Who is Eligible for Sperm Donation?
Couples seeking to fall pregnant via Sperm donation have to because there is an absence of sperm after ejaculation or after surgically removing tissues samples from the testicles (TESE) viable sperm sample cannot be found this is called Azospermia.
Most common reasons couples turn to Sperm Donation are:
Azospermia, when viable sperm is not found for ICSI, via ejaculation or after being surgically removed; When young some males may be exposed to mumps or other types of illnesses that causes a fever and can cause infertility later on. Others can be genetically related i.e. Kleinfelter Syndrome in that the males carries an extra X chromosome (XXY) or undescended testis which they can try to correct early on via surgery. If after many failed IVF attempts, the treatment show a lack of fertilisation or embryo development because of the sperm sample then sperm donation can be considered.
Single women or women in same sex relationships may also seek Sperm donation in order to fall pregnant.
How is a Sperm Donor selected?
There are many credible Sperm banks based in Europe, and on site we store donor Sperm. Matching the right donor sperm is very important, the first match is the donor sperm blood group, then eye colour in turn with hair colour, couples are advised to match as closely as possible to the male but single women match to the characteristics they wish to have in a donor.
We are more than happy to work with a European sperm bank of your choice as long as we have enough time for the official authorisation from the Ministry of Health, a sperm donor that you wish to have treatment with can be accepted. In turn if a patient has a sperm donor candidate they wish to bring with them, as long as the necessary screening is carried out, we can comply with this request. What are the treatment stages in Sperm Donation?
The treatment process for Sperm Donation can be Artificial Insemination (IUI) or via IVF treatment. This will be decided on age, egg reserve, egg quality etc. once assessment has been completed by your doctor, this is why doctors and the chosen centres experience is very important.
Artificial Insemination (IUI)
Women who are of a young age (<35yrs) and have a good egg reserve are a viable candidate for IUI with donor sperm. They will also require clear fallopian tubes and then the ovaries will be prepared accordingly ready for insemination, the chances of pregnancy are on average 15% (10-20).
It is important that a patient has a regular menstrual cycle, then follicle development can be monitored and also when ovulation may occur, medication can also be used for the treatment this could be oral or a combination of hormonal injections. The follicle development will be monitored with regular ultrasounds as well as blood tests to monitor the LH surge and Progesterone hormone levels. Closely monitoring hormone levels will give an indicator as to when the hCG shot should be administered and then 36 hours after the donor sperm can be directly placed within the uterus to enable the chances of fertilisation.
The chosen donor sperm sample is processed and then injected via a catheter into the uterus. The processed sperm is then injected into the uterus via a catheter, and is left to swim via the Fallopian tubes in order to maximise fertilisation. Patients are advised that if after the procedure they do not see a period, when to carry out the pregnancy Beta HcG blood test to see if a pregnancy has occurred.
IVF Procedure
The female should be assessed by a medical professional. Certain blood tests are needed to assess fertility her levels. Examples of blood tests for the female are Anti Mullerian Hormone (AMH), TSH, Prolactin etc. as well as gynaecological examinations, a trans-vaginal scan to monitor the egg reserve and a Hysterosalpingogram (HSG) to check the fallopian tubes and uterus.
Ovarian Stimulation
Based on the results from the blood test assessment and scans, a medication protocol is designed for the female, this will be daily hormonal injections with a combination of vitamins to stimulate the antral follicles and enable the follicles to grow.
There are two types of stimulation protocols, Long and Short, the preferred protocol is generally the Short protocol (Antaggonist) as stimulation will begin on day two or three of the menstrual cycle and will last between 11-13 days. Ultrasounds and blood tests will be needed at certain stages of the stimulation, so the female will be closely monitored to check follicle development.
The hormone stimulation is a series of hormone daily subcutaneous injections (GnRH) and these encourage the eggs in your body to grow but the dose of the medication is also dependent on factors such as how may potential antral follicles are present, height and weight.
Trigger injection ready for Egg collection
Once the stimulation process is completed and the follicles are of a certain size to be triggered, the last injections are applied and these are to invoke ovulation and also help to increase the number of mature eggs collected. There are two different types of trigger injections that can be used individually or in combination (containing hCG / containing GnRH analogue) but these injections are also sold under different brand names in different countries. Based on your follicle development, your doctor will determine which trigger injections should. Egg collection (OPU) is performed, 34-36 hours after the trigger injection is administered at a certain time.
The egg collection itself is a very straight forward procedure, and anaesthesia is used to sedate the female, to make the egg collection less stressful. Prior to the egg collection we need the female to be nil by mouth (no food or water) for 4-6 hours because anaesthesia will be administered intravenously. After the egg collection procedure, a new medication protocol will begin (e.g. Progesterone) to prepare the body for the transfer of the embryos to maximise the chances of pregnancy.
Fertilisation
The fertilisation of bringing the egg and donor sperm together is carried out by the embryologists within the laboratory, there are different techniques that can be carried out:
Embryo Monitoring
After Microinjection, the dishes are labelled and stored within special incubators with the patients ID and 16-18 hours after injection they are monitored to determine whether fertilisation has taken place.
Embryo Transfer
Your doctor will advise you (based on embryo development) which day the transfer will be best to be carried out. Depending on egg count or endometrium thickness, your doctor may decide to freeze the embryos for transfer at a later stage.
If the embryo transfer process is carried out in the same cycle the transfer will take place on day 3 or on day 5 post egg collection. The day of embryo transfer will be determined by the physician and embryologist, taking into account the number of embryos, their quality and they will take into account your previous treatment results.
If after the embryo transfer, you have more good quality embryos, these can then be frozen for future transfer attempts, we find this very important as the same donor sperm may not be available if you wanted to proceed for a sibling in the future.
The Transfer procedure is a straight forward and painless procedure, it does not require any anaesthesia or sedation. Patients who are sensitive maybe sedated for the transfer if needed. The transfer is carried out with a full bladder, so you are requested to drink plenty of water before the procedure. Once the bladder is full the endometrium can be clearly identified with the aid of ultrasound guidance. The embryologist draws the embryo into a catheter and passes it to the doctor and with the aid of the ultrasound the catheter is guided by a nurse the catheter is placed on to the endometrium and the embryo(s) are released. After the transfer, you are taken to the room and are asked to rest for approximately 1 hour. After the transfer, and resting for one hour, medication protocol will be adjusted and you will be discharged from the Centre as you will be treatment as an outpatient.
Post Transfer
On the transfer day, the date of when the pregnancy test should be carried out will be advised, it is usually 12 days post transfer when a beta HcG blood test is advised to be carried out.
For sperm/embryo donation, we only use certified donor sperm that is obtained from reliable sperm banks, which have been approved for use by TRNC Ministry of Health.
The most important for pregnancy in sperm donation are age, egg number and quality of the patient looking for treatment. That is, the chances of pregnancy in young couples is higher, but this chance decreases due to egg quality as women age. In 20-year-old couples who do not have any additional negative factors, their chances of pregnancy are 70-75%, chances of pregnancy in their 30s is 60-65%.
