IVF with donor sperm

Sometimes the cause of a couple’s infertility is the health of a man. In this case, you can consider IVF with donor sperm. Also, this type of artificial insemination makes it possible for women who do not have a permanent partner to give birth to a child.

Many women dream of a child. But not everyone is able to get pregnant naturally. Then IVF comes to the rescue. If a woman is single or her partner is diagnosed with infertility, donor sperm can be used. The gynecologist Svetlana Murashko tells about the features of this procedure.

Indications for IVF

IVF with donor sperm is indicated (1):

Women who are not married and do not have a permanent sexual partner. Such patients are inseminated with donor sperm;
couples in which there is a high risk of having a child with congenital anomalies due to poor genetics of the husband. If the risk of transmission of congenital diseases is more than 25%, doctors recommend the use of donor sperm;
couples in which a man is unable to conceive due to castration, lack of testicles, lack of sperm in the semen.

If IVF with donor sperm is planned in a married couple, the procedure is carried out only with the consent of both partners.

How to choose a donor for IVF

All donor candidates, in accordance with the order of the Ministry of Health (No. 107n of 30.08.2012) (2), undergo a full medical examination, which includes:

extended spermogram;
blood tests for HIV, hepatitis B, hepatitis C, syphilis;
general, clinical and biochemical blood tests;
determination of blood group and Rh factor;
analysis for sexually transmitted diseases: cytomegalovirus, chlamydia, ureaplasmosis, mycoplasmosis, herpes simplex viruses;
examination of the therapist;
psychiatric examination;
examination by a urologist;
genetics examination.

The received donor material is sent to quarantine for six months.

After some time, the examination is repeated. Male sperm in its natural form is not used. A freeze and quarantine period is applied for a secondary check for possible diseases. Freezing is necessary to prevent transmission of the infection.

All these measures are taken to exclude the birth of a child with genetic abnormalities and hereditary diseases.

If the results of long-term observation of the biomaterial are negative, it can be thawed and used.

Each donor fills out a questionnaire in which they indicate:

nationality;
weight and height;
blood type and Rh;
eye and hair color;
education.

Sperm banks also offer a description of the appearance and childhood photos of the donor, an audio recording of the donor’s voice in which he discusses various topics, talks about his hobbies, describes life stories.

Husband’s sperm

IVF with donor sperm is indicated in the presence of serious abnormalities in the husband’s sperm. These include:

lack of spermatozoa;
a large number of dead spermatozoa;
a large number of abnormal spermatozoa.

IVF with donor sperm is also carried out if the husband has genetic diseases, if there is a risk of their transmission.

Third Party Candidate Sperm

In Our Country, sperm donor candidates are men aged 18 to 35, without bad habits, citizens of the Federation. We repeat once again: in order to exclude viral diseases, the donor’s sperm is frozen for 6 months. Six months later, the donor is again checked for infections. And if signs of diseases are not found, sperm can be used for fertilization.

Stages of the IVF procedure

1. Diagnosis of infertility

If, with regular sexual activity for 1 year, pregnancy has not occurred, the couple is diagnosed with infertility. For women over 35, this period is reduced to 6 months. In this case, you need to contact a reproductive specialist.

2. Preparation for IVF

Preparing for IVF is the most important step. The final outcome of the procedure depends on it. In order to understand the causes of infertility and ensure the birth of a healthy child, it is necessary to pass a series of tests. This applies to both men and women (3). The list of necessary examinations for patients entering the IVF procedure is approved by the order of the Ministry of Health.

Tests for men

Men are examined for sperm quality, i.e. on the number of healthy, motile spermatozoa capable of fertilization. Sexually transmitted infections are also excluded.

Analyzes and examinations for women

Women undergo a more detailed examination. They take blood tests for hormones, infections, chronic diseases, diseases of the reproductive system, and consult with various specialists.

3. Stimulation of superovulation

In order to receive several eggs at the same time, the patient is prescribed hormone injections. This procedure is called superovulation stimulation.

4. Puncture of follicles

When the follicles mature, the patient is given a special injection – a trigger for the final maturation of the eggs. Then the doctor with the help of a special needle under the control of ultrasound takes the follicular fluid. From the material obtained, the embryologist selects eggs for fertilization.

5. Fertilization of eggs

The eggs and sperm are placed in an incubator, in a special nutrient medium, where fertilization takes place. With a large number of abnormal forms of sperm, intracytoplasmic sperm injection into the egg (ICSI) is indicated. In this case, the most promising spermatozoon is selected and introduced into the cytoplasm of the egg.

6. Cultivation of embryos

The next day, the embryologist determines how many eggs have been fertilized and then monitors the development of the embryos. Some of them may lag behind in development or not develop at all. The most promising embryo is selected for transfer to the uterus.

7. Embryo transfer

A few days after fertilization, the embryo is transferred to the uterus. The process is carried out using a catheter through the cervical canal. The procedure does not require anesthesia.

8. Pregnancy support

After embryo transfer, additional hormonal support with progesterone preparations is required, in some cases in combination with estrogens. This is due to the fact that the corpus luteum, as in a normal pregnancy, may not form or secrete an insufficient amount of hormones. (3)

Expert Commentary

The use of donor sperm is necessary in a number of situations, according to experts.

Donor material allows a single woman who wants a child to become pregnant and give birth;
donor material is used for severe and/or absolute male infertility;
the use of the husband’s sperm did not lead to pregnancy after numerous IVF cycles;
The use of husband’s sperm in the IVF program requires expensive preimplantation genetic diagnosis (PGD). (Spouse has a hereditary disease). The use of donor sperm from a donor examined for hereditary diseases makes it possible not to perform PGD on embryos.

However, there may be some risks associated with the use of donor sperm.

Infection risks. If a couple acquires biological material from a clinic that complies with order 107n, then this risk is minimal. The sperm donor is examined for HIV, syphilis, viral hepatitis, herpes, cytomegalovirus. An analysis is also taken for chlamydia, mycoplasma, ureaplasma, trichomonas and gonococci. According to the order of the Ministry of Health 107n, only donor sperm that has passed quarantine is allowed to be used. Within six months from the moment of sperm donation to the cryobank, it cannot be used for fertilization. It is necessary to endure quarantine. The fact is that some infections cannot be detected at an early stage. After 6 months, the donor must be examined again, after which the sperm can be removed from quarantine and used for fertilization.
Psychological risk for parents (the child is not biologically related to the father of the child).
The risk of mental illness in a child. Although all donors are consulted by a psychologist and narcologist, there is still a small risk of mental illness. Donors may withhold information about mentally ill relatives.
Risk of increased hereditary diseases in the general population. It is important to control the number of children born from one donor in order to avoid random mutations. Children of the same donor can meet, start a family, and their children will have a high risk of genetic diseases. No more than 10 children from one donor per 800 population in one region are allowed. If the donor has some kind of genetic pathology, then the percentage of children with genetic abnormalities in the future may increase significantly.
The risk of having a child with a genetic disease. Currently, in all countries of the world, including Our Country, genetic testing of sperm donors is not mandatory. Only a few IVF clinics screen donors for these diseases. There are a great many such mutations, most often screening is carried out for the most frequent of them. When choosing a clinic, you should opt for the one that conducts advanced genetic screening for all donors
The risk of external dissimilarity of the child to the parents. Despite the choice of the donor according to his phenotypic card, where his external data is written and childhood photographs may be attached, there is a risk that the child will not be very different from his parents.