What is donor insemination or DI?
Donor insemination (DI) uses sperm from a known or unknown donor to help women become pregnant, and can be used in instances of male infertility, or when there is no male partner. At London Fertility Centre we actively recruit our own sperm donors and we buy donor sperm from recognised and licensed donor banks too. All sperm donors recruited at London Fertility Centre have to be in good health and are screened for sexually transmitted diseases and some genetic disorders. Prospective parents can choose the appropriate physical characteristics from the panel of donors so that skin colour, height, eye and hair colour can be matched. Ethnicity or racial origin will also be matched. DI-IUI involves using sperm from a known or unknown donor for intrauterine insemination (IUI).
In DI-IUI, sperm from the donor is placed into the uterus at the time when the woman ovulates.Donor sperm can also be used for in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) treatments, where the woman undergoes an egg collection and her eggs are inseminated or injected with donor sperm.
Is donor insemination for me?
We may recommend this treatment if:
- your partner is unable to produce sperm
- you do not have a male partner
- your partner’s sperm count or quality is so poor that it is unlikely to result in conception
- your partner has a high risk of passing on an inherited disease
Counselling for DI patients and partners
Prior to DI treatment being offered to you, it is essential that you see our independent counsellor for a session of implications counselling to ensure that you are fully aware and understand the implications of accepting donor sperm.
To arrange an appointment, please contact LFC’s reception team on 0207 224 0707 or by email to reception@lfc.org.uk
What donor information will be available to me?
You will not have access to any identifying information about the donor. You will, however, be able to access non-identifying information about them, such as physical appearance (eye colour, height), ethnicity and personal interests. You will be informed of their genetic history and the likelihood of your offspring inheriting physical characteristics from the donor. If there is a goodwill message written by the donor to the donor-conceived child, you will be able to read it and their reasons for donating. If your treatment is successful, after the birth of your donor-conceived child you can access information about the number, sex, and year of birth of genetically related donor-conceived children by contacting the Human Fertilisation and Embryology Authority (HFEA). A donor can only be used to father a maximum of 10 families.
What screening tests does the donor undergo?
All sperm donors must have no known personal or familial history of inherited disorders and no current infection of sexually transmitted diseases. The sperm donor will have a detailed medical history taken and will undergo rigorous screening tests before, during and after donating. These tests include:
- gonorrhoea (urine test)
- chlamydia (urine test)
- syphilis
- cytomegalovirus (CMV)
- hepatitis B and C
- HIV
- HTLV
- blood group
We will also test routinely for the following genetic disorders:
- Karyotype and cystic fibrosis
- Sickle-cell anaemia, beta-thalassaemia (if applicable)
There is always the possibility that a screened sperm donor is a carrier of a genetic disease or infection that has not been identified. Donor sperm will be quarantined for six months before being tested again for HIV.
How does donor insemination work?
Before proceeding with donor insemination you will need to have an initial consultation, at which stage we shall discuss with you whether a tubal patency test should be performed. Screening tests for cytomegalovirus (CMV), blood group, HIV, hepatitis B & C, syphilis and gonorrhoea will also be carried out. In addition, you will have screening to ensure that you are immune to Rubella (German Measles) and a full blood count will be performed. Your hormone profile will also be assessed to determine any hormonal imbalance. The selection of a suitable donor is also carried out at this stage. At consultation you will be given a donor characteristic match form to complete and we will try to match these characteristics, as best we can. Occasionally donors may stipulate restrictions on who can use their sperm. As such, we will only offer you sperm from a suitable donor. You are not obliged to accept the donor who is offered to you. If donor sperm is in short supply, you may have to wait for suitable sperm to become available. You are also able to use your own sperm donor, provided he is suitable and passes all screening and health checks.
You and your partner, if applicable, will then both need to undergo counselling. You will both also be required to sign a consent form agreeing to treatment using donor sperm and will need to consent to the disclosure of information and complete a Welfare of the Child form. If you are not married or are in a civil partnership, you and your partner will also need to complete legal parenthood consent forms. If you are undergoing IVF/ICSI treatment with donor sperm, the sperm will be thawed on the day of egg collection and processed to inseminate your eggs. If you are undergoing DI-IUI, you may be given fertility drugs to stimulate egg production if you are not ovulating.
If we have to give you medication to stimulate egg production, we shall carry out blood analysis to test your hormone levels from day three of your menstrual cycle, and from day 10 of your menstrual cycle on a daily basis to identify when you are at your most fertile. It is common with stimulated DI-IUI to carry out ultrasound scanning to ensure that no more than two mature eggs are about to ovulate.
With DI-IUI the donated sperm is inserted into the womb using a straightforward procedure. Although this procedure is normally painless, a small proportion of women may experience temporary menstrual-like cramping. You will be given at least 24 hours notice before your insemination treatment. Click here for further information about the intrauterine insemination (IUI) procedure.
A week after DI-IUI is performed a blood sample may be taken to measure your progesterone hormone level to confirm that ovulation has occurred.
Reserving donor sperm
Following guidelines from all donor banks in the UK working with LFC, patients are allowed to reserve donor sperm for two treatment cycles only (four ampoules for IUI/IVF, and two ampoules for ICSI per treatment cycle).
Owing to reduced availability of donor sperm, patients may have limited choice of donors, or be asked to postpone treatment until a suitable donor becomes available.Donor banks reserve the right to withdraw a donor from use for treatment at any time. Purchasing donor sperm does not guarantee that the sample can be used for treatment.
Chances of success with DI-IUI
Female fertility diminishes with age, so if you are using your own eggs, on average, the younger you are the higher your chances of success. In 2006, the national live birth rate for women receiving IUI treatment with donor sperm was:
- 15.0% for women aged under 35
- 10.4% for women aged between 35-39
- 5.5% for women aged between 40-42
- 1.3% for women aged between 43-44
In the event of three (or less, depending on your situation) unsuccessful cycles of DI-IUI, we will consult with you about the possibility of donor insemination with IVF or ICSI.
What are the risks of DI-IUI?
The biggest risk associated with stimulated DI-IUI is the risk of multiple births.
Legal parenthood and DI
The sperm donor is not the legal parent of a child born through DI. If you are married or in a civil partnership your spouse will automatically be the legal parent of the child, unless they do not consent to the DI. If you are in a heterosexual relationship and not married, or in a same-sex relationship but not in a civil partnership, you and your partner can complete HFEA consent forms to entitle your partner to become the legal parent of the child.
Telling your child about their origins
If your child, or children, were conceived as a result of DI, telling them about their origins can be a sensitive topic to discuss. However, if handled honestly and discussed at the right time, the issue need not be a difficult one to broach. We believe that donor-conceived children should be informed of their origins at an early age. Evidence suggests that discovering donor-conceived origins later in life can be emotionally damaging for children and relatives.
Access to information for donors and donor-conceived people
The HFEA registers all information regarding treatment with donors. A donor may request non-identifying information about any children born as a result of their donated sperm, including the number of children born, their sex, and their year of birth. From the age of 16, donor-conceived children have access to the following non-identifying information about the donor:
- physical description (height, weight, eye hair and skin colours)
- year and country of birth
- ethnicity of donor and donor’s parents
- number and sex of other genetic children donor had when they registered
- marital status at time of donation
- details of any screening tests and medical history
- reasons for donating
- a goodwill message from the donor
- skills and any other details the donor may have chosen to supply, such as occupation, religion and interests
Parents of donor-conceived offspring can only find out non-identifying info about the donor. Only donor conceived offspring, from the age of 18, can access the full name (and previous names), date and place of birth, and last known postal address of the donor.
From 16 (if contemplating marriage), or 18, people can ask the HFEA if they were conceived as a result of donor insemination and if so, whether they are related to the person they are about to marry.