Choosing to use donor sperm for intra-uterine insemination (IUI) or in vitro fertilization (IVF), enables pregnancy in women who are single or in same-sex relationships. For other couples with severe, untreatable male factor infertility, or in the cases when the male carries a hereditary disease that he doesn’t wish to pass on, use of donor sperm becomes the treatment of choice as well. At Pacific NW Fertility, we accept donor sperm from a few, regulated and reputable sperm banks. Women considering the use of donor sperm should know that thorough screening is carried out and documented on all donor sperm samples available according to Federal Regulations. This screening is performed by the cryobank providing your donor sperm and typically involves a thorough family history, complete medical, social and sometimes psychological history, blood group information, genetic screening and screening for transmissible diseases.
As part of the regulated guidelines, all donated sperm must be quarantined for a period of 6 months to ensure that the donor still screens negative for infectious diseases such as HIV after initial testing. This quarantine period is also performed by the cryobank from where you have selected your donor sperm.
You will have the opportunity to select your own donor through these cryobanks. Catalogues are often available online, and can be requested by mail as well. Donor choice can be based on racial or ethnic background, physical or social characteristics, or previous history.
As part of the donor insemination process, all women or couples considering this option are encouraged to meet with a reproductive counselor. This is an important step in the process as it allows for discussion of the decision making process as well as consideration of the impact the choice may make on the individual or couple. We also advise that you consult with an attorney who specializes in the reproductive laws of Washington state.
Inseminations are performed 7 days a week. Typically 1 insemination is performed each cycle to ensure the maximum chance of conception. It can typically take 4-6 months of inseminations to achieve a viable pregnancy. We would advise ordering several donor sperm samples in preparation for this duration. Any leftover samples can remain frozen for future use.
The intrauterine insemination process is simple and quick. Once you arrive in the clinic the day of the insemination, the lab will start to thaw the sperm. When it is ready, you will be asked to come into the exam room. Just as with a routine Pap test, a speculum is placed into the vagina to clearly see the cervix. The sperm is labeled with your identity which you verify for us with a signature. The sperm is then loaded into a small syringe with a soft plastic-tipped catheter. The catheter is passed through the cervix and into the cavity of the uterus, where the sperm is injected slowly. Once the insemination is completed, you will be asked to rest for 5-10minutes and then you carry on with your usual daily activities.
Success rates of Donor Sperm IUI
Published rates of success in women under 40 years are about 10-15% per cycle. After 6 months of inseminations, about 50% of women are pregnant. After 3-6 cycles with no success, it may be important to consider some fertility treatments to maximize your chances in a shorter time period. Your doctor will discuss this with you during the course of your treatment if necessary. Once a pregnancy occurs, it is no different than one that occurs naturally in any other woman of the same age. The risk of miscarriage, or congenital abnormalities is also the same as others in the same age group. You will be asked to sign consent forms which include acknowledgement that a child born through TDI is considered to be the legal child of the mother, and her partner (if applicable).
If having future pregnancies is important, some women or couples choose to use the same donor. We can store multiple samples at Pacific NW Fertility for up to 5 years in these cases for future family planning. If you desire longer storage, we will be happy to refer you to a long-term storage facility.
Information on CMV for Patients Using Donor Sperm
What is CMV?
Cytomegalovirus, commonly known as CMV, is a virus that most American adults have been exposed to and have developed immunity to. CMV is a member of the herpes virus family which includes cold sores, chicken pox and infectious mononucleosis. The virus is carried by people and is not associated with food, water or animals. In healthy adults and children, CMV can cause mild cold or flu-like symptoms that may last 1-2 weeks. Many people who acquire CMV were never symptomatic and most people do not know whether they have ever been infected. However, if a woman who has never had CMV becomes exposed to the virus during pregnancy, such as using CMV positive sperm, there is a small risk that the child could develop serious health problems.
How is CMV spread?
CMV is spread person-to-person by direct exposure to urine, saliva, mucus, cervical secretions, semen, blood, or breast milk. Most individuals are exposed to CMV in childhood in settings like daycare centers. Adults can also be infected through unprotected sexual contact. An infected mother can transmit CMV to her fetus. Prevention consists primarily of avoiding exposure to infected body fluids and practicing good personal hygiene. There is no vaccine for CMV. Nearly all adults will be exposed to CMV in their lifetime. In the USA, it is estimated that 50-85% of adults will test positive for prior infection by 40 years of age. In developing countries, it is almost 100%.
What is the significance of CMV and pregnancy?
If a pregnant woman has never been exposed to CMV and has her first infection during pregnancy, there is a chance that the fetus could become infected before the mother's body can eliminate the virus. Transmission to the fetus only occurs in a third of women who have a primary infection during pregnancy. Twenty percent of babies born with an infection develop medical complications. Those symptoms can include low birth weight, deafness, blindness, mental retardation, small head, seizures, jaundice, brittle teeth and damage to the liver and spleen.
How does CMV testing work?
CMV status is determined based on an antibody blood test. This test looks at two antibodies, CMV IgG antibody and CMV IgM antibody. A positive CMV IgM antibody result is consistent with a current or recent CMV infection. A positive CMV IgG antibody result indicates a past exposure or infection from the CMV virus.
People who are CMV IgG positive, IgM negative are considered immune, and not actively infectious. The FDA allows people with such profiles to donate semen for procreative use either as anonymous or directed sperm donors.
Can I use a CMV positive sperm donor if I’m CMV negative?
It is recommended that CMV negative patients use CMV negative sperm donors in order to decrease risk of acquiring CMV during pregnancy. Even though the chance of transmitting congenital CMV to a developing fetus from semen used at the time of conception is extremely low, the risk exists.
I would encourage my friend to seek professional help as early as possible. Both seeing a medical team that specializes in fertility treatment as well as someone to support their emotional health. I would advise them to consider all options. Loving a child regardless of how they came to you is such an incredible gift. I would encourage my friend to not give up no matter how hard the process becomes.