ICI: An Introduction To Intracervical Insemination

When we think of fertility treatments, most of us probably jump to artificial insemination, IVF, IUI, or maybe even a turkey baster. Few would think of ICI, intracervical insemination, but that is changing. ICI offers similar efficacy rates at a fraction of the cost of in-clinic treatments. Read on to learn how Béa Fertility’s at-home insemination kit is changing the way we approach fertility treatments.

Intracervical insemination (ICI) is a form of artificial insemination that involves keeping semen held against the cervix for an extended amount of time (usually 4-12 hours).

This is usually done using a small silicone cup, something like a menstrual cup (often called a ‘cervical cap’). The cervical cap holds semen in place. This is why you’ll sometimes see ICI – intracervical insemination – referred to as CCI, Cervical Cup Insemination, or Cervical Cap Insemination.

A drawing of a uterus with a blue  cervical cup inserted at the cervix

Whatever it’s called, the goal of intracervical insemination is to concentrate semen in the cervical mucus, to increase the number of sperm which make it through and into the uterus, towards the egg.

As fertility treatments go, ICI is natural, non-invasive, and proven through decades of clinical research. Scientific papers and records from physicians show that ICI used to be the de facto clinical treatment from as early as 1940, to around 1980.

What happened to ICI?

In the 1970’s there was a significant technological advancement that allowed scientists to ‘wash’ semen – separating out healthy sperm cells to be injected directly into the uterus. With this technology came Intrauterine Insemination – IUI – now the most popular fertility treatment worldwide.

ICI involves waiting in the clinic for upwards of 4 hours, until a physician can remove the cervical cap for you. With IUI, you can get up and go. It’s a lot more time efficient, which is good. It’s also a lot more invasive and expensive, which is not so good.

Graph showing the difference between ICI and IUI. ICI is affordable, non-invasive, effective but not time efficient. Whereas, IUI is effective and time efficient but not affordable or non-invasive.

Efficacy rates

According to a number of studies, the differences in efficacy between ICI and IUI both treatment types, over 3 and 6 cycles, are marginal.

A 2015 study involving 1843 women, each undergoing multiple cycles of either IUI or ICI, found pregnancy rates of 20.1% after 3 cycles in the ICI group, and 22.4% after 3 cycles in the IUI group. The same study found a pregnancy rate of 40.5% after 6 cycles in the IUI group, and 37.9% after 6 cycles in the ICI group.

Line graph showing that The efficacy rates of ICI and IUI across three cycles are very similar

Affordability

Over 3 cycles, IUI has shown to be 2.3% more effective than ICI. This 2.3% gain in effectiveness will cost more than 4x what you might have paid for ICI. London clinics will offer a single round of IUI for £800-£1500. The increase in efficacy does not correlate to the significant increase in treatment cost.

When it comes to conception, cumulative success rates are the key to success. The lower cost of ICI, reduces the financial restrictions that often prevent those trying to conceive from accessing multiple cycles of treatment.

Put simply: lower cost = more cycles and a higher chance of success.

Graph showing that the cost of IUI is approximately four times higher than the cost of ICI

The true power of fertility treatments comes from cumulative success rates: the longer you try for, the higher the chance of success.

Graph showing cumulative success rates of IVF, IUI and ICI

This sounds obvious, but the economics of this break down when each IVF treatment round costs well over £3000 – very few people can afford multiple rounds of fertility treatment.Today, the average spend per couple on treatment in the UK is £12,000. The average spend on fertility treatment in the US is $61,000 per couple. That kind of expense is beyond the reach of most.It is simply not fair, and this is why we need to bring affordable, gateway treatments into the market so people can take advantage of cumulative success rates without breaking the bank.

Graph showing the differences between the cost and efficacy of IV, IUI and ICI

Wait a second, isn’t this just the syringe method?

The syringe or straw method of insemination is not the same as intracervical insemination. You’ll sometimes hear people talking about ‘intracervical insemination by straw’, ‘syringe insemination’ or the ‘syringe method’.

ICI mechanically holds semen against the cervix for extended periods of time, whereas the straw or syringe method injects semen into the vagina, essentially mimicking intercourse.

Can you get pregnant if you inject sperm with a syringe?

In one study comparing syringe insemination with cervical cap insemination, the pregnancy rate in the straw insemination group was 5.9% after one cycle. The pregnancy rate in the cervical cap insemination group was 15.2%. Nearly three times higher.

The concentration of semen in the cervical mucus was 3.25 times higher than after sexual intercourse. Accompanied by two sperm (one beige one pink)

How can I access ICI at home?

In 2022, we’ll be launching the first complete, clinical grade, at-home ICI kit in the UK. In each kit, you’ll get 2x insemination devices, which will help you easily place a cervical cap to perform ICI at home. You’ll also get LH (ovulation) tests, hCG (pregnancy) tests, and everything you need to support you on your conception journey.

To get notified when the kit launches, sign up to our mailing list.

Any general advice given by our care team or posted on our blog, website, or app is for informational purposes only and is not intended to replace or substitute for any medical advice, diagnosis, or treatment. Béa Fertility, the trading name for StepOne Fertility Ltd. makes no representations or warranties and expressly disclaims any and all liability concerning any treatment, action by, or effect on any person following the general information offered or provided within or through the blog, website, or app.