December 11, 2014
How To Get Pregnant With a RacquetballThe DIY crowd is revolutionizing artificial insemination
by Allison Yarrow
When Nellie Mead and Teresa Espinosa conceived their daughter, they did it without sex, a fertility clinic, or medical supervision. Instead, Espinosa injected a friend’s sperm into a menstrual cup she bought at a drugstore. She then inserted the cup into Mead’s vagina in their Spring Hill, Florida home. Aliena was born in July.
“I was shocked when it worked,” says Mead, 25, who had thought her only options were “to have sex with a guy and that wasn’t happening” or “to save thousands of dollars to buy sperm.” That was until she uncovered a trove of at-home artificial insemination advice online. Mead devoured YouTube testimonials, where a search for “home insemination” yields more than 11,000 results (though some are clips of impregnating livestock).
Single women, lesbian couples, and straight couples with fertility troubles are increasingly experimenting at home with store-bought goods, in an effort to skirt expensive fertility procedures like Intrauterine Insemination (IUI) and In-Vitro Fertilization (IVF). At-home inseminators enlist friends or acquaintances to donate sperm, or procure free donor samples from dating-style portals like the Known Donor Registry, Pollen Tree, and Pride Angel. Some go a more orthodox route and purchase sperm from FDA-regulated banks, which can cost from about $500 to $1500 per cycle. In addition to saving money, many at-home inseminators say they prefer bedrooms to treatment rooms, because they can personalize the conception experience, imbue it with romance, and reduce stress. Legal experts warn, however, that inseminating at home can compromise a couple’s legal rights.
Embracing the DIY ethos, Mead and Espinosa assembled a kit of store-bought tools over the ten months they tried to conceive. Items included an ovulation predictor kit, various sized syringes (1 milliliter was the winner), menstrual cups intended to catch period blood, prenatal vitamins and herbs like Evening Primrose and Chasteberry, and Robitussin cough syrup to loosen cervical mucus and whisk sperm on their course.
Mead, who shaves the sides of her head and wears baseball caps, documented their attempts in a series of “pregnant stud updates” on YouTube, with Espinosa at her side. Their video announcing Mead’s pregnancy was watched more than 100,000 times, and now they’re selling a version of their kit on eBay.
The trend wouldn’t have taken off without the Internet. Tabitha Freeman, a research associate at Cambridge University, studies the growth of Internet-abetted artificial insemination and is examining 1,000 users of Pride Angel, which aims to match sperm and egg donors with recipients, most frequently in the U.K., U.S., and India. She estimates that roughly 70 percent of the nearly 500 sperm recipients in her study wish to inseminate at home. A third of all sperm orders at the Cryos International Sperm Bank based in Denmark are intended for at-home insemination, and that that number increases each year, according to managing director, Ole Schou.
The main reason couples bypass assisted reproductive technologies to inseminate at home is cost. The average out-of-pocket price for fertility treatments exceeds $5,000 and In Vitro Fertilization (IVF) tops $19,000, according to a study of San Francisco clinics published in The Journal of Urology in 2013. Couples often bankroll medical conception by borrowing cash, or taking out second mortgages on their homes. A Barclay’s phone operator pled guilty to stealing more 4,000 pounds from his employer to underwrite his wife’s IVF. In many cases, insurance policies won’t cover assisted reproductive technologies for individuals who haven’t been diagnosed with fertility problems, and often they won’t subsidize assistance at all.
“As lesbians a lot of us want kids and we already know that shit’s too expensive,” Mead says. It’s exactly why sites like Pride Angel, which counts more than 4,800 users willing to give sperm for free, are growing. “The cost of fertility treatment is high. This is more accessible, more direct and it cuts out the middleman. You go straight to the donor,” says Freeman.
Still, plenty of fertility specialists believe that insemination—particularly more invasive strains like IUI, in which washed sperm are placed in the uterus to fertilize an egg, and IVF, when an embryo is created outside the womb, then implanted in the uterus —belongs in a medical setting, where they first originated. Dr. Eric Surrey, a reproductive endocrinologist at the Colorado Center for Reproductive Medicine told Slate he understands the desire for couples to “have as pleasant an environment as possible” when trying to conceive, but that “insemination is a medical procedure, and like anything else in medicine, it requires training.”
The Pipers conceived in their donor’s guest bedroom in Boston. A nurse practitioner in Belfast, Maine, Lindsey Piper performed IUI on her wife, Allison Piper, and believes that method is “easier than putting in an IUD.” IUI requires sperm to be washed, or vetted for strong swimmers and rid of a substance called prostaglandin, which can cause cramping. Piper washed the sperm herself—she performs IUIs at the feminist health center where she works, and says there each treatment costs $300. She used a speculum and a four-inch syringe fitted with a thin catheter measuring 10 centimeters.
“They were in the bedroom doing their thing,” she says of Brian and Mike, the gay couple who donated sperm, “and Brian would holler upstairs, ‘yoo-hoo!’ and that’s how we’d know the sample was ready. One of us would come down and get it.” Piper recently taught a group of homebirth midwives an at-home IUI technique, and also tutored her neighbor, who she says conceived on the first try. One study found that IUI was nearly three times more effective than Intracervical Insemination, which Mead and Espinoza used, for women using frozen donor sperm. Piper says it makes no difference statistically for a woman with normal fertility.
Heterosexual couples with fertility challenges are also employing gadgets to get pregnant at home. (Infertility is vaguely diagnosed as a year of trying to conceive without success.) The creators of a new product called The Stork believe it can be more effective than sex, and call their device the first over-the-counter conception assistance device aiming to “bridge the gap between infertility and expensive treatments.” The $79.99 kit designed for one-time use has sold 30,000 units at CVS and Drugstore.com since the FDA approved it in July. It was modeled after Gulf War veteran and engineer Steve Bollinger’s own infertility hack—he split a racquetball in two, ejaculated into half and inserted it into his wife’s vagina. The couple conceived two kids this way.
The Stork’s forbear may have been a rubber ball, but it mimics the decades-old medical practice of cervical cap insemination. The difference is that it attaches a string, much like a tampon for easy removal (after a prescribed 6 hours), and it is sold over the counter for at-home use. It’s comfortable enough that women “have run half marathons with these things,” Bollinger says.
“We’re not utopia or a magic bullet,” he adds. “But we get sperm and egg closer, which is the only thing medicine has really done in the last 50 years.”
While The Stork’s success rate is still being researched—doctors are recommending it to fertility patients who want to join the study—Bollinger claims it has “very similar results to IUI, which costs between $1,000 and $5,000 per attempt in a doctor’s office.” In theory, such a device could boost fertility in couples by giving sperm a head start, which is helpful if there is a decreased amount of healthy ones, or if the vaginal tract is inhospitable due to stress or other causes.
Medical professionals warn that inseminating at home can pose health risks, like tissue damage, uterine perforation, infection, or the contraction of sexually transmitted diseases, but perhaps the greatest threats are legal. Many of the legal protections that protect parents who conceive by medically-supervised artificial insemination do not cover couples who artificially inseminate at home. This means that donors to at-home inseminators can legally claim parenthood and that, for lesbian couples or straight couples using a sperm donor, the non-carrying partner still must navigate a tricky path toward adoption.
Reproductive law specialist Melissa Brisman says she would “absolutely not” endorse at-home insemination because most states require it to occur under the supervision of a licensed medical professional in order to fully terminate a donor’s parental rights. “It’s one thing to be more comfortable, and to have things feel better. It’s another if that sacrifices your legal rights,” she says. “When there are no medical personnel, you’ll have a problem terminating the donor’s parental rights.”
While the law favors doctors’ offices, Brisman estimates that "hundreds of couples in each state are currently inseminating at home." She has retained 20 pregnant lesbian couples in the last two years who have done so and want to legally refute a donor’s parental rights and navigate adoption proceedings for the non-carrying partner.
Often, women using friends’ donor sperm forgo contracts all together. Mead refused to draw up papers (“we knew him, it would have been awkward”), but hopes their email exchange, which included record of a $150 payment to the donor, would hold up in a Florida court. For the Pipers, a conversation about intent and goals was assurance enough. “They have white couches and white carpets and everything matches. They’re fine and don’t want kids,” Lindsey Piper says.
Brisman wouldn’t advise this route. “Clients have a hard time taking the emotion out of it, because it’s a baby,” Brisman says. “But it’s five to ten years down the road that I’m worried about. When the kid is five and the couple gets divorced.”
“Macgyvering” conception feels like a natural act to men and women raised on the Internet, Bollinger says, rather than a question of ethics or the law. Birth control methods teach men and women that they are gods of their own reproduction. At-home insemination advocates see the practice as simpatico with the homebirth movement—women forgoing hospitals in favor of laboring at home. “Since birthing left the woman realm and became a medical thing, women have been quick to outsource fertility to clinics,” Piper says. While she doesn’t recommend non-medical professionals undergo IUI without education, she says that the technology is accessible.
Meanwhile, Lindsey Piper is now pregnant with the couple’s second child. After driving the four hours to Boston, Allison inseminated Lindsey with Mike’s sperm, which she transported in a pickled carrot jar. It worked on the second try.
Lesbians inseminating their partners report feeling more empowered and connected by emptying the syringe themselves rather than watching or waiting outside while a doctor in a lab coat does it. Mead says inseminating at home was the best way to form a family that she could imagine. “I loved that Teresa was part of the entire process, just like a heterosexual couple,” Mead says. “She can really say she got me pregnant.”