of a man's ejaculate is 3-5cc. And fresh sperm that is inseminated vaginally lives for up to 72 hours, or three days. When sperm is frozen for quarantine, or purchased from a sperm bank, the lifespan of the sperm is reduced to about 24 hours when inseminated vaginally. With intrauterine insemination, excellent timing is imperative, as sperm only live for 6-8 hours once they are placed directly into the uterus."
There are legal issues involved in using fresh sperm, of course, as well as the safety and how-to concerns. If fresh sperm is used in a home setting, even if it is not through intercourse, the known donor is considered to be a legal parent of the child in the eyes of the law. Anonymous donors, on the other hand, legally give up parental rights and responsibilities to children conceived by their sperm specimens. Directed donors whose sperm is used in a clinic insemination also affords more legal protection.
Sperm banks who ship to homes
We asked four sperm banks known to have friendly policies for single women and lesbian couples about their regulations about sending sperm to the home:
- The Sperm Bank of California: "We have always shipped to women's homes for home insemination or just if they prefer to receive the sample and bring it to their MD themselves. They do need to be working with a physician but it doesn't have to be an RE and the MD doesn't have to do the inseminations. We like to know they are under medical supervision for several reasons: (1) if they get pregnant we want to know they have a provider in case of any complications including miscarriage, (2) we can only give general fertility information and refer women to their MDs for more specific information, and (3) the state of NY licensing requires women are working with an MD.
- Pacific Reproductive Services will ship sperm to any woman, at any location she wishes including her own home, who has completed our registration process. The requirements for anyone wishing to purchase sperm is detailed on our website, pacrepro.com."
- California Cryobank ships to clients' home. "We still need a physician's authorization for release of semen (A1). As long as we have the proper A1 form signed by the client's physician, we will ship to whatever address they ask us."
- Currently, Xytex will ship samples directly to a patient's home if their licensed physician has signed a consent form stating that he/she will be supervising all inseminations. "This may change at some point in the near future, but for the moment we'll ship it only with a doc's signature and promise to supervise."
Also, don't miss these podcasts:
PODCAST: At-home insemination: everything you want to know but might be afraid to ask
PODCAST: Negotiating with a known donor
