How to Plan for Artificial Insemination

For infertile couples or women choosing to have a baby without a male partner (or on their own), artificial insemination can get the job done. Relatively inexpensive and noninvasive, this is the process of injecting sperm directly into the woman's vagina (an ICI or intracervical insemination) or uterus (IUI or intrauterine insemination). While these methods are not exactly romantic, the wriggling, bright-eyed results are a dream come true.

Instructions

Difficulty: Moderate

1. Talk to your OB-GYN about the procedure's costs, details and any other issues, including guarantees. Get a referral to a fertility doctor if necessary. Ask friends and family for recommendations.
2. Investigate sperm banks (if necessary). Ask your OB-GYN for recommendations, search online and talk to friends or family who have gone through the same thing. Make a list of questions you have and, if you cannot find the answers on the bank's site, call the bank directly.
3. Be aware that sperm is prepared differently for the two different procedures. You'll need to choose IUI or ICI at the time you place your order with the bank.
4. Consider asking someone you know to be a donor if it's a priority that you know your child's father. Tread extremely carefully with a known donor. This scenario has "emotional minefield" written all over it. People's feelings for the baby can change drastically after the birth. There is enormous potential for heartache, distress-- even litigation--but also for extraordinarily joyful and creative family connections between all parties.
5. Determine when you ovulate (see 251 Orchestrate the Perfect Conception). If the do-it-yourself route doesn't deliver the goods, talk to your OB-GYN, who may perform blood tests and/or a sonogram to determine precisely when ovulation will occur. Fertility drugs may be called for. Research your options.
6. Choose ICI if you prefer the lowest-tech approach. This procedure-- think turkey baster here--can be done at home by yourself, a partner, midwife or close (and about to get closer) friend. The sperm, either fresh or frozen (warmed to body temperature), is simply squirted into the mom-to-be.
7. Opt for an IUI if you need to optimize both time and money. There is a greater success ratio with IUI than ICI inseminations, although they are more expensive. Schedule an appointment for the procedure with your OB-GYN or midwife just before ovulation.
8. Get sperm when the time is right. Ask your known donor to produce a sample, or have the sperm bank deliver the sample to your house or your doctor's office.
9. On the big day, arrive at the doctor's office with partner or liquidnitrogen tank in tow. Be sure to bring his favorite magazines (wink, wink), because his first and only contribution to this process will be the one he makes in a small sterile cup. If your new best friend is in a large, cold tank, dip the frozen vial into a cup of lukewarm water, then bring it to body temperature by tucking it under your arm for 10 to 15 minutes. Relax. The procedure, very similar to a Pap smear, causes little discomfort.
10. Prepare to spend a minimum of about 20 minutes flat on your back to give the sperm time to reach the egg.
11. Take a home pregnancy test. Many tests on the market today are capable of detecting human chorionic gonadotropin or HCG (a hormone present in women's urine during pregnancy) at very low levels. That means you can get an accurate test result just six to eight days after conception--well before your first missed period. Positive? Congratulations! Negative? Despair not: Fertility experts consider it normal to take a full year to get pregnant.

Tips & Warnings

• Plan to be on a flexible schedule. Both parties must be able to drop everything and go to the doctor's office when the moment is right.
• Ask your insurance company exactly what procedures are covered. Then check your bank account to confirm that you can cover the costs without blowing your future kid's college fund.
• For more information, contact the American Society for Reproductive Medicine (asrm.org).
• Success rate per try (without fertility drugs) is about 4 percent with IUI alone. Adding fertility drugs can raise the chance of success to 7 to 18 percent, depending on the woman's age and health.
• Pay particular care to donor selection, sperm testing, and genetic screening issues. If it's relevant to your circumstances, find out about the bank's policy on donor anonymity.
• Fertility drugs can have side effects such as weight gain, dizziness and hormonal swings (just like pregnancy).
• IUIs involve a small risk of infection.