Alternative Insemination (AI)

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Alternative insemination (AI), also called artificial or donor insemination, is a method of conception whereby freshly gathered or frozen sperm (first thawed) is inserted manually into a woman's vagina or uterus to fertilize an egg.

Insemination is usually performed on or near the day of ovulation, when a woman's egg is released from her ovary. AI is used among lesbian, gay, bisexual, and transgender (who are not taking hormones) people. Women may obtain sperm from a male friend or from an anonymous donor at a sperm bank. A woman may conceive and act as a surrogate mother for a gay man's child after being inseminated with his sperm.

The conception rate through AI is similar to that through sexual intercourse. Approximately 11% of women who are trying to conceive are successful during a given menstrual cycle. Failure to conceive with AI is most often a result of fertility problems and not insemination error. There is a 20% rate of miscarriage among women who use AI and women who conceive during sexual intercourse. Age and medical history affect a woman's ability to conceive regardless of the method. It is a common misconception that more boys than girls are born of AI, but there is no data that suggests that this is true.

AI can be a cost-effective alternative to adoption, which can cost anywhere from $10,000 to $30,000. AI using banked sperm may cost $500 to $1000, depending on the number of inseminations that are needed to conceive.

Choosing between an anonymous or a known donor may be complicated by logistical and social factors.

Insemination with a known donor is cost effective, can be done responsibly at home, and can provide a child with an identifiable father. General medical standards require a woman to use fresh sperm during home insemination, which can be difficult if the donor is not near. For most people, it results in a rewarding, personal environment for mother, father, and child. However, some difficulties compel women to choose an anonymous donor:

• Custody and visitation rights; legal issues
• Greater risk for sexually transmitted disease when using untested, familiar sperm
• Parenting and family complexities

Insemination with an anonymous donor is safer and more reliable, since the sperm is tested for sexually transmitted diseases (STDs) and because the procedure is managed by an experienced care team. Thawed, donated sperm lives for only 1 day, so conception is harder than with fresh sperm, which can live for several days in the uterus. Several factors make anonymous donation easier for some women:

• Medically tested sperm
• No legal or custody issues
• Single parenting; no identifiable father

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