Some midwives and women's health experts teach the at-home method of vaginal insemination. But IUI or ICI need to be done by a medical provider, using sterile technique, since they involve introducing substances into the cervix and uterus, which are sterile environments. Medical providers who do ICIs and IUIs in their offices use sterile techniques to introduce the instrument into and through the cervix and into the uterus.

"If sterile technique were not used, bacteria could be introduced, causing a high risk of infection, which could develop into pelvic inflammatory disease and cause infertility, not to mention pain and fever," says Liz Coolidge, a licensed mental health counselor who runs the Alternative Insemination Program at Fenway Community Health Center in Boston. "[On the other hand] a woman really cannot hurt herself doing a home vaginal insemination."

Whether a woman is using ICI, IUI, or doing an at-home insemination, she must order either unwashed or washed sperm from the bank. specifying the method [preparation of the specimen]. "Washed" means the sperm is separated from semen. Most experts recommend against putting unwashed sperm (sperm unseparated from semen) into the uterus because it can cause a bad reaction, including nausea and vomiting.

"We won't do inseminations with fresh sperm in our office. We teach women how to use it for at-home insemination. But I counsel them about evaluating the risks of STDs," Coolidge says.