Home insemination: how a forgotten fertility treatment is making a comeback

The inescapable truth is that 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 people, who are left with no choice but to go down the private fertility clinic route. This can cost up to £1,600 for one round of IUI and £5,000 for one round of IVF. However, what if we told you there was a way to access artificial insemination, at home, without the hefty price tag of fertility clinics? Sounds too good to be true? Enter Béa Fertility.

While IVF and IUI are the most popular forms of assisted conception, they are not the only options out there. There is a treatment that can be done at home, which was popular for most of the 20th century, before falling out of favour when the arrival of ‘sperm washing’ led to the development of IVF and IUI – which have become the go-to treatments in fertility clinics. This forgotten treatment, known as ICI, is being brought back by Béa Fertility to level the playing field when it comes to assisted conception

So, what is ICI?

ICI (intracervical insemination) is a fertility treatment that involves placing sperm near the cervix to aid conception. This can be performed using a cervical cap that will keep semen against the cervix for an extended amount of time.

How is it better than the syringe method?

You’ll sometimes hear people talking about ‘intracervical insemination by straw’, ‘syringe insemination’ or the ‘syringe method’. The straw or syringe method injects semen into the vagina, essentially mimicking intercourse. While true ICI uses a cervical cap that will mechanically hold semen against the cervix for an extended time (up to one hour).

Compared to the syringe method, a cervical cap is scientifically proven to have higher efficacy rates per insemination. A key study comparing syringe insemination with cervical cap insemination found that the pregnancy rate of the syringe insemination group was 5.9% after one cycle, whereas the pregnancy rate of the cervical cap insemination group was 15.2% - nearly three times higher. Another study found that the concentration of semen in the cervical mucus after cervical cap insemination was 3.23x higher than after sexual intercourse.

The purpose of using a cervical cap is to prevent backflow into the vagina and concentrate semen in the cervical mucus, to increase the number of sperm which make it through and into the uterus. Cervical mucus is magic. It provides the perfect environment for sperm to swim (the vaginal pH is not ideal for sperm), it filters out irregularly shaped sperm cells and it even provides sustenance for the sperm as they make their way through the uterus to the egg.

By concentrating sperm in this magical fluid for an extended period of time, we increase the probability of sperm making it into the uterus, and eventually, to the egg.

Will I get pregnant with ICI?

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 1,843 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. The study concluded that they “found no substantial benefit of IUI over ICI”.

But how affordable is it?

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.

The true power of fertility treatments comes from cumulative success rates: the more treatment cycles you complete, the higher the chance of success. This sounds obvious, but the economics of this break down when you consider that each IVF treatment round can cost well over £5,000. Ultimately, very few people can afford multiple rounds of expensive fertility treatments.

Adequate fertility care is still reserved for those who are lucky enough to afford it. Today, the average spend per couple on fertility treatment in the UK is £12,000 per cycle. That kind of expense is wildly out of reach for most people. It’s 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 on IUI and IVF.

How can I access ICI at home?

Béa Fertility is developing the first complete, clinical-grade, at-home ICI kit in the UK. In each Béa Treatment Kit, you’ll receive 2x semen collection pots and 2x insemination devices, which will help you easily place a cervical cap with semen near the cervix, to perform ICI at home.