What Is Artificial Insemination with Husband’s Sperm (AIH)?

Artificial insemination from husband/partner (AIH) or partner insemination is an infertility treatment used to treat male infertility problems, such as low sperm count or poor sperm quality. From sperm collection to insemination per se, it is a simple and cost-effective procedure that helps many heterosexual couples fulfill their dream of creating a family.

The following sections will provide you with information on the many aspects involved: the basic requirements for IUI referral, the process step by step with its pros and cons, the average cost, and additional information such how does AIH at home work.

Definition and requirements

Artificial insemination by husband/partner (AIH) can be defined as a fertility treatment by which a woman is inseminated with the sperm of her partner. It is also called artificial insemination with the husband's sperm, homologous artificial insemination or partner insemination.

This means that this method for dealing with infertility is specifically aimed at heterosexual couples, typically when the man has been diagnosed with male infertility or sterility, but also in cases of unexplained or immune infertility, among others.

To guarantee a minimum chance for success with AIH, both members of the couple should meet a series of basic requirements:

• Tubal patency in at least one Fallopian tube to allow the passage of sperm toward the egg
• The woman should be aged 36 or less to increase the likelihood of embryo implantation
• The man's MSC (motile sperm concentration) should contain at least 3 million sperms after being processed at the laboratory

An AIH cycle is considered to have been successful if the woman gets pregnant. Broadly speaking, the chances of success with AIH reach 15-25% per cycle, depending on the fertility clinic, the severity of what is causing infertility, and the particularities of each situation.

Reasons for AIH

Artificial insemination may be the treatment of choice in many types of fertility issues. If the man has low sperm count, or if the sperm he produces is not strong enough to swim through the cervix and reach the egg, AIH might be the solution to achieving a pregnancy.

Specifically, artificial insemination from husband is indicated in the following cases:

• Problems with ovulation
• Inability to impregnate the woman by sexual intercourse
• Mild male infertility cases
• Mild-to-moderate endometriosis
• Women with cervical factor infertility
• Immune infertility
• Unexplained infertility

Partner-sperm intrauterine insemination can be right for women that have something known as unreceptive cervical mucus, too. This alteration causes the mucus that surrounds the cervix to prevent sperm from getting into the woman's Fallopian tubes. With IUI, the sperms skip this step entirely.

Procedure step by step

First of all, there exist four types or artificial insemination, though IUI is the most commonly used:

• Intrauterine insemination (IUI)
• Intracervical insemination (ICI)
• Intratubal insemination (ITI)
• Intrauterine tuboperitoneal insemination (IUTPI)

Once the type of AI is chosen, the process can get started. The steps involved are explained in the following sections:

Tracking and predicting ovulation

Every AIH process requires the patient to undergo mild ovarian stimulation for best results. The aim is to produce multiple eggs to increase the likelihood of success. If the woman has regular menstrual cycles, AI without stimulation, that is, a natural cycle may be considered.

IUI is normally carried out after the patient has ovulated, as this is the moment when a woman most fertile is—the oocytes have just been produced. Your doctor may give you an ovulation prediction kit (OPK) to detect your hormone levels and predict when you are going to ovulate with accuracy.

How do ovulation predictor kits (OPKs) work?

Collecting and preparing the semen sample

When the semen comes from the male partner, the sample can be obtained by means of masturbation, surgical sperm aspiration, or vibratory/electric stimulation (in case the man is not able to ejaculate in the usual way).

Once the sample is collected, it is "washed" by means of sperm capacitation in order for any element that could interfere with fertilization to be removed. When this is done, it is ready for artificial insemination.

Putting the sperm into the uterus

As soon as the semen sample is prepared, insemination will be carried out after ovulation, that is, about 2 weeks before the first day of the monthly period. During IUI with the husband's sperm, the specialist puts the sperm directly into the uterus with a fine catheter.

For the process to be properly performed, the doctor uses a speculum, an instrument to keep the vagina walls open during the process. When the catheter enters the uterus, the sperms are pushed through it.

Steps followed in artificial insemination using the husband's sperm (AIH)

Pros and cons

A major advantage of AI is that it helps address infertility in men and women, and makes pregnancy achievable where it was previously not possible. It is a simple, painless procedure that does not require special aftercare or surgery.

An specific pro of AIH over AID (artificial insemination by donor) is that is allows for genetic preservation. For some, the biological factor is very important when creating a family. Also, it is a cost-effective method if compared to more complex techniques such as IVF.

On the other side of the coin, it does not come without some associated disadvantages. The following are the main ones:

• Risks: If IUI is combined with fertility medications such as gonadotropins, multiple births can occur. It increases the chances for having a premature birth or miscarrying. Also, a woman's ovaries can become swollen after combining fertility drugs with IUI (i.e. OHSS).
• Ejaculatory abstinence: Timing is critical in IUI procedures, and ejaculatory abstinence can increase the treatment's success rates. For this reason, men should be on standby for 2 to 3 days before providing the semen sample to the clinic.
• Number of attempts: AIH may not work for everyone. AI has cumulative success rates, which means they increase in subsequent attempts. If success does not happen after the fourth, you might be suggested to move to IVF.
• Two-week wait: As any other fertility treatment, AIH requires time and patience: you will have to wait for around 15 days before taking a pregnancy test. Otherwise, you might get a false negative result.

If several AIH cycles have failed due to male fertility problems and you are considering IVF, you might need to use donor sperm to have a baby. Depending on the severity and on a case-by-case basis, this might be the option of choice. See also: IUI with donor sperm.

How much does it cost?

If compared to other assisted reproductive technologies (ARTs), partner-sperm artificial insemination has the major advantage of being cheaper. If done at a private facility, the price might range from €600 to €1,000, depending on the city and the center chosen.

Also, artificial insemination might be covered by insurance in your country provided that you meet certain requirements. In the UK, the National Institute for Health and Care Excellence (NICE) established that up to 6 cycles of IUI may be offered on the NHS if:

• The couple is unable or finds it very difficult to have vaginal sex
• Specific help to conceive is needed. For example, to prevent a viral infection that can be sexually transmitted
• You are in a lesbian relationship and have a fertility problem

Before getting started with treatment at a private clinic, couples are advised to keep in mind that fertility medications are not included in the total cost of treatment generally, including progesterone drugs used to prepare the endometrium, if needed.

Some clinics offer special discounts and plans for those couples who need more than a single IUI cycle to achieve a pregnancy. We recommend you to ask for a detailed cost estimate before making your decision in order to gain the most benefit out of it.

Artificial insemination by husband at home

Partner insemination can be carried out at home as well, although it is not considered to be a fertility method in such cases, as no laboratory or clinic is involved to prepare the couple for the treatment.

The turkey baster method is the most common way of turning to AIH at home. Insemination kits can be purchased at pharmacies or even ordered online. However, patients are recommended to use a disposable syringe instead of a turkey baster.

For the semen to be collected, use a clean or sterile glass or plastic cup, or a collection condom, and have the male ejaculate into it. Do not use a regular condom, as it might contain chemicals that could kill sperm.

Once the semen is collected, get into a position where you can do it comfortably, with the minimal movement. Ideally, you should have your hips raised or lay on your side with the pelvis canted. Sperm should be injected slowly.

Timing for this kind of AIH is critical, so having an ovulation prediction kit is strongly advisable. Do not forget that the best timing is the day of ovulation, or 2-3 days before that day.

An advantage of DIY artificial insemination by husband is that it is easy and no special equipment is required. However, a major con is that the success rates are the same as with intercourse, given that the sample has not been processed at the laboratory.

FAQs from users

Is artificial insemination by husband the same in serodiscordant couples and in healthy couples?

Due to advances in sperm washing techniques and large medical studies, HIV serodiscordant couples can be offered IUI (intrauterine insemination) provided the semen sample from a HIV positive man is prepared in a reproductive laboratory capable of appropriate preparation of the specimen in order to maximize the reduction of HIV transmission to the woman and baby.

Can I undergo artificial insemination without husband's consent?

No, it is not possible. When a woman is married or in a civil relationship, the clinic needs her consent and her husband's approval to proceed with the fertility treatment of choice, either AI or IVF. In case of divorce, consent would be required as well.

It is possible, however, if the couple is divorced or separated and the woman wants to get pregnant through IUI with donor sperm, as the man would not be considered to be the legal father of the child, that is, he would have no legal right or responsibility to the baby.

Can I undergo artificial insemination with my husband's sperm if he is dead?

It is possible provided that he left consent before passing away, and it is done within a limited period of time post-mortem. Nevertheless, the answer to this question depends on the regulations governing it by country. In Spain, for instance, this period is 12 months.

AIH vs. AID, what's the difference?

With AIH, the husband's or partner's sperm is used, while AID involves using donor sperm to achieve a pregnancy. Also, the success rates of AID are normally higher than those of partner insemination, as donors are young men able to produce high-quality semen samples.

On the other hand, with AID the child will not share the intended father's genetic material in case it is used by a heterosexual couple.

Can I get started with IUI even though my husband's traveling?

Yes, provided that your husband/partner has agreed to it and signed the consent to proceed with the treatment. However, this is only possible if he has some sperm vials frozen. Fresh insemination is not possible as his presence at the clinic on the day of the procedure is required.

What are the benefits of using your husband's sperm cells to get pregnant?

The main benefit of using the husband's sperm instead of donated sperm is that your child will share your DNA: half his, half yours. The result would be the same as with natural insemination (i.e. sexual intercourse).

This is an advantage for the child as well: he will know about his biological origins and be able to develop an emotional attachment more easily.

Suggested for you

AIH is a type of artificial insemination which characterizes itself for the use of the partner's sperm, but the steps involved are the same regardless of whether it is AIH or AID. Learn more about this treatment basics here: Artificial insemination (AI).

Artificial insemination or AI is the simplest of all infertility treatments. However, it is precisely this low degree of complexity what makes its success rates to be the lowest if compared to more sophisticated procedures such as IVF or IVF with ICSI.

In case IUI fails and you are referred to one of them, be prepared by gathering all the information you might need with these posts:

• In vitro fertilization (IVF)
• Intracytoplasmic sperm injection (ICSI)

If you have heard about both intrauterine insemination and in vitro fertilization but are not sure what is the difference between them, this article might be useful: IUI or IVF?