Reproductive ParenthoodBy Alternative Insemination
Regina Kim, MDFebruary 2009
Method of conception whereby sperm is inserted manually into the vagina or uterus
LGBT sensitive and supportive care: Alternative insemination, not artificial
Not an infertility issue
IUI
ICI
Vaginal Insemination3
Vaginal-pool Inside the vagina
Intracervical, or ICI Just inside the cervix, the opening of the
uterus Intrauterine, or IUI
Inside the uterus Performed by trained medical professional
4
Known donorFresh sperm - from friend, familyFrozen sperm - from friend family –
processed at andrology lab
Unknown donorFrozen sperm - purchase from sperm
bankOpen donor - open to being contacted
when child is 18
Cost effective Home insemination in the vagina Can provide a child with an identifiable
father May have more viable and motile sperm Difficulties:
Can’t keep longer than 1-2 hours after ejaculation - difficult to obtain for optimal timing
Custody and visitation rights; legal issues Greater risk for sexually transmitted
disease when using untested or unquarantined familiar sperm
Parenting and family complexities
Known donor (friend, family) to donate, then sent to be processed and frozen for insemination
Routine donor screening is performed Insemination (IUI) done by health
care professional Parenting and family complexities Expensive - Cost to process, store,
and inseminate
Frozen sperm - anonymous or open donor Insemination: Vaginal, ICI or IUI Safer and more reliable Tested for sexually transmitted diseases Medical history available Tested for count and motility Mitigates legal or custody issues Difficulties
More expensive Timing is crucial - thawed sperm lives for only 1
day compared to 1 week for fresh sperm Thawed sperm may be less motile
Known donorFresh sperm - from friend, family (home)Frozen sperm - from friend family –
processed at andrology lab (Vaginal, ICI at home or IUI in office)
Unknown donor (Vaginal, ICI at home or IUI in office) Frozen sperm - purchase from sperm
bank Open donor - open to being contacted
when child is 18
Data from The Sperm Bank of California 2004-2005
VP- vaginal pool
IUI- intrauterine insemination
Women reach peak fertility during their 20s
Young, healthy woman, fresh sperm with a normal sperm count – 20-25% pregnancy rate with well-timed inseminations
Older women and those using frozen sperm, the odds of success per insemination decline
Ovulation prediction and timing of ovulation is the most critical element
Ovulation detection kits are typically used along with careful tracking of cycle for a minimum of 3 months
Most likely to conceive about 24 hours after the ovulation detection test is positive
Fertility Awareness Methodtracks basal body temperature, cervical mucus, and cervical position and texture
Ovulation predictor kits detects the LH surge in the urineovulation occurs 12-24 hours after LH surge
Women are born with all their lifetime supply of eggs
Healthiest eggs are ovulated during 20’s and
early 30’s Ovarian reserve decreases after age 35 Rate of miscarriage increases after age 35 Consider fertility testing Recommend consulting reproductive
specialist after 3-6 cycles without positive result
Depending on individual’s coverage Different degrees of coverage Based on medical definition of
“infertility” Infertility - ‘timed unprotected
intercourse for more than 12 months without pregnancy’
Ovulation detection kits $ 17- 30 Frozen sperm $200 -$500/vial x 1-2 vials per
cycle Shipping fee for sperm $0 for local pick up to
$190 Speculum and syringes for home
insemination Insemination fee –varies $350-500 Pregnancy test kits $ 10 per cycle
= Total using frozen sperm, IUI $600-$1600 per cycle
(these are approx costs and does not include pre-conception consultation, labs and exam)
Financial resources Pregnancy can take months to achieve
expect 6-18 months Emotional resources Co-parenting is complex The coming out process escalates
Understanding the parental rights of known and unknown donors
Your partner’s rights to co-adopt your child, if desirable
Legal protections in the health care setting, such as powers of attorney and will
Clarifying your desires for guardianship in the event you can no longer care for your child
Care for your health:Stop smoking, reduce alcohol, caffeine, exercise, get a health check up
Start tracking your cycle and ovulation Take a folic acid 1mg a day Make a timeline Consult medical and legal professional
19Alternative Insemination- Howard Brown Health Center
Insemination - home or clinic Sperm- fresh or frozen Your comfort with various levels of
donor screening Your own medical care before, during,
and after achieving pregnancy Your selection of qualified medical
professionals to assist in the process of insemination
Your selection of a qualified health care practitioner to care for your child
Sperm banks The Sperm Bank of California
http://www.thespermbankofca.org Pacific Reproductive Services
https://www.pacrepro.com California Cryobank
www.cryobank.com Midwest Sperm Bank
www.midwestspermbank.com
National Center for Lesbian Rights www.nclrights.org
Lamda Legal Defense and Education Fundwww.lamdalegal.org
Howard Brown Health Centerwww.howardbrown.org
The Center on Halstedwww.centeronhalsted.org
HIV-1 and HIV-2 Hepatitis B and C Syphilis Blood ABO-Rh type Chlamydia, Gonorrhea CMV antibody HTLV-1,2 Complete chromosome
analysis Herpes Simplex Virus-
1,2
Chem profile Complete Blood Count Lipid panel Thyroid testing Comprehensive seminal
analysis Cystic fibrosis test Thalassemia Sickle cell Tay-sachs
Top Related