For over a century, the assisted reproduction technique of artificial insemination or intrauterine insemination using donor sperm has been performed. The need for donor sperm has decreased in the last 10 years with the institution of intracytoplasmic sperm injection (ICSI), which helps treat male infertility by injecting the sperm directly into the egg for fertilization. However, using donated sperm is appropriate when the male partner has very low sperm counts or his sperm ducts are blocked. There are many causes for these abnormalities, such as the absence of the vas deferens (which transports the sperm from the testicles to be ejaculated), a previous vasectomy that is irreversible, or testicular failure due to radiation, chemotherapy, or other causes.
Donor sperm may also be necessary when the male partner carries a genetic defect that he does not want to pass on to the child, or if a single woman desires to become pregnant without a partner.
Sperm donors should be of legal age but less than 40 years old to minimize potential defects associated with older men’s sperm. Donors are traditionally anonymous, but may also be known or introduced to the couple or single woman.
In most cases, donor sperm is obtained from a sperm bank. Sperm donors undergo extensive medical and genetic screening. In addition, FDA regulations require anonymous sperm donors to be screened for communicable diseases and associated risk factors. Since the emergence of AIDS in the late 1980s, artificial donor insemination has only been performed with frozen and quarantined sperm. Current guidelines from the FDA and from the American Society of Reproductive Medicine recommend that sperm be quarantined for at least six months before being released and used.
If screening or testing proves positive for communicable diseases or associated risk factors, a potential donor is denied. To begin with, a comprehensive medical questionnaire helps evaluate the donor’s health and family medical history. The donor’s personal and sexual history is particularly examined to eliminate potential donors who are at high risk for communicable disease including HIV, Hepatitis B, and other sexually transmitted diseases. At least two generations of family medical health history is obtained from family members, then prospective donors undergo a physical examination and screening for visible physical abnormalities and sexually transmitted diseases, blood type and Rh factors through blood analysis.
Current FDA regulations require infectious disease testing to be performed and return negative results within seven days of all sperm donations. Anonymous donors must also be tested for sexually transmitted diseases prior to donation and at six-month intervals.
Although the FDA exempts known sperm donors from the six-month retesting requirement, the American Society for Reproductive Medicine recommends even known donors be tested then retested after six months for sexually transmitted diseases.
In addition to the medical information, the donor will also be asked to provide detailed information about their education and personal habits, hobbies, and interests. Sperm banks may provide pictures, video or audiotapes from the donor, and some donors may agree to allow the child conceived through the donated sperm to contact them once they reach legal age.
After the six-month holding period, sperm donors are tested again for communicable diseases and the donated semen are analyzed again for any freezing/thawing damage. If the post-thaw semen meets the minimum standard, it can be used for the sperm donation process. Donor sperm may be used for artificial insemination via intrauterine insemination (IUI), intracytoplasmic sperm injection (ICSI), or for in vitro fertilization (IVF) cycles. The use of frozen sperm over fresh sperm does not lower success rates overall.
Seeking professional counseling is recommended when considering sperm donation. Talking with a trained professional who is familiar with the complexities and lifelong implications of using donor sperm can be very helpful in determining the final decision.