Lesbian Artificial Insemination – Process, Success Rate & Cost

By (gynaecologist), (embryologist), (embryologist) and (fertility counselor).
Last Update: 06/05/2020

Artificial insemination is a popular option to build a family among lesbian couples wishing to have a baby. IUI for same-sex couples is the simplest method to achieve a pregnancy as long as at least one partner meets a series of basic requirements related to tubal patency and age. High success rates can be achieved if the process is carried out properly.

What follows is a guide to intrauterine insemination for lesbian couples, with its success rates and average cost. Also, other non-clinical alternatives for being inseminated are mentioned, though they are not considered to be fertility treatments per se.

Process of IUI for same-sex couples

The clinical insemination process for lesbian couples works the same as that followed in the case of heterosexual couples or single females. In the case of lesbian couples, they have the chance to choose who they want to be the one getting pregnant.

To do so, your doctor will ask you both to undergo a fertility evaluation to see who fits best all the requirements for the treatment to be successful: tubal patency, age, absence of infections or viral diseases, etc.

Many fertility tests require the woman to be at a certain phase of the menstrual cycle.

Once you have decided who is going to be inseminated and therefore carry the baby to term, the next step involves taking fertility medications to control the ovulation cycle. During that period of time, the woman is monitored through ultrasound to see if everything is working as expected.

Intrauterine insemination is scheduled just before ovulation occurs: with a thin catheter, the sperm of a donor is inserted through the cervix into the uterus and placed as close as possible to the egg, thereby increasing the chances for fertilization.

Lesbian couples have no alternative but to use a sperm donor to conceive via artificial insemination. Broadly speaking, and depending on the country, they can choose between a known or an anonymous donor. The following section will provide you with further information on how to find the right for you.

Finding a sperm donor

The most advisable is to visit a lesbian-oriented, gay-friendly sperm bank. However, the fertility clinic of your choice may offer sperm donation as well. Whatever your case, you might be asked to choose between a known or an anonymous donor.

When matching a patient to a sperm donor, experts try to find the highest possible level of compatibility between them.

This is of outmost importance when it comes to matching their immunological and phenotype characteristics.

If you prefer a known donor, that is, you wish to be the one who selects the traits of the man who will share his genetic material with your baby, aspects such as the race and the blood type might be crucial. For more information on this, do not miss this post: How to find a sperm donor.

Known sperm donor agreement

On the other hand, you will have to sign a contract to make sure the donor agrees to have no legal right to the baby. Some lesbians want to a have a father involved in their child's life, in which case co-parenting might be the best option for you.

When being a sperm donor for a lesbian couple, if you agree to co-parenting, your level of legal parental responsibility depends on whether it is a single lesbian woman or a civil partnered lesbian couple. All this questions should be clearly communicated prior to artificial insemination.

Success rates for lesbian couples

The main benefit of IUI for lesbian couples is that they can choose which partner is going to carry the pregnancy. Although each couple is free to decide, normally it is the one with the best fertility who is inseminated to increase the likelihood of pregnancy.

Apart from that, the success rates of lesbian insemination are the same as IUI with donor sperm or with the husband's sperm: they depend on the fertility status of the woman being inseminated, which basically depends on her age.

Other factors which might have an influence on the results of IUI include the endometrial thickness and the ovarian stimulation protocol followed. Keeping this in mind, the success rates of AI are 16-20% on the first try, a rate which keeps on increasing up to the fourth attempt (31-35%).

The success rate of AI is cumulative.

If a pregnancy has not been achieved after the 4th attempt, we may suspect that there exists a fertility problem. In these cases, the couple will be suggested to move to in vitro fertilization (IVF). To learn more about this technique for same-sex couples, visit the following post: Reciprocal IVF.

Average cost

The cost of artificial insemination for lesbian couples is the same as in any other procedure with donor sperm: about €1,700 on average. The cost of IUI with donor sperm is always more expensive than artificial insemination by husband because donors are screened and economically compensated.

The fees included in the initial price might vary from clinic to clinic, and also depending on the country, its regulations on assisted conception, etc. However, quotations for IUI normally include:

  • Monitoring of ovarian stimulation
  • Sperm laboratory processing (i.e. sperm capacitation)
  • Compensation paid to the sperm donor
  • Donor screening
  • Insemination procedure

More often than not, fertility medications to induce ovulation are not included in the cost of AI. However, the cost derived from these medications is cheaper in comparison with IVF cycles, as the purpose is to trigger the maturation of just one or two eggs, so the dosage administered is low.

Other insemination options

In addition to clinical artificial insemination, lesbian couples have two more options: one the one hand, at-home artificial insemination or DIY insemination, and, on the other hand, natural insemination (NI).

It should be clear that none of them is considered infertility treatments. Yet, they are valid option for LGBT family building, though the risks involved should be taken into account. Continue reading the details of each option hereunder:

Artificial insemination at home

Performing intrauterine insemination (IUI) at home is more complicated than intravaginal insemination (IVI), as it involves a thin catheter and knowledge on where to place it. For this reason, women tho self-insemination normally do IVI instead of IUI.

As for the semen sample, it can be obtained through two ways of obtaining it:

Getting sperm from a sperm bank
Some sperm banks allow patients to buy sperm online and have it shipped directly to their residence. It usually comes with a full kit for self-insemination (syringe, gloves, guidelines, etc.).
Having someone you know donate sperm
If you have chosen your potential sperm donor (e.g. a friend, family member...), the next step is to visit a bank for washing and processing the sample, making sure he is free from STDs and other diseases.

Natural sperm donation

Natural insemination means having a man you know have sex with one of the partners, thereby getting pregnant naturally. The main risk of this method is that, if no agreement is signed, the donor might claim his parental rights to the child once born.

Also, if the man has not undergone all the necessary tests to discard the presence of STDs, they might be transmitted to the child. So, if you have decide to turn to this option, having the donor carry out all the necessary tests is crucial.

FAQs from users

Whom will the sperm donor look like in artificial insemination for female couples?

By María Arqué M.D., Ph.D. (gynaecologist).

In artificial insemination treatments with donor sperm, the selection of the donor is carried out seeking the maximum phenotypical and immunological similarity with the recipient woman. In most centers, in cases of female couples, the physical characteristics of both are taken into account for the selection of the most suitable donor.

Can same-sex couples get IUI on NHS?

By Sara Salgado B.Sc., M.Sc. (embryologist).

Yes, according to the National Institute for Health and Clinical Excellence (NICE) guidelines, gay couples should be offered NHS fertility treatment as well. In the case of IUI, up to 6 cycles can be done on the NHS. If none is successful, reciprocal IVF might be covered in some cases.

What is the difference between reciprocal IVF and lesbian insemination?

By Sara Salgado B.Sc., M.Sc. (embryologist).

Reciprocal IVF is done via in vitro fertilization, that is, the woman who is going to carry the pregnancy undergoes ovum pick-up (OPU) surgery and embryo transfer (ET), with fertilization taking place outside her body.

In the case of IUI, one partner is inseminated with donor sperm, but fertilization occurs inside her body, without undergoing surgery for egg retrieval or ET.

Does insurance cover artificial insemination for lesbian couples?

By Sara Salgado B.Sc., M.Sc. (embryologist).

Insurance coverage for lesbian artificial insemination is offered in some countries. As mentioned earlier, the UK is one of the countries where this option is possible. As for the USA, some insurance policies do cover fertility treatments.

In Spain, however, medical justification is required: in this case, a diagnosis for male infertility. Given the absence of a male partner, the Public Health does not cover IUI with donor sperm for lesbian couples.

Reciprocal IVF vs. donor insemination, what's better?

By Rebeca Reus BSc, MSc (embryologist).

It is not a matter of choosing one over the other, but about considering the pros and cons of each option. Usually, women in a lesbian relationship are recommended to start with IUI and after 3-6 failed cycles, they are recommended to move to IVF, as higher success rates are expected to be reached.

However, a couple may wish to undergo this process in order for both women to participate in the pregnancy actively. It is their choice.

Suggested for you

Have you tried artificial insemination several times with no luck? Maybe it is time to consider IVF. If you want to learn more about this fertility option, do not miss this post: What is reciprocal IVF?

To learn more about other conception options for women in a lesbian relationship, do not miss the following post: Baby options for lesbian couples.

Do you know how does sperm donation work? If you have any question, enlighten yourself with this article: What is sperm donation?

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Authors and contributors

 María Arqué
María Arqué
M.D., Ph.D.
Doctorate in Reproductive Medicine at the Autonomous University of Barcelona, specializing in Obstetrics and Gynecology. Dr. María Arqué has many years of experience as a Reproductive Medicine and Gynecologist Consultant and currently works as Medical Director at Fertty International. More information about María Arqué
Licence number: 080845753
 Rebeca Reus
Rebeca Reus
BSc, MSc
Degree in Human Biology (Biochemistry) from the Pompeu Fabra University (UPF). Official Master's Degree in Clinical Analysis Laboratory from the UPF and Master’s Degree about the Theoretical Basis and Laboratory Procedures in Assisted Reproduction from the University of Valencia (UV). More information about Rebeca Reus
 Sara Salgado
Sara Salgado
B.Sc., M.Sc.
Degree in Biochemistry and Molecular Biology from the University of the Basque Country (UPV/EHU). Master's Degree in Human Assisted Reproduction from the Complutense University of Madrid (UCM). Certificate of University Expert in Genetic Diagnosis Techniques from the University of Valencia (UV). More information about Sara Salgado
Adapted into english by:
 Sandra Fernández
Sandra Fernández
B.A., M.A.
Fertility Counselor
Bachelor of Arts in Translation and Interpreting (English, Spanish, Catalan, German) from the University of Valencia (UV) and Heriot-Watt University, Riccarton Campus (Edinburgh, UK). Postgraduate Course in Legal Translation from the University of Valencia. Specialist in Medical Translation, with several years of experience in the field of Assisted Reproduction. More information about Sandra Fernández

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