If you're like us, you're clueless about the process you need to follow to try to get pregnant with donor sperm. This post will be an educational overview of what we have to look forward to in the coming months.
As a reminder, this blog is not posted in "real-time." For example, Brian and I joined Team Donor Sperm back in the fall of 2020, but didn't even START the process of shopping for a donor until the end of December.
So grab your morning coffee, kick up your feet and get ready for a little education about the process of trying to conceive (TTC) with donor sperm. 🤓
Oh, I almost forgot to mention: I am not a doctor or a scientist, so don't use this post as an end-all-be-all for achieving conception with donor sperm. Listen to your doctor.
STEP 1: Choose a Donor 🤯
Pretty self-explanatory. Gotta find a donor before you can begin the process. Don't worry, there will be an entire post dedicated to choosing a donor in the near future.
STEP 2: Order Sperm 🤑
Once you choose a donor, you need to place your order. Our fertility doctor recommends ordering three vials of sperm at a time because it can take four to six tries for this to work.
BEWARE: Sperm is expensive. One vial of sperm generally costs between $900-$1100 but prices can vary between sperm banks. Oh, and don't forget about shipping. The sperm bank will ship directly to your fertility clinic for a hefty overnight shipping fee of around $300, which I am sure includes whatever is needed (dry ice? cold packs?) to keep the sperm alive during transit.
STEP 3: Track Cycle Very Closely 🧐
You must start tracking your next cycle extremely closely. Your first day of full flow is considered Day 1 of your cycle. Spotting doesn't count. If you start full flow after 5 p.m., the next day is considered Day 1. Use an app. Or if you're like me, use an old-school paper calendar.
STEP 4: Start Ovulation Medication 😡
There are a couple different medications (Clomid and Femara) you may choose to take (not required) that work by making the body think your estrogen levels are lower than they are, which causes the pituitary gland to increase secretion of the follicle stimulating hormone and the luteinizing hormone. The medication often produces more than one egg per cycle, which can increase your chances of multiples (twins, triplets, etc.).
If you choose to use this medication, you will start on Day 3 of your cycle and continue taking it orally for five days. Watch out for hot flashes and major mood swings (be sure to warn your partner!). Your hormones may go crazy during the remainder of your cycle. PMS ain't got nothin' on fertility medication.
Don't forget about the cost of the medication. Some insurances don't cover fertility drugs.
STEP 5: Begin Ovulation Kit 🚽
On Day 12, you'll begin testing once a day to check for ovulation. You can purchase an ovulation kit from Amazon or any pharmacy/drug store for around $30. The tests work by peeing on the test stick first thing in the morning
The tests will detect the hormone in your system that means you're ready to ovulate. Let's go back to sixth grade sex ed for a moment. Ovulation happens when a mature egg is released from the ovary. The egg then moves down the fallopian tube where it can be fertilized. If sperm are in the fallopian tube when the egg is released, there is a good chance that the egg will be fertilized, creating an embryo.
STEP 6: Call Clinic for Ultrasound If No Positive Surge 📞
If you don't experience a positive ovulation surge on your test kit by Day 15, call the clinic to schedule a vaginal ultrasound.
Some women's hormones are not detected with the kit, so they have to go to the clinic for an ultrasound to check the size and amount of follicles on each ovary. This will help the doctor schedule the intrauterine insemination (IUI) to increase the chances of the sperm meeting the egg.
It's just like when you are trying to get pregnant naturally from sex. The sperm will only meet the egg during your fertile window (when the egg is ready to be released from the ovary).
STEP 7: Schedule Intrauterine Insemination (IUI) 👩⚕️
Once it's been determined that you're ovulating (either by ovulation kit or vaginal ultrasound), you'll schedule your IUI with the doctor or nurse. Generally, it's scheduled for the morning after your positive surge.
In a nutshell, the physician will insert a speculum into your vagina so they can see your cervix. They will then insert a catheter through your cervical opening and into your uterus. Then, they'll put the vial of sperm (all $1000 of it) into your uterus through the catheter to place the sperm close to your fallopian tubes.
This procedure costs roughly $525, but varies from clinic to clinic. Keep in mind that most insurance companies do not cover the costs of procedures like this.
STEP 8: Make an Appointment for a Progesterone Test 🩸
During your first IUI cycle, your doctor may request progesterone testing one week after your IUI. Your progesterone levels will confirm whether or not you ovulated. Progesterone levels are measured through a blood test.
Progesterone is a hormone that prepares the endometrium for the potential of pregnancy after ovulation. It triggers the lining to thicken to accept a fertilized egg. It also prohibits the muscle contractions in the uterus that would cause the body to reject an egg.
If your progesterone test comes back with normal-high levels, you may not need to do this test during any other cycles.
STEP 9: Take an At-Home Pregnancy Test 🤰
If you haven't started a period exactly 14 days after your IUI procedure, you can take an at-home pregnancy test.
STEP 10: Set Up an hCG Test 🧪
If your at-home pregnancy test comes back positive OR you're unsure (trust me, there are instances where you may question the validity of a pregnancy test) you'll schedule an hCG blood test at your clinic.
This blood test measures the specific level of hCG in the blood. hCG is the hormone produced during pregnancy.
STEP 11: If you're not pregnant, repeat steps 1-10. 😭
Let's add up the rough cost for one IUI cycle:
One Donor Sperm Vial: $1,000
Overnight Shipping: $300
Ovulation Medication + Kit: $70
IUI Procedure: $525
Co-Pays for Office Visits/Labs: $100
Total: $1,995
For nearly $2,000 (give or take) you have a 10-20% chance to conceive through one cycle of IUI. The peak IUI effect is during the third or fourth cycle, but it could take up to six or seven cycles––if it's going to work at all.
While that can add up quickly, it's much cheaper than IVF (which could be your next step if IUI isn't successful).
This is just the science of it all, friends. If you've been following along this far, you know there's a lot of emotion and detail that comes with this journey––and we definitely haven't been shy about it all. So stay tuned for our first-hand experiences with all of these steps, starting with choosing a donor.