Sperm Donation (Using a Sperm Donor)

Use of donor sperm

Many children are conceived each year through the use of donor sperm. Patients using donor sperm include single and lesbian women, partners of men with no or only very few sperm present in the ejaculate, and partners of men with a genetic condition that may be inherited by the child. Donor sperm may also be purchased as a backup when there are concerns about the fertilizability of the male partner’s sperm. While most patients use an anonymous sperm donor, known or directed sperm donation is possible. Donor sperm may be used for both IUI and IVF cycles.

Donor sperm selection

Patients may use sperm from any licensed sperm bank. RSC accepts donor sperm from most sperm banks within the United States. Information about a donor’s physical characteristics, race ethnic background, educational background, career history and general health should be available on the sperm bank’s website. Many sperm banks provide written profiles about the donors. Some sperm banks may provide non-identifiable information about the donor (perhaps even provide photographs) as well as a service for adult offspring to obtain information about the donor.

Donor screening

RSC follows the recommended guidelines set by the American Society for Reproductive Medicine. In short, a sperm donor is tested for a number of infectious diseases in compliance with state and federal regulations, the semen sample is frozen and quarantined for 180 days, and the donor is retested. Only then will the frozen samples be released for purchase by a patient. Testing is performed for infectious diseases including HIV, Hepatitis, Syphilis, Gonorrhea, Chlamydia, Streptococcal species, Trichomonas and Cytomegalovirus (CMV). All of these organisms can be transmitted via semen to the woman. Some may have grave effects on the fetus; others affect the woman. The donor sample is also checked for the presence of white blood cells which may indicate an infection within the reproductive tract.

A donor would be excluded from a program if he or his sexual partner has experienced any of the following: a blood transfusion within one year, a history of homosexual activity, multiple sexual partners, a history of intravenous drug use, or a history of genital herpes.

Before beginning the donor insemination process, a careful medical and reproductive history should be collected on the woman. A rubella titer, blood type, and antibody test for CMV should also be performed. If a woman tests negative for CMV, we recommend she use a CMV-negative sperm donor. Some practices may want to document normal ovulation patterns, and many physicians order a hysterosalpingogram to document that the woman’s fallopian tubes are open.

Ordering frozen donor sperm

Frozen donor sperm may be ordered by the patient directly from the cryobank either on the website or over the telephone. All sperm banks have customer service representatives to help patients through the selection and ordering processes. For your convenience, cryobanks will ship frozen sperm overnight directly to our clinic. In some instances, patients may bring the frozen sample themselves, though this is rare. Patients should be selective about the sperm bank and the sperm sample. The sperm bank should be licensed, ensuring that the organization adheres to state and federal guidelines for screening donors. Be sure to check the post thaw quality of the sample as well, and work with banks that provide a minimum of 15 million total motile sperm per vial after thawing for IUI. RSC prefers donor sperm be shipped overnight Monday through Thursday for delivery Tuesday through Friday. Patients should plan ahead so the sperm arrive at the IVF lab at least a few days before use. Two vials are recommended so that in the rare event of a poor sperm thaw, we have a backup vial available.

What type of sperm to order?

Donor sperm is prepared one of three different ways:
1. Intracervical (ICI): This sample is not washed prior to freezing. A cryoprotective buffer is mixed with the ejaculated sample, and the sample is frozen in multiple vials. This type of sample is used for intracervical insemination. ICI samples cost less, but if they are to be used for IUI, additional processing by the andrology laboratory is necessary to remove the seminal plasma, adding additional cost to preparing the sample.
2. Intrauterine (IUI): This sample is pre-washed by the cryobank before freezing. IUI prepped samples are simply thawed, loaded into a catheter and deposited into the uterus via the cervix. IUI prepped samples can be used for IVF, but ICI sperm works just as well and is less expensive to order.
3. ART: This sample is prepared by the cryobank specifically to be used during an IVF cycle. These vials contain fewer sperm than ICI or IUI prepared samples and are slightly less expensive.

Preparing for donor insemination

We have found that many of our patients who chose to use donor sperm benefit from speaking with a counselor or psychologist prior to beginning treatment. RSC recommends that any patient considering donor insemination see a counselor who is skilled at clarifying feelings about infertility and about the use of donor insemination. These conversations will allow patients and their partners the opportunity to discuss factors they may not have considered including donor selection, disclosure to family, etc.

The donor insemination process itself involves inseminating the woman as close to the time of ovulation as possible. Many women monitor their ovulatory cycles by testing their urine for an LH surge which indicates that ovulation will soon take place. An ultrasound is often used to help confirm timing. Inseminations are usually done about 24 hours after the LH surge is detected by the urine test.

Intrauterine Insemination (IUI)

IUI is always used for insemination at RSC because it increases the success rates over intracervical insemination. The sperm are deposited directly into the uterus via the cervix. The insemination is usually painless. Some women with a tight cervical opening may experience cramping if an instrument is used to gently open the cervix.

Success rates

The highest success rates for patients using donor insemination are reported in women less than 35 years of age with no infertility problems, and for women under 35 whose partner has azoospermia (no sperm). Lower success rates are reported in cases of female factor affecting fertility (ovulation disorder, endometriosis, DES, etc) or if the woman is over 35 years of age.

Success rates vary from 5-15% per month and are age-dependent. It is important to note that achieving pregnancy may take many cycles. If no pregnancy occurs after several cycles your physician may recommend further evaluation, including a hysterosalpingogram. Ovulatory stimulating drugs such as Clomiphene or injectable gonadotropins may be prescribed. Ovulation tracking combined with IUI may help increase the likelihood of success for some women.

RSC approved cryobanks

California Cryobank
Los Angeles Office
11915 LaGrange Ave.
Los Angeles, CA 90025
Ph: (866) 927-9622
Fax: (866) 625-7336

California Cryobank
Palo Alto Office
4294 El Camino Real
Palo Alto, CA 94304
Ph: (650) 324-1900
Fax: (888) 317-4721

Fairfax Cryobank
3015 Williams Drive Suite 110
Fairfax, VA 22031
Ph: (800)-338-8407
Fax: (703) 698-3933

Cryogenic Laboratories
1944 Lexington Ave North
Roseville, Minnesota 55113
Ph: (800) 466-2796
Fax: (651) 489-8989

New England Cryogenic Center
153 Needham Street
Building One
Newton, MA 02464
Ph: (800) 991-4999
Fax: (617) 244-6659

Sperm Bank of California
2115 Milvia St., Suite 201
Berkeley, Ca 94704-1157
Ph: (510) 841-1858
Fax: (510) 841-0332

Pacific Reproductive Services
444 DeHaro Ste. 222
San Francisco, Ca 94107
Ph: (888) 469-5800
Fax: (415) 863-4358

Xytex Coorporation
1100 Emmett Street
Augusta, GA 30904
Ph. 706-733-0130
Fax 706-763-9720

Scandinavian Cryobank
305 Broadway, 9th Floor
New York, NY 10007
Ph.866-366-6777 or 212-822-1414
Fax 917-591-4227

NW Cryobank
508 West 6th, Suite 801
Spokane, WA 99204
Ph: (800) 786-5251
Fax: 509) 232-0145

Seattle Sperm Bank
4915 25th Ave NE, Suite 204
Seattle, WA 98105
Ph: (206) 588-1484
Fax: (206) 588-1485

Cryos International
90 Maiden Lane, Suite 302
New York, NY 10038
Ph: (866) 366-6777
Fax: (917) 210-3464

Sperm bank resources

American Association of Tissue Banks

The American Society for Reproductive Medicine

 

Thanks to the contributions here by Diane N. Clapp, BSN, RN, Medical Information Director, RESOLVE: The National Infertility Association.