Between 2006 and 2010 an estimated 700,000 women between the ages of 25-44 underwent insemination procedures. However, the actual insemination rate is likely much higher. In the United States, donor insemination is not tracked, which makes getting the exact number of procedures and resulting births currently impossible. Donor insemination may be the pathway you choose to build your family. Here’s what you need to know.

Who Needs Donor Insemination to Get Pregnant?

An individual or couple may consider donor insemination for any number of reasons.

Male Partner With Severe Male Infertility

Infertile couples facing severe male infertility—azoospermia or extremely low sperm count—may consider donor sperm. For some of these couples, IVF with ICSI and TESE or TESA may be another option they consider before moving onto donor sperm. TESE stands for testicular sperm extraction, and TESA stands for testicular sperm aspiration. The sperm cells mature in the lab until they’re ready to inseminate an egg via IVF-ICSI, wherein a sperm cell is directly injected into an oocyte. However, this isn’t an option for all couples. For some men, even TESE and TESA can’t retrieve viable sperm cells for IVF.  Another issue with IVF-ICSI with TESE/TESA is it can be prohibitively expensive. Donor insemination isn’t cheap, but it’s significantly less costly than IVF-ICSI with TESE/TESA. Another reason why a couple may choose donor sperm over pursuing IVF-ICSI with TESE/TESA is the increased risk of passing on male infertility to a male child. Some intended parents are okay with this risk, while others are not.

Male Partner Has Untreatable STD

The vast majority of sexually transmitted infections can be treated. However, there is an increasing number of STIs that are antibiotic resistant. Sometimes IVF can be used to reduce the risk of passing on the disease to the female partner, but not every couple wants to go that route. For these couples, donor insemination might be a possible road to parenthood. If a male partner is HIV positive and the female partner is HIV negative, there may still be a possibility of the couple having a genetic baby together without passing on HIV to the female partner. This involves the use of anti-viral drugs and sperm washing. Talk to your doctor about your personal situation.

Non-Correctable Problems With Ejaculation

As discussed earlier, sometimes treatments like TESE or TESA can be used along with IVF-ICSI to enable a couple to have a genetic child together. However, not all couples are able or want to pursue this option. They may want to look at donor insemination as a pathway to parenthood.

Genetic or Hereditary Disease Concerns on Male Partner’s Side

IVF with PGD—a method of screening for genetic diseases—can be used in some cases. However, some couples would prefer to use a sperm donor. In rare cases, couples that are Rh incompatible may consider donor sperm. This can usually be resolved with treatment, but if the female partner can’t have the Rhogam shot, due to an allergy, for example, a sperm donor may be another option.

Single Women

Women who want to have a baby but don’t have a partner may consider getting donor sperm.

Lesbian Couples

Lesbian couples frequently seek out a sperm donor to have a child.

What Happens Before the Donor Insemination Process

The steps before the actual donor insemination will vary depending on your situation. For example, have you been trying to have a baby for a while, and this is your next step in fertility treatment? Or, are you just starting to consider building a family and donor insemination is your chosen path? With this caveat in mind, here’s what you might expect before your donor insemination cycle.

Finding a Physician or Fertility Clinic

First, you’ll want to find a primary care provider or a fertility clinic who can oversee your donor insemination process and cycle. This will typically be a fertility clinic, but some gynecologists and midwives offer guidance and support during donor insemination. Whenever you’re looking for a doctor or clinic, take into consideration not only their success rates but also their attitudes. This is especially important for single women and lesbian couples looking to have a baby. You want to be in an environment that welcomes and accepts your lifestyle.

Basic Fertility Testing

Even if you have no known fertility problems, you will want to have at least basic fertility testing before you try donor insemination. Why have basic fertility testing? The primary advantage is to avoid wasting time and money on donor insemination cycles that are unlikely to succeed. For example, you may have blocked fallopian tubes from an undiagnosed infection. You can’t get pregnant with donor insemination if your tubes are blocked. Another example, perhaps you have an undiagnosed ovulation problem. You might benefit from adding fertility drugs to your insemination cycles, but you wouldn’t know that if you didn’t do testing first. Basic fertility testing involves:

Basic gynecological screenings like a pap smear and sexually transmitted infection testing Hormonal blood work A specialized X-ray known as an HSG A pelvic ultrasound, specifically an antral follicle count (especially if you’re age 35 or older) 

Psychological Counseling

Your physician may or may not require counseling before proceeding with a donor insemination cycle. This depends on your situation and how you came to this family building decision. Whether or not your health care provider recommends counseling, you should seriously consider seeking it out yourself before proceeding. Topics you may discuss with a counselor include:

Informed consent on the possible psychological risks and benefits of donor insemination Processing any feelings of shame regarding donor conception Grieving the loss of one partner not having a genetic connection to the child (applies to couples with several male infertility and lesbian couples) Processing the emotions that come with single motherhood-by-choice Deciding who will carry the pregnancy (for lesbian couples) Understanding the benefits and risks of using a known sperm donor Understanding the benefits and risks of choosing an anonymous, semi-open, or open sperm donor Discussing how you’ll decide which sperm donor to use Considering how and when you’ll tell your child about their donor conception roots

Legal counseling may be recommended or required, depending on your situation. For example, if you’re a lesbian couple, the partner who doesn’t carry the pregnancy may want to pursue legal adoption of the baby when he or she is born. This should be discussed and considered before pregnancy even starts. Another situation when legal counseling is strongly recommended is if you’re using a known donor. There are many legal risks to this path, and you will want to seek out legal advice from a lawyer familiar with family reproductive law.

Finding a Sperm Donor

There are several places you can find a sperm donor, including:

Fertility clinicsSperm banksYour personal connections

When looking at sperm donors found through a clinic or sperm bank, you’ll also hear terms like “semi-open” and “anonymous” donor arrangements. This refers to the ability to have contact between your future donor-conceived child and the donor. The general advice these days favors semi-open arrangements because it allows at least one contact between the donor-conceived child and the sperm donor.  If you decide to use someone you know—also known as a “known donor”—be aware that there are many legal and psychological intricacies involved. There have been cases where known sperm donors later decided to sue and attempt to get parental rights, and there have been cases when women who have used a known sperm donor attempted to sue the donor for child support payments. These issues have occurred even with contracts being signed before the donor insemination took place.

Choosing a Sperm Donor

The process of choosing a sperm donor is a personal one. There’s really no right or wrong way to decide, but there are some basic things to know before you start your search. Sperm bank databases carry various amounts of information. You’ll likely find at least one picture (usually of the donor when they were a baby or young child), and some personal details like their profession. Some donor databases will also give you likes and dislikes, personality, and IQ testing results. Keep in mind is that your donor-conceived child isn’t destined to have the exact likes and dislikes as their donor. Think about how much you have in common with your genetic mother and father, assuming you know them. You may have some things in common, but in other ways, you are likely very different. Some factors you may consider when choosing a donor include:

Appearance. For example, you might want a donor with the same hair and eye color as your partner.Blood Type. This is especially important if the woman who will be carrying the baby is Rh negative.Medical and Psychological History. Information about a donor’s health and their family health history can help assess the risk for genetic and health conditions.Personality. While you can’t know for sure, you may be able to guess based on a donor’s answers to questions found in the database.

The Donor Insemination Cycle

What your donor insemination will look like depends on the type you are planning to have. There are three types of donor insemination used and there are advantages and disadvantages to every option.

Intra-cervical (ICI) or intra-vaginal insemination (IVI)Intrauterine insemination (IUI)IVF with donor sperm

Generally speaking, IUI is the most common method used because the success rate is slightly higher than intra-vaginal or intra-cervical insemination. IVF with donor sperm is only chosen if there are fertility challenges with the woman carrying the baby. You may have a natural cycle or a cycle with fertility drugs. A natural cycle just means that you won’t be taking any fertility drugs to stimulate or boost ovulation. You only need fertility drugs with insemination if there are ovulation concerns in the woman who will carry the pregnancy.

Can You Do a Donor Insemination At-Home?

Doing sperm insemination at home may feel more comfortable and convenient, but there are risks you need to consider. Going to a fertility clinic or doctor’s office is, from a legal and medical standpoint, usually the preferred option. There are several reasons someone might want to do at-home insemination:

Intimacy. Insemination in a fertility clinic is not romantic and the process can be intimidating.Cost. At-home insemination will generally cost less than going to a medical office.Discrimination. Single women and lesbian couples living in rural areas may have difficulty finding a clinic willing to work with them.

Some donor banks will send donor sperm to your home, along with instructions on how to inseminate yourself. Inseminations at home are always vaginal. If you’re planning on using a known donor (someone you know personally), you absolutely should not try at-home insemination. The law in many locations states that donor insemination done outside of a medical facility with a known person is not legally considered donor insemination. The sperm donor would be considered the child’s legal father, and he would have the legal rights and obligations of any biological father, regardless of any contracts signed saying otherwise.

Success Rates for Donor Insemination

Your odds of success depends on several factors, including:

Type of insemination procedure (IUI is more successful than ICI or vaginal insemination)Age of the woman being inseminatedAny underlying or present female fertility problemsWhether or not fertility drugs were used with the cycleHealthy lifestyle habits of the female partnerThe health of the male donor (more relevant when using a known donor, since all sperm donors are carefully screened.)

In a study of 402 women having IUI with donor sperm, researchers found that the pregnancy rate per cycle was 17.2 percent. This rate was calculated over 1,264 cycles in total. (In other words, most women had multiple insemination cycles before achieving pregnancy success.) The recommendation is to try three to six cycles of IUI before considering other higher-tech methods of conception.

How Much Does Donor Insemination Cost?

You can expect to pay anywhere from $700 to $1,200 for donor sperm, which takes shipping into account. This cost is for one vial of donor sperm, which is good for one cycle or attempt. Known donors typically don’t receive financial compensation, but they will still need to go through a medical screening, and their sperm will need to be processed and stored. This will cost at least a few hundred dollars. Considering that you may need to try a few cycles to achieve pregnancy success, you may want to have the donor bank send to your fertility clinic a few vials at once to save a little money. Shipping donor sperm can be very expensive. Another reason you may want to purchase multiple vials of the same donor sperm is that you hope to have more than one child and hope to use the same donor sperm (if possible) for each conception. You’ll also need to consider storage fees charged by your clinic, which can be a few hundred to several hundred dollars per year. In addition to the cost of the donor sperm itself, you will also need to pay for:

Consultation with your doctorPossible legal fees (if using a known donor)Payment to meet with a counselor (especially with resolution to male infertility)Fertility drugsCosts for monitoring the cycle (ultrasounds, blood work)The insemination procedure

However, some costs may not repeat. For example, if you already shipped the vials in bulk to your clinic, or you have completed consultations with a therapist or lawyer, you won’t need to pay for those services again.

Is Donor Insemination Safe?

Donor insemination via a fertility clinic is generally safe. If no fertility drugs are being used (which introduces a different set of potential risks), the primary medical risks of donor insemination are:

Risk of infectionRisk of the family medical history shared by the donor being incorrect

Sperm banks and fertility clinics are careful to screen donors and verify information that donors share. Still, there have been cases where donors have not shared vital family history information (such as a history of mental illness).

Alternatives Donor Insemination

Your alternative options to donor insemination depend on why you’re considering using a sperm donor. With that said, some possible alternatives include:

IVF with an embryo donor IVF with ICSI and TESE/TESA (testicular sperm extraction, if that’s a possibility in your particular case) Adoption Foster parenting Co-parenting (which can include insemination, to some degree, except with co-parenting, the known donor would be agreeing to also play a parenting role in the child’s life) Living a child-free life

A Word From Verywell

Donor insemination is a path to parenthood that many individuals take, for a variety of reasons. Coming to this decision, choosing your donor, and proceeding with the insemination cycles can be stressful. On the other hand, the process can also bring joy, excitement, and hope. Don’t feel like you need to go through the process alone. Talk to your health care provider and a professional counselor who is familiar with donor conception so you can feel supported and make informed decisions.