ICI is the 1940s fertility treatment making a comeback in 2022 and changing the face of the fertility industry.
Fertility treatments are becoming increasingly expensive and inaccessible for many. NHS-funded treatment in England is dictated by a postcode lottery and cuts to funding (together with inconsistent rules about access) mean that only 32% of the country’s IVF cycles and 6% of IUI cycles are funded by the NHS. The rules are even harder to navigate for same-sex couples and single women, who are left with no choice but to go down the private fertility clinic route to get the artificial insemination they need. This can cost up to £1,600 for one round of IUI and £5,000 for one round of IVF. But what if there was a way to access to perform artificial insemination, at-home, without the hefty price tag of fertility clinics? Enter Béa Fertility and intracervical insemination (ICI).
While IVF and IUI are the most popular forms of assisted conception, they are not the only ones out there. There is in fact a treatment that can be done at home and was popular for the majority of the 20th century, but fell out of favour with the arrival of IVF and ‘sperm washing’, which became to go-to treatments in fertility clinics. This vintage treatment, known as ICI, is being brought back by Béa Fertility in an attempt to level the playing field, when it comes to assisted conception.
So what is ICI?
Essentially, it is a form of at-home artificial insemination where semen is held up against the cervix for an extended period of time This is usually done using a small silicone cup or ‘cervical cap’, which is a bit like a menstrual cup. The cervical cap holds semen in place,increasing the concentration of the semen in the cervical mucus, and therefore increasing the chances of fertilisation.
ICI was the original form of artificial insemination and as early as 1910 and 1920, you would find fertility clinics offering this in various shapes or forms. It was really popular right up until the mid 1970s but fell out of favour with the development of IVF, which inadvertently led to IUI too. While IVF is a far more involved procedure and not a like-for-like exchange for ICI, the need to extract sperm cells out of semen samples for the treatment also enabled clinicians to inject sperm cells directly into the uterus, bypassing the cervix’s semen filter. This is what is known as IUI.
As to whether ICI or IUI is a more effective treatment, for a long time there wasn’t enough data to compare the two. But from 2015 onwards, more effort was put into establishing a comparison. One of the main conclusions that’s found is actually there isn’t enough evidence to suggest that there’s any difference in efficacy at all between the two. And if there is any difference in efficacy, it’s very small. For example, a study in Europe of 1,800 women found that the cumulative success rate across six treatment cycles of ICI was 37.9%, compared to 40.5% for IUI.
How is ICI making artificial insemination at-home possible?
Unlike IVF and IUI, ICI is the only treatment that really works outside of a fertility clinic, making it appealing to those who want their conception to be less clinical and more personal. It’s natural, there are no drugs associated with stimulating a cycle, it is invasive to a point but it’s effectively a tampon applicator, except instead of pushing out a tampon you’re pushing out a cervical cap. It’s so simple that it really is ideally suited for people to perform artificial insemination at home.
That said, not everyone will be able to use at-home insemination, thanks to the laws around donor sperm in the UK. Single people and same-sex couples who need donor sperm to conceive can either buy from a sperm bank or use known sperm donated by a friend or loved one. Sperm bought from a sperm bank cannot be sent to home addresses and must be processed through a private fertility clinic. While this is not a legal requirement for known sperm, it is preferable as fertility clinics do a lot of the necessary groundwork to protect the users, from legal work around parental rights to screening the sperm for genetic disorders, STIs and HIV.
The Béa Fertility Treatment Kit is set to launch next year and will be priced between £250 and £300 – around five times cheaper than one round of IUI. For that price you get two artificial insemination devices (when you inseminate on consecutive days at ovulation, you can boost efficacy) as well as 20 ovulation tests, a few pregnancy tests and two semen containers.
At-home ICI treatment therefore is not immediately accessible to everyone who needs assisted conception. However Béa Fertility is working on ways to offer the right support to those using known donors. They are speaking to family lawyers about the best way they could offer a known donor agreement service with their kits.
This article was edited by Béa Fertility, read the original article by Sadhbh O’Sullivan in full in Refinery29.
Disclaimer: Gender is experienced differently by all, particularly when it comes to our fertility. Our articles are written by a variety of authors, all of whom bring their experiences into their writing. Some articles will reflect these experiences more than others, and our goal is always to create content that represents all families.