Self insemination

Women choose self-insemination for a number of reasons. They may already know a man they would like to use as a donor, they may want to know the identity of the donor even if he will have no role in parenting or contact with the child, or they may not want to undergo insemination in a clinic setting.

Many women have conceived using self-insemination. The insemination procedure itself is very simple, but there are a number of issues involved in finding your donor and making your arrangements with him. Successful insemination can take up to a year or more to achieve, so your donor must be committed to regular semen donations perhaps for some time. You may also need to arrange for other people to make a regular commitment to pick up the sperm if necessary and bring it to you.

It is important to make your expectations of the donor clear regarding his potential role and level of involvement. Even when you have reached agreement with your donor on these issues, bear in mind that both your own and his situation and/or feelings may change during the time it takes for insemination to be successful, as well as after the baby is born. You can avoid problems by keeping discussion of these issues alive. If you do not have a donor and cannot or do not want to find one through your own social networks, there are other ways of finding one.

Many women advertise for donors through the gay press. If you are thinking of finding a donor through an ad, you will of course be entering negotiations with someone who is a stranger and therefore an unknown quantity.

Men who offer sperm for donation may want some degree of contact with the child. You will have to be clear in your negotiations with potential donors about what the arrangements are if insemination is successful, particularly the degree of contact and involvement the donor can expect with the child. You will also have to negotiate health tests.

Some women's centres co-ordinate self insemination groups which invite potential donors to contact them. Again, you will have to think through the nature and extent of contact you and your child will have with the donor, as well as any financial aspects of the arrangement.

Insemination — First Steps

Going to a clinic

You can also obtain sperm through donor insemination from some fertility clinics. Women's Health has details of clinics which are willing to offer donor insemination to lesbians and single women.

Use of a clinic guarantees that the sperm is fertile and has been screened for sexually transmitted infections. It also provides you with an anonymous donor if that is what you want. The donor's identity is kept confidential by the clinic.

Sperm donors used by clinics are men aged between 18 and 55 with a relatively high sperm count who have undergone health screening for hepatitis and sexually transmitted infections including HIV. Before starting treatment, clinics must offer the opportunity for women to receive counselling.

The disadvantages are that going to a clinic can be expensive, and some clinics may be hostile to, or refuse to treat, lesbians and single women.

A possible problem is that everyone has to undergo an assessment which involves answering a number of personal questions. This is to satisfy the legal requirement that the clinic 'take account of the welfare of any child who may be born as a result of treatment (including the need of that child for a father) and of any other child who may be affected by the birth'. Some clinics, as a matter of policy, do not offer treatment to single women or to unmarried couples.

Most clinics have upper age limits for women, although there is no national age limit.

Health screening

If you are finding your own donor his fertility is not guaranteed, even if he already has children. It is a good idea to get the donor to ask his GP to check his sperm count.

You must also discuss health screening with him. You could prepare a questionnaire about his health background. Lisa Saffron's book Challenging Conceptions has a useful example.

Most people are aware of the need for HIV testing. An HIV test may not show HIV positive until three months after infection. This is why your potential donor should have two HIV tests, at least three months apart, and should avoid putting himself at risk in the interim before the sperm is donated.

The donor should also be tested for other sexually transmitted infections. The tests can all be done free at a Genito-Urinary Medicine (GUM) clinic.

Pre-conceptual care

Knowing you want to be pregnant gives you the opportunity to prepare yourself physically. If you smoke you really should try to give up, as smoking contributes to low birth weight babies and recent evidence has shown that pregnant women who smoke may give birth to babies with breathing problems.

The Health Education Authority recommends that women planning a pregnancy should take a supplement of 0.4 mg (400 mcg) folic acid, and continue taking this for the first three months of pregnancy. Folic acid halves the risk of the baby having a neural tube defect such as spina bifida.

It is also wise to cut down on drinking alcohol, if not cut it out altogether. This is not only to avoid harm to the baby but also because alcohol may reduce your fertility.

Try to eat a well-balanced diet which should include lots of fruit and lightly-cooked vegetables.

Rubella is a virus infection which can cause blindness, deafness and heart disease in the baby if you have it during pregnancy, especially during the first three to four months. It is worth having your blood checked for immunity to rubella, even if you have had a vaccination. You should wait three months after a rubella vaccination before doing an insemination.

Insemination — The Process

Fertility awareness

To maximise your chances of getting pregnant it is important to inseminate at the time when you ovulate. You can find out when this is by charting the minor changes in your body temperature, and observing the changes in your cervical mucus. The Women's Health leaflet Knowing your cycle outlines how to do this.

How self-insemination is done

The man ejaculates into a clean glass or plastic container. Aim to keep this at body temperature. Semen becomes more liquid up to 20 minutes after ejaculation. If you want to use it straight away, it is easiest to wait until it has liquefied before sucking it up into a syringe without a needle. (Syringes without needles are available from Women's Health.)

If the semen has to be stored or transported it will remain active for 1 to 2 hours as long as it is kept at or just below body temperature. A good way to transport it is to suck it into a syringe then wrap the syringe in clingfilm. Some women use a speculum to locate their cervix, then squeeze the contents of the syringe close to the cervix. Do not inject the sperm directly into the cervix as this could cause injury. Some women simply empty the syringe without using a speculum to locate their cervix. After insemination, lie down with a pillow under your hips for 15 to 30 minutes. It is best to inseminate at least twice and preferably three to five times in each fertile period.

What if I don't get pregnant?

You may get pregnant after your first or second cycle, but it is quite normal to take six to twelve cycles, especially if you are only inseminating once or twice per cycle.

If you have not conceived after a year you may have fertility problems. Your donor should see his GP and ask for semen analysis, which will include checking that the sperm are active and present in sufficient numbers.

Investigation of female infertility is more complicated. If the donor's sperm appears to be normal and you are inseminating at the best time each month but without success, the next step is to ask your GP for a referral to an infertility specialist. Getting a referral and being given the appropriate investigations and treatment depend on the attitudes of your GP and specialist towards self insemination.

Some lesbians and single women have had great difficulty in obtaining infertility investigations. This is where contact with other women who have used self insemination may help. Other women may know the name of a sympathetic consultant to whom your GP can refer you.

Insemination - Issues to consider

Legal rights

When sperm has been obtained from a clinic, the donor is not the legal father and has no legal responsibilities for the child. The clinic keeps the identity of the donor strictly confidential.

However, when a child is conceived as a result of self insemination the donor (if identified) is recognised as the father and as such has rights under the Children Act.

A child born as the result of donor insemination through a licensed clinic has the legal right at the age of 18 to apply to the HFEA to obtain information about his or her origin, including non-identifying information about the donor.

Other issues to consider

Most people you come into contact with will assume that you conceived through sex with a man, unless you tell them otherwise. You will need to consider carefully what you want to say so that you can cope with the inevitable assumptions and questions from medical staff, family, friends and acquaintances.

Support

Contact with other women who are planning or have done self-insemination can be a useful way of gaining support and sharing information. From time to time there are groups organised through women's centres. If you don't know any other women in the same situation you could contact the nearest women's centre, and think about advertising through a gay or women's publication. The DI Network provides contact and support for those who have children, or plan to have children, conceived using donated sperm or eggs.

Insemination — Resources and contacts

Self-Insemination Workshops and kits

Workshops for lesbians thinking about having a child by donor insemination, also individual and couple sessions, facilitation of meetings with donors, and advice on health screening. Sliding scale of fees. Contact Lisa Saffron, Tel 0117 904 4500. Email: Lisa_Saffron@compuserve.com or write to:
Lisa Saffron
Box 55
Green Leaf Bookshop
82 Colston Street
Bristol BS1 5BB

Kits containing syringe and extending tubes, fertility charts and separate advice leaflets for men and women, £5 from Lisa Saffron at the above address.

Human Fertilisation and Embryology Authority (HFEA)

The HFEA is responsible for licensing and monitoring clinics that carry out in vitro fertilisation, donor insemination and human embryo research, and it regulates the storage of eggs, sperm and embryos. It also collects information about the outcomes of fertility treatments. Publications include an annual Patients' Guide to DI and IVF Clinics, and a list of all licensed clinics.

HFEA
Paxton House
30 Artillery Lane
London E1 7LS
Tel: 020 7377 5077
Fax: 020 73+77 1871
www.hfea.gov.uk

Books

Good for You: a handbook on lesbian health and wellbeing by Tamsin Wilton (London: Cassell, 1997)
Useful chapter on pregnancy, birth and parenting which includes questions to ask yourself to help decide on a method you want to use to obtain sperm.

The Ultimate guide to Pregnancy for Lesbians: how to stay sane and care for yourself. Tips and techniques from conception through birth by Rachel Pepper (San Francisco: Cleis Press, 1999).

Valued Families: the Lesbian Mothers Legal Handbook by Lynne Harne and Rights of Women (London: The Women's Press, 1997)
Information on all aspects of lesbian parenting including fostering, adoption, donor insemination; co-parenting; housing; domestic violence; custody and contact disputes; immigration and wills; self-help legal advice; psychological studies and children's experiences.

What about the children? Sons and daughters of lesbians and gay parents talk about their lives by Lisa Saffron (London: Cassell, 1996)

Challenging conceptions: planning a family by self-insemination by Lisa Saffron, (updated 1998. Self-published book)
Available from Green Leaf Bookshop, see address under Self Insemination Workshops.

DC Network (Donor Conception Network, formerly Donor Insemination Network)

DCN
PO Box 265
Sheffield S3 7YX
Tel/fax: 020 8245 4369
Email: dcnetwork@appleonline.net
www.dcnet.org
A self-help group for women and men who either have children conceived with donated gametes—donor insemination and IVF with donor sperm or donated eggs—or who are contemplating having treatment. The Network has a coordinator for single women and a coordinator for lesbian couples.

Useful contacts

Stonewall Parenting Group
c/o 16 Clerkenwell Close
London EC1R 0AA