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Donor Insemination: The Basics

Donor insemination is one possible path to parenthood for the LGBT community. This page outlines some of the basics.

Conception Methods

There are two methods on conception: intracervical insemination (ICI) and intrauterine insemination (IUI.) Here are the key differences between them:

Intracervical Insemination
The sperm is placed just inside the woman's cervical opening through the use of a speculum and syringe.

  • It can be performed at home or in a doctor's office.
  • It is less expensive than intrauterine insemination

Intrauterine Insemination
The sperm is placed just inside a woman's uterus, using a flexible catheter.

  • It can only be performed in a doctor's office.
  • It is more expensive than intracervical insemination. But it tends to lead to a pregnancy more quickly.

Known vs. Unknown Donor

The first choice anyone considering donor insemination must make is do you want to become pregnant through a friend or acquaintance (that is, a "known donor") or through someone you find through a sperm bank (an "unknown donor").

Known Donor

Here is a brief overview of the advantages and risks involved in choosing a known donor followed by some of the precautions you should take if you pursue this path.

Advantages

  • You know what the donor looks like and acts like.
  • As he or she grows up, your child can develop a relationship with the donor.
  • The donor may be genetically linked to the non-biological mother, guaranteeing her some biological connection to the child.

Risks

  • If a known donor later develops strong feelings for your child, you, or if you have a partner, she, could lose custody or have it curtailed; and
  • The man you choose could be HIV-positive or have another serious transmittable disease that he might pass on to your child.

This is why so many experts recommend that women choose an unknown donor. While they pose their own disadvantages, they do protect you from the legal risks of a custody battle and greatly reduce the risk of your child's exposure to HIV and other viruses.

Precautions

  • Asking your donor to go to a sperm bank, where his specimen can be quarantined and tested for HIV and other diseases; and
  • Learning what experts recommend as the best tactics for protecting yourself legally.  See Known Donor Agreement.

Unknown Donor

Using a sperm bank typically does not offer your child the opportunity to know the donor, at least, perhaps, until after the age of 18. But in many ways, it remains a safer alternative than becoming pregnant through someone you know.  

Practical Advantages

Reduced Risk of HIV/AIDS
Accredited banks quarantine a semen sample for six months before releasing it to any woman. The reason: When a man is exposed to HIV, he may not develop any antibodies for as long as six to eight weeks and, thereby, may unknowingly put others at risk. By quarantining all specimens, a sperm bank allows plenty of time for thorough testing for HIV and other sexually transmitted diseases.  

Ability to Control Your Child's Exposure to Problematic Genes
With a sperm bank, you can choose your donor based on a clean bill of health, or, at least, a clear-headed evaluation of the donor's comprehensive medical history.

Reduced Risk of Custody Challenges
In some states, when a woman has a child with the help of a male friend or acquaintance, she exposes herself to potential custody challenges. But when she has a child with the help of an anonymous donor found through a sperm bank, she is shielded from those challenges because unknown donors surrender all their parenting rights.

Read more in: Selecting Sperm Banks and Unknown Donors

Insurance Coverage for Fertility Services

Health insurance companies generally only pay for alternative insemination when a woman has a diagnosis of infertility - that is, when it is considered "medically necessary." There are different definitions of infertility. The most common and traditional one is when there has been 12 months of unprotected intercourse without conception. Depending on a woman's age, some insurance companies reduce that to six months of unprotected intercourse - or inseminations (performed in a doctor's office, not at home).

If you are uncertain about what your health insurance policy covers, you can call the customer representative and ask:

  • What infertility treatments are covered?
  • What is the definition of infertility?
  • How is it documented?
  • Does the policy cover insemination for same-sex couples?

Find more information at Resolve, the national infertility association, the American Society for Reproductive Medicine or the InterNational Council on Infertility Information Dissemination.

See also: Discussing Donor Insemination with Children