ART or Assisted Reproductive Technology

 Assisted Reproductive Technology, or ART, is a term that covers all technical procedures or services devoted to helping women achieve pregnancy through artificial insemination.

American Association of Tissue Banks or AATB

The American Association of Tissue Banks, or AATB, is a national association that issues guidelines for and accredits tissue banks, including reproductive tissue banks like sperm banks. It is a voluntary accreditation.

American Society for Reproductive Medicine or ASRM

The American Society for Reproductive Medicine (ASRM) is an organization created to advance the "art, science, and practice of reproductive medicine." 

It provides a forum for lay public, researchers, physicians and affiliated health workers through education, publications, and meetings. Founded in 1944, its initial name was the American Fertility Society (AFS).

Andrology

The science dealing with the structures, functions, and disorders of the male reproductive system.  It is estimated that about 40% to 50% of fertility problems in couples are due to sperm-related problems. Andrology labs usually perform various semen analyses to determine health and viability of sperm.

Autosomal Recessive

 "Autosomal recessive" refers to a specific pattern of inheritance.   If a disorder is inherited in an autosomal recessive manner, it means an individual has to inherit two mutations of the disorder, one from each parent, in order to be affected by it.

A person who has only one recessive gene is said to be a "carrier" for the trait or disease, but they do not have any health problems from "carrying" one copy of the gene. However, they could have a child affected with this disorder if their partner also carries a mutation for that same condition.  This is  the case with genetic disorders like SMA (Spinal Muscular Atrophy), Tay Sachs Disease, Cystic Fibrosis and Sickle Cell Anemia.

Most people do not know they carry a recessive gene for a disease until they have a child with the disease. Most banks screen for Tay Sachs (primarily on Jewish donors) and Cystic Fibrosis.  Others may test for Sickle Cell Anemia but the only bank currently testing for SMA is California Cryobank.

 

 

 

CMV or Cytomegalovirus

Cytomegalovirus (CMV) is a very common viral infection. About 50-80% of all adults in the US show evidence of previous CMV infection. 

In healthy individuals it causes a mild transitory infection with few or no symptoms. Recovery is rapid with no lasting manifestations. Once a CMV infection occurs, that individual remains antibody positive for life.

If a woman has postitive CMV antibodies and gets pregnant, it can cause serious birth defects in the developing fetus. The mother usually has only mild symptoms and recovers rapidly.

 Donors who have had a CMV infection and recovered are described as "CMV positive" or "CMV+". They are referred to as having an inactive or latent infection.

Such donors are healthy and do not transmit CMV to sexual partners or household contacts. Virtually all new CMV infections are acquired from other persons who have an active CMV infection.

Some physicians believe that CMV positive donors present some risk to CMV negative recipients but there seems to be little scientific evidence to support that concept. Consult with your physician regarding your own CMV status.

Cryobank

A tissue bank that provides storage of cells and tissues at ultra low temperatures using liquid nitrogen. The temperature of liquid nitrogen is about -196 C or -324 F.

  

 

 

Cryopreservation

The storage of cells and tissues in liquid nitrogen.

Cryoprotectant

A chemical component of a freezing solution used in cryopreservation. The purpose of the cryoprotectant is to help protect the semen from freeze damage.

Cystic Fibrosis

This is one of the most common severe genetic disorders that occur in people of European origin. The carrier rate is about 1 in 24 persons of northern European ancestry.  Carriers are healthy and have no symptoms.

For a child to be affected both parents must be carriers. In this situation, the risk of having an affected child is about one in four.

Sperm banks generally perform carrier testing on their donors, but the majority don't test for every mutation.

If you are known to be a carrier for CF, genetic counseling is recommended.  Consult your physician for further information and inform the sperm bank about your situation.

Directed Donor

A directed donor is a known or "private" donor. The directed donor may be a relative of the husband or an individual that you know.

Some sperm banks have "directed donor programs" that will assist you in the required testing and processing. The potential donor will need to have a semen analysis before proceeding because his sperm count and motility may not be satisfactory.

The FDA requires that all donors must under go the same infectious disease testing that regular donors must have.

Embryo

This is defined as a fertilized egg. In humans, the fertilized egg is usually called an embryo from the time the egg is fertilized until the eighth week of development, after which it is called a fetus.

Gamete

Reproductive cells (sperm in men, ovum in women) that can form a cell or zygote (see zygote) by uniting.

ICI or Intracervical Insemination

Intra-Cervical Insemination: this is a method of insemination where the sperm specimen is placed in direct contact with the cervix.

 

ICSI or Intracytoplasmic Sperm Injection

Intra-Cytoplasmic Sperm Injection or ICSI is the injection of a single sperm into the egg. This may be performed in the laboratory as a part of the IVF procedure.

It requires the use of special micromanipulation tools and microscopes which enable embryologists to select an individual sperm cell which is then carefully injected into cytoplasm of the egg.

These results in normal fertilization in approximately 70-85% of eggs injected with viable sperm.

ID Release

A sperm donor who has agreed that the sperm bank may release his identity directly to the donor conceived child at age18 without further consent or notification of donor.

Some legal experts have offered the opinion that the donor has a legal right to withdraw his consent for disclosure.

“Open Donor” is frequently used interchangeably with ID release donors. Direct contact with the sperm bank is advised to avoid confusion.

IUI or Intrauterine Insemination

Intra-Uterine Insemination is a method of insemination which places washed sperm directly into the uterus by passing a catheter through the cervical canal.

Washing  sperm cells is necessary to remove the seminal fluid which contains compounds that cause painful uterine cramping. Proper timing of insemination is important with IUI.

Pregnancy rates are generally higher with IUI than ICI.

 

IVF or In Vitro Fertilization

In vitro fertilization (IVF) is the process by which human eggs are fertilized in an embryology laboratory.

 

Motility

Fertilization of an egg ordinarily requires a living, motile sperm that can swim into the fallopian tube where the sperm binds to the egg and penetrates the outer membranes. The stronger the sperm, the faster it swims.

Motility is an estimate of the percentage of motile sperm and is a measure of fertility potential of the donor’s sperm.

Photo Matching

Some sperm banks will accept a photo of yourself or your partner, and then try to find a donor with similar features/appearance. This service is called "photo matching" and ranges in price.

Semen

Semen is fluid from the penis that comes through the urethra upon ejaculation; it contains sperm.

Sickle Cell Anemia

Sickle cell anemia is a disorder of hemoglobin which is the molecule that carries oxygen in our blood cells.  Symptoms include episodes of joint and bone pain and increased risks for strokes, infections, and organ damage.  It is inherited in an autosomal recessive manner and occurs most often among individuals of African descent.

Sperm Bank

On our web site, we use the term "sperm bank" for any place that provides donor sperm to the public.

Some sperm banks are large companies that sell other biological products; others are smaller fertility clinics that also collect and store sperm.

Most of these banks are registered with the FDA but some only provide storage for their patients or for preservation of fertility for cancer patients.

Straw

A container resembling a straw that's used to package frozen sperm or other tissue. Some sperm banks package sperm in straws.

Most use vials. Usually a straw or vial contains enough sperm for a single insemination, but you should always confirm with the sperm bank if you're not sure.

Tay-Sachs Disease

Tay-Sachs disease is a severe neurological disorder that causes seizures, blindness, and muscle weakness.  Symptoms often begin in infancy and result in death by five years of age. 

It is inherited in an autosomal recessive manner and occurs most often among individuals of Ashkenazi Jewish and French Canadian ancestry.

Zygote

The fertilized egg is referred to as a zygote and is composed of a set of chromosomes from each parent. The zygote develops into an embryo.

What to Expect on First Visit to a Reproductive Endocrinologist

On your first visit to your  Reproductive Endocrinologist (RE), you  will discuss your medical history, including any procedures you’ve had done in the past, your efforts at having a baby, sexual history and behavior, any miscarriages or irregular periods and any family history of infertility.

After this, you will talk about any tests that need to be performed and possible treatment options in the event you are diagnosed with infertility. You will also have the opportunity to speak with the office about the doctor’s billing and financial policies.

Your first visit may or may not involve a physical exam or tests. Some important initial tests must be performed in the first 3 days of your ovulatory cycle, so your follow-up visits for testing may depend on your body’s schedule.

Your RE may schedule you for basic tests to determine the age of your eggs (your ovarian reserve), check your hormone ratio and fallopian tubes and examine your thyroid function (too much or too little thyroid function can negatively affect your fertility).  If you have a partner, your RE will recommend testing on them as well. Please see Medical History Review and Physical Examination for more details on physical exams and testing.

Follow Up Visits to Your Reproductive Endocrinologist

During your follow up visit (s) your reproductive endocrinologist will perform any previous tests you scheduled with them. Depending on the tests you've scheduled to take, this can take a lot of time or you could be in and out shortly. Either way, this is an important visit and it will usually be timed to coincide with your ovulatory cycle.

Getting Your Fertility Test Results

After you’ve completed any follow-up visits and tests, you will get your results. If they look normal, e.g. the blood tests show everything is ok with your hormone levels, your tubes and uterus look normal and nothing out of the ordinary has been identified, your RE may clear you to 1) keep trying to conceive naturally if you have a partner or 2) to begin any assisted reproductive therapies like IVF, IUI, ICI or ICSI.

If you still don’t get pregnant, your RE may bring you back for further testing and diagnosis. It’s important to understand that each person’s experience is different. Some women may conceive immediately, others not at all, and for still others, it can simply take a long time.

Remember: ALWAYS check with your doctor first before following any outside advice, even if it’s well-documented.

What Donor Info Do You Get from Your Sperm Bank?

Sperm Banks offer a variety of information about the donors you see in their catalogue. From life and medical history and various personality-revealing reports to audio interviews and baby photos, sperm banks try to give you as much knowledge as possible about their donors.

Here is the general information most larger sperm banks offer. Keep in mind that various banks also have their own special features; for example, California Cryobank's Donor-Look-a-Likes feature, where you can see the celebrities your donor might resemble, or Faifax's Donor Silhouettes.

Donor Profile
A quick run-down of a donor's main characteristics, like hair color, eye color, height, weight, degree (if bank lists it), education, blood type, ethnic origin, whether he has ICI, IUI or IVF-ready vials available, ancestry and more.

Long Donor Profiles, Extended Donor Profiles, Medical History Profiles
Sperm banks may differ in how they name these reports, but they are essentially longer donor profiles that often contain all the general information in a donor profile, plus a three-generation medical and genetic history, notes about what they study, their religious affiliations and more.

Audio Interviews With Donors
A number of sperm banks offer audio interviews with donors so you can get a sense of who they are. Most of the time they are fairly simple, allowing you to hear a donor's voice as he responds to specific questions.

Baby or Childhood Photos
A number of sperm banks offer baby photos in lieu of adult photos for their anonymous donors. Because of legal issues, sperm banks aren't allowed to show the adult photos of their anonymous donors, but they may use baby photos. Photos of donors may range in age from  6 months and 6+ years. Since baby photos are offered by the donors, they will range in quality.

Personality Tests
Another donor information product a sperm bank may offer is a personality test. This test may be used  as tools to assist with donor selection or may provide an interesting insight into your own child's temperament some day.

Staff Impressions
These are reports written by employees who have worked directly with donors. They may be free and contain employees' observations and opinions on the donor.

Donor Essays
Donor essays are written by donors. They are usually in a question-answer format, e.g. what is your favorite color, what's your ultimate goal in life, why do you want to be a donor.

Facial Features Reports
These reports provide information about a donor's particular facial features to assist in the donor
selection process, e.g. eye shape, how they're set in the face, skin color, skin tone, face shape and much more.

Donor Matching or Photo Matching Consultations
If an individual wants to find a donor that resembles them, a husband, family member or other person, various sperm banks offer donor photo matching services, where a  consultant matches the client's photo with the donor's photo.

Other Sperm Bank Products:
Various sperm banks may offer other products as well, including Handwriting Analysis (Graphology), donor profile silhouettes, Donor-Look-A-Likes, adult photos and donor selection services.

How Much Does Donor Sperm Cost?

The cost of donor sperm varies among sperm banks and depends on what combination of products and services you want. Some providers have an array of fees, broken down to the smallest details, such as whether you download a report from the web or have it mailed to you.

Some sperm banks tend to have more complicated fees and charge for every little thing, whereas others may have simpler, more straightforward pricing. Overall, you can expect to pay around $300-$800 per insemination for sperm, including shipping. Usually the cost of sperm is not covered by insurance.
 
A good rule of thumb is: never assume anything. Always ask your sperm bank to provide a written explanation of all fees and charges.

 

Donor Screening

How do I know the sperm is safe?
By reading the fine print and asking the right questions.

NOTE: This page is intended as an informational guide, not a definitive reference. When selecting a sperm bank, always consult with your physician to ensure the screening performed is appropriate for your medical situation. Please read our disclaimer.
 
You can use the information on this page as a source for questions to ask your doctor or sperm bank. A good rule of thumb is: never assume anything. Always ask the sperm bank to provide a written explanation of all screening and medical tests performed. If you're not sure, ask! 
 
Screening Sperm

All sperm banks make their donors undergo a complex screening process to reduce the risk of disease. While each sperm bank differs in the kinds of tests it performs, all the banks test for major diseases such as HIV/AIDS and other sexually transmitted diseases.

This usually includes a six month quarantine or waiting period during which the sperm is set aside so the test can be performed again later (it can take up to six months for HIV to appear). Some banks periodically re-test their donors at regular intervals. 
 
Types of Screening

Initial donor screening typically includes a physical exam, age selection (for example, donors are typically between 18 and 35), staff interviews, psychological profile and so on. Some banks require donors to be attending college; some have special programs recruiting donors with advanced degrees.

Many banks check for undesirable behavior such as excessive drinking or smoking, or behavior considered high risk for sexually transmitted diseases. A typical sperm bank might accept fewer than ten percent of applicants, some even fewer.  
  
Disease testing to minimize the risk that the sperm carries potentially harmful diseases such as HIV/AIDS, syphilis or hepatitis.

These tests can range from simple cell cultures (eg, for Herpes or Chlamydia), to elaborate chromosome testing for genetic diseases such as cystic fibrosis. Many sperm banks test for race-specific diseases where appropriate.

For example, sickle-cell anemia can affect people of African descent, so black donors are usually tested for it. Tay-Sachs is a disease that can affect people of Jewish or French Canadian descent.  
 
Quality testing to measure the sperm's viability typically includes measuring the number of sperm cells (sperm count) and their motility, or how active the cells are. The more active the sperm, the more likely it is to fertilize an egg. 
 
Because the list of diseases and tests that sperm banks perform is long, complex and continually changing as they improve their services, we at SpermCenter.com do not attempt to list every test performed by every sperm bank.

 

Sperm Donor Photos

Members often ask, "Can I see photos of the sperm donors?" The answer is usually no.

Most (but not all) sperm donors wish to remain anonymous. When they decide to donate their sperm, they sign a contract with the sperm bank.

Usually, one of the terms in the contract is that the bank agrees to keep the donor's identity private. Some donors do agree to release their identity when any offspring becomes an adult, usually in 18 years. (See our tutorial on ID Release Donors). This doesn't mean you can see the donor's photo now.

Sometimes a donor will give the bank an adult photo on condition that it is used only for photo matching (see our glossary of fertility terms).

Most sperm banks offer some kind of photo-matching service. With photo-matching, you give the bank a photo of your husband/partner or someone else, and the bank selects a donor with similar features or appearance—but you don't get to see a picture of the donor yourself.

That said, some donors do allow their photo to be released, and many provide baby photos. Even when photos are available, sperm banks do not post them on the web for the general public to see; you will usually have to pay a small fee to see a baby or adult photo, often as part of a more detailed donor profile package.

At SpermCenter, we just list whether or not a sperm donor has a photo but we don't specify what kind. You need to contact the sperm bank directly for that information.

Pregnancy Reported - Does it Matter

There are several factors you may wish to consider in evaluating whether it's important that a donor has had a reported pregnancy.

Many (perhaps even most) women/couples fail to report their pregnancy, so a No doesn't mean this donor has no pregnancies, only none reported. Sperm banks have no way to know if a donor conceives unless the mother/couple tells them.

Relatively new sperm donors may not have had time to have any reported pregnancies.
Pregnancy Reported doesn't tell you how many pregnancies were reported, only that there's at least one.

Sperm banks are highly incentivized to sell only fertile sperm. All sperm banks test sperm for viability by measuring such factors as sperm count and motility (See our page Screening Donor Sperm). On each sperm bank's description page, we provide a link to the bank's own description of their testing/screening procedures.

Taking all these factors into consideration, it's our opinion that Pregnancy Reported doesn't tell you much, if anything, about how likely you are to conceive by a particular donor. We think it's more important to select the donor based on other criteria like ethnicity or genetic disease screening.

That said, many women/couples who experience difficulty conceiving prefer to restrict their search only to donors for whom there is a known pregnancy, which is why many banks report this information.

Blood Type and Rh Factor - What Do They Mean

Blood Type, Rh and Sperm Donors

When choosing a donor, most people don't have to worry about their sperm donor's blood type, unless their goal is to have a baby with a blood type that matches their's or their spouses. If a woman is Rh positive, e.g. A+, O+, B+ or AB+, she doesn't have to worry about blood type at all. If a woman is Rh-, she should consult with her doctor before choosing a donor to discuss possible issues that might come up if she's considering an Rh+ sperm donor.

A, B, O, and AB are the main categories of blood with which most people are familiar. Each blood type is further categorized by the presence (positive) or absence (negative) of antigens in the blood, called the Rh factor (Rhesus factor, named after the kind of monkey first tested for the Rh factor). People who have the Rhesus factor are Rh-positive, so someone with the blood type O who has Rh antigens has O+ blood.

Rh+ people are the most common type. People with no Rhesus factor (people that don't have the antigen in their blood) are considered Rh-.

A blood type's Rh factor is usually considered important with regards to pregnancy, where an  Rh+ baby born to an Rh- mother runs the risk of developing Rh disease. Only Rh- women risk having a baby born with the Rhesus factor disease; Rh+ women do not.

If a Woman is Rh-

To conceive an Rh+ baby, an Rh- mother needs to have been with an Rh+ man. An Rh+ man has a 50 percent chance of passing on his Rh+ blood type to a baby he fathers.

The Rhesus factor is less likely to affect a woman's first baby because the woman's blood will have had less time to produce the antibodies to fight off the antigens in the baby's  blood. If the woman's immune system responds by producing antibodies, those antibodies will be present in her body for  life. Thus, different Rh factor types between a woman and her baby may increase the potential for Rh disease in each following pregnancy.

If the mother is Rh- and the baby is Rh+, and the baby's blood enters the woman's bloodstream during pregnancy, labor, or delivery, the woman's immune method may respond by producing antibodies to fight off the baby's antigens. This incompatibility won't affect the health of the mother but it can affect the baby's health. Potential health problems include jaundice, anemia, brain or heart dysfunction ands in serious cases, fatality.

Preventative measures are available to protect against Rhesus factor. Women should get tested early in their first pregnancy to determine if they are Rh- and whether they are sensitized. Sensitization (when a woman's bodies produces antibodies) may occur anytime a woman and her baby's blood mix. This includes blood tranfusions,normal pregnancy, ectopic pregnancies and miscarriages.

If a woman is Rh- and has not yet been sensitized, she may be injected with a blood product known as Rh immunoglobulin (Rhlg) six months into her pregnancy. This should prevent sensitization for the rest of the pregnancy. The Rhlg shot seeks to destroy any antigens present in the bloodstream before the mother can generate antibodies.

Newborns are reccomended to be tested for their Rhesus blood type. If the baby is Rh+, the mother may receive another Rhlg shot soon after birth to prevent her from sensitization. Rhlg injections only last for a given pregnancy so later pregnancies may need separate Rhlg injections.

Open or ID Release Donors

Open or ID release donors are sperm donors who have agreed to being contacted by their adult offspring.  This is usually when the adult offspring reach age 18.  

In the USA the term “Identity Release” was first used in 1983 by the Sperm Bank of California. Today a number of other sperm banks have similar programs but may use different terminology such as “Open Donors.”

These programs may differ somewhat from bank to bank. For example, at one bank it may mean the donor's identity can be released when your child is 18. At another, it may only mean the bank will attempt to contact the donor.

You will also see different terms used to describe this concept. “Open donor,” “willing to be known” and “non-anonymous” for example. At SpermCenter, we use the term Open/ID release since we feel it best fits the concept.

Keep in mind that the essential function of any Open/ID release program, no matter what it’s called, is to give donor offspring a way to contact their sperm donor.

Here are several important facts you should know if you’re considering an Open/ID release donor:

• Participation in Open/ID release programs is entirely voluntary by the donors.
• Sperm donors may change their mind about contact in the future and withdraw their consent even though they had previously signed an agreement giving consent to be contacted. Anonymous donors may later agree to contact with offspring.
• If knowing your sperm donor's identity is important to you, always check with your sperm bank first to ensure you understand their policies.
• If you see a “yes” in your donor’s profile on SpermCenter to the question “Open/ID release?” please understand that it means is the bank has some form of Open/Identity release program. This does not guarantee that your child will be able to meet the donor. It indicates the donor’s intent at that point in time. 
• While sperm banks are legally obligated to protect the identity of an anonymous donor, an adult child can still ask the bank to contact their donor because they would like to have more information about the donor. In these situations it may be best to contact the director directly regardless of their published policy.

Sperm Donor Infectious Disease Testing

The FDA now requires that all donors be screened and tested for sexually transmitted diseases. These are referred to as “Relevant Communicable Diseases” or RCD.

The required tests are for the agents that cause HIV, HTLV, HBV, HCV, Chlamydia, Gonorrhea, Syphilis and CMV. This testing with the required six month quarantine and retesting have nearly eliminated the risk of acquiring an infection from donor sperm with one of these diseases. 

There are two components in risk reduction, one is the infectious disease testing, the other is a required medical and social history of the donor which assists in identifying risk related behavior. 

Both are considered essential in the management of the donor in order to reduce risk of infection. Testing alone is not adequate.

Sperm Donor Health and New Medical Information Updates

This is a very relevant and important issue for sperm banks and  families with donor conceived children. However, there are significant barriers to making this happen. Essentially, a sperm donor can not be compelled to comply.

Their personal health information is protected by privacy laws.

The issues of how a sperm bank can obtain a donor's information, how it will be incorporated into the donor’s records and, not least, how will it be made available to you is still a hot area of discussion in the fertility industry.

Accreditations, Licenses and Guidelines: What do They Mean?

FDA
FDA registration is required for all sperm banks and they are required to comply with FDA regulations. This became effective May 25, 2005. Sperm specimens, collected before that date, are not subject to the current FDA requirements. SpermCenter.com verifies the FDA registration of every sperm bank listed.

The FDA performs inspections to determine regulatory compliance. If serious deficiencies are found the facilities will be issued a warning letter ordering correction within a defined time period, or if more serious may order the sperm bank to cease operations immediately. The FDA does not issue licenses to sperm banks.

Accreditation
The only organization that inspects and accredits sperm banks is the American Association of Tissue Banks (AATB).  Sperm banks are not required to have AATB accreditation.

It is strictly voluntary and the sperm bank has to pay substantial fees to maintain their accreditation. The AATB has developed a comprehensive set of standards that are more extensive than the FDA and nearly all state departments of health.

Accreditation by the AATB is granted only after an onsite inspection has determined that the bank is in compliance with its standards. This is a measure of quality.

New York Department of Health
The New York Department of Health has developed a comprehensive set of regulations and requires that all sperm banks that provide donor sperm to NY residents are inspected and have a current license by the Department of Health.

Their requirements are in many ways comparable the AATB standards.  In the absence of AATB accreditation this is perhaps the best alternate measure of quality.

State Licenses Other Than New York
There are a number of other states that have licensing requirements. Some may require inspections while others only require payment of a licensing fee. In general it is difficult to determine what most of these licenses mean. In our opinion, unless there are published regulations and accompanied by an onsite inspection to determine compliance they have little value in assessing quality.

CLIA
This refers to the Clinical Laboratory Improvement Act passed by Congress. CLIA regulations do not apply to sperm or other tissue banks. These regulations are aimed at diagnostic clinical laboratories. 

Some states may require sperm banks to be CLIA licensed, but where they are required, the inspections are limited to clinical laboratory procedures and have very little value as a means to determine the quality of sperm banking procedures and practices. 

ASRM
The American Society for Reproductive Medicine (ASRM) publishes guidelines for sperm and egg donor programs.

It is important to point out that the ASRM does not perform inspections and it has no means of enforcing compliance with its guidelines.  A statement that the sperm bank follows ASRM guidelines has very little value to the public because there is no way to verify compliance.

Does the Bank Ship Donor Specimens in Liquid Nitrogen Dry Shippers?

The best way to ship sperm is in liquid nitrogen vapor tank that is generally called a “dry shipper.” Dry ice is an option but it is not the preferred method because it does not completely arrest cell metabolism and will reduce the life expectancy of frozen sperm.

Sperm will stay viable in a nitrogen tank for at least seven days, even longer if the tank is fully charged.  Most experts discourage using shipping tanks for storage and recommend transfer to a monitored liquid nitrogen storage tank designed for storage.

How Many Years Has the Sperm Bank Been in Business?

This is important information because it allows you to evaluate their reputation among medical professionals rather than having to rely on their claims.

This track record allows you measure their practices against their claims. Your relationship with your donor’s bank will be important for decades to come. Getting pregnant is just the beginning. The bank controls access to the donor and is the custodian of the donor’s records.

The longer a sperm bank has been in business, the more experience and customers they're likely to have. On our Sperm Banks search, we show the number of years each sperm bank has been in business.  Choosing a sperm bank is a lot like finding a good doctor or lawyer.

Ask people you trust and try to find people that will be willing to share the basis for their opinions with you.

Reported Pregnancy and Birth Outcomes

It is very important you report all pregnancies and births to the bank for a number of reasons. Banks need to monitor the relative fertility of the donor, be informed of the number of reported pregnancies and live births and of any adverse outcome such as birth defects and suspected genetic disorders.

Sometimes the first indication that the donor may be a carrier of a previously unsuspected genetic disease is from a report of a birth defect.

Limiting the number of pregnancies and or births

At present there are no laws or regulations that limit the number of pregnancies allowed from one donor. However medical professionals agree that the number of donor conceived children should be limited. The debate centers around what that number should be and how does the bank actually establish controls.

There are numerous sound reasons why limits need to be established.

We at SpermCenter recommend you ask the sperm bank what those limits are and how they actually control the number. This is important because many women either don’t report their pregnancy or may do so several years later. 

In general the only way to control the number of donor offspring is to limit the number of donor specimens (vials or straws) distributed for insemination.

Most banks have established limits based upon the number of families with children by the donor rather than the actual number born. The limits reported range from 10 to 40 family units per donor. These limits are self imposed and are derived from published guidelines.

Sperm Donor Genetic Testing

Current generally recommended genetic testing

Genetic testing helps reduce risk for certain specific genetic disorders.

None of this eliminates risk. 

For all donors:

Cystic Fibrosis mutations, Chromosome analysis (Karyotyping), Spinal Muscular Atrophy (SMA) mutations and hemoglobin evaluation for abnormal hemoglobins and thalassemia.

Donors of Ashkenazi Jewish origin:

Current recommendations include, Tay-Sachs disease, Canavan disease, Familial dysautonomia, Bloom syndrome,  Fanconi anemia type C, Gaucher disease, mucolipidosis type IV and Nieman-Pick type A.

Egg donors:

Recommended to have testing for Fragile X as well as the same diseases listed for sperm donors.

It is important to understan that the donor sperm recipient provides fully ½ of all the DNA of a child. Ideally the recipient should have genetic evaluation similar to that of the sperm donor.

There are also some diseases that are inherited solely from the mother. These are mitochondrial disorders. We humans inherit our mitochondria exclusively from our mothers.

If you know you are a carrier for a known genetic disease we strongly urge you to discuss this with the sperm bank before you choose a donor.

Sperm Donor Health and Medical Information

This is a very relevant and important issue for sperm banks and  families with donor conceived children. While nearly ever one agrees that this is important there are significant barriers to making this happen. Donors can not be compelled to comply.

Their personal health information is protected by privacy laws. The issues of how a sperm bank can obtain the information, how it will be incorporated into the donor’s records and, not least, how will it be made available to you are all issues under hot debate in the fertility industry.

What Does a Three Generation Genetic History Mean?

The AATB requires that every donor have a three generation medical and genetic history in order to properly evaluate risk of genetic diseases in donor conceived offspring.

This consists of the donor, any children he may have had, his parents with their brothers and sisters including their children and the donor’s maternal and paternal grandparents with their brothers and sisters. All of this information is provided by the donor.

Except in rare circumstances no documentation is provided. It is dependent upon the donor’s knowledge of his family’s history and what he has been told by his relatives.

To one degree or another it will always be incomplete, and on occasion, be inaccurate. The sperm bank is dependent upon the donor to provide this information which in turn it evaluates.

This is best performed by a trained and qualified genetics counselor, either face to face or by telephone or by similar methods.

Why Do Banks Do a General Health Evaluation?

To determine how healthy or at-risk a potential sperm donor may be. This consists of a through medical and family history and a complete physical examination by a qualified physician. Many sperm banks also perform a complete blood count, urinalysis and a general chemistry profile.

Questions to Ask Before Choosing a Sperm Bank

Questions to Ask Your Sperm Bank:

What accreditations, registrations and licenses do they have?

Sperm banks MUST be registered by the FDA. Its a requirement. If a bank isn't registered by the FDA, stay clear. Always call to double check a banks qualification if they don't list their registration or accreditations on their website.

Sperm banks may be accredited by the American Association of Tissue Banks (AATB), but this is voluntary.

They are required to be licensed by a state department of health under CLIA if they have a clinical laboratory.

In addition, the American Society for Reproductive Medicine (ASRM) publishes guidelines that most sperm banks follow. 

We list each bank's accreditations on their bank profiles in the fertility professionals search.
  
What type of screening does the bank perform?

One of the most important things the sperm bank does is screen sperm donors and the sperm itself in order to reduce the risk from potentially harmful diseases.

In addition, sperm banks measure the sperm's motility.

Do all donors receive a physical exam that includes blood testing?

Does the bank review the donor's family medical history going back one or two generations?

Does the bank personally interview each donor?

Do they perform genetic screening or chromosomal analysis? 

Does the bank track medical history? 

Tracking the donor's medical history is extremely important. Suppose your donor comes down with a genetic disease after you've already had children using his sperm?

Your child could have the same disease. In certain cases, you might be able to use the information to take preventive action to protect your child.

It's extremely important to ask the bank: Do you track the donor's medicacl history and will you notify me of any changes? 
  
Does the bank track pregnancies?

Tracking pregnancies is important for two reasons.

First, tracking pregnancies is the only way to know how many children have already been born from a particular donor. Unfortunately, tracking pregnancies is not always easy, because often women are so happy to be pregnant they don't report it to the sperm bank.  

Second, it’s the only way the sperm bank can provide you with any new medical information that becomes available about the donor you used.
 
Does the bank limit the number of donor pregnancies?

There is no law limiting the number of pregnancies allowed from one donor, but medical professionals agree that the number should be kept low in order to avoid consanguineous complications among offspring conceived by the same donor.

Different sperm banks follow different guidelines to limit the number of pregnancies from a single donor.  
 
How many years has the bank been in business?

The longer a sperm bank has been in business, the more experience and customers they're likely to have. On our Sperm Banks page, we show the number of years each sperm bank has been in business.  
 
Does the bank perform a freeze test?

Some donors' semen freezes better than others'. The sperm bank should perform a freeze test to determine how well the semen freezes.  
 
Does the bank ship using nitrogen?

Donor sperm must be frozen to a very cold temperature in order to preserve it for long periods of time. The best way to ship sperm is in a dry nitrogen vapor dewar (a tank kind of like a thermos that's charged with liquid nitrogen).

Sperm will stay viable in a nitrogen tank for at least seven days, even longer if the tank is fully charged. Some banks may offer dry ice as an option because it's cheaper, but most fertility specialists don't recommend this.  
 
What kind of cryoprotectant does the bank use?

Sperm banks use a cryoprotectant to improve freezability. Some cryoprotectants can cause an allergic reaction which may be serious.

For example, egg yolk can cause allergic complications whereas glycerin is safer. Your doctor can recommend a bank whose procedures he/she is comfortable with. 

 

 

What is Donor Insemination and How Does it Work?

Donor insemination refers to the use of a sperm donor by a woman that does not have a fertile male partner. Common examples include single women, same sex couples and traditional heterosexual couples that have chosen to use a sperm because of male partner infertility or certain genetic disorders.

The insemination is performed by placing the donor sperm in or at the cervix generally referred to as ICI or Intracervical Insemination.  The other method is Intrauterine Insemination (IUI) where the sperm is inserted directly into the uterus.

If neither of these methods is feasible, In vitro fertilization (IVF) is recommended.  In this procedure an egg is removed by aspiration from the ovary, placed into a Petri dish and fertilized by the addition of sperm.

How Donor Insemination Works – An Overview:

 In general these are the steps usually recommended:

1)    Find a good doctor. The most reliable way is to find a good fertility clinic which will have trained and certified reproductive endocrinologists (RE).

Go in for a preliminary consultation – many fertility clinics offer free ones, so take your time and choose the one that makes you feel most comfortable.

If you’re unsure where to find a clinic, ask for a recommendation from friends or colleagues or go online and do a search for fertility clinics in your area. SpermCenter’s Fertility Clinic search or Find A Fertility Clinic are great resources.

2)    Once you’ve set yourself up with a clinic and doctor you like, they will give you a full physical examination and relevant laboratory testing to determine your general health and identify any factors that may adversely affect your fertility potential. 

This generally includes the determination of your blood type and screening for infectious diseases such as HIV, hepatitis, syphilis and gonorrhea. Many physicians will review your genetic history for risks and may recommend consultation with a genetics counselor.

3)    After this initial evaluation you and your doctor will discuss options for insemination such as ICI, IUI and IVF to determine which method would be best for you.

4)   Next, you will need to choose your sperm donor. It is important to remember that when you select a donor you are  also choosing a sperm bank. Both are important.

Please see our section on how to choose a sperm donor for more information about donor selection. We highly recommend you start with our Donor Wizard, which takes you step-by-step through the process of choosing a donor.

5)    After you’ve ordered your donor sperm and it’s been delivered, your doctor will perform the insemination and schedule any follow up visits. 

IVF Isn't the End of the Road for Infertile Couples

New York Daily News health and lifestyle author Katie Charles wrote an interesting article that nicely lays out other options besides IVF for those needing a helping hand to conceive.

IVF is often considered the "last line of defense" against infertility, but before you go straight to it, you may want to think about other, possibly cheaper forms of artificial insemination like Intrauterine Insemination and Intracervical Insemination.

Please follow the link below to read more:
http://www.nydailynews.com/lifestyle/health/2009/11/11/2009-11-11_ivf_isnt_the_only_treatment_for_couples_struggling_to_conceive.html

Self and Home Insemination

Many women prefer to perform their insemination in the privacy of home (also called self-insemination), but not all sperm banks will ship sperm directly to your home.

Some sperm banks will, but most banks require a doctor's authorization, and some sperm banks will ship only to a clinic or doctor's office.

At SpermCenter.com, we list which banks do and don't ship directly to your home. Just go to the Sperm Banks page and click on the bank's name to see detailed information.

We provide this information for your convenience, but generally, whether the bank will ship to home or not shouldn't be of major concern as long as you're working with a doctor, because you can always have the sperm shipped to your doctor, who can then give the sperm to you to take home.

Please note: Only ICI (intra-cervical insemination) can be performed at home. IUI (intra-uterine insemination) requires insertion of a catheter (tube) through which the sperm is placed directly into the uterus.

This must be done under sterile conditions, usually a doctor's office.

Whether you decide to perform insemination yourself or visit a doctor's office or clinic is a personal choice that's yours to make.

Our advice is to consult with your doctor to help you decide whether home insemination is right for you, given your specific medical issues and health history.

While home insemination can be perfectly safe, and many women routinely do it, it's also possible to harm yourself depending on what type of sperm you purchase and how you perform the insemination.

That's why we recommend that you work closely with your doctor and get as much professional advice as you can, in order to make an informed choice that's right for you.

 

Women Who Relax May Have Better Luck With IVF

A recent article from Reuters Health examines findings by researchers who say women coping with the stresss of infertility treatment by "letting go" may be twice as likely to get pregnant as those that don't.

They (being Dr. Nathalie Rapoport-Hubschman of the Rabin Medical Center in Petah Tikva and her colleagues) suggest that techniques like meditation and similar exercises that relax you may help improve your chances.

The researchers saw a strong correlation between higher IVF success rates and what they call "emotion-focused coping," which includes the use of humor and relaxation to help yourself de-stress and let go. 

The researchers looked at 88 women undergoing IVF, 21 of whom got pregnant. The only factors that independently influenced IVF success, the researchers found, were a woman's age and whether she had high "letting go" coping levels at the beginning of the study.

So what does this mean for you? It means that rather than just dealing with the stress of trying to have a baby, think about taking a step back and thinking about what is contributing to the already monumental amount of stress you're under.

Think about doing things you enjoy that make you happy and ultimately, that help you relax. Whether this is through meditation, a movie night with the girls, a long hot bath or anything else, the more you teach yourself to let go, the easier it may be to conceive.

Medical History Review and Physical Examination

The medical history and physical examination will be the first step in evaluating infertility problems, as medications,childhood illness, injury,chronic disease, injury, reproductive organ surgery and recreational drug use can affect fertility.

Issues discussed during the medical history may include:

• The use of any prescription or non-prescription medicines
• The use of alcohol, marijuana or other substances
• Exposure to occupational or environmental chemicals
• Exposure to radiation
• Past infections in the reproductive or urinary tract (especially sexually transmitted diseases)
• Prior reproductive or abdominal surgical procedures (like appendix removal or hernia repair)
• Sexual practices, including birth control use
• Any pain felt during sex
• Age at first menstruation
• Menstrual cycle characteristics (length, associated pain)
• Pap test results
• Pregnancy history

Your reproductive endocrinologist will pay special attention to the outer sex organs, as well as characteristics such as breast development, to check for  abnormalities or  possible hormone problems.

Information from the medical history and physical examination will be used to determine what further tests may be needed, if any, and what possible solutions exist.

The solutions to each woman’s problems differ. For example, one woman who is having trouble conceiving might only need to learn to estimate when she is likely to be ovulating, as this increases chances of pregnancy. A second woman may be menstruating irregularly or not at all – in this situation, the solution may be more complex and require more testing.

Tests Your Reproductive Endocrinologist might recommend include:

• Blood testing
• Ovulation testing, like an endometrial biopsy, to verify ovulation and inspect the lining of the uterus
• Fallopian tube testing
• Hormone testing, to measure levels of female hormones at certain times during a menstrual cycle
• Ovarian reserve testing
• Ultrasound
• Measurements of thyroid function (a thyroid stimulating hormone (TSH) level of between 1 and 2 is considered best for conception)
• Laparoscopy, where a doctor inspects the pelvic organs
• Fertiloscopy, a relatively new surgical technique used for early diagnosis
• Pap smear, to check for signs of infection
• Pelvic exam, to look for abnormalities or infections
• Patient-specific X-rays

Support Resources for Women With Infertility Issues

If you are struggling with infertility, it is important that you find healthy and positive ways to cope with your emotions. Professional resources are also available to help you express both common and uniquely female feelings about infertility:

These include:

American Society for Reproductive Medicine (ASRM)
1209 Montgomery Highway
Birmingham, Alabama 35216-2809
Phone: (205) 978-5000
Fax: (205) 978-5005
www.asrm.org

The American Society for Reproductive Medicine is interested in all aspects of the reproductive lifecycle and is committed to providing patient information on a wide range of topics. ASRM provides information on infertility, menopause, contraception, reproductive surgery, endometriosis, and other reproductive disorders.

Various patient organizations also exist to help individuals facing reproductive health issues and provide resources and support groups:

RESOLVE: The National Infertility Association
7910 Woodmont Avenue
Suite 1350
Bethesda, MD 20814
Phone: (888) 623-0744 (National Helpline)
Phone: (301) 652-8585 (National Office)
Fax: (301) 652-9375
Email: info@resolve.org
www.resolve.org

The mission of RESOLVE: The National Infertility Association is to provide timely, compassionate support and information to people who are experiencing infertility and to increase awareness of infertility

American Fertility Association (AFA)
666 Fifth Avenue
Suite 278
New York, NY 10103
Phone: (888) 917-3777
www.theAFA.org

The American Fertility Association (AFA) is a national organization dedicated to supporting men, women and families facing infertility and decisions related to family building and reproductive health -- from prevention and treatment to social, psychological and financial concerns. Through educational symposia and forums, free publications, interactive media and advocacy for research funding and policy, The American Fertility Association serves as a lifetime resource for women, men and families needing reproductive information and support and to forward the causes of adoption and reproductive health.

In Vitro Fertilization

In Vitro Fertilization, or IVF, is an assisted reproduction method where an egg is fertilized in a laboratory using donated sperm or sperm from a woman’s partner. If an embryo develops, it is transferred to the uterus to grow naturally.

Women who choose IVF often suffer from infertility factors like damaged or non-existent fallopian tubes or endometriosis, or choose IVF because their partner may be the one affected (e.g. defective sperm quality).

IVF requires healthy ova, healthy sperm and a uterus that can maintain a pregnancy to be successful. Because it costs more than other methods of assisted reproduction, IVF is generally attempted only after less expensive options have failed.

IVF consists of these basic steps:

1. Ovarian Stimulation:
   Treatment cycles are typically started on the third day of menstruation. A regimen of fertility medications is given to stimulate the development of multiple follicles of the ovaries and produce mature eggs.
2. Egg Retrieval:
   Eggs are retrieved using a method where an ultrasound-guided needle pierces the vaginal wall to reach the ovaries. Through this needle follicles can be gently "vacuumed" out (aspirated). The follicular fluid is given to the IVF laboratory to identify ova. They usually remove 10 to 30 eggs. The process takes around 20 minutes and is usually administered under general anesthesia or conscious sedation.
3. Fertilization:
   The eggs are fertilized with sperm in the laboratory.
4. Selection:
   Embryos that have reached the 6 to 8 cell stage are chosen for embryo transfer, usually three days after retrieval.
5. Embryo Transfer:
   The embryos judged to be the "best" are transferred to the patient's uterus through a thin, plastic catheter, which goes through her vagina and cervix. Several embryos may be passed into the uterus to improve chances of implantation and pregnancy.

Follow-Up:

Patients usually start progesterone medication after egg retrieval. Sometimes they are also given estrogen medication after the embryo transfer. Pregnancy testing is typically done typically two weeks after egg retrieval. If the result is positive, an ultrasound two weeks after can determine the fetal heartbeat and number of fetuses.

Variations of the IVF procedure exist, depending on individual circumstances. These include:

• Natural Cycle IVF
  Also known as no or low stimulation IVF, this is essentially IVF with none or very low dose fertility drugs. For some couples, the choice is financial, as NC-IVF is a fraction of the cost of standard IVF, so it may be their only chance at treatment. For others, the choice may be medical - they may be at risk if they take fertility drugs (e.g. if they have a history of ovarian cancer, depression or bad reactions to a previous fertility drug course). Women who have suffered with ovarian hyper-stimulation syndrome may be offered this type of treatment in place of standard IVF. Other people may just dislike drugs and prefer a more natural approach to infertility.
• Frozen Embryo Transfer
  Frozen embryos are thawed and then implanted in the uterus. These can be a woman’s own eggs or those from a donor.
• Gamete Intrafallopian Transfer (GIFT)
  Eggs are removed from the woman and placed in one of the fallopian tubes, along with the man's sperm. This allows fertilization to take place inside the woman's body. Therefore, this variation technically isn’t in vitro fertilization, though it is considered assisted reproduction.
• Zygote Intrafallopian Transfer (ZIFT)
  Egg cells are removed from a woman's ovaries, and fertilized in vitro. The resulting zygote is placed into the fallopian tube by the use of laparoscopy.
• Intracytoplasmic Sperm Injection (ICSI)
  a single sperm is injected directly into an egg. This procedure is most commonly used to overcome male infertility problems, although it may also be used where eggs cannot easily be penetrated by sperm.
• Assisted Hatching
  Before an embryo can be implanted, it needs to "hatch" from the protective layer surrounding it (the zona pellucida). Sometimes this protective layer becomes too thick, making it difficult for the embryo to emerge. In this case, a procedure is performed that involves thinning or making a small hole in the protective layer to help the embryo hatch.

IVF Success Rate

Success with IVF varies because many factors come into play, the most significant being a woman’s age and whether or not she uses her own embryos. A woman’s own embryos are dependent on her age; donated embryos may be more viable if they come from someone younger.

 The older a woman gets, the more her chances of success decline.  However, if a woman has no uterine problems and has conceived successfully before, her chances of doing so through IVF increase. The success rate of IVF in general has improved steadily over the years.

 According to reports from the Centers for Disease Control and Prevention (CDC), assisted reproductive technologies are responsible for a little more than 1% of total U.S. births. The live birth of at least one infant occurred in almost 35% of cycles in the U.S. in 2006 in which women underwent IVF and embryo transfer with their own eggs.

IVF Risks

IVF is generally safe, but as with any surgical procedure, a few patients will experience side effects and complications. Complications associated with IVF treatment may include problems experienced as a consequence of ovarian stimulation, the risk of multiple pregnancy, side effects from medications, risks associated with egg collection and the possibility of ectopic pregnancy.

Intrauterine Insemination

Intrauterine insemination (IUI) is a commonly used method of donor insemination (DI). It is relatively cheaper and simpler than in-vitro fertilization (IVF). Doctors may suggest IUI as a first option for women under age 40, depending on the woman’s diagnosis.

Though IVF tends to be more effective per cycle, couples can try more often with IUI since it’s more affordable. IUI usually works within 3 or 4 treatment cycles (3-4 months) for women ovulating (producing eggs) on their own; if conception hasn’t occurred by this time, the chances of success with IUI decrease. In women with polycystic ovaries (PCOS), lack of ovulation or in women taking drugs to ovulate, it may be reasonable to try IUI for longer.

Fresh or frozen and thawed sperm is placed in the uterine cavity (IUI) or the cervix (Intracervical Insemination). Of these two options, IUI is used most frequently. It is performed with donated sperm or sperm from a partner.

The IUI Process

1)  Menses Cycle Observation and Screening

Because insemination and ovulation have to occur simultaneously (eggs are fertilizable for only about 12-24 hours max after ovulation), a woman's menstrual cycle is closely observed, as are factors like her basal body temperature and changes in vaginal mucus.  

Ultrasounds, urine tests or blood tests may also be performed in addition to screening for hormonal imbalances, infections, or structural problems that may render the IUI less likely to succeed.

Medications like clomophine citrate (Clomid), gonadotropins (hMG) or Motroxodine (XDWD) or shots like human chorionic gonadrotropin (hCG) may be prescribed to stimulate the ovaries.

2) Sperm Collection

A sperm sample is provided by the male partner of the woman undergoing artificial insemination or a sperm donor. The man providing the sperm is usually advised not to ejaculate for two to three days before providing the sample to ensure an optimal sperm count.

When using intrauterine insemination (IUI), the sperm is “washed” in the lab to remove any mucus and non-motile sperm in the semen. This increases the chances of fertilization.

3) Insemination

 A speculum is placed in the vagina and the cervical area is gently cleaned. The sperm is placed either in the cervix (intracervical insemination, ICI) or higher in the uterus (intrauterine insemination, IUI) using a sterile, flexible catheter.

ICI is the simplest method of artificial insemination and 'unwashed' or raw semen may be used. It is a method used in many home and self inseminations. When performed at home without the presence of a professional this procedure is sometimes referred to as intravaginal insemination or IVI. However, IUI is generally considered more effective.

The process of IUI or ICI insemination (and the discomfort level) is generally considered similar to that of a pap smear.

IUI Success Rates

The success rate of IUI depends upon several factors. First of all the cause of the infertility problem is important. For example, men with normal sperm counts who are unable to have intercourse have a much higher chance of success than men who can have intercourse but have a poor sperm count.

IUI generally yields a higher success rate when combined with ovarian stimulation. Additionally, if the woman is over 35, the chance of a successful pregnancy significantly decreases. The chance of conceiving in one cycle is usually about 10-15% and the overall conception rate is about 50% over 4 treatment cycles (vs. nature, where the chance of conception is about 15 to 25 % per cycle).

IUI is not recommended for people with:

• Tubal blockage or severe tubal damage
• Ovarian failure
• Severe male factor infertility
• Advanced stages of endometriosis

Risks of IUI
There is very little risk associated with the actual IUI process if done with a natural ovulatory cycle. The risk factor comes into play predominantly with women taking infertility drugs, as they may cause a woman to ovulate more, which may lead to multiple pregnancies. However, with proper and regular monitoring, these risks should be minimized.

In Vitro Maturation

In Vitro Maturation (IVM)

IVM is new assisted reproduction and donor insemination method where an egg is matured and fertilized in the lab to attempt pregnancy as an alternative to standard IVF.

A woman might be a good candidate for IVM if she’s experienced previous bad reactions to fertility drugs, has developed ovarian hyper-stimulation syndrome (OHSS), polycystic ovarian syndrome (PCOS) or has had cancers that are hormonally responsive.

Women under 35 years of age with large numbers of ovarian follicles or women who have attempted stimulated IVF and produced a large number of eggs are good candidates for IVM.

In Vitro Maturation is cheaper than IVF because it doesn’t involve expensive fertility injections like gonadotropin. An IVM cycle costs approximately $5k to $7k as opposed to traditional IVF, which costs about $15k to $20k. An IVM cycle is generally shorter than an IVF cycle as well.

The IVM Process

1)      A woman has a vaginal ultrasound between days 3 and 5 of her menstrual cycle. If no evidence for natural ovulation and regular menstrual cycles exists, she might be a candidate for just IVM. If her ovulatory cycle is regular, she may be a candidate for natural cycle IVF combined with IVM.

2)      hCG is injected into the woman and the eggs are retrieved 36 hours later.

3)      The immature eggs are placed in a petri dish with a special hormone-infused culture medium to help the eggs mature.

4)      The matured eggs are exposed to, or injected with, sperm and cultured for several days to allow embryo development.

5)      The embryos are implanted back into the woman’s uterus.

 Risks of IVM

IVM requires less fertility medication which significantly decreases the risk of OHSS and other drug-related complications. However, the technology is still being developed and the overall success rates and long-term outcomes of IVM are unclear.

Treatment May Heal Uterine Fibroids, Not Harm Fertility

Uterine fibroids (benign, though painful, tumors in the uterus) are one of the most common reasons for hysterectomies, afflicting about 30% of women in the U.S. However, there is a treatment that kills the tumors but not the option of having children.

It is called uterine fibroid uterine fibroid embolization, or UFE. A doctor will go in and thread tiny spheres that block the branches of the artery that go to the fibroids, This cuts off the blood supply to the fibroids, making them shrink, then die, becoming scar tissue.

Please read more about this treatment here.

 

 

Where do Extra Embryos Go After IVF?

Excerpt from CNN Health:

“By the time she was in her 40s, Andrea Cinnamond was afraid she'd never be a mother. Then came the day in 2005 her daughter was born through in vitro fertilization, followed two years later by twin sons…”

Link:
http://edition.cnn.hu/2009/HEALTH/09/01/extra.ivf.embryos/index.html

Medical History Review

When a couple thinks they may be infertile, the spouse usually tested initially is the man, as male examination and testing is less complicated than that for women.

A thorough review of the man's medical and surgical history is necessary because chronic disease, pelvic injury, childhood illness, abdominal or reproductive organ surgery, recreational drug use and medications can affect fertility.

Physical Examination for Men

A physical examination may detect testicular irregularities, evidence of hormonal disorders or evidence of testosterone deficiency.

While assessing reproductive-fertility history, your doctor will probably inquire about the following:

• Early  and late puberty
• Previous pregnancy
• Sexual intercourse
• STDs
• Lubricant use

 

Semen Analysis

Because semen quality can affect sperm function and movement, a semen analysis is performed to examine the entire ejaculate.

Generally, three semen samples are taken at different times to account for variables such as temperature and error.

The semen fluid test examines possible impediments to sperm performance. Sperm may swim more slowly through cervical mucus if they’re contained in abnormally thick semen, which can inhibit fertilization. Abnormal sperm shape can also indicate poor sperm health.

Other semen tests focus on sperm's ability to swim through cervical mucus and enter an egg.

6 sperm factors are analyzed in semen analysis:

1. Concentration (sperm/milliliter; cc)
2. Volume (total volume of ejaculate)
3. Total motile count (total number of moving sperm)
4. Morphology (sperm shape; normal structure associated with sperm health)
5. Motility (or mobility; % sperm movement)
6. Standard semen fluid test (thickness, color)

To identify diseases that affect fertility, such as kidney disease, diabetes, and repeated urinary tract infection (UTI), post-ejaculation urinalysis may also be performed.

Blood tests may also identify disorders that impair testosterone and sperm production.

Azoospermia is the absence of sperm in the semen. Men with normal reproductive tracts and hormone systems can have azoospermia due to a lack of sperm-producing tissue in the testes or an obstruction.

Assisted Reproduction

Assisted reproduction can help induce ejaculation, manage erectile dysfunction and aid insemination.

Drug Therapy to Improve Fertility

Drug therapy may be one of the options you discuss with your doctor when considering ways to increase your fertility. Medications exist that can help improve sperm production, treat hormonal dysfunction, cure infections that compromise sperm and fight sperm antibodies.

Here are some common infertility medications you may come across:

• Antiestrogen Agents to aid in testosterone production.
• Antibiotics to treat fertility-impairing infections of the urinary tract, testes and prostate

 

Questions to Ask Your Doctor About Male Infertility

Here is a list of some of the most important questions to ask your doctor when you go to a fertility clinic for infertility-related issues. Feel free to print this list out - we've added spaces for you to fill in your own answers to these questions:

1.    What are the common causes for male infertility? 

2.    What does male infertility diagnosis involve?

3.    What types of diagnostic tests will be used to determine the underlying cause?

4.    Is my infertility the result of a congenital condition or an acquired condition?

5.    Might my fertility change over time with or without treatment?

6.    Is the cause for my infertility treatable?

7.    With treatment, what are the chances that my partner and I will be able to conceive?

8.    Why do you recommend this treatment?

9.    What are the benefits, disadvantages, and possible risks of this fertility treatment?

10.    What is the pregnancy success rate following this treatment?

11.    If this treatment is not successful, what other types of treatment are available?

12.    What is the usual cost for infertility treatment?

13.    Are these costs usually covered by insurance?

14.    Can you recommend a local or online support group or a counselor who specializes in male infertility?

15.    Can you recommend additional sources for information about male infertility?

Asking these questions will help you feel more in control, become an informed patient and aid you in the rest of your journey to conceive.

Surgery to Assist Reproduction

Various types of surgery may be conducted to combat male infertility, including:

• Vasoepididymostomy: a microsurgical procedure that corrects obstruction in the coiled tube that connects the testes with the epididymis. Obstructions commonly result from STDs and also include cysts and tubal closure (atresia), which is usually genetic.
• Vericocelectomy: the removal of a varicocele from the testes, often results in increased sperm count.
• Testis Biopsy

 

Support Resources for Men With Infertility Problems

If you are struggling with infertility, it is important that you find healthy and positive ways to cope with your emotions.

Some suggestions include:

• Askingyour reproductive endocrinologist for the name of a support group for men struggling with infertility;
• Talking to a mental health counselor;
• Investigating all that you can about male infertility. If you feel uncomfortable going to a bookstore or library, do your research online.

There are a number of established resources in place to help patients with male factor fertility problems. The first goal should be to find an urologist with special training in male reproductive medicine and surgery. A number of organizations can assist you in identifying such physicians near your community.

These include:

American Society for Reproductive Medicine
(ASRM)
1209 Montgomery Highway
Birmingham, Alabama 35216-2809
Phone: (205) 978-5000
Fax: (205) 978-5005
www.asrm.org

The American Society for Reproductive Medicine is interested in all aspects of the reproductive lifecycle and is committed to providing patient information on a wide range of topics. ASRM provides information on infertility, menopause, contraception, reproductive surgery, endometriosis, and other reproductive disorders.

American Urological Association (AUA)
1000 Corporate Boulevard
Linthicum, MD 21090
Phone: (866) RING AUA (1-866-746-4282) or
(410) 689-3700
Fax: 410-689-3800
www.auanet.org

The American Urological Association (AUA) offers an online patient information resource, which was written and reviewed by urology experts in partnership with the American Foundation for Urologic Disease. You can access this online patient information source at www.urologyhealth.org.

Various patient organizations also exist to help individuals facing reproductive health issues and provide resources and support groups:

RESOLVE: The National Infertility Association
7910 Woodmont Avenue
Suite 1350
Bethesda, MD 20814
Phone: (888) 623-0744 (National Helpline)
Phone: (301) 652-8585 (National Office)
Fax: (301) 652-9375
Email: info@resolve.org
www.resolve.org

The mission of RESOLVE: The National Infertility Association is to provide timely, compassionate support and information to people who are experiencing infertility and to increase awareness of infertility

American Fertility Association (AFA)
666 Fifth Avenue
Suite 278
New York, NY 10103
Phone: (888) 917-3777
www.theAFA.org

The American Fertility Association (AFA) is a national organization dedicated to supporting women, men and families facing infertility and decisions related to family building and reproductive health -- from prevention and treatment to social, psychological and financial concerns.

Through educational symposia and forums, free publications, interactive media and advocacy for research funding and policy, The American Fertility Association serves as a lifetime resource for men, women and families needing reproductive information and support and to forward the causes of adoption and reproductive health.

How Much Does Sperm Donation Pay?

The question "how much does sperm donation pay" is a common one we get here at SpermCenter.

The easiest answer is that it depends on the bank. Some banks, like California Cryobank, pay $100 per donation, while others like Fairfax Cryobank may pay more or less depending on whether there is a bonus involved, whether they pay up front, etc.

Bonuses may be offered for things like baby or adult photos, and you may get more if you decide to become an open donor (which usually means you allow your offspring to contact you and get access to medical information when they turn 18).

Your best option is to contact the bank or fertility clinic in your area, as they can give you specific quotes.

How To Become a Sperm Donor

We get lots of email from men wanting to know how they can become a sperm donor. We are not a sperm bank, so you can't donate with us. But here are some things you should know if you want to become a sperm donor:  
 
Requirements

The requirements for becoming a sperm donor are very high. Most sperm banks reject 90-95% of all applicants. You must be in excellent health and between 18 and 35 years old.

You must be free from sexually transmitted diseases and not a heavy drinker or smoker. If you are adopted, you may be required to have medical records of your biological parents.  
 
Committment

You must be willing to make visits to a clinic or sperm bank 1-3 times a week for at least six months.  
 
What to expect

You can expect to have a full medical exam including blood and semen analysis, and you may be asked to visit again for a follow-up exam in three or six months.

You will be paid for each specimen, usually somewhere between $50-100 per specimen.  
 
Where to go

You can use our fertility professional search find a sperm bank or fertility clinic near you. Tell them you're interested in becoming a sperm donor. They may be able to recommend a sperm bank in your area.  
 
If you have questions about fertility

If you have fertility-related questions, try contacting Resolve, which has an anonymous toll-free help line. The number is on their website.