Many infants are conceived each year using this method. Couples use donor sperm (DS) when the husband/partner has no sperm or a very poor semen analysis (azoospermia, oligospermia, poor motility), or when there is a genetic problem which could be inherited from the male. Single women who want a biological child also use donor sperm.
One must be psychologically ready to proceed with DS. Most doctors recommend that any patients considering DS see a counselor who is skilled at clarifying feelings about infertility, and about trying DS. It is essential that both partners feel comfortable with the decision and that all fears and questions be openly discussed. For some, it may mean dealing with various moral and ethical questions; for others, exploring questions about donor selection and whether to be open about the decision to do DS and whether to tell a child conceived by DS how they were conceived.
Some clinics will not allow couples to mix the donor’s and husband/partner’s sperm in an insemination because clinics feel if a couple requests this they may not have done the necessary psychological work involved in deciding to do DS.
Couples or individuals usually have the right to decide which sperm bank and which donor to use. Information about a donor’s physical characteristics, race, ethnic background, educational background, career history, and general health should be available. Many banks and clinics provide written profiles about the donors they have available. Some sperm banks/clinics are open to providing non-identifiable information about the donor.
Clinics will conduct a full semen and chromosomal analysis, and ask questions about your family history in terms of genetic disorders and health issues. Some of the tests required involve screening for HIV I and II, hepatitis B surface antigen (HBs Ag), hepatitis C (HCV-Ab), liver enzymes, glucose, cholesterol, triglyceride, urea, electrolytes, T. pallidum (syphilis), and gonorrhoea. Usually the results of the mandatory HIV tests will be given to the donor.
The Donor Insemination (DI) procedure involves inseminating the woman as close to the time of ovulation as possible. Blood tests are performed to check for an LH surge which indicates that ovulation will soon take place. Inseminations are usually done about 24 hours after a surge of LH is noted. Clinics do one or two inseminations per cycle.
For Intrauterine insemination the thawed specimen is processed to remove the seminal plasma from around the sperm cells (Intrauterine insemination without doing this process would cause uterine cramping and possible allergic response.) After the sperm is processed, it is injected, using a syringe and thin catheter, into the uterus via the cervix. The insemination is usually painless; some women who have a tight cervical opening experience cramping if an instrument (tenaculum) is used to open the cervix.
Many women find it helpful to have their partner/husbands with them, especially the first time DI is done. This helps affirm that choosing DI was a mutual decision and a potential beginning to their parenting experiences.
The highest success rates for DI are reported in women who have no infertility problems, are under 35 years old and whose partner/husbands have azoospermia (no sperm). Lower success rates are reported where there is a female factor (ovulation problem, endometriosis, DES, etc.) Or the woman is over 35.
If no pregnancy occurs after several cycles, the doctor will continue an evaluation of the woman. This involves a hysterosalpingogram, a laparoscopy and hysteroscopy to be sure there are no adhesions or endometriosis, and an evaluation of the luteal (post-ovulatory) part of the cycle by endometrial biopsy and/or checking progesterone levels in the blood. Other hormonal tests as well as ultrasound monitoring of follicular development may be indicated.
Ovulatory stimulating drugs such as clomiphene or injectable gonadotropins can be given to the woman. Closely tracked ovulation monitoring as well as IUI can help increase the likelihood of success for some women.