DONOR INSEMINATION
Artificial insemination by donor semen (AID) has been used for years as a therapeutic treatment for male infertility when male factors such as azoospermia, Rh incompatibility or genetic disorders are present. In the past, fresh semen was routinely used for AID. However, screening procedures to ensure that the donor was free of infectious organisms were not well defined. Organisms transmitted by donor semen can cause serious infections in women and may adversely affect the outcome of pregnancy. With the recent rapid spread of AIDS and other sexually transmitted diseases, the use of fresh semen has been discouraged as screening of donors at the time of donation is not adequate to rule out the presence of infectious agents in the semen (e.g. in the case of HIV I and HIV II, ninety days or more may elapse before the onset of seropositivity).
Since the protection of women and their offspring is the prime concern of all professionals providing AID service, screening of donors and donated semen should be an essential element of any AID program. All Cryo-Genie sperm banks use stringent screening criteria for their donors to ensure safety and quality of semen samples.
Recent data has shown that the pregnancy rate using frozen semen compares well with the use of fresh semen if the sample contains an adequate number of motile sperm and if the sample is inseminated by the intrauterine route at the optimal time.
Initial Criteria for Donor Selection
* Height
* Age
* Educational Qualifications
* Genetic History of Donor and His Family
* Semen Profile
o Agglutination time
o Concentration > 60 million/ml
o Volume > 1.5 ml
o Motility (RPL) > 50%
o Morphologically normal > 60%
o Grade > 3
o Freezing efficiency > 75%
o WBC < 1 million/ml
* Initial Clinical Examination (repeated every three months if the donor is selected)
o HIV I and II
o Hepatitis B
o Hepatitis C
o Chlamydia
o Syphillis
o Gonnorhea
Donors are disqualified if they do not meet the above criteria or test positive for any of the clinical exams. If a donor is selected his physical characteristics, such as height, complexion, color of eyes and hair, are recorded. The donor's ABO-Rh blood type is also determined. He is then asked to provide semen samples on the premises of the semen bank. No samples collected elsewhere are accepted.
Samples are analysed and processed to separate progressively motile sperm from other constituents of the semen such as seminal plasma, immotile sperm and white blood cells. Progressively motile sperm are then diluted with an appropriate cryoprotector, divided into 0.5 ml cryovials and frozen. Frozen samples are stored in liquid nitrogen until the time of use. A quality check is made on each batch by removing one vial from that batch and examining the thawed sample under the microscope. These samples are now ready for intra-uterine insemination after thawing.
Frozen Donor Samples
* Samples are ready for use with Intra Uterine Insemination procedure. No further procesing is required.
* Each vial contains a minimum of 20 million motile sperms with good linear progressive motility in 0.5 ml volume.
* Samples are quarantined for six months before release.
* Donors are screened for HIV, HBSAg, HCV, VDRL, Gonorrhea and Chlamydia.
* Donor blood group and physical characteristics data is available for matching.
* Multiple insemination with sperm from the same donor is possible.
* Quality control on each sample is available upon request.
* Samples are transported in liqid nitrogen.
* Complete confidentiality of the donor and the recipient is assured.
Advantages of Cryopreserved Sperm
1. Quarantine of the sperm sample until appropriate testing can be completed to ensure that the risk of transmitting disease is minimized.
2. Ease of scheduling insemination when ovulation is optimal.
3. Multiple insemination in a given ovulatory cycle with the same donor sample.
4. Availability of known quality sperm over an extended period of time.