About Donor Insemination
Donor Insemination (DI) is a procedure in which a woman who wishes to conceive is inseminated with sperm donated by a man who is not her intimate sexual partner. DI is an excellent option for couples where the male partner has extremely low sperm counts or no sperm, a previous vasectomy or carries a genetic disorder that he does not want transmitted to his offspring. Some cases of severe male factor infertility may be treated with in-vitro fertilization (IVF) instead of DI, and this option should be considered as well. DI can also be used for women without a male partner. We have been helping LGBT patients and single women build their desired families since the inception of South Jersey Fertility Center in 1989.
While many options are available, by far the most common treatment is insemination with donor sperm. The World Health Organization states that “Reproductive rights rest on the recognition of the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health.” All of us at SJFC wholeheartedly endorse this sentiment and firmly believe in everyone’s right to have the dream of parenthood fulfilled in the way that best suits them. What follows is a description of the donor sperm process.
Obtaining Donor Sperm in New Jersey
The donor sperm is obtained from a sperm bank. We will accept sperm from any reputable sperm bank, but most commonly we work with Cryobiology, Xytex. California Cryobank, Fairfax Cryobank, and Seattle Sperm Bank . The donors are screened by the banks for infectious diseases such as HIV, Hepatitis, Syphilis, Gonorrhea, Chlamydia, Herpes and Trichomonas. The samples are frozen for 6 months and the donors are retested for infectious diseases again before the sample is released. Donors also undergo genetic screening and sign away any paternity rights. Basic characteristics of the donors are provided by the banks and include ethnic origin, blood type, height, weight, eye, hair and skin color, years of college and profession. Other detailed information may be available for some donors, but the donor’s identity remains anonymous. Most couples select a donor based on desirable characteristics, but as with any genetic trait, physical or intellectual characteristics cannot be guaranteed in the offspring.
DI can be done in a natural cycle, if your cycles are regular and you ovulate reliably. In this case you would use over-the-counter LH ovulation predictor kits to detect ovulation. The insemination is usually performed the day after you see a color change on the kit. You should call the office when you see a color change, to schedule the IUI for the next morning. On Saturday you should check before 7:00 am and if you have a color change, call the office at 7:15 am and arrange to have the insemination done the same morning. We do not do inseminations on Sundays. If you have a color change on Sunday, please call the office at 7:15 am on Monday morning to arrange the insemination for Monday morning.
You as the patient will work with the sperm bank to select the donor and order the specimen to be sent to South Jersey Fertility Center. Payment is made by you directly to the bank. The cost includes a fee for the specimen and a charge for shipping the specimen in a liquid nitrogen tank. Because the shipping charge is relatively expensive ($100-$200) you may want to ship more than one specimen at a time. When the specimen arrives at our center we will transfer it to our cryotanks for short term storage. We prefer not to hold the specimens for long periods of time so you should order the specimen to be sent to us the month before the insemination cycle, or at the time of your period at the latest. The specimens are usually washed by the sperm bank before freezing and are labeled “washed” or “IUI-ready” and are preferable to unwashed specimens. We recommend intra-uterine insemination (IUI) where the sperm is placed with a small catheter through the cervix and into the uterus as opposed to cervical inseminations where unwashed sperm is placed on the cervix, because the pregnancy rates are better with IUI. Success rates with DI range from 5-20% per try depending on multiple factors. Prior to starting the DI process, you must have cervical cultures performed and infectious disease screening done on both you and your partner. Our office must have the results of this testing prior to performing your first insemination.
About Fertility Medications
If your cycles are not regular, or if you have not conceived after several natural cycles with DI, we may recommend fertility medications such as Clomid or FSH shots. In these cases, your insemination is timed by ultrasounds showing that the follicles have matured to the correct size, and then a shot of hCG is given to induce ovulation 1-2 days later and this is when the donor insemination is performed.
We will not take the specimen out of the cryotank until you arrive at the office. We will only take the specimen out of the cryotank ahead of time with your permission. If the laboratory thaws the specimen and for some reason you do not come in for the insemination (such as your car breaks down), the specimen will have been wasted since re-freezing is not recommended. After the insemination you will be asked to lie flat for 10 minutes, then you may resume you usual daily activities without restriction.
Since this is an alternative way to have children, it is very important that both members of the couple are 100% supportive of the decision to do DI. For this reason we require that both members of the couple sign the consent for insemination. The male partner is accepting the full legal and financial responsibility of paternity despite the fact that this is not his genetic child. This is a big step for many patients, and requires time to contemplate all of the issues. Psychological counseling can be very helpful for some couples to feel comfortable moving forward with DI. Couples should also think about whether they will eventually tell their child that he or she was conceived by DI. Ultimately, DI offers a wonderful way for patients to experience the joy of pregnancy, childbirth and raising a family in cases in which it might not have otherwise been possible.