There a number of indications for the use of donor sperm. Donor insemination can be used when the male partner has severe semen abnormalities. The use of donor sperm for severe male factor infertility has decreased significantly over the past several years with the increased utilization of intracytoplasmic sperm injection (ICSI) for the treatment of male infertility. Donor sperm can also be used if the male partner is a carrier or is affected with a significant genetic defect, and the couple wishes to avoid passing this on to their children. More commonly, donor sperm are used by single women or lesbian couples who desire pregnancy.
Insemination using donor sperm has been practiced for over a century. With the emergence of HIV-AIDS in the 1980s, donor insemination has been performed exclusively with frozen and quarantined sperm. Current guidelines recommend that sperm be quarantined for at least six months before being released for use.
Insemination is timed to occur at the time of ovulation. Blood work and ultrasound is often done to help pinpoint the opportune time for insemination, which can be done during a woman’s natural cycle or in conjunction with an ovulation induction cycle. The procedure is simple and is performed in our offices. A very thin, flexible catheter with the prepared sample is placed through the woman’s cervix into her uterine cavity. This very brief, painless procedure places all of the motile sperm in the uterine cavity, close to the entrances to the fallopian tubes, where fertilization typically occurs.
In traditional IVF, the sperm are mixed with the woman’s egg in a laboratory. If ICSI is needed, a small needle is used to inject a sperm into the center of the egg. The fertilized egg grows in a laboratory for one to five days, then it is placed in the woman’s uterus (womb).
ICSI helps to overcome a man’s fertility problems, for instance:
• He may produce too few sperm
• His sperm may be not be shaped correctly or move in a normal fashion
• The sperm may have trouble attaching to the egg
• A blockage in his reproductive tract may keep sperm from getting out ICSI can also be used when the use of traditional IVF has not produced fertilization, regardless of the condition of the sperm.
ICSI fertilizes 50% to 80% of eggs. But the following may occur after the use of ICSI:
• The ICSI procedure might damage some eggs
• The egg might not grow into an embryo even after it is injected with sperm
• The embryo may stop growing
Once fertilization takes place, a couple’s chance of giving birth to a single baby, twins, or triplets is the same if they have IVF with or without ICSI.
If a woman gets pregnant naturally, there is a 1.5% to 3% chance that the baby will have a major birth defect. The chance of birth defects after ICSI are rare. Certain conditions that have been associated with the use of ICSI (Beckwith-Wiedemann syndrome, Angelman syndrome, hypospadias, or sex chromosome abnormalities) are thought to occur in far less than 1% of children conceived using this technique.
Some of the problems that caused your infertility may be genetic. Therefore, boys conceived with the use of ICSI may have infertility issues as adults.