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Alternative insemination (AI), also called artificial or donor insemination, is a method of conception whereby freshly gathered or frozen sperm (first thawed) is inserted manually into a woman's vagina or uterus to fertilize an egg. Insemination is usually performed on or near the day of ovulation, when a woman's egg is released from her ovary. AI is used among lesbian, gay, bisexual, and transgender (who are not taking hormones) people. Women may obtain sperm from a male friend or from an anonymous donor at a sperm bank. A woman may conceive and act as a surrogate mother for a gay man's child after being inseminated with his sperm.

The conception rate through AI is similar to that through sexual intercourse. Approximately 11% of women who are trying to conceive are successful during a given menstrual cycle. Failure to conceive with AI is most often a result of fertility problems and not insemination error. There is a 20% rate of miscarriage among women who use AI and women who conceive during sexual intercourse. Age and medical history affect a woman's ability to conceive regardless of the method. It is a common misconception that more boys than girls are born of AI, but there is no data that suggests that this is true.

AI can be a cost-effective alternative to adoption, which can cost anywhere from $10,000 to $30,000. AI using banked sperm may cost $500 to $1000, depending on the number of inseminations that are needed to conceive.

Choosing between an anonymous or a known donor may be complicated by logistical and social factors.

Insemination with a known donor is cost effective, can be done responsibly at home, and can provide a child with an identifiable father. General medical standards require a woman to use fresh sperm during home insemination, which can be difficult if the donor is not near. For most people, it results in a rewarding, personal environment for mother, father, and child. However, some difficulties compel women to choose an anonymous donor:

• Custody and visitation rights; legal issues
• Greater risk for sexually transmitted disease when using untested, familiar sperm
• Parenting and family complexities

• Medically tested sperm
• No legal or custody issues
• Single parenting; no identifiable father

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