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A Special Donation

Posted Sep 25 2009 3:34pm

Every year physicians who are training in Obsterics and Gynecology (interns and residents) have to take a yearly test called the CREOG (Council on Resident Education in Ob/Gyn) exam. Almost every year there is a question regarding severe male factor that asks which treatment option is the most cost-effective. Given their training by Reproductive Endocrinologists (like yours truly) most residents immediately choose the IVF/ICSI answer. But that is incorrect. Donor inseminations using high quality cryopreserved sperm actually work quite well. Success rates depend upon the age of the woman but it is hard to beat donor inseminations for simplicity.

The hardest part about using donor sperm is making the decision to use gametes other than one’s own. For some couples, this is not an acceptable option whereas for others it has been a wonderful and relatively affordable way to have a family.

So who needs to consider using donor sperm? Funny you should as because that is the “Question of the Day.”

35. Should I consider using a sperm donor to conceive?

Couples who desire a child but in whom the male partner has a very low sperm count (oligospermia) or no sperm at all (azoospermia) often consider using third-party sperm donation and artificial insemination. Donor sperm can also be used by single women or lesbian couples. Many high-quality, reputable commercial sperm banks exist. They recruit and thoroughly test the donors and provide a listing of their available donors and their characteristics from which the couple can then choose. The donated sperm is obtained from the donor, tested, and quarantined for at least 6 months at the sperm bank. The donors are then retested.

The specimen is released for use only after the tests results are confirmed as normal. The frozen sperm is then usually sent to the physician’s office, and artificial insemination is performed around the time of the woman’s ovulation. Placement of the sperm inside the uterus (IUI) results in better pregnancy rates than placement of the sperm in the vagina or cervix. Frozen donor sperm can also be used for more advanced fertility procedures such as gonadotropin/IUI or IVF with or without ICSI. If a woman wishes to use sperm from a known donor with whom she does not have a physical relationship, then the sperm must be quarantined for at least 6 months and the donor retested for infectious diseases before the specimen can be used for fertility treatments.

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