Conceiving via Artificial Insemination
Make sure you can cover the cost of the procedure. Artificial insemination can cost anywhere from $460 to $1,500 not including any fertility medications you may need to take. Make sure your budget allows for that expense as well as the cost of consultations, semen testing, and ultrasounds. If you have insurance and live in Arkansas, California, Connecticut, Delaware, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas or West Virginia, your insurance company may cover some of the costs.
Choose a sperm donor for the procedure. If you know someone you'd like to be a sperm donor, consider their health, personality traits, and whether or not you trust them. Meet with them privately to ask them in person so they know you’re dedicated. You may also want to consider what they look like, their cultural or ethnic background, and how smart or creative they are. Avoid asking someone who is busy raising a newborn or has a lot of other things going on because the request may be too much to ask of them at the time. You might say something like, "I have something big to ask of you... I admire your sense of humor and love the fact that you come from the same background as me. Whether it's a yes or a no, I cherish our relationship just the same. Do you think you'd want to be my sperm donor?" If you don’t have a potential donor in mind, you can seek out an anonymous sperm bank.
Contact a fertility clinic that offers artificial insemination. Search online for fertility centers in your area or ask your doctor if they can point you in the right direction. You can also look on the CDC's website as they have a database of all the licensed fertility centers in the country. Once you find one, ask them questions like: How often do your doctors perform artificial insemination and what are the success rates? Do you have an age limit for artificial insemination? Are all of your physicians certified by the American Board of Obstetrics and Gynecology? Would I, as a patient, have a say in how many embryos are transferred? What's the cost of artificial insemination? I don’t currently have a donor, does your clinic have an anonymous sperm donor program?
Take medications to induce ovulation if your fertility doctor or OBGYN recommends it. If you've struggled with fertility in the past or are over the age of 35, your fertility doctor or gynecologist may prescribe that you take medication to increase the number and quality of eggs your ovaries produce. Take 1 pill a day for 5 days or however long your doctor recommends. Clomiphene is the most common estrogen modulator used to treat fertility problems. It’s usually covered by insurance, but if you don’t have insurance, it costs around $438 for a supply of 30 oral tablets. Let your doctor know if you've ever had ovarian cysts, liver disease, uterine fibroids, thyroid disease, abnormal vaginal bleeding, or adrenal disease.
Have your donor collect a sperm sample at home or in your doctor's office. Your doctor may be able to give your donor a kit or jar to collect their semen. If not, book an appointment for your donor to go into the clinic so they can collect the sample there. If you've opted to use sperm from a sperm bank, they'll send the specimen straight to your doctor's office before your procedure. Let your sperm donor know that they shouldn't have sex or masturbate for at least 2 days before the collection so they can give the highest quality and quantity of sperm. After collection, the semen will be washed and prepared in a way that separates low-quality sperm from high-quality sperm. Washing removes chemicals on the specimen that may irritate the uterus and allows men who are HIV positive to donate healthy specimens. If your donor has had any recent health problems (like a UTI), your doctor may require them to take a round of antibiotics before donating their semen.
Monitor your ovulation cycle and call your doctor as soon as your period starts. Your doctor can help you pinpoint the perfect time to schedule your procedure by monitoring your cycle. Or, you can monitor it yourself using at-home fertility tests. Call your doctor as soon as you start menstruating to schedule an appointment for a day when you're most fertile (about 12 to 14 days before you start your period). If you keep track of your periods with a calendar, use that to help you predict your most fertile days. Feel free to take a fertility test just to make sure.
Wear comfortable clothes on the day of the procedure. Wear comfy clothes for your appointment that you can easily take off and put on. Place your legs into stirrups and try to relax. Be prepared to feel slight cramping during the procedure while the doctor inserts a speculum and catheter into your uterus. The procedure only takes 5 minutes and feels similar to getting a PAP smear. Your doctor will have you lie down for 10 minutes afterward so the specimen has a better chance of latching onto the walls of your uterus.
Take a pregnancy test 9 to 14 days later. Schedule an appointment with your doctor to get tested or take an at-home test. If you get a positive reading from an at-home test, let your doctor know so they can test you again to confirm the pregnancy. You can buy at-home pregnancy tests from any drugstore or most grocery stores. They cost around $10 per test.
Get another treatment 1 month later if necessary. If the pregnancy test comes up negative, let your doctor know you’d like to try again. Keep monitoring your cycle and schedule the next treatment to take place 12 to 14 days before you start your period. In lots of cases, it takes a few treatments to get it right, so don't lose hope! The success rate for artificial insemination ranges from 37.9% to 40.5% after 6 treatments, but some women experience success on the first or second try. If you go through 3 or 4 treatments with no success, your doctor may recommend you try IVF.
Getting Pregnant with IVF
Talk to your doctor to see if you’re a good candidate for IVF. Let your doctor know that you’re looking to conceive and are curious about IVF. If you have irregular cycles, endometriosis or polycystic ovarian syndrome, IVF is a good option for you because the process induces healthy ovulation. Note that IVF isn't recommended for women over 40 years of age because the success rate drops by as much as 30%. If you're around this age, talk to your doctor about what you can do to increase the odds of success (like hormonal supplementation or dietary changes).
Determine whether IVF is an affordable option for you. Check your finances before deciding to do IVF because the entire treatment can cost $20,000 or more. Depending on where you live, your insurance company may cover some of the costs, but not all. You can file Medicare claims for some of the costs of IVF (like testing and appointments), but you'll likely end up paying heavy out-of-pocket expenses. Keep in mind the extra cost of check-ups, ultrasounds, and the actual delivery if your IVF is successful.
Allow 4 to 6 weeks to complete the entire IVF treatment. Be patient with the process because your initial fertility testing (which includes collecting and testing the eggs, collecting and preparing the sperm, and assessing your uterus) will take 4 to 6 weeks. Keep your schedule relatively flexible because you may need to go into your doctor's office for blood tests every so often—even daily, in some circumstances. How often you need to get blood tests depends on your age, overall health, and how close you are to the embryo transfer date. Your doctor may recommend you take fertility injections for 8 to 14 days before they extract the eggs. Everyone's body is different, so your doctor may prescribe additional medication to take before you start injections or have you start taking injections before the first day of your period. The egg retrieval process requires you to be put to sleep, so plan to have someone else drive you to and from the doctor’s office.
Prepare to wait 3 to 4 more weeks for the extracted eggs to mature. Know that once your eggs and the sperm have been tested, they'll need to sit around for a few weeks until they're ready for fertilization and implantation. This waiting period increases the chance that you'll get pregnant once the embryos are transferred into your uterus. During this time, your doctor may recommend you take progesterone, a hormone that will help prepare your uterus for the pregnancy. Progesterone is covered by most insurance plans but if you don’t have insurance, it’s about $32 for enough to last the 3 to 4 weeks before the embryos are transferred.
Book an appointment to have the embryos transferred. Expect to spend about an hour at your doctor's office to have the fertilized eggs transferred into your uterus. The procedure itself only takes 5 minutes, but you should allow ample time to talk to your doctor before and after. In most cases, your doctor will work with you to determine how many embryos you want to have transferred. The procedure itself is similar to getting a PAP smear—all you have to do is put your legs into stirrups and allow the doctor to implant the embryos with a speculum and a catheter.
Follow your doctor's post-IVF care instructions. Stay on any medications your doctor has prescribed and don't skip any doses or stop for any reason (even some light bleeding is expected during IVF). If your doctor recommended prenatal vitamins at the start of the IVF process, continue taking those as well. For the best chance of conceiving: Don't do any intense exercise. Avoid exposing yourself to heat—that means no hot baths, jacuzzis, saunas, steam rooms, heating pads, or hot yoga.
Take a pregnancy test 2 weeks later and follow up with your doctor. Purchase an at-home pregnancy test from your local drugstore or grocery store and let your doctor know the results. If it’s positive, they’ll do another test in their office to make sure. If the first test comes out negative, don’t worry. It’s common for people to have to do a second round in case the embryo doesn’t implant itself correctly. If you decide to try again, work with your doctor to learn about and correct anything that may have gone wrong the first time around. The success rate for IVF varies depends on your age: 13% to 18% for women over 40 23% to 27% for women 38 to 40 33% to 36% for women 35 to 37 41% to 43% for women under 35.
Adopting a Child
Be a foster parent to an adoptable infant, toddler, child, adolescent, or teen. Look up a foster care agency in your state and give them a call to talk about your options in starting the process. The children who are up for adoption are those whose parents and relatives have lost total custody of the child. While it’s possible to foster an infant, know that infants in foster care are more likely to be drug-exposed (or addicted) or have fetal alcohol syndrome, an intellectual disability, and other issues. To be a foster parent, you have to meet the following basic requirements: Be at least 21 years of age. Be in good physical health. Pass a criminal background check. Be able to financially provide for a child.
Contact a private adoption agency if you want to adopt an infant. Do a simple online search for “adoption agency” and your state or city (e.g., “adoption agency Sacramento CA”). Public agencies don’t typically allow infant adoptions, so if you’re looking to take in a newborn, a private agency is the way to go. Note that private adoption agencies may charge anywhere from $5,000 to $40,000. This sounds like a lot, but it goes towards covering the home study, birth-parent counseling, adoptive parent training, and social work services. You can also adopt an infant from a potential birth parent if you already know someone—you’ll just need to get an adoption attorney to go through with the process. Private adoption agencies are also a good option if you want to adopt a child from a foreign country.
Be open to adopting siblings who need to stay together. Consider adopting siblings if you have the means to do so. A lot of children who are up for adoption have undergone some kind of neglect or abuse so an adoption agency may require them to be adopted together for their own wellbeing. Adopting siblings can help ease the transition because each child will have someone who knows them well while they get used to living in a new home with new parents.
Go through the legal process involved in adopting a child. Look up an adoption services provider to help you navigate everything you need to do to legally adopt a child. You can also hire an adoption attorney. Either one can help you navigate the following necessary steps: The home study necessary to prove the child will be in a good environment. The placement process that matches you with children available for adoption or allows you to connect with potential birth parents. Be aware that this process can take months or years. Filing required legal documents to officially adopt the child.
Expect to wait anywhere from 6 months to 7 years to complete the process. Know that adoption is a lengthy process and the length of time depends on how long the pre-placement steps take (like home study, paperwork, counseling) and the particular situation of the child you’re adopting (e.g., their age, location, and race). If you’ve been fostering the child already, the adoption process can take 6 to 18 months. If you’re adopting an infant from an agency, it may take 2 to 7 years. International adoptions typically take at least 6 years. However, countries that have a high demand for adoptions (like Ethiopia, Honduras, Bulgaria, and Nicaragua), may only take 1 to 2 years. The process to adopt older children and teens is typically much shorter than the process to adopt infants or toddlers. If you’re financially stable and have a savings set aside specifically for the adoption, it may take less time. Children who are of western European descent are usually more sought-after than children of other backgrounds.
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