Artificial insemination using donor sperm has been practiced for over a century. Over the past 10 years, the use of donor sperm has decreased as the use of intracytoplasmic sperm injection (ICSI) for the treatment of male infertility has become widespread. Since the late 1980s, with the emergence of acquired immunode ciency syndrome (AIDS), artificial donor insemination has been performed exclusively with frozen and quarantined sperm. Current FDA and ASRM guidelines recommend that sperm be quarantined for at least six months before being released for use.
Indications for Sperm Donation
Currently, therapeutic-donor insemination (DI or TDI) is appropriate when the male partner has severe abnormalities in the semen parameters and/or reproductive system. These abnormalities include both obstructive (caused by a blockage of the ejaculatory ducts) and nonobstructive (due to testicular failure) azoospermia (absence of sperm), which may be congenital or acquired. Severe oligospermia (decreased sperm count) or other significant sperm or seminal fluid abnormalities also are indications for DI. DI also is indicated if the male has ejaculatory dysfunction or if he is a carrier or affected with a significant genetic defect and would prefer not to pass this gene on to his children. DI may be used if the female is Rh-sensitized and the male partner is Rh-positive. DI often is used in the treatment for a single woman who desires a pregnancy but who lacks a male partner but it is illegal in Thailand due to Thai legislation.
Selection of Sperm Donors
- Sperm donors should be of legal age and ideally less than 40 years of age to minimize the potential hazards of aging.
- Routine blood analysis includes documentation of the donor’s blood type and sexually transmitted diseases.
- A donor is ineligible if either screening or testing indicates the presence of a communicable disease or of a risk factor for a communicable disease.
- A family medical health history is obtained for at least two generations of family members.
- For anonymous donors, testing for Treponema pallidum (syphilis), Chlamydia trachomatis, Neisseria gonorrhoeae, HIV-1, HIV-2, hepatitis B surface antigen, and hepatitis C antibody are performed prior to donation and thereafter should occur at six-month intervals, according to FDA guidelines.
- Donors are asked to provide detailed information about their personal habits, education, hobbies, and interests. The risk of sexually transmitted diseases are evaluated.
The insemination procedures
The insemination procedure can be done both intrauterine insemination with frozen sperm and for process of assisted reproductive technologies (IVF, ICSI)