A common road to parenthood for LGBTQ people is assisted fertilization, i.e. insemination or IVF treatment. An insemination can be done at home or at a clinic. Here we have gathered information about how you can go about it and give tips about what to think about before a home insemination.
To do a home insemination means that you yourself/yourselves inject sperm into the vagina during ovulation with the help of a plastic syringe or tube. The sperm can come from a donor/co-parent/friend or something in between, depending on what your family and arrangement looks like. Here’s information about how you go about carrying out an insemination at home; what you should think about and what you need to arrange practically.
If you are going to do a home insemination it can be wise to think about legal aspects beforehand. What do you want the child’s family to look like? What adults are going to be close to the child and who will be the legal parents? The legal situation varies depending on if you are a single parent, if those who are to become parents are genetically linked to the child through sperm and eggs, if you are more than two parents or if the donor wants to be an active part of the child’s life.
When a couple with opposite legal genders who are married or live together, both of them become the child’s legal parents. In all other cases the sperm donor is viewed as the legal parent, together with the person who carries the child. Family law/social services are then obliged to conduct a fatherhood investigation to try to find out who the donor is. Read more about fatherhood investigation and legal parenthood here.
Blood test and examinations before the insemination
Even if you do an insemination at home you can be in touch with caregivers, for example the MVC (the maternity clinic), a gynaecologist or counselor before the insemination. It can be about talking about the practicalities, what you should think about before or discuss what roles you will have and the expectations of everyone involved.
Before the insemination both the person who has the sperm and the person who has a uterus and eggs should be tested for HIV/STIs (sexually transmitted infections). An HIV test only shows if the person had HIV six weeks ago. When you have tested for HIV you should therefore wait six weeks and take another test. During this time you should only practice safer sex. It can be good to get tested for other STIs, for example gonorrhea, chlamydia, syphilis, hepatitis B and C, which can affect the ability of getting pregnant and should be treated before a pregnancy. Hepatitis and HIV that is untreated can also be transmitted to the child during pregnancy, childbirth and breast-feeding. Also make sure that the person who is to get pregnant is immune to rubella before a pregnancy. This is checked through a blood test. If the person who is to become pregnant isn’t immune vaccination against rubella is recommended before trying to get pregnant.
Some choose to do a fertility assessment before the insemination starts or after a number of trials that haven’t resulted in a pregnancy. A gynaecologist can conduct different examinations to determine if there are any medical obstacles for pregnancy. Even if the insemination doesn’t take place in a clinic there is nothing that stops healthcare from helping you with examinations and blood tests before an insemination at home. The person with the uterus can for example have a gynaecological exam with a vaginal ultrasound, examine hormone levels and do a flushing of the ovaries to see if there is free passage, see Fertility assessment (link). The person with sperm can get help examining the quality of the sperm.
When does ovulation occur?
In order for a fertilization to be possible you need to inseminate when you ovulate. That means from a couple (about three) of days before ovulation to a day after. Sperm can live and fertilize an egg in the fallopian tubes for about five days. The egg can be fertilized 12-24 hours after ovulation. That means that it’s better to inseminate before rather than after ovulation, if you have to choose a time. You can keep track of your ovulation by keeping a journal about when you menstruate and calculate when your ovulation happens, which is usually in the middle of the menstrual cycle, that is, between two menstruations. Most ovulations happen 14 days before the next menstruation.
Ovulation can however vary from time to time and from person to person and a more precise way of exactly monitoring ovulation is to buy an ovulation test that indicates ovulation. It works in a similar way to a pregnancy test; you pee on a stick every morning and when the stick gives an indication (becomes positive) ovulation will happen within 24-36 hours. It’s therefore good to inseminate the same day you get a positive ovulation test and/or the day after. Even if ovulation tests give clear results for most people it can also be good to get to know ones own body and learn the signs of ovulation since no test is exact. For some it hurts during ovulation, discharge in the vagina can change in consistency (ovulation secretion resembles egg whites, i.e. it’s clear and tough and can have a “slippery” feel) and some people get an increased sex drive.
How to, in practice?
Inserting sperm into the vagina with a syringe or tube requires some preparation but is relatively easy. You need a plastic syringe without a needle, for example a medicine syringe for children (if it doesn’t have broad edges at the tip), and/or a thin plastic tube and something to keep the sperm in. The sperm can be kept in a jar, a condom (make sure it doesn’t have a spermicide coating) or the like, but the most important thing is that it keeps body temperature. If it needs to be transported before it’s inseminated it can be kept in the armpit during the transportation. It’s best if the sperm can be used as soon as possible, after an hour outside the body the possibilities of a pregnancy are decreased. If sperm is kept in a condom it’s important to check that this condom doesn’t contain spermicides. The sperm are then introduced into the vagina with the help of syringe or tube. It’s important to try and get the sperm as far into the vagina as possible. The os uteri, that the sperm enters through, is in the inner part of the vagina.
Known sperm donor – who becomes the legal parent/s?
In most home inseminations the donor will be known, which means that the one who carries the child knows who the donor is. If the donor is known and also will become the legal parent to the child, a paternity investigation will only work as a confirmation. The person who contributed the sperm will then, together with the person who carried the child, become the child’s legal parents. If the donor confirms the paternity, or is established as the father without there being anyone else who wants to adopt the child, the donor will continue to be registered as a father. The child will then have rights of access and inheritance rights to the donor and the donor will have the obligation to pay allowance. However this doesn’t automatically mean rights to access or shared custody.
Unknown sperm donor – who will become legal parent/s?
When the person carrying the child has made it clear that they don’t know who the donor is, the family law/social services usually stops the paternity investigation. If information arises about the donor at a later stage the paternity investigation can be re-opened, up until the donor’s death.
To be registered as single legal parent to a child conceived through home insemination, the family law/social services have to register father unknown in the paternity investigation. Since it’s the family law’s/social service’s job to investigate who the child’s parents are, the person who contributed sperm will always be registered as the father if he is known. The paternity investigation should be terminated within a year if no father can be registered. If there’s information about the donor at a later stage a paternity investigation can be re-opened, until the donor’s death. A donor that has been established as a father can only renounce fatherhood by consenting to another person adopting the child.
The background of the legislation
The reason that the law has come into being is so that it always (if possible) should be possible to establish two legal parents to a child and that the paternity investigation usually isn’t stopped until another parent is registered is based on a feminist view that if someone has contributed sperm to father a child they shouldn’t be able to avoid their legal parenting responsibility. Something that historically has been a fact for many involuntarily single women and that today’s legal texts are based on.
If you are two people who wish to become legal parents to the child and are using donated sperm in an insemination at home, you can agree that the donor should renounce the fatherhood by consenting to an adoption when the child is born. To do this the intended parents need to be married. The child then gets two legal parents after the adoption, the one who gave birth to the child and the person they are married to. Read more about how an adoption works here.
An adoption cannot be made beforehand. A legal parenthood can therefore not be renounced beforehand by writing your own contracts or agreements where you state who you want to be active adults in the child’s life. But it can still be good for intended the parents and the donor to discuss what you want and write it down for yourselves.
Where can I turn if I want to know more about home insemination?
In Stockholm there’s Mama Mia Söder, a maternity clinic where you can get counseling and support when it comes to home insemination. Storkkliniken in Denmark also offers counseling before home insemination. During the session practical, emotional and legal matters can be discussed. The counseling can take place at the clinic or over the phone and costs money.