sperm donor, gamete donation
Sperm donation is the donation by a male (known as a sperm donor) of his sperm (known as donor sperm), principally for the purpose of inseminating a female who is not his sexual partner. Sperm donation is a form of third party reproduction including sperm donation, oocyte donation, embryo donation, surrogacy, or adoption. Number of births per donor sample will depend on the actual ART method used, the age and medical condition of the female bearing the child, and the quality of the embryos produced by fertilization. Donor sperm is more commonly used for artificial insemination (IUI or ICI) than for IVF treatments. This is because IVF treatments are usually required only when there is a problem with the female conceiving, or where there is a “male factor problem” involving the female's partner. Donor sperm is also used for IVF in surrogacy arrangements where an embryo may be created in an IVF procedure using donor sperm and this is then implanted in a surrogate. In a case where IVF treatments are employed using donor sperm, surplus embryos may be donated to other women or couples and used in embryo transfer procedures.
On the other hand, insemination may also be achieved by a donor having sexual intercourse with a female for the sole purpose of initiating conception. This method is known as natural insemination.
The donation
Donor sperm and fertility treatments using donor sperm may be obtained at a sperm bank or fertility clinic. Here, the recipient may select donor sperm on the basis of the donor's characteristics, e.g. looks, personality, academic ability, race, and many other factors. Sperm banks or clinics may be subject to state or professional regulations, including restrictions on donor anonymity and the number of offspring that may be produced, and there may be other legal protections of the rights and responsibilities of both recipient and donor. Some sperm banks, either by choice or regulation, limit the amount of information available to potential recipients; a desire to obtain more information on donors is one reason why recipients may choose to use a known donor and/or private donation.
A sperm donor will usually donate sperm to a sperm bank under a contract, which typically specifies the period during which the donor will be required to produce sperm, which generally ranges from 6–24 months depending on the number of pregnancies which the sperm bank intends to produce from the donor. Donors may or may not be paid for their samples, according to local laws and agreed arrangements. Even in unpaid arrangements, expenses are often reimbursed. Depending on local law and on private arrangements, men may donate anonymously or agree to provide identifying information to their offspring in the future. Private donations facilitated by an agency often use a "directed" donor, when a male directs that his sperm is to be used by a specific person. Non-anonymous donors are also called known donors, open donors or identity disclosure donors.
Donor selection
A sperm donate must generally meet specific requirements regarding age (most often up to 40) and medical history. Potential donors are typically screened for genetic diseases, chromosomal abnormalities and sexually transmitted infections that may be transmitted through sperm. The donor's sperm must also withstand the freezing and thawing process necessary to store and quarantine the sperm. Samples are stored for at least 6 months after which the donor will be re-tested for sexually transmitted infections. This is to ensure no new infections have been acquired or have developed during the period of donation. If the result is negative, the sperm samples can be released from quarantine and used in treatments.
Screening includes:
Preparing the samples
A sperm donor is usually advised not to ejaculate for two to three days before providing the sample, to increase sperm count and to maximize the conception rate. A sperm donor produces and collects sperm by masturbation or during sexual intercourse with the use of a collection condom.
Sperm banks and clinics usually "wash" the sperm sample to extract sperm from the rest of the material in the semen. A cryoprotectant semen extender is added if the sperm is to be placed in frozen storage in liquid nitrogen, and the sample is then frozen in a number of vials or straws. One sample will be divided into 1-20 vials or straws depending on the quantity of the ejaculate and whether the sample is washed or unwashed. Following the necessary quarantine period, the samples are thawed and used to inseminate women through artificial insemination or other ART treatments. Unwashed samples are used for ICI treatments, and washed samples are used in IUI and IVF procedures.
Anonymity
Anonymous sperm donation occurs where the child and/or receiving couple will never learn the identity of the donor, and non-anonymous when they will. Non-anonymous sperm donors are, to a substantially higher degree, driven by altruistic motives for their donations.
Even with anonymous donation, some information about the donor may be released to the female/couple at the time of treatment. Limited donor information includes height, weight, eye, skin and hair color. In Sweden, this is all the information a receiver gets. In the US, on the other hand, additional information may be given, such as a comprehensive biography and sound/video samples.
Information made available by a sperm bank will usually include the race, height, weight, blood group, health, and eye color of the donor. Sometimes information about his age, family history and educational achievements will also be given.
Different factors motivate individuals to seek sperm from outside their home state. For example, some jurisdictions do not allow unmarried women to receive donor sperm. Jurisdictional regulatory choices as well as cultural factors that discourage sperm donation have also led to international fertility tourism and sperm markets.
Legal aspects
A sperm donor is generally not intended to be the legal or de jure father of a child produced from his sperm. Depending on the jurisdiction and its laws, he may or may not later be eligible to seek parental rights or be held responsible for parental obligations. Generally, a male who provides sperm as a sperm donor gives up all legal and other rights over the biological children produced from his sperm. However, in private arrangements, some degree of co-parenting may be agreed, although the enforceability of those agreements varies by jurisdiction.
Laws prohibits sperm donation in several countries: Algeria, Bahrain, Costa Rica, Egypt, Hong Kong, Jordan, Lebanon, Lithuania, Libya, Maldives, Oman, Pakistan, Philippines, Qatar, Saudi Arabia, Syria, Tajikistan, Tunisia, Turkey, UnitedArab Emirates, and Yemen.
Donated sperm is recommended for:
Sperm donation is used for an artificial insemination in IUI or ICI or, less commonly, it may be used in other assisted reproductive techniques such as IVF and ICSI. The primary recipients are heterosexual couples suffering from male infertility, but also lesbian couples or single women.
There are no health risks for a donor. Man may donate for a longer period than two years if a sperm bank has access to world markets to reduce the risk of consanguinity (but local lays vary widely).
There are no health risks for a donor. Man may donate for a longer period than two years if a sperm bank has access to world markets to reduce the risk of consanguinity (but local lays vary widely). The number of children permitted from a single donor varies by law and practice. These laws are designed to protect the children produced by sperm donation from consanguinity and further accidental incest in later life: they are not intended to protect the donor himself and those donating sperm will be aware that their donations may give rise to numerous pregnancies in different jurisdictions. Such laws, where they exist, vary from state to state, and a sperm bank may also impose its own limits.
Laws regulating sperm donation also address issues such as permissible reimbursement or payment, rights and responsibilities of the donor towards his biological offspring, the child's right to know his/her father's identity, and procedural issues. In general, laws are more likely to disregard the sperm donor's biological link to the child, so that he will neither have child support obligations nor rights to the child, when sperm donation happens in a clinical setting and/or under medical supervision. Absent specific legal protection, courts may order the sperm donor to pay child support or recognize his parental rights. Even when donors choose to be anonymous, offspring may still find ways to learn more about their biological origins. Registries and DNA-databases have been developed for this purpose. Registries that help donor-conceived offspring identify half-siblings from other mothers also help avoid accidental incest in adulthood.
Despite laws limiting the number of offspring, some donors may produce substantial numbers of children, particularly where they donate through different clinics, where sperm is onsold or is exported to different jurisdictions, and where countries or states do not have a central register of donors.
The growth of sperm banks and fertility clinics, the use of sperm agencies and the availability of anonymous donor sperm have served to make the use of sperm donation a more respectable, and therefore a more socially acceptable procedure. The intervention of doctors and others may be seen as making the whole process a respectable and merely a medical procedure which raises no moral issues, where donor inseminations may be referred to as “treatments” and donor children as ”resulting from the use of a donor's sperm”, or ”born following donation” and subsequent children may be described as “born using the same donor” rather than as biological children of the same male.
As regards health of sperm donor conceived children, they have a birth defect rate of almost a fifth compared to the general population. Also it has been shown that donor conceived people don’t have more adolescence problems than children of divorce.
In some cases female wishes to conceive additional children by sperm donation and she will often wish to use the same donor to have full biological siblings, who have the same biological parents. Many sperm banks offer a service of storing sperm for future pregnancies, but few will otherwise guarantee that sperm from the original donor will be available. Sperm banks rarely impose limits on the numbers of second or subsequent siblings. Even where there are limits on the use of sperm by a particular donor to a defined number of families (for example the UK) the actual number of children produced from each donor will often be far greater.
If donor conceived people want to find genetic half-siblings from the same gamete donation or sperm donor, there are donor registrations which facilitate it. Even when the donor is anonymous, he has the donor number at the fertility clinic where he donated. Thanks to these donor numbers they are able to find each other.
A semen pH value outside of the normal range which is harmful to sperm and can cause infertility.
Female disorder in reproductive system at which a woman miss the uterus and thus she is not able to get pregnant and carry a child.
A type of cancerous tumor that develops in the gland cells.
A tumor-forming variant of adenomyosis (endometriosis in the myometrium of the uterus).
Medical condition characterized by the presence of ectopic endometrial tissue within the myometrium.
Failure of the adrenal glands to produce sufficient amounts of hormones.
The absence of a menstrual period in women of reproductive age.
The pathological inability to ejaculate in males, with (orgasmic) or without (anorgasmic) orgasm.
A neurodevelopmental disorder with intellectual and developmental disability, sleep disturbance, seizures, jerky movements and frequent laughter.
A disorder of sex development in which individuals have both testes absent at birth.
An eating disorder characterized by the maintenance of a body weight below average, fear of gaining weight, and a distorted body image.
Failure of the ovaries to release an oocyte over a period of time generally exceeding 3 months.
A condition when immune system mistakenly attacks some of the standard proteins in blood.
An inflammation of the appendix that may be associated with female infertility.
A medical condition, where the walls of the uterus stick to one another due to bands of scar tissue.
Male diagnosis connected with male infertility characterised by the complete absence of semen.
The thickening, hardening and loss of elasticity of the walls of arteries.
A condition arising from an abnormal immune response to a normal body part.
A disease in which antibodies against the thyroid gland and its hormone products are produced and destroy the thyroid’s cells and the entire gland.
Complete absence of sperm in the ejaculate of a man.
A noncancerous increase in size of the prostate.
Inborn morphological deviation of the uterus - one of the Müllerian duct anomalies where the uterine cavity is divided in the upper part.
A blockage of both fallopian tubes.
A cancer that develops from breast tissue.
Narrowing of cervix - the opening to the uterus.
A common sexually transmitted disease (STD) caused by the Chlamydia trachomatis bacteria that can lead to serious reproductive morbidity.
A condition in which the vasa deferentia reproductive organs, fail to form properly prior to birth.
Fallopian tube(s) blocked from birth unabling to let the ovum and the sperm converge, thus making fertilization impossible.
Male infertility diagnosis characterized by extremely low concentration of sperm in semen.
A man's inability for or persistent difficulty in achieving orgasm, despite typical sexual desire and sexual stimulation.
A class of sexual disorders defined as the subjective lack of normal ejaculation.
Cancer that arises from the endometrium, the lining of the uterus.
Thickening of the lining of the uterus.
The finger like overgrowths attached to the inner wall of the uterus that extend into the uterine cavity which are made of endometrial tissue
Benign ovarian cysts containing thick, old blood that appears as a brown fluid.
A state in which pieces of the tissue alike to the lining of the uterus (endometrium) grow in other parts of the body.
An inflammation of the inner uterine lining that could interfere with conception and pregnancy outcomes.
An inflammation of epididymis.
The inability (that lasts more than 6 months) to develop or maintain an erection of the penis during sexual activity.
An obstruction prevents the egg or sperm from traveling down the tube, thus making fertilization impossible.
An abnormal growth of fallopian tube tissue.
Persistent, recurrent problems with sexual response, desire, orgasm or pain which may cause fertility problems.
Genetic condition that is the most common inherited cause of intellectual disability, as well as the most frequent cause of autism spectrum disorder.
A sexually transmitted infection which is the most common cause of diseases accompanied by genital ulceration.
Fleshy growths or lumps found around the genitals and anus transmitted through sexual intercourse or during labor.
A group of rare diseases in which abnormal trophoblast cells grow inside the uterus after conception.
A rare abnormality of sperm morphology, with the majority of sperm cells being round-headed, which leads to male infertility.
Any congenital developmental disorder of the reproductive system characterized by a progressive loss of germ cells on the developing gonads.
A sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae.
The tumor that arises from the granulosa cells (normally surrounding the oocytes and line the developing follicle) and could impair menstrual periods.
Occlusion of some part of the female genital tract, especially occlusion of the vagina by a thick membrane.
Various types of conditions that can affect the function of the heart or blood vessels, which may have the negative effect also to the infertility
A collection or retention of blood in the uterus, affecting the patient´s fertility.
Hematosalpinx is a medical condition involving bleeding into the fallopian tube.
An infection caused by the hepatitis B virus which inflames the liver and which could also impair sperm motility.
An infection caused by the hepatitis C virus (HCV) that affects the liver and could be transmitted through sexual intercourse by blood or from infecte
A viral infection that progressively destroys certain white blood cells and can cause acquired immunodeficiency syndrome (AIDS).
A common virus that affects both males and females that could result in genital warts or cancer.
An accumulation of clear fluid in the tunica vaginalis, the most internal of membranes containing a testicle.
A hydrosalpinx is an abnormal pouch containing liquid in a fallopian tube.
A medical condition characterized by excessive levels of androgens in the body.
An excessive amount of estrogenic activity in the body.
Decreased functional activity of the gonads, with retardation sexual development, associated with high levels of hormones that stimulate the gonads.
The condition of elevated concentrations of gonadotropins within the blood.
Excess levels of insulin circulating in the blood relative to the level of glucose and impairing the hormonal levels, even those involved in reproduct
Abnormally elevated levels of any or all lipids in the blood.
The presence of abnormally high levels of prolactin in the blood.
Condition that occurs due to excessive production of thyroid hormone by the thyroid gland.
A medical condition characterized by not enough androgenic activity in the body.
A lower than normal level of estrogen which is the primary sex hormone in women.
A medical term which describes a diminished functional activity of the gonads – the testes and ovaries.
Partial or complete loss of production of one or more of the pituitary gland hormones.
A deficiency in the serum levels of the prolactin hormone.
An anomaly of the penis, with the opening of the urethra located on the underside of the penis, which may lead to infertility.
A condition in which a man has an unusually low ejaculate (or semen) volume.
Group of diseases, which have impact on function of hypothalamus.
A surgery performed to remove a woman's uterus.
A condition in which fertility impairment occurs spontaneously or due to an unknown cause.
A genetic condition where the primary symptom is a failure to start puberty or a failure to fully complete puberty.
The set of symptoms that result from two or more X chromosome in males.
Laurence-Moon syndrome (LMS) is a genetically predisposed disorder affecting both genders.
A presence of more than one million of white blood cells in 1 millimeter (mL) of ejaculate.
Mutation causing impaired Leydig cell differentiation and testosterone production.
Patients with a low number of retrieved oocytes despite adequate ovarian stimulation during fertility treatment.
Collection of autoimmune diseases in which the human immune system becomes hyperactive and attacks normal, healthy tissues.
The time in most women's lives when menstrual periods stop permanently, and the woman is no longer able to have children.
An abnormal condition in a woman's menstrual cycle.
The condition of only one testicle present in the scrotum.
Mumps was a common childhood viral disease caused by the mumps virus. Mumps frequently causes orchitis and impairs male fertility.
Necrospermia is a condition in which spermatozoa in semen are either immobile or dead
Type of cancer arising from the lymphoid tissue.
Complete absence of sperm in the ejaculate due to testicular failure.
A frequent autosomal dominant developmental disorder primarily characterized by short stature, typical facial features and heart defects.
A manifest variant of nutcracker phenomenon, renal vein entrapment syndrome, or mesoaortic compression of the left renal vein.
A disease of excess body fat that can have a negative effect on health, leading to reduced life expectancy and other health problems.
Absence of sperm in the ejaculate despite normal spermatogenesis, caused by an obstruction of the genital tract.
Repetitive nocturnal complete collapses (apneas) or partial collapses (hypopneas) of the upper airway during sleep.
Male fertility diagnosis defined as a combination of low sperm concentration, reduced motility and abnormal sperm morphology in the ejaculate.
Light or infrequent menstrual flow at intervals of 39 days to 6 months or 5–7 cycles in a year.
Semen with a low concentration of sperm and is a common finding in male infertility.
Defect during oocyte maturation.
An inflammation of the testes, involving swelling and heavy pains.
A type of cancer in which abnormal cells begin to grow in one or both of a woman's ovaries.
Abnormal sacs filled with liquid or semi-solid matter found in the ovary, which can have negative impact on female fertility.
A clinical symptom complex that can occur in some women undergoing assisted reproductive technologies and that could result in pregnancy complications
A physical syndrome described by pain or burning sensation of the urethra or perineum during or following ejaculation.
The rare chronic disease typically features a number of small, interlinked abscesses within the pelvis.
A form of abdominal adhesions in the pelvis.
Infection of the upper part of the female reproductive system and a common complication of some sexually transmitted diseases.
An infectious disease caused by the bacterium Mycobacterium tuberculosis and one of cause female infertility.
A pituitary malfunction is a disorder affecting the pituitary gland, either by overproduction or underproduction any of pituitary gland hormones.
An abnormal growth that develops in the pituitary gland that could impair the hormonal balance needed for fertility function.
A condition in which a woman has an imbalance of female sex hormones. This may lead to changes in the menstrual cycle, cysts in the ovaries, trouble g
A condition of abnormally high concentration (more than 250 million / ml ) of sperm in the semen.
A condition of low fertility characterized by low numbers of remaining oocytes in the ovaries or possibly impaired oocyte development or recruitment.
A genetic disorder due to loss of function of specific genes on chromosome 15.
A man experiences orgasm and expels semen soon after sexual activity and with minimal penile stimulation.
The loss of function of the ovaries before age 40.
An inflammation of the prostate gland.
A distally blocked Fallopian tube filled with pus.
Three or more consecutive pregnancy losses prior to 20 weeks gestational age from the last menstrual period.
Three or more consecutive pregnancy losses before 20-24 weeks of gestation or below a fetal weight of 500 g.
A kidney cancer that originates in a part of the very small tubes in the kidney that transport waste molecules from the blood to the urine.
The absence of implantation after three or more transfers of high quality embryos or after placement of 10 or more embryos in multiple transfers.
The semen, which would normally be ejaculated via the urethra, is redirected to the urinary bladder.
A long-term autoimmune disorder that primarily affects joints.
Surgical removal of one (unilateral) or both (bilateral) fallopian tube(s).
An acute inflammation of the fallopian tubes.
The absence of any developmental stage of sperm cell in the testes.
An infection of the paranasal sinuses and/or the lungs, associated with several conditions of impaired fertility.
Antibodies that bind to sperm, inhibiting their movement, stopping recognition and entry into the egg.
High level of DNA damage in sperm cells that may lead to male infertility.
A rare disorder characterized by a phenotypic female with an XY karyotype.
A sexually transmitted infection caused by the bacterium Treponema pallidum subspecies pallidum.
Teratospermia is a condition characterized by the presence of sperm with abnormal morphology that affects fertility in males.
A medical condition in which the testes diminish in size and may be accompanied by loss of function (production of sperm and testosterone).
Cancer that develops in the testicles.
The inability of the testicles to produce sperm or testosterone.
Emergency medical condition occurring when the spermatic cord twists and cuts off the testicle's blood supply.
Cancers that develop within the thyroid gland.
A medical condition impairing the function of the thyroid.
Medical emergency that afflicts the human penis.
A permanent form of female sterilization, in which the fallopian tubes are severed and sealed or "pinched shut", in order to prevent fertilization.
Turner syndrome is a genetic disorder in which a female is partly or completely missing one X chromosome that results in ovarian dysgenesis.
In the case of cryptorchidism one or both testes are absent from the scrotum. It is is the most common etiologic factor of azoospermy in the adult.
Congenital uterine anomaly (one of the Müllerian duct anomalies) usually associated with communicating or non-communicating rudimentary horn.
A condition of blocked passage through one of the Fallopian tubes.
womb cancer
The most common benign smooth muscle tumors of the uterus encountered in women of reproductive age.
Rare uterine malignant tumour that arises from the smooth muscular part of the uterine wall.
A type of female genital malformation resulting from an abnormal development of the Müllerian duct(s) during embryogenesis.
Congenital uterine malformation where both Müllerian ducts develop but fail to fuse, thus the woman has a "double uterus".
A form of a congenital malformation where the uterine cavity is partitioned by a longitudinal septum. It is one of Müllerian duct anomalies.
A form of a congenital malformation where the uterus is partially divided by a longitudinal septum. It is one of Müllerian duct anomalies.
A disease of the vagina caused by excessive growth of bacteria, with possible detrimental effect on female fertility.
An abnormal enlargement of the pampiniform venous plexus in the scrotum.
The male sex chromosomal disorder characterized by a spectrum of clinical presentations, ranging from ambiguous to normal male genitalia.
A family of genetic disorders caused by missing gene(s) in the Y chromosome.
A rare condition causing chronic lung disease, rhinosinusitis and azoospermia.
