Sperm donation is a well-established form of assisted conception treatment. It has been used for more than a century. In the United Kingdom it is a legally accepted form of treatment. Atotal of 5,447 donor insemination cycles were carried out in the United Kingdom in 2016, about 10% higher than in 2015. 42% of women were registered with male partner, 41% had female partner and 17% had no partner. (HFEA 2018 report). In some countries, sperm donation is not allowed. The use of frozen sperm is now mandatory in many countries to minimize the risk of HIV transmission to the recipients.
It is important that both the donor and recipient couples be adequately counseled, screened and made aware of the psychological, moral and legal implications of sperm donation before being accepted onto the program.
To whom donor insemination is advised?
There are selected groups of patients to whom sperm donation is recommended.
- A couple wishes to have a child, the female partner appears to be fertile but her husband or the male partner have either a very poor sperm or no sperm in his semen. This could be due to vasectomy, testicular damage by chemotherapy or radiotherapy for cancer, inability to ejaculate normally or another irreversible male fertility factor. This is by far the most common group seeking donor insemination. The introduction of intracytoplasmic sperm injection (ICSI), surgical sperm retrieval and rectal electroejaculation procedures into in-vitro fertilization (IVF) programs, have helped many men to father their own children when only a few sperm are available. However, the high cost and complexity of these procedures put them beyond the means of many couples.
- A couple wishes to have a child, but there is a risk that the husband or male partner may pass on an inherited disease such as hemophilia and Duchenne's muscular dystrophy. Although antenatal fetal diagnosis is available for an increasing number of these conditions, termination of pregnancy remains unacceptable to many couples. Recent advanced in preimplantation genetic diagnosis has enabled couples to undergo IVF, preimplantation embryo biopsy and the transfer of normal embryos. However, the high cost and complexity of these procedures put them beyond the means of many couples.
- Where there is a high risk of transmitting infectious disease to the offspring or woman from the man
- If the female partner is Rhesus (Rh) sensitized and the male partner is Rh positive (severe rhesus incompatibility).
- Donor insemination may also be used to treat single women or lesbian couples. Nearly 40% of women receiving donor insemination in the UK fell in this category during 2006. According to the Human Fertilisation and Embryology Authority UK, donor insemination for women without a partner increased from 330 in 2007 to 468 in 2012. (HFEA 2007, 2014)
- The husband or male partner has an incurable sexually transmitted disease such as HIV.