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Sperm donation , using donor sperm has been practiced for a period of years, it has Sperm-Donation brought about a rapid change over the years to many couples who are battling with infertility problems.,Nevertheless technology and new ART techniques are in focus and one of them is intra- cytoplasmic sperm injection(ICSI) which helps in male infertility, has spread widely.
Indications for Sperm Donation:
Therapeutic-donor insemination(DIorTDI) is recommended when the male partner has sever abnormalities,with regards to semen and to reproduce. These problems are both obstructive(this is caused due to a block in ejaculatory ducts) and non-obstructive (due to testicular failure),azoospermia(absence of sperm), which may congenital or acquired. The examples of obstructive azoospermia include congenital and the absence of the vas deferens, or due a previous vasectomy. Other examples of non-obstructive azoopermia include primary or secondary testicular failure , it could be due radiation done through chemotherapy. Oligospermia(decreased sperm count) or sperm deficiency or seminal fluid abnormalities, these are indications for DI, also know for males to have ejaculatory dysfunction, or if the male is a carrier of any genetic disorders, that refrain him from passing the gene to the his siblings. If the female RH-sensitized DI may be used ,if the male partner is RH-positive. Women who are single and desire a pregnancy, but lacks a male partner , DI is ofter used.
Selection of Sperm Donors
The most important factor in selecting a donor is that should be legal age and below the age of 40 ,so that there are untoward complications , with age in mind. There are many anonymous donors ,who do not like to be know, nevertheless if the donor wishes to meet the recipient ,or otherwise directed to the couple or single woman. As per ICMR (Indian Council for Medical Research, this is the Government organization) states that the donors , anonymous donors ,must know the donor and recipient, to build a rapport , not intimately or sexual, as both donors and recipient’s go through the same process of screening and testing,however the ICMR requires that anonymous donors are screened in case of any risks, and clinical evidence of communicable disease agents or kind of diseases.
The donor is ineligible, if the tests and screening indicates the presence of a communicable disease or risks factors of a communicable diseases. A questionnaire is given to the donors to evaluate their health and also review their family medical history as it is a primary focus in selecting a donor. Great importance is given to potential donor’s medical sexual and personal history,this is done so that males who at high risk of communicable diseases including HIV, hepatitis and other sexually transmitted diseases. The medical health history of the family is obtained at least two generations down. Screening and testing for visible physical abnormalities are done for prospective donors, to test and see for sexually transmitted diseases , regular blood analysis which includes the documentation of the donor’s blood type. According to the Medical Board there are certain regulations, require infections-diseases test to be done and noted to be negative within 7 days of all sperm donations. The sperms are collected by the act of masturbation , and concentrated into small volumes of motile sperm and then frozen until used.
Anonymous donor go through a series of tests for Treponema pallidum (syphilis), Chlamydia trachomatis, Neisseria gonorrhoeae, HIV-1, HIV-2, human T-lymphotropic virus (HTLV)-I and HTLV-II, CMV, hepatitis B surface antigen, and hepatitis C antibody are done prior to the donation, and these tests are to be carried out at 6 months intervals, according to ICMR. The ICMR does not allow direct sperm donors unless they are retested. The contrast to other communicable diseases ,a positive result does not make the the sperm donor ineligible ,as there are many ways and programs that allow the donors sperm to be used with positive recipient’s. Genetic testing is impractical, however the ethnically based genetic testing is standard in most of the sperm banks
Sperm donors and anonymous donors undergo and psychological evaluation and counseling. The donors assessment should note any risks involved and be evaluated for financial and emotion coercion. The donor should discuss all positive and negative feelings regarding disclosure and identity , plans for the future contact.
Sperm donors do undergo a semen analysis, and this sample should be thawed , so that it can be evaluated post-freezing/and met thawing semen parameters. Sperm is susceptible and could be damaged with freezing , and varies from donor to donor . If the sperm that is thawed is not too damaged and meets minimum semen parameters, donors are selected. In general, specimens should contain a minimum of 20 to 30 million motile sperm per milliliter after thawing. Post-thaw motility is generally in the range of 25% to 40%. Sperm banks offer two types of samples ,Intracervical insemination specimens (ICI) are prepared for intracervical insemination only and must be washed if used for intrauterine insemination's. Although sperm preparations for ICI are available,most of the reproductive endocrinology practices are by IUI and ICI the samples are pre-washed for IUI, in both these procedures the samples are frozen and quarantined for a minimum of of 180 days , until the donor is retested for communicable diseases and the results are negative.
The donors , in addition to medical information the donors are asked to provide information about their personal habits, education, hobbies and interests,the sperm banks can provide pictures and videos of the donors, and request the donor for audiotapes. Any child conceived through DI once reaches a legal age , the donors can disclose there identity
In addition to the medical information that is obtained from the donor, donors are asked to provide detailed information about their personal habits, education, hobbies, and interests. Sperm banks may provide pictures of the donor and video or audiotapes from the donor. Donors may identify themselves as open to contact from any child conceived through DI once a child reaches legal age.
The Insemination Procedure :
Couples should be evaluated with regards to causes of infertility with a comprehensive medical history & physical exam of both the partners. Before the donor insemination , the couple must be evaluated for causes of infertility with a medical history& physical exam of both the partners. Most women document their ovulation by a ovulation predictor kit or, by the basal body temperature chart, further to this an examination of the pelvis, a hysterosalpingogram (HSG) or sonohysterogram (SHG) will help evaluate further the uterine cavity and patency of the fallopian tubes.
Insemination is done close to the woman's natural cycle or in conjunction at the time of ovulation. This is a simple procedure and can be done at the physician office. The patient is made to lie on the examination table, the physician or the nurse then places the speculum into the vagina to visualize the cervix , the semen sample is the taken into an insemination catheter attached with a syringe. With help of the IUI procedure the semen specimen is placed through the cervix , into the uterine cavity, this helps the concentration of the sperm to reach the uterine cavity & the fallopian tubes where fertilization occurs.
Pregnancy rates , with regards to donors insemination depends on many factors, which include age of the female, the recipient and also other fertility factors , like endometriosis, tubal disease or even ovulation dysfunction. Studies have confirmed that pregnancy rates with IUI are greater, than ICI (frozen donor semen)is used . The birth defects which bring about risks factors with donor insemination is no different from normal conception, its range is about 2%to 4%.