Artificial insemination or intrauterine insemination using donor sperm has been practiced for over a century, although the first published reports about the practice were in 1945. Over the past 10 years, the utilization of donor sperm has decreased as the utilization of IVF and intracytoplasmic sperm injection (ICSI) for the treatment of male infertility has become widespread. Since the late 1980s with the emergence of AIDS, artificial donor insemination has been performed exclusively with frozen and quarantined sperm. Current guidelines from the FDA and also from the American Society of Reproductive Medicine recommend that sperm be quarantined for at least six months before being released for use. In most cases, donor sperm is obtained from a sperm bank. Sperm donors undergo extensive medical and genetic screening.
For a couple, seeking sperm donation is appropriate when the male partner has very low sperm count or blockage of sperm ducts. These abnormalities have many causes, some of which are congenital from birth, e.g., the absence of a man’s vas deferens, which transports the sperm from the testicles to the penis. Another cause of infertility in a man would be a previous vasectomy, which is irreversible. Also, a man’s testicles may fail from radiation or chemotherapy or other reasons. Sometimes a man produces normal amounts of sperm, but he may be a carrier of a genetic defect that he may not want to pass on to his children.
Donor sperm is also used in the treatment of single women or same-sex female couples who desire a pregnancy. This may be the largest group of donor sperm users. Drs. Servy and Massey have long been known for their open door policy to any social situation.
The use of donor sperm, eggs, or embryos is a complicated issue that has lifelong implications. Talking with a trained counselor who understands donor issues can be very helpful in the decision-making process. The Servy Massey Fertility Institute has experienced mental health professionals available. If a couple knows the donor, their physician may suggest that both the couple and the donor speak with a counselor and an attorney. Some states require and most IVF centers recommend an attorney to file paperwork for the couple with the court when donor sperm or embryos are used.
Sperm donors should be of legal age and ideally less than 40 years of age to minimize the potential of defects associated with older men’s sperm. Traditionally, donors have been anonymous; however, the donor may also be known or directed to the couple or single woman.
Our centers in Atlanta and Augusta are able to recommend several highly professional sperm donor agencies. However, a donor chosen by the couple is also acceptable. When applicable, general physical characteristics of the male partner may be considered when choosing a donor. In addition, matching the blood type of the woman being inseminated reduces risks of problems in later pregnancies.
FDA regulations require anonymous sperm donors to be screened for communicable diseases and even risk factors for communicable diseases. A donor is ineligible if either screening or testing is positive for either a communicable disease or a risk factor for a communicable disease. A comprehensive medical questionnaire evaluates the health of a donor and reviews his family medical history. Particular attention is paid to the potential donor’s personal and sexual history to exclude those males who are at high risk for communicable disease including HIV, Hepatitis B, and other sexually transmitted diseases. A family medical health history is obtained for at least two generations of family members. Prospective donors then undergo a physical examination with screening for visible physical abnormalities, as well as testing for sexually transmitted diseases, blood type and Rh factors through blood analysis.
Current FDA regulations require infectious disease testing to be performed and noted to be negative within seven days of all sperm donations. For anonymous donors, testing for all sexually transmitted diseases is performed prior to donation and after a six-month period.
The FDA exempts sperm donors who are known or directed to the intended couple (not anonymous) from the six-month retesting requirement. However, the American Society for Reproductive Medicine recommends that these types of donors be tested and retested just as anonymous donors.
In addition to the medical information that is obtained from the donor, donors are asked to provide detailed information about their personal habits, education, hobbies, and interests. Sperm banks may provide pictures of the donor and video or audiotapes from the donor. Donors may identify themselves as open to contact from any child conceived through donor insemination once a child reaches legal age.
The donor will undergo a semen analysis and the sample will be thawed to evaluate post-freezing/thawing damage. Sperm damage with freezing varies between individuals, as well as between samples of a given donor. Donors are selected if the post-thaw semen meets a minimum standard.
Donor sperm may be used for artificial insemination via intrauterine insemination or intracytoplasmic sperm injection or for in vitro fertilization cycles. Overall, the use of frozen sperm rather than fresh sperm does not lower success rates.