If you’ve listened to your reproductive endocrinologist explain the insemination process to you, there’s a chance you’re thinking, “That sounds simple enough…couldn’t I do that myself?” You’ve got sperm. You’ve got someplace to put it (a.k.a. your vagina). Do you really need to schedule a doctor’s appointment for this?
The answer, surprisingly, might be no—but only if you’re talking about artificial insemination, not its more complicated cousin, intrauterine insemination (IUI), which definitely has to be done by a medical professional. Here’s how the two procedures size up in comparison (and how to know which one is right for you).
Artificial insemination vs. IUI: the basics
The short version: artificial insemination refers to the process of inserting ejaculate into the vagina, close to the cervix, using a needleless syringe (i.e. the “turkey baster” method…more on that later!). It’s sometimes referred to as intracervical insemination (ICI). IUI, on the other hand, involves a speculum and the placement of sperm directly into the uterine cavity instead of the vaginal canal.
They both can get you pregnant, obvs. But here’s a few other ways they’re similar:
- No sex is required, which means that both ICI and IUI work as well for heterosexual couples as same sex (or single women, or gay men working with a surrogate, or whatever). Pretty much anytime conception without intercourse is the goal, either procedure can be used if you’ve got sperm and eggs.
- Ovulation is key. Whichever method you choose, it’s important to make sure that the you’re within your fertile window. If you’re having an IUI at your fertility clinic, your doctor will be helping you track your ovulation and figuring out the best timing for the procedure. If you’re planning to DIY at home, you’ll need an OTC ovulation predictor kit to help you.
Now here’s how they’re different:
- Know-how. IUI is best performed in a doctor’s office, because really, they know reproductive anatomy best…and let’s be honest, you can better avoid infection if you’re in a sterile environment. According to Dr. Mark Trolice, reproductive endocrinologist at Fertility CARE: The IVF Center, you’ll also need someone trained in speculum use. If you’ve somehow forgotten (how could you?) a speculum is that long pointy thing your OB breaks out during your pelvic exams to get a good look around in your vagina. You’re invading an organ with that thing, people, and you really don’t want to mess around. ICI, on the other hand, is fairly user-friendly even for novices.
- Unwashed vs. washed semen. If you haven’t been paying close attention thus far, heads up because this is important: never put an unwashed sample of sperm directly into your uterine cavity (seriously, like ever). The seminal fluid that bathes sperm contains something called prostaglandins, which—if placed inside the uterine cavity—can cause a severe reaction in the form of painful uterine contractions, warns Dr. Trolice. This seminal fluid is washed away in preparation for an in-office IUI, so it’s not an issue there. And it’s totally fine to put unwashed semen into your vagina during an ICI (since that’s basically what happens during sex). But if you injected unwashed semen into your uterus during an at-home IUI, it would be very, very bad. Trust us.
Okay…but tell me how at-home insemination works?
Remember how we said it was pretty foolproof (the process, not necessarily the “getting pregnant” part)? We weren’t lying. You grab some semen—from your partner or sperm donor—and a home insemination kit, which usually includes ovulation predictor materials and that turkey baster we talked about before.
Okay, it’s not actually a turkey baster, but a plastic syringe and plunger that functions the same way as one. Also, FYI: frozen sperm will have be thawed briefly before use, but once it’s at room temperature (or if you’re starting with freshly ejaculated sperm), make sure to use it within 30 minutes.
Once you have your syringe filled with semen, this is what you do:
- Lie down on your back.
- Insert the syringe into your vagina, pushing gently until it stops and aiming it toward your cervix.
- Empty the syringe, then take it out.
- Chill out for 15 to 30 minutes. If you’ve done ICI, you’ll want to stay horizontal for a bit to make sure the sperm get where they need to go. (Note that this isn’t necessary for IUI: a 2016 study presented to the European Society of Human Reproduction and Embryology showed no significant difference in conception rates between women who lied down for 15 minutes after IUI vs. women who didn’t.)
That’s it! See? Easy peasy.
Which one is more likely to get me pregnant?
At-home insemination is more convenient and private, plus you don’t have to involve your insurance company and the cost (for the kit) is minimal. But according to Dr. Trolice, if you’re considering the success rates of the two procedures, you’ll definitely want to stick with in-office IUI.
Essentially, washed sperm used for an in-office IUI places the best, fastest sperm directly into the uterus—much farther up than standard vaginal insemination. Overall, the American Pregnancy Association claims success rates for IUI can be as high as 20%, but take this with a grain of salt: this percentage totally depends on why you’re doing IUI in the first place, as well as the protocol of meds leading up to the procedure.
Spell it out for me one more time.
Theoretically, if you personally know a midwife (or some other medical practitioner) who has access to a speculum AND you’ve purchased pre-washed sperm from a sperm bank, then you could do an IUI in your living room—but that’s a lot of conditions to meet, so it’s honestly just not worth the risk. If you’re okay with the lower odds of pregnancy, a plain ol’ “turkey baster” ICI is way easier and less dangerous to do at home. Leave the IUIs to the professionals, please.