We do not recommend Home Insemination for a number of reasons.
Some of them are in the article: http://extra.globo.com/noticias/rio/rede-social-abriga-arriscado-mercado-de-venda-doacao-de-esperma-17542050.html
Below, we replicate some aspects of this matter and other relevant ones:
Doctors warn that, due to the time the viruses can be "hidden" in the body, this practice exposes the woman and - in the case of a pregnancy - the baby to risks of contamination by AIDS, hepatitis C and B, among other diseases .
More common in Europe, these “surrogate parents” start to multiply in Brazil and act in three modalities: AI (an acronym for artificial insemination), NI (natural insemination, that is, sex), and PI (partial insemination, when the donor masturbates, and penetration occurs only for ejaculation). Links direct you to pages that sell semen storage kits for express mailing. Some prefer anonymity. Others make appointments at home or at a hotel. All prearranged, say those involved. All absolutely unsafe, doctors warn.
This type of direct donation, without screening or specialized medical follow-up, is totally not recommended . In fertilization clinics, the donor undergoes clinical screening and tests to rule out sexually transmitted diseases (STDs), such as AIDS and hepatitis C. Only then, he collects the sperm sample, which is frozen in liquid nitrogen, so that the sperm remain preserved. The tests are repeated six months later, to avoid the so-called immune window, when the virus still does not show up in the tests. Only then is the sample released - explains Adelino Amaral, president of the Brazilian Society for Assisted Reproduction.
Some clinics go even further and offer tests that eliminate genetic mutations. In the exchanges of messages on Facebook, many require the presentation of tests discarding STDs, health certificates and family history of illnesses. There are those who think it is better than nothing, but the measure is far from guaranteeing safety to the “fresh donation” method. Here, the risks are real and can be fatal or lead to permanent infertility due to STDs.
Although sperm donation is not paid in Brazil, as determined by law, a sample, sufficient for insemination, costs between R$2,500 and R$3,000 in fertility clinics, depending on the costs involved. Add to this value the price of the intrauterine insemination treatment, whose success rate is around 20%; or in vitro fertilization, with a 40% success rate. At this stage, expenses range from R$5,000 to R$30,000 per attempt. Across the country, only 12 services offer treatment against infertility through the SUS. None in Rio de Janeiro. When there is a shortage of supply, an alternative high-risk market is formed.
Furthermore, there is no population control. Therefore, children from the same donor may find themselves and become sexually involved in the future, not knowing that they are genetic "siblings".
The effectiveness of inserting semen through a syringe in the vagina is 4% to 5% - explains Assumpto Iaconelli Junior, director of the Fertility Medical Group.
Known Donor Insemination - This option is the cheapest, but it carries some risks. First, as the donor is always known, this means that if the desired parenting project does not include the donor as a parental figure, there is no guarantee that the donor will later change his mind and at any point decide to father the child. A possible problem is in the future the donor wanting to blackmail for "rights" to the child.
Concerns about legal issues are real, as those who opt for this apparent financial ease could end up spending a lot more on a future lawsuit.
The second risk is that, unlike what happens in a sperm bank, sperm donation is not subjected to rigorous control and testing, which ensure that the donor is not a carrier of a Sexually Transmitted Infection (STI) or even of important genetic diseases. Therefore, when choosing a known donor, unless he undergoes tests and remains for at least 6 months without any sexual activity, until the moment of donation, it is impossible to be sure at the time of donation and insemination that his semen is completely healthy and does not put the health of the inseminated woman at risk.
Shared Egg Donation Program
The option to have a treatment accompanied by a suitable professional and make your treatment cheaper is to be an egg donor. Thus, the woman who receives your eggs will pay for her treatment and for yours.
The Shared Ovodonation Program consists of treating two patients simultaneously: an egg donor and an egg recipient. These patients have in common the indication for an IVF treatment (obstructed tubes and age, sexual orientation, for example), normal medical and genetic evaluation, negative tests for infectious and sexually transmitted diseases and common characteristics. The donor patient, under 35 years of age, donates part of her eggs to another patient (RECEIVER), which is strictly prohibited because it establishes a financial link to the donation treatment.
Eggs can also be purchased through Egg Banks, from which the donors with the greatest similarity to the couple are chosen. Just like semen donors, egg donors undergo a genetic evaluation and careful tests to rule out the presence of infectious and sexually transmitted diseases.
Insemination with Sperm Bank Donor
This option is the safest. Depending on the country or sperm bank, it is possible to choose between a completely anonymous donor or an open identity donor (see the topic “Anonymous Donor or Open Identity Donor” in the section “Clinical Insemination Abroad” below on this page ) and obtain in some cases some information about the donor, but at the same time ensure that he does not have parental rights over the child generated through insemination.
Some sperm banks, upon medical authorization, ship units of unwashed (ICI) or washed (IUI) sperm directly to a private address (eg at home) for vaginal insemination. Unwashed sperm, which usually exists for cervical (ICI = intracervical insemination) or vaginal insemination, includes seminal fluid.
It usually has fewer sperm, but studies indicate that there are no higher success rates in inseminations with more than 10 million sperm. The quantities in the units made available to ICI guarantee this number or even, generally, a higher number.
However, there are cases of women or couples who prefer to use washed sperm units (IUI = intrauterine insemination), because not having the seminal fluid, the sample has more concentrated sperm values. It is not clear, however, whether this fact increases the success rate of vaginal insemination. The IUI units are, in fact, specially prepared for intrauterine inseminations, that is, inseminations directly into the uterus, which is a procedure, due to the risk of infection it entails, it should only be done by a specially prepared health technician and in a clinical environment .
On the other hand, the seminal fluid in the ICI units is important for sperm to survive better when in contact with the acidic environment of the vagina, such as in vaginal insemination. As IUI units are generally more expensive than ICI units, perhaps the financial factor is something to consider, but home insemination pregnancies have been reported, both via ICI and IUI units.
The difference between fresh sperm from a known donor and frozen sperm from a sperm bank is the amount of the sample, sperm in it, and the survival time of the sperm in the uterus after insemination. Frozen sperm have a smaller amount of sperm because the sample per unit is smaller and up to half of them can die in the thawing process (but, as mentioned, if the minimum number of sperm per insemination is 10 million, which usually is is guaranteed in sperm bank units, there will be no significant difference).
On the other hand, if the sperm in a fresh sample can live up to 5 days in the uterus, in the case of frozen sperm, the sperm usually survive 24 hours, maximum 36 hours. However, this factor is not necessarily a problem, if home insemination is well scheduled, as we will see later.
Finally, although it is not a rule, in some cases, when resorting to a sperm bank, it is possible to have access to a lot of data about the donor (personal and family clinical history, written and/or recorded interview, photo in child, letter from motivation, etc.).
In Brazil, only properly authorized clinics can import sperm and there is no sperm bank that sells (or can sell) units for insemination at home.
Do a home insemination
To maximize the success of a home insemination it is necessary to follow some procedures, namely knowing your own menstrual cycle and using methods to predict the ovulation time window.
Most women have a regular cycle of 28 days or that is very close (either less or more than a few days) of this value or that varies from month to month, depending on whether you ovulate from the left or right ovaries, for example. The ideal is to start, as soon as possible, recording the day on which the period appears every month, whether in a notebook, a diary or, even better, on a website or even in a mobile application created for this purpose, for 6 months (but if it's for less time, it's okay as long as you know your menstrual cycle well).
In addition to the day of menstruation, considered the first day of the cycle, it is necessary to know the day of ovulation. This can be achieved by the Basal Body Temperature Measurement method (BTT = Basal Body Temperature), made with a proper thermometer that can be purchased at the pharmacy or parapharmacy, or through Ovulation Tests (OPK = Ovulation Predictor Kit). The first is more time consuming and requires that the first temperature be taken every day, in the morning, in bed, after waking up and without getting up yet, while the second is a little faster and uncomplicated, because it is a simple urine test that can be done anywhere, but possibly more expensive.
Ovulation Tests available from pharmacies or parapharmacies are generally of little variety and expensive (Clearblue, Predictor, Fertifacil). It is possible to buy them cheaper, or even other cheaper varieties and brands, using foreign European websites. Another way to detect if you are close to ovulation time is through the Cervical Mucus and the Position of the Cervix, but these are generally considered to be complementary methods to the two mentioned above and not sufficient by themselves for those trying to program an artificial insemination.
If you notice that your menstrual cycle is irregular (too long or too short or that ovulation does not always happen) it is important to see a doctor first, as you will need to understand the causes and take the necessary treatments. Irregular cycles are usually associated with conditions such as Polycystic Ovaries or Deficient Luteal Phase, which are relevant factors for greater or lesser fertility and, consequently, imply greater or lesser difficulties in en.
In Brazil, it is only possible to carry out clinical insemination with an absolutely anonymous sperm bank donor. In fact, here, generally speaking, very little data about the donor are offered and very few options for choosing about their characteristics, which is not a problem for many women, but not the ideal situation for others.
In other countries, where insemination for single women or couples of women is also allowed, such as Belgium, the UK, the Netherlands, Sweden and Denmark, it is, however, possible or even only allowed (as in the case of the United Kingdom and Sweden) insemination with an open identity sperm bank donor, ie a donor who gives permission for the children generated by his donation to meet him after the age of 18, if they wish or even to have access to medical information in the event of serious health problems that may require it, without any implication or danger with regard to the parental rights of the couple or woman who resorted to insemination.
There is no consensual data on the effect on a child generated from an anonymous donor of not being able to know the donor who contributed to their pregnancy, so this is a very personal choice for each couple or woman. However, there are very clear guidelines on how to act when the child starts asking about where he came from and who the donor is: the recommended thing is to answer the children the truth (they usually start asking questions about who their “father” is between 3 and 5 years), in age-appropriate language, explaining that an anonymous man wanted to help his mother (or mothers) conceive him, that he is a donor, but not his father. In fact, a giver is a giver and not a parent, so try to avoid using the word “father”, which has a different emotional charge.
As already mentioned in the topic "Home Insemination", although it is not the rule, in some cases, when using a sperm bank, it is possible to have access to a lot of data about the donor (personal and family clinical history, written and/or recorded interview , child photo, motivation letter, etc.), with American and Danish sperm banks, which sell sperm to any country, an example in this area.
Tips for getting pregnant with homemade artificial insemination
Before trying AI, see a fertility specialist to make sure you don't have problems that prevent you from getting pregnant or having a healthy pregnancy. AI can be expensive and if the hopeful mom doesn't ovulate regularly then she may need assistance from a fertility specialist to avoid wasting her financial resources. AI can still be done at home, but fertility drugs may be needed to help with the process.
Education about the AI process and what needs to be done is very important. The mother-to-be should educate herself as much as possible so that she knows the failure and success rates. Researching how the procedure is done and finding information on how to do it at home can help with planning. Also ask an obstetrical gynecologist for information.
Make an insemination kit
Get an insemination kit. They can be purchased as a kit or as individual items. The success of AI depends on how the sperm will be injected into the woman. A needleless syringe or an oral medicine syringe may work for insemination. A soft towel or cloth and pillows will be needed. Pillows will need to be placed to elevate the hips, and the towel or cloth will catch any fluid that comes out after the injection.
monitor the cycle
Monitoring the fertile periods in the cycle is the most important aspect of successful AI. If insemination is done when the woman is not fertile, the semen will be wasted. The cycle can be monitored with basal temperature measurement and/or ovulation kits. For at least three months before taking the AI, the hopeful mom should take her basal body temperature. Either an ordinary thermometer or a digital basal temperature thermometer should be used so that variations in degrees can be monitored. Fluctuations are often a few hundredths of a degree and a normal thermometer doesn't show this. This measurement should be taken on waking up, after at least a few hours of sleep. The basal body temperature thermometer should be kept within reach of the woman where she sleeps with a notepad or chart to record the results. The three-month period before trying to get pregnant is to determine when ovulation usually occurs. Typically, a woman's basal body temperature will be basically the same every day. On the day of ovulation, the temperature drops dramatically and then rises. If pregnancy does occur, it is usually when the temperature remains high for 16 or 18 days after ovulation. This should be felt for at least a month after the possible positive pregnancy test. Doctors can prescribe an ovulation kit or they can be purchased directly from pharmacies. Prescription ones are more expensive, but they have the advantage that they can be used for more than the seven days that a simple kit provides. The ovulation kit will usually give you a three-day margin to do the insemination. In general, with sperm from a sperm bank, insemination can be done within 24 hours of ovulation. This kit provides instructions on how to determine when current ovulation occurs.
Not all doctors agree that the position helps achieve pregnancy, but it won't hurt. The most recommended position is lying down for 15 to 20 minutes with the hips raised after insemination. As with normal conception, an orgasm is recommended in a woman's insemination, but there is no evidence that having an orgasm affects the chances of pregnancy. Penetration must be avoided.