While there are many different types of fertility treatments available, couples dealing with male factor infertility are not always able to take advantage of these therapies. Low sperm count, poor motility, or abnormal morphology of sperm can make it very difficult to conceive using your partners sperm. However, donor sperm is increasingly becoming a viable option for many couples. Research shows that, in the UK alone, this special procedure is helping a thousand families every year in giving birth to a child. So what is a donor sperm and how can it help you combat infertility?
What is Sperm Donation?
This is a procedure by which the egg of a female is fertilised, using artificial insemination techniques or IVF, with sperm from a healthy male that has been donated and kept frozen in a sperm bank. The resulting embryo may then develop into a foetus inside the uterus. This way, a couple gets a chance to conceive a child who has genetic traits of one of the parents and the mother can experience pregnancy.
Who can Benefit from Sperm Donation?
Sperm donation has found much use for those couples where:
- The man has a low sperm count or is suffering from azoospermia i.e. no sperms in the ejaculate although if the woman has fertility problems like ovarian failure, sperm donation is not useful.
- The man has genetic defects, such as haemophilia, that may get transmitted to the child through the father.
- Both partners have normal reproductive organs but may not be able to have a child because of their Rhesus incompatibility. Rhesus is the antigen present in the red blood cell of human beings. Those of us who have this antigen are said to be Rh positive, and those who don’t are Rh negative. If a couple has different Rh factors then it is good to opt for a donor sperm, as they will have difficulty conceiving naturally.
- Donor sperms have also known to be utilised by single women who wish to have their own child.
There are two types of donors: known and anonymous. Using a known donor means that you will ask someone you know to donate their sperm for you to use. Using an anonymous donor is more common and refers to obtaining your sperm from a bank. You will not know the name, address or any other identifying details of the donor.
Sperm donors are usually men between the ages of 18 and 35. To be a donor, a man must be healthy with no known hereditary, genetic disease or any serious disability. Men who are or have been drug users or those who are HIV positive are not suited to become donors.
Some sperm banks enter into a contract with the donor according to which he has to donate sperms for a specific period, anywhere from six to 24 months. The Human Fertilisation and Embryology Authority (HFEA) is the governing body in UK that regulates all the activities of sperm banks and fertility centres. Once a donor registers with a sperm bank, it is essential that the HFEA be given his details.
Sperm banks check a donor’s background and medical history. His habits, physical characteristics, and family history are carefully noted to help in future matching with recipients.
The donor also has to go through a number of tests like, the HIV and syphilis tests, tests to check for infections like gonorrhoea, and blood tests to reveal his blood group & Rh type. This is required to ensure his complete fitness and make sure that the recipient or the child are not in danger of getting any infections from the sperms. A semen sample given by the donor is analysed by the bank as well, to check for the sperm health and sperm count before a donor can be registered.
Usually there is a quarantine phase till which the donor sperm cannot be used, as during this time it is screened and various tests are carried out to check its quality. The length of quarantine is usually about six months.
According to the HFEA, the identity of the sperm donor cannot be revealed to the recipients, though his physical characteristics, blood group and other pertinent information can be told in order to help in matching. Likewise, the donor cannot be given the identity of the recipient or the outcome of any treatment using his donor sperm. Also, once sperm has been donated, the donor does not have any parental rights to any children born from his sperm.
The HFEA guidelines also state that sperm from a donor can only be used for a maximum of 10 conceptions. Donated sperm cannot be stored for more than 10 years.
Sperm donors are usually paid on the basis of the number of times they visit a particular bank for donation, however full payment is only made after all tests are complete and his sample has been found healthy.
Recently, there has been an increasing number of children born through sperm donation that would like to know about their genetic father as well as whether they have any half siblings. In response to this, national registries have been established that utilise DNA testing methods for the matching purpose.
When someone opts for sperm donation, it is still routine for the female partner to undergo a fertility evaluation. This is to make certain that she does not have female infertility issues, such as fallopian tube damage, which may interfere with the fertilisation process or the proper development of the embryo.
These tests may include hormonal level tests to find out the amount of hormones, especially estrogen, Follicle Stimulating hormone and progestrone present in the body. Their presence or absence may reveal the condition of the reproductive organs.
Other tests can include a pelvic assessment and tests for diseases like AIDS, Hepatitis B/C or syphilis. Additionally, blood group, blood glucose level, and Rh factor are tested to ensure complete health and to make an appropriate match with a similar donor sperm.
Some fertility clinics may also want the assurance that the recipients are married or have a stable relationship.
Counselling of the recipients is done for two reasons. Firstly, counselling will give you the opportunity to ask and have answered any questions you may have about the process and using donor sperm. Secondly, after speaking with you, your fertility specialist will have a comprehensive idea as to what kind of donor will best match your requirement.
However, counselling is not just about finding the right donor for you. The psychological and genetic impact on the recipient and the offspring may be immense. Therefore speaking with a counsellor can help ease any worries you may have regarding the legalities, and the questions that the child may have about his birth. A counsellor may also raise some issues that you and your partner may not have considered yet.
Donor sperm can be used in place of your partner’s sperm during IUI or IVF. If are using an anonymous donor, you will need to purchase this sperm from a sperm bank. Only sperm samples that have already been quarantined and tested will be available for sale. The sperm bank will prepare the sperm sample, which involves washing it, before sending it to your fertility clinic. If you have decided to use a known donor, their sperm sample will need to be quarantined for six months and tested before you will be able to use it.
If you are using donor sperm with IUI, you may still receive fertility drugs to help prepare your uterus for pregnancy as well as to develop extra egg follicles. The donor sperm will be introduced to your uterus the same way as it would if you were using your partner’s sperm for this procedure. At around the time of ovulation, through a very simple and painless procedure, a concentrated dose of the donor sperms is placed inside the uterus using a plastic catheter. After about two weeks, a pregnancy test will be performed to see whether the procedure was successful.
Donor sperm used for IVF will be combined with your collected eggs in controlled lab conditions. If any embryos are formed, they will be transferred back to your womb so they can implant in your uterine lining. A pregnancy test will be done two weeks later to see whether the IVF was successful.
The Risks Involved
Physically, the biggest risk involved with using donor sperm is the possibility of infections being transmitted, particularly if you are using a known donor who may not undergo as extensive testing. Rigorous screening procedures can reduce this risk significantly. Check with the sperm bank from which you are buying the sperm or the fertility clinic that will be collecting your donor’s sperm (if the donor is known) to find out just which tests they will be performing.
Aside from the physical risks, couples using a known donor would be wise to draw up a legal contract, with the help of a lawyer, that details what rights the donor will have to any resulting children. While sperm banks make anonymous donors sign a contract waiving any rights they may have to children conceived from their sperm, there are fewer laws in place to protect the rights of those involved when a known donor is used.
Not all couples are comfortable with the idea of a child being only partially biologically related to them. It is important that you and your partner discuss this issue at length, raising any concerns either of you have, before proceeding. Talking with a counsellor first can help you examine these issues in depth. Receiving counselling is also a good idea if you are using a known donor.
Because using someone you know as a donor can be taxing on a relationship, talking over the donor’s role in the child’s life, as well as any other concerns you, your partner, your donor, or your donor’s partner may have, with a professional can help you avoid problems later on.
The use of donor sperm has been found to be very successful in cases where the female has normal functioning of the reproductive system. In the UK, almost a thousand couples are using donor sperms annually for artificial insemination.
Couples using donor sperm in IUI have a success rate of about 11%. IVF performed with donor sperm is associated with a success rate of 20% to 26%.
In the U.S., the cost of anonymous donor sperms ranges from $200 to $3000 per unit of semen. Added to the sperm cost is the cost of the treatment, either IUI or IVF, which may range from ₤500 to ₤1000. If opting for donor sperms, you should also include additional costs of the drugs, treatments, and number of visits to the clinic to better judge the total expenditure of the whole process.