The logistics of a home intrauterine insemination (IUI) are pretty simple. If you’re using frozen sperm, you can thaw the vial under your arm for a few minutes before we get started. If you’re using fresh semen, we spin it in a centrifuge to separate the sperm from the seminal fluid, which can take up to an hour. While the sample is thawing or spinning, we explain the rest of the procedure and answer any questions you have.

Next, you find a comfortable spot to lay down (usually your bed) and we set up our supplies nearby. With your help, we place a speculum in your vagina to get a good view of your cervix. We attach a syringe to a thin catheter and draw the sperm into it. We pass the catheter through your os (the opening in your cervix) into your uterus: a distance of just a few centimeters. When the catheter is in place, the syringe plunger is depressed slowly, sending the sperm into your uterus. Within about 15 minutes, millions of sperm are making their way toward your uterine tubes. We hope an egg is waiting in one of those tubes to meet them!

I’ve had four IUIs: two at Kaiser Oakland’s Reproductive Endocrinology office and two at home. Take a guess which pair were better! My home IUIs were more physically and emotionally comfortable, more welcoming of my wife’s participation, and much more firmly grounded in consent. I could fit the timing into my schedule — ovulation can happen outside of traditional business hours, Kaiser! — and get cozy in my own bed as soon as we were done. Receiving conception support from midwives cemented my commitment to make fertility consultations and IUIs a centerpiece of the care I provide.

In each IUI Evaly and I offer, there are three moments when I feel especially connected to the spiritual energy and revolutionary power of midwife-provided conception care. The first happens when we’re all settled in for the thawing or spinning that happens before the IUI. While we’re waiting, we have a chance to do something virtually unheard of in clinical settings: build a friendly, trusting relationship with each other. I’m glad to pet your dog as we try to decipher your ovulation signs. I’m curious to learn the sweet story of how you met your partner or what brought you to the Bay Area, and I’d love to make you a cup of tea while we trade insights from our fertility journeys. The authentic connection we share with our clients is one of my favorite parts of midwifery care.

The second moment happens when we begin the IUI by asking if you’d like to insert the speculum. For many people, this is the first time they’ve been invited to actively participate in their reproductive care. For us, the benefits are obvious: you know your body best, and the moment we begin such an intimate procedure should be completely up to you. We make every effort to prioritize your comfort and consent.

Of all three moments, the third is the one I feel most deeply. After we’ve removed the catheter and speculum, while the sperm are busy making their way toward your egg, and you’re snuggled up in bed, we pause to honor all of the intention, imagination, and interdependent magic it takes to create new life this way. For many clients, an IUI is the culmination of years of planning and dreaming, sometimes with significant setbacks and heartbreak along the way. It can be a joyful and tearful minute or two as we think about all the people who have helped you manifest your vision of parenthood: friends and family, your sperm donor, even the folks in a faraway manufacturing facility who packaged up the syringe and catheter. Most importantly, we pause to celebrate you and the creativity, determination, resilience, and courage that have brought you to this moment. We’re grateful you’ve invited us to share it with you.

If you have questions about conception care or you’d like to schedule an IUI or fertility consultation, please email Evaly at evaly@islandmidwife.com. We’re looking forward to meeting you!