Chapter 54
DIY - Insemination

from the book How to Have a Baby: Overcoming Infertility
by Dr. Aniruddha Malpani, MD and Dr. Anjali Malpani, MD.

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DIY (do-it-yourself) or self-insemination, is a method in which the woman (or her partner ) inserts semen into the vagina herself, without medical intervention. This is a useful technique for couples with sexual dysfunction (e.g. inability to consummate the marriage because of impotence or vaginismus); when the husband cannot perform sexual intercourse for any reason on the fertile days; or for single women or lesbians .

It’s surprisingly easy to learn to do, but because most women know so little about their own anatomy, most are very uncomfortable even attempting to try it. This guide should help you with the basics, but the only way to learn is by doing it. You can also ask your doctor for help and she may be able to guide you in the beginning. Some couples may get turned off by the idea, because it is so "clinical", with a little bit of imagination, and your husband’s cooperation, you can make it fun!

So what do you need? Very little, really.

The most important ingredient is a freshly ejaculated semen sample. Ask your husband to ejaculate in a clean glass or plastic container. Make sure this is wide-mouthed, so it’s easier for him to aim accurately – you don’t want any of it to spill out! Sometimes getting a sample can be difficult, and you may need to seduce your husband! Using a vibrator, or liquid paraffin as a lubricant, can help enormously. You can also use frozen semen samples from a sperm bank, after allowing them to thaw at room temperature.

After the semen sample has liquefied (this takes about 30 minutes), you are now ready to perform the procedure. Ask your husband to put on disposable gloves and then suck up the semen sample into a 10-ml plastic disposable syringe (without a needle). Our patients find it more convenient to use a disposable plastic pasteur pipette, but this may be difficult to find. You can even use a turkey baster, which has become a legendary symbol in the lesbian community, but the small amount of semen does not require such a large instrument.

The semen now needs to be squirted into your vagina, and this is the tricky part. You need to lie on a bed, with your knees and thighs bent, and your knees wide apart, so that your husband can see your vulva clearly. He then guides the tip of the syringe into your vagina (he can do this just by feel, by inserting the left index finger into your vagina, and using this to guide the syringe, which is in his right hand). He can put the syringe in as deep as he wants – don’t worry - it won’t get lost. He then plunges the barrel, depositing the semen into the vagina.

You may find it easier to lie on the edge of the bed, so that your hips protrude over the edge. Putting a pillow under your hips can make it easier for your husband to perform the insemination. You can remain lying on your back for about ten minutes, after which you can resume normal activity. Some of the semen will leak out, and this is normal.

While using a speculum is not essential, it can help, because it makes it easier to inject the semen at the mouth of the uterus (the cervix). You can use a disposable plastic speculum, and when you insert the speculum, make sure the blades are closed. You can slide it in upwards, or else sideways, turning it when it has been pushed all the way into your vagina. When the handles are above your pubic bone, squeeze them together, which will open your vaginal walls. You will hear a click when the speculum is locked open. If your husband holds a torch, he’ll be able to see your cervix, which is round and pink with an opening (the os) in the middle. The mucus may appear as a clear bubble, or a thread like raw egg white. You can use a mirror to see what’s going on for yourself, if you so desire! After the insemination, make sure that you release the handles and collapse the blades before removing it from your vagina.

Some women use a cup or cap for self-insemination. Rubber cervical caps are designed for contraception (hence the name "cap") but they can be used for insemination. There is also a cervical cup especially designed for insemination, which is slightly larger and more shallow, the name "cup" indicating that it serves as a semen receptacle. You simply squat down, check the position of your cervix, and insert the cap containing the semen in that direction, holding it upright at all times. Check all around the top of your vagina to make sure that you didn’t miss you cervix. The cup can be removed after several hours. Take care to break the suction by hooking a finger over the edge of it before trying to pull it out.

Timing the procedure is extremely important, because you need to inseminate during your "fertile period". Fortunately, it’s quite easy to determine when you ovulate, and you can either monitor your cervical mucus, or use an ovulation prediction kit.

You can assemble your own self-insemination kit and this should contain:

• Ovulation prediction test kits (to help you to time the procedure)
• Semen container (wide-mouthed plastic jar)
• Lubricant (liquid paraffin) to help your husband, if needed
• Disposable 10 ml plastic syringe (without needle)
• Disposable paper/rubber gloves

Options:

• Cervical cap
• Plastic speculum
• Torch
• Mirror

If you prefer, you can order a ready-made kit from www.drmalpani.com !

by Dr. Aniruddha Malpani, MD and Dr. Anjali Malpani, MD.

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Other IHR Web sites: 
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Professionals: InfertilityProfessionals.com
Professionals: InfertilityWebsites.com