Insemination Decision 3: ICI, IUI, or IVF

Oh, acronyms. When we don’t know what you mean it’s so frustrating. When we unlock your secrets it’s so satisfying. The acronyms ICI, IUI, and IVF stand for the main methods of lesbian insemination. You can think of them as equivalent to aiming a ball at a net from 10 feet, 5 feet, and – uh – dunking.

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ICI, or IntraCervical Insemination, uses a flexible catheter or device to insert unwashed sperm* directly into your cervix (the area behind the vagina, just in front of the uterus). This procedure can be done at home or in a doctor’s office, and is typically the easiest and cheapest method of insemination. It also most closely replicates natural conception, where the chances of pregnancy are about 25% per cycle, depending on the woman’s fertility and quality of the sperm. All that said, performing ICI at-home tends to carry a much higher risk of infection, because ICI sperm is unwashed, meaning the sperm are still mixed together with the seminal fluid. Basically, when a man and a woman have sex, the cervix typically filters out bacteria or fluid that shouldn’t be traveling to the uterus. If a woman is being inseminated with that sperm, the critical filtering step may be lost, resulting in the higher risk of infection.

Pros: It’s cheap(er), quicker, and it can be done at home

Cons: It’s potentially less effective than IUI and IVF, there is a higher risk of infection, and if you have any fertility issues, ICI may not be effective.

IUI, or IntraUterine Insemination, uses a flexible catheter or device to insert prewashed sperm directly into the uterus, giving it a better chance of reaching the fallopian tubes – where the magic happens. This procedure can be done at home or in a clinic or office. IUI-prepped vials of sperm from a sperm bank are typically more expensive.

Pros: Sperm has a better chance of reaching its goal. It can be done at home or in an office or clinic.

Editor’s Note: Read our interview on At-Home Insemination for Lesbian Couples for more on doing an IUI at-home.

Cons: IUI vials typically cost about $100 more than ICI vials, and $200 more than sperm used in IVF (unless you are using sperm from a known donor, in which case cost of sperm is not a factor)

IVF or In Vitro Fertilization, is a method of assisted reproduction where a sperm sample and a woman’s egg are placed in a laboratory dish, where fertilization occurs. An embryo (one or two fertilized eggs) are then placed in the woman’s uterus to develop. While the sperm used in IVF is usually cheaper (there is less of a need to prepare it since it’s being handled in a lab), the procedure can be quite costly, and may not be covered by insurance (especially for lesbians without fertility problems). Typically, lesbians use IVF when other methods of conception have not worked, or there is a fertility problem that makes ICI or IUI ineffective.

Pros: Higher chance of pregnancy (about 20-30% chance per cycle)

Cons: The procedure is much more expensive, and more invasive 

A note about drugs: Many lesbians who have tried for several cycles of ICI or IUI without success consider using fertility drugs (such as Clomid) to stimulate ovulation. If you decide to try fertility drugs, your fertility specialist will need to perform insemination and monitor your cycle and progress (and you will not be able to inseminate at home). The most common side effect with drugs like Clomid is that you increase the chance of having twins or multiples.

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