Question and Answer Follow Up from the Fairfax Cryobank Home Insemination Webinar
Thank you to all of those who attended the Home Insemination Webinars! It was a pleasure for us to present the information and answer your questions. Each of the questions was reviewed by our presenters and answered by the appropriate person:
- Kate Wisda, NP Women’s Health Nurse Practitioner, Pacific Reproductive Services
- Michelle Ottey, Ph.D. Lab Director, Fairfax Cryobank
- Cheryl Daubenberger, Director of Client Services, Fairfax Cryobank
Tracking Your Cycle and Fertility
With period cycle tracking, is it pointless to track your period if you’re still on birth control pill?
Excellent question! Correct, it is not helpful (for our purposes) to track your cycles when you are on oral contraceptive pills (OCP). OCP, in a sense, takes control of your cycle and tells your body what to do. Off birth control, your cycle will likely be different (in length, ovulation day, etc.).
What is the benefit of using the OPK with 2 lines vs the one with the smiley face?
We have found better results with First Response’s kit with two lines. The results are often more precise with variations in color, making it easier for our purposes (inseminating as close to ovulation as possible). The other ones with the digital happy faces will give a larger window of fertility that is more appropriate with the use of fresh sperm/ hetero sex. Remember: the window of fertility is shorter for inseminations because the thawed sperm do not live as long in the female body.
Any suggestions if we haven’t been able to get over the counter predictor kits to show an LH surge – are there other options that we can use outside of a doctor’s office?
If OPK tests don’t work for you, don’t worry, you are not alone! There is plenty that can be done to help you get pregnant, but it does require a visit to a provider for assessment and treatment as needed. Please note that you should always read the instructions for OPK tests- they require more planning and timing than a urine pregnancy test. Be sure to give the kits a try for a few cycles before you determine that they don’t work for you.
How many times a day should you test using OPK?
Here at our clinic, Pacific Reproductive Services in Pasadena, CA, we ask our patients to test only in the morning. If you choose to do additional tests in the afternoon or evening, that is your choice.
When do you consider the 1st day of your period?
The first day of your cycle is your day using a pad, tampon, menstrual cup, etc.
Can ovulation window change from month to month?
It sure can! A difference of 1-3 days does usually not cause for concern. If you’re having sudden or more drastic changes (4+ days difference), let your provider know. They can help you determine if there is cause for concern.
What is the best way to test fertility?
First off, you’ll need the assistance of a medical provider to test your fertility. Most OB/GYN’s are happy to provide pre-conception assessments and labs. Necessary tests and procedures can vary for each patient. I will say that here at Pacific Reproductive Services, one of our gold standards for determining egg reserve/fertility in women of Advanced Maternal Age (35yr+) is the blood test for Anti-Mullerian Hormone (AMH). Ask your OB/GYN if this test is appropriate for you.
Do you recommend taking any supplements to increase chances?
It is recommended that a woman trying to conceive start prenatal vitamins at least 3 months beforehand in order to build adequate stores of folic acid. *Please always consult with your medical provider before starting ANY supplement, no matter how benign they may seem. I will caution you that certain supplements require extended use before trying to conceive (3-6 months) and others can drastically affect your hormones, causing cycles to be irregular. Irregular cycles can make it even harder for you to predict ovulation and therefore conceive.
If I’m over the age of 35 and my PCP/OBGYN states no concerns with fertility during the last year, should I still follow up with my doctor before beginning this process?
We recommend speaking with your provider to keep them in the loop.
I’m 48. No other health issues. Is ICI or IUI better for me? Should I use 2 vials per insemination?
Because of your age, you will need to first determine your level of fertility. See your provider for a fertility assessment. You do not need to use 2 vials for 1 insemination. You can do 2 inseminations in 1 cycle at 12 and 24 hours after your LH surge (+OPK). A count of 10 million is the standard per insemination. As for your age, see your provider for a fertility assessment.
I used Clomid previously. should that be continued?
Clomid can provide great results with follicle development. Please discuss continued use with the provider that is prescribing the medication.
Can a person do their own insemination?
Absolutely, as long as they have the required range of motion to work the syringe and insert the syringe.
Is there a way to kill the sperm? (What if you accidentally push out the syringe back into the vial and then back into the syringe?)
That would not kill the sperm but try to minimize the manipulation of the sperm to prevent damaging. However, the mistake you describe should not cause a significant loss.
What if you live in an apartment that is hotter than average or is doing this during summer months in a non-airconditioned place, will this be a problem for thawing the vial?
It should be fine; thawing at ~70-75 degrees (room temp) for 20 m is sufficient. If the room is warmer, it may only take 10-15 m.
If you are doing 2 vials are you able to reseal the chamber to keep the second vial frozen for the next 12 hours?
Yes, carefully remove the first vial without exposing the second vial to room temp, place the lid back on and it should be fine.
Best time for ICI insemination from the frozen donor?
When you ovulate- roughly 24 hours after your LH surge (+ OPK).
Is a “soft cup” the same as a silicone menstrual cup?
No, the soft cups are made, usually, from a silicon ring with plastic or plastic film. The soft cups are more flexible but can be a little more challenging to open in the vagina.
How long do we leave the soft cup in for?
Look at the instructions, generally, it is up to 10-12 hrs. With any cup you use, please be sure to read the recommendations for the time limit and follow accordingly.
If you purchase 2 ACT vials, should you use them both on the same day? Or on different days?
It depends on your fertile window, might want to stagger them and do one a few hours into the window and a second a few hours later.
If I want to use 2 vials for my home insemination cycle, when do I perform the 1st insemination then 2nd?
Usually at 12 and 24 hours, but it will depend on your “fertile window”.
Is the needle already sterilized upon arrival?
The needleless syringe is sterile in its packaging. Please note: an ICI is not a sterile, surgical procedure. It requires clean but not sterile devices.
Will sexual stimulation and orgasm, causing increased vaginal fluid, increase better chances of achieving a pregnancy?
Yes, we know that the cervical fluids and uterine cramping associated with orgasm can encourage sperm to travel upwards- through the cervix and into the uterus.
How severe is the cramping?
There should not be any cramping from ICI. Some women report mild cramping after IUI.
How many inseminations can you get per vial?
1 per vial
Would you recommend using 1 IUI vial at 12 hours, or 2 ART vials at 12 and 24 hours of ovulation? This is if there isn’t ICI available.
I would recommend using 1 IUI vial at 24hours. Always aim for a full count of ~10 million sperm. ICI and IUI vials each have 10 million. ART typically has less (a little more than half at ~6 million). If you wish to do 2 inseminations, aim for 2 full count vials at 12hr and 24hr. You can combine 2 ART vials to equal 10 million.
Is it important for the vial to stay upright the whole time?
When thawing, yes
How long does sperm live in the body?
Fresh sperm can live in the female reproductive tract 3-5days, previously frozen sperm can live 12-24hr, some sources suggest up to 72hr.
Is the IUI medical procedure more effective than at-home inseminations?
ICI success rate per cycle is typically 5%, IUI is 20%, hetero sex is 20%. These numbers include all women of reproductive age. If a woman has no fertility issues and is in general good health then all the numbers go up, including ICI which then jumps to about 10-15% chance/ per cycle.
Does the chance of pregnancy increase with every ICI/IUI?
No, success rates are for each cycle.
How much does Fairfax Cryobank charge to do an IUI?
Fairfax does not perform IUIs, our PRS clinic in Pasadena CA does, for more information you can call or visit the website: https://www.pacrepro.com/index.php
After insemination, is it okay to work out during the two-week wait?
Yes! Stick to business as usual and have fun! When trying to conceive, it is important to be aware of stress levels. Exercise is a great way to keep the body and mind healthy.
After several unsuccessful tries at home should you try IVF or IUI?
Typically, the move is ICI to IUI to IVF (due to factors such as cost and convenience). To save time and money, ask your provider for a fertility assessment to determine if you should switch to IUI or IVF.
Purchase, Shipping, and Pickup Questions
There is a lot of different information around using a CMV positive donor if you yourself are CMV negative. Any thoughts?
Please follow your medical provider’s recommendation. All of our donors, both CMV negative and positive donors, are screened to ensure that there is no virus in the sperm sample.
What is the average time frame from picking donor to getting it delivered?
This is specific to each client’s personal journey; however, as soon as a donor is selected, we are able to deliver an order within 1-2 business days.
How many days before predicted ovulation day should you order the sperm?
As soon as you know the date that the semen samples should be delivered, you should call to place your order and our Client Service team will walk you through the process. We offer 2 types of delivery, next day is available. Our tanks keep it frozen for 7 days, but we recommend upgrading to a 14-day tank.
Can we use any type of vial for the home insemination? ICI or IUI vials can both be used?
Correct, 1 ICI, 1 IUI, or 2 ART
Does my provider need to sign a release or authorization? Why?
Because Fairfax Cryobank does not perform medical procedures, we need to ensure that you have a medical provider who can work through this process with you and answer any medical questions that may come up.
Where do I find the Home Delivery form on the Fairfax website? I only see the option to ship to a medical facility.
This form is not available online, you will need to call Client Services to request a Home Delivery form.
Can we really just order the sperm online? There are no other requirements – consulting with someone at Fairfax, etc.?
Semen orders for home delivery are unable to be placed online, you will need to call and speak with a Client Service Specialist. There are no other requirements.
Can the two vials be sent in one shipment single canister for the purpose of the 12-hour and the 24-hour insemination?
Yes, just remove the first vial carefully without exposing the second vial to room temperature.
If I plan on ICI, but have no pregnancy after multiple attempts and realize I need to come in for IUI can I transfer my purchased ICI to IUI?
If you have purchased ICI vials, your clinic can wash the vial and use the sample for an IUI. Another option for semen samples that have never left our storage facility is to exchange them for a different donor or preparation type.
I would be picking up my purchase from the Roseville MN located. How do I know which donors sperm is at this specific location?
All donor sperm can be shipped to any of our locations for the storage and pick up.
If we’re local to one of your locations can we pick up both the sample and home insemination kit? Would that still require the authorization form?
Yes, you are able to pick up from us directly and you will not need your clinic to sign off on this; however, you will need to be working with a clinic that has a registered account with Fairfax.
Can you pick up sperm if you’re not doing home insemination? And deliver it to your health care provider?
What is the fee for storing vials?
Storage fees can be found online, here: https://fairfaxcryobank.com/fees
To watch the full Home Insemination Webinar – Please click below
Please note the webinar is pre-recorded and the promotional code is no longer valid.