Donor conception using donor sperm allows couples to conceive where sperm is completely absent, or is least likely to result in a conception or present a high risk of passing on an inherited disease. Most donor sperm in the UK is now used by women in a same sex relationship or who are single.
Depending on the fertility history of the woman, donor insemination (DI) is normally used in ICI (intra-cervical insemination-or vaginal insemination) or IUI (intra-uterine insemination).
If the donor sperm quality is poor or in older women or women where there has been repeated failure in pregnancy then IVF or ICSI procedure may be performed.
Donated sperm may be used in natural or stimulated cycles depending on individual preference or clinical advice.
Apart from your medical history the hormone tests will be performed to make sure that you are producing eggs and tubal patency test may be performed, along with screening for HIV, hepatitis B & C, cytomegalovirus (CMV), syphilis and gonorrhoea.
Counselling will be recommended to ensure you have understood the implications of using the donor sperm and the child born so that an effective consent is in place before insemination.
The selection of a suitable donor is dependent on availability, your preference and access to donor sperm supply your clinic may have. Quality of post-frozen donated sperm should also be considered for the ease of pregnancy and the clinic will advise you.
Purchasing sperm from another UK centre or importing sperm from an international donor bank with HFEA approved procedures are most common `Known donors’, usually friends or non-blood relations that are brought to the clinic by a patient for their own use specifically are also being used. All `known donors’ are screened in exactly the same way as the normal donors and will be excluded from donating if they screen positive for any active or past viral infection. CMV positive is acceptable but a risk disclaimer has to be signed . With known donors poor quality sperm will not be excluded from the programme but may indicate a need for the patient to be treated with ICSI.
Known donors over the age of 42 years will be considered following a medical with the Consultant or IVF Specialists. In addition he should also agree for their GP to be contacted. Your donor does not need to be resident in the UK but must be able to fulfil all screening criteria locally at an accredited medical centre. Storage visits are best accomplished within the UK but in exceptional circumstances samples may be donated abroad and then imported to the clinic. If necessary the known donor should be prepared to attend implications counselling and be fully informed of the HFE Act with regards to their ID being released if requested when offspring reach the age of 18 years, and be fully aware of the legal implications of their status as a ‘known donor’. This is particularly important, if the patient is a single woman. We strongly recommend that before starting a treatment with a known donor you seek independent legal advice. Any donor can withdraw consent for use.
The costs of purchase, transport, storage fee and treatment must be paid by the patients or as agreed beforehand.
Before starting the programme, during and on their final donation visit the following tests are performed: Gonorrhoea; Trichomonas; Chlamydia (on urine); HIV I and II, Hep B, Hep B Core and Hep C; CMV IgG and IgM (all donors who are CMV IgM negative) at the time of donation; Syphilis; HTLV 1 and 2; Blood group and Rhesus factor; Chromosome karyotype; Cystic Fibrosis Screen. Donors of particular racial groups will also be tested for: Sickle Cell Anaemia; Thalassaemia, Tay Sacs.
All donors complete a detailed medical questionnaire with an extensive list of medical conditions along with information on sibling, parent and uncles/aunt medical problems. Donors are offered to have independent counselling before completing the interview with a medical practitioner.
All donated semen are quarantined for 180 days before release for use after all viral and bacterial tests are complete and satisfactory.
Some donors may decide to write a ‘pen sketch’ about themselves, which is made available to patients after the birth of a child and it is intended to help when parents decide to talk to their off spring about their sperm donor.
From 1 April 2005 this is the information the HFEA collected from donors:
Donor-conceived people conceived after 1 April 2005, when they reach 16 years old, are able to apply to the HFEA to receive the non-identifying information that their donor provided (all information given by the donor except for their name and last-known address).
Donor-conceived people conceived after 1 April 2005, when they reach 18 years old are able to apply to the HFEA to find the information their donor provided, including identifying information.
Donor-conceived people conceived before 1 April 2005 will not have identifying information unless the donor has volunteered the loss of his anonymity. They may find out if the person they plan to marry is their genetically related half sibling.
Donor conceived people before 1 August 1991have no recourse to donor information as the HFEA was not set up to licence clinics, unless volunteered by the donor.
Donors can from 1st October 2009 request information any children born as a result of their donation about the: number of children born, sex of the children born and t the years of birth.
It is important to know that the child born using donated sperm is legally yours even if the consenting partner has no genetic relationship to the child. Legal advice should be sought in case of doubt.
About choosing of sperm from bank
Patients seeking donor sperm normally choose physical characteristics mainly along ethnic background followed by background information on the profession, activities and interests of the donor. Additional information such as previous pregnancy and availability of donor sperm is also important especially for purchasing a reasonable number of vials to allow for a sibling pregnancy.
In the first instance we generally recommend the purchase of up to six vials of sperm to ensure that a set of cycles can be accomplished without needing to organise multiple shipments and higher fees. You will need to pay an annual fee for the storage of the samples.
The supplier may grade semen quality according to the suitability of the proposed method of insemination based on their post-freezing criteria. Most donor sperm is used by intrauterine insemination (IUI) method which needs processing of sperm to remove the seminal fluid which contains dead cells and prostaglandins which may cause severe contractions and expulsion of the sperm if introduced in the uterus. IUI allows for more living sperm cells to reach the uterus and consequently more sperm is available for fertilization. Proper timing of insemination is important with IUI. This method places washed semen directly into the uterus by passing a catheter through the cervical canal. IUI ready sperm can also be purchased which avoids further washing.
Intracervical insemination (ICI) will allow for unprocessed semen to be placed near the os of the cervix as would normally happen during sexual intercourse. These specimens hold all of the naturally occurring ejaculate fluid and cells. There will still be plenty of motile sperm including dead sperm as well and the cervix and cervical fluid will only let the highly motile sperm cells up into the uterus and fallopian tubes. These unprocessed specimens containing raw semen can be used for IVF cycles and IUI after they are washed following thawing of the frozen specimen by a doctor/nurse.
Before placing your order it is best to consult your physician with regards to whether IUI-ready sperm or ICI sperm should be ordered. Both IUI-ready sperm and ICI can be used for IVF. Our team is experienced to help you locate a suitable donor.
Gulam Bahadur – Andrologist.