Donor insemination

The use of frozen donor sperm for intrauterine insemination is a relatively common practice. If you’re planning to use donor sperm for at the New England fertility Institute there a few details with which you should familiarize yourself prior to your scheduled insemination.

Choosing a Sperm Bank

As a patient of New England fertility Institute you a free to obtain frozen donor sperm from their sperm bank of your choice. The New England fertility Institute does not advocate any particular cryo- bank. We do however receive a majority over donor sperm from California cryo-bank, a national sperm bank. If you’re interested in this facility as a possible source for donor sperm, we will be happy to provide you with their printed material. We have no business connection with this company but have had good experience with their samples over the years. Information on this and other cryo-banks may be found on the Internet. If you chose to use a different bank please make sure that they measure up to the national standards. All sperm banks are regulated by the FDA and must follow strict guidelines for donor screening, testing, and handling of semen samples and record keeping.

You must also be aware that most cryo-banks offer both standard and pre-washed specimen. It is no obvious advantage to choosing either of these options, as the price for sperm preparation and intrauterine insemination it the New England fertility Institute is the same for both.

The following cryobanks have worked with New England Fertility Institute in the past:

• Cryobank.com: California Cryobank provides sperm donor banking services.
• NECryogenic.com: New England Cryogenic Center provides sperm donor banking services.

Choosing a donor

The sperm banks offer a dazzling array of donors, making your decision even more difficult.

The donor list includes basic information on the donors such as height, weight, skin tone, ethnic background and other personal characteristics. Our staff will be happy to help you make your decision and pick a donor. It is however mostly a personal and not a medical decision.

The sperm banks offer a list of their donors. This list can be found on line and in the information brochures available from our office. The catalog includes the general characteristics of the donors. More detailed information can be obtained from the sperm bank (for a fee). You should consider narrowing down your choices and ordering several profiles to review. We will be more than happy to help you make the final decision.

Over the years we have realized that it is best for the patients to work directly with the cryobank to choose a donor. The large banks have counselors who will walk you through the process. We at NEFI are always happy to review your choices and help you make your final decision.

Medical considerations:

• In choosing a donor you may want to consider blood type. There is no need to match you blood type (A, B, AB or O) to the donor’s. However, if your blood type is Rh- you may prefer an Rh- donor. In the past Rh incompatibility could pose serious health issues with the baby. In modern obstetrical practice Rh immunization is rarely an issue. Thus in summary, you need not consider blood type and Rh when choosing a donor.
• Donor Screening: All donors are screened by the sperm bank. The infectious disease testing follows FDA guidelines. In addition, the donor often undergoes genetic as well as psychological evaluation. In all cases following the initial donor screening, the semen sample is frozen for six months and the infectious disease screening repeated prior to the sample being released.

Getting ready

Once you have decided on the cryo bank and the particular donor you will need to arrange for the samples to be delivered to our office. The New England fertility Institute has its own long term storage facilities on site, thus allowing multiple samples to be shipped and stored in our facility until ready to be used. Expect approximately 2 weeks to complete the ordering shipping procedures. Please be aware that any delay in the arrival of the sperm may cause the patient to miss a cycle of intrauterine insemination. A good rule of thumb is to order your sample before starting your medication

• Evaluation cycle: During the initial consultation we will discuss various tests which we recommend prior to starting the insemination process. The purpose of the evaluation is to identify and correct factors which may prevent you from achieving a successful pregnancy.

The evaluation will examine the various aspects of your reproductive system and will check your hormone balance, ovulation, and the condition of the uterus and the fallopian tubes. We will also obtain bacterial cultures of your cervix and vagina and thus minimize the risk of infection with the insemination.

The list of test will be customized to your individual profile and will be presented to you during the initial consultation. You will be asked to call the office with the onset of your cycle to begin the evaluation. Once the evaluation is complete, the clinician will discuss the findings and will make recommendations (additional testing, use of ovulation drugs etc.)

• The procedure: The semen sample is processed in order to remove any of the additives used for freezing. The sperm cells are concentrated in a small amount of fluid and loaded into a syringe. Once the patient is ready in exam room the sample will be brought in and the clinician (nurse practitioner, nurse, or physician) will perform the procedure. A speculum was placed into the vagina and the cervix is visualized. The catheter, a small plastic tube containing the insemination sample, is maneuvered through the cervix into the uterine cavity. No anesthesia is required for the procedure as the placement of the catheter may cause only mild cramping, which generally abates within one to two minutes. The specimen is gently placed into the uterine cavity once any cramping has subsided. After the procedure, the patient is asked to rest of 5–10 minutes in the exam room and then is allowed to resume her normal daily activities.
• Natural vs. Hormonally stimulated cycle: Following the evaluation we will discuss your options. In some cases due to an ovulation dysfunction the use of ovulation drugs in necessary in order to insure a good chance of success. In some cases despite normal ovulation we recommend using ovulation drugs which allow us to better control the timing of the inseminations.

If you prefer to have your inseminations on a natural cycle, we will help you determine the optimal timing of the procedure.

Expectations

In general we expect the treatment to be successful within the first 3–4 attempts. If unsuccessful, we will meet and discuss other options. Your profile (age, medical problems etc.) will determine your chances of success and the treatment recommendations and plan.