Use of donor sperm for fertility treatment
How are suitable donors selected?
Before you sign the accompanying declaration, we would like to explicitly draw your attention to the following information.
In our centre, most of the donors are students. All of the donors responded voluntarily to our request for candidate donors. The motivation for being willing to act as a donor is mainly an attitude of concern and a willingness to help others who are struggling with fertility problems. The donors know that their sperm can be used for the treatment of fertility problems in a male/female relationship, in a female/female relationship or for single women who wish to become mothers. The fact that the donors receive some compensation for their sample is not the primary motivation for donating, given that this compensation is kept low (compensation for the effort involved in donating and not as a â€˜priceâ€™ for a sperm sample). In addition, an entire selection procedure has been performed before someone is accepted as a donor and begins to receive any compensation at all. Therefore, being a sperm donor is certainly not a way to earn some quick money.
The donor sperm originates from our own selected donors or is obtained from an external sperm bank that adheres at a minimum to the same safety guarantees as those that we adhere to in our centre.
When a person is interested in being a donor, he will first receive an information brochure, and then he is asked to bring in a sperm sample. If this sample is of sufficient quality, the donor is called in for further evaluation.
The supply of donor sperm is stored at the University Hospital (UZ) in Ghent. The Sint-Lucas Hospital ensures that the donor sperm is present here at the time that the treatment must occur and provides for the necessary transport.
The donor is then clinically examined by a specialist (urologist). This examination includes the personal and family medical histories of the donor. Particular attention is paid to ruling out risk factors for sexually transmitted diseases. A blood test is performed in order to rule out a number of infectious diseases (Hepatitis B, Hepatitis C, CMV, HIV, Syphilis), and a urine test is done to detect the presence of Chlamydia. Genetic testing is also performed (chromosome analysis). In addition to these tests, an evaluation is performed by the psychologist or counsellor, who
You have come to us with a request for donor sperm for the purpose of achieving pregnancy via artificial insemination or in vitro fertilization. Prior to this you have had a conversation with both the treating gynaecologist and the psychologist for the purpose of discussing all of the aspects of the treatment. The team has declared its agreement for the use of donor sperm for your fertility treatment.
tries to gain insight into the motivation of the donor and can perform a psychological assessment for the purpose of detecting personality disorders. Only when the results of all of these tests are normal is the donor accepted, and he can begin to regularly bring in a number of sperm samples. After being tested, these samples are frozen and stored for a period of 6 months. After 6 months, a new blood sample is taken to repeat the tests listed above. If the results are still good, the sperm samples are released for use. The reason for this delay is that certainty regarding infection with the tested viruses can only be assured after 6 months.
How anonymous is the donor sperm? In our centre, we work as a rule with anonymous donors. An anonymous donor is defined, in conformity with the Belgian statute regarding donors, as a donor who does not and never will know the identity of the recipient. No one, neither a legal entity nor the government, can discover or demand the identity of the donor. For a period of 30 years, only the head of the sperm bank can retrieve, if necessary as an exception on medical/genetic grounds, the identity of the donor. This donor can then be contacted for a specific medical examination (without having to surrender his anonymity with regard to the recipient). The child will therefore not be able to learn later who the biological father is. In some families, this is the desired situation; in others this may be considered a disadvantage. Nevertheless, this is the agreement with the donors, and for many donors this is an absolute condition for their willingness to act as a donor. Signing the consent declaration implies that the prospective parents release the Fertility Centre of Sint-Lucas Hospital and the doctors who will be employed there in the future from all liability and/or claims that may be
a consequence of the impossibility of providing the personally identifying details of the donor. As an exception, known sperm donors can be used. This occurs in situations in which both the donor and the recipient know the other’s identity at the time of the donation. This method is sometimes employed for lesbian couples who obtain a sperm donor themselves. This does imply that the candidate donor goes through the same, complete screening procedure as an anonymous donor (procedure which takes 6 months to a year).
Based on what characteristics can a donor be chosen? A number of characteristics of the donor are recorded. This allows the recipient to match the characteristics of her partner, who is unable to produce his own sperm cells, or, in a lesbian relationship, the characteristics of one of the two partners. The following characteristics are recorded: Skin colour Hair colour Colour of the eyes Height Body type Blood group For more exceptional characteristics (for example, another race), donor sperm will usually be obtained from an external (international) sperm bank. Different rates apply to these cases. After you submit any preferences, the sperm bank selects a fitting donor from the available supply. Due to the shortage of donors, it is not always possible to find a perfectly matched donor. No guarantees can be given with regard to specific characteristics. Even with a perfect match, there is no guarantee of the expected characteristics of the child.
What is the chance of pregnancy? The chance of pregnancy per insemination cycle is approximately 15%. This is somewhat lower than the chance of spontaneous pregnancy in a couple without fertility problems (20%); this difference is mainly related to the fact that donor sperm has been frozen. Freezing is unavoidably accompanied with a certain loss of quality. This can be seen in a decrease in the mobility of the sperm cells after thawing and has the ultimate consequence that the chance of pregnancy is lower than can theoretically be expected. It is important to realize that several attempts may be necessary before pregnancy is achieved. When inseminations during natural cycles have not been successful within a reasonable amount of time, additional hormonal stimulation can be considered. If this, too, does not lead to pregnancy, IVF with donor sperm is still a possibly. Luckily this is usually not necessary, and pregnancy can be achieved in a simpler manner, even though it is sometimes necessary to exercise patience.
Is pregnancy after donor insemination different than other pregnancies? When you become pregnant after the use of donor sperm, there is no difference whatsoever between your pregnancy and a spontaneous pregnancy. This means that you have the same chances of an untroubled pregnancy but also the same chances of miscarriage or a child with congenital abnormalities. The use of donor sperm has no influence on these factors, in either the positive direction or the negative direction.
How many pregnancies can one donor engender? The number of pregnancies that can be engendered within one region by the same donor is not unlimited. This avoids the risk
that half-brothers and half-sisters would enter into relationships with one another in the future. In accordance with the relevant legislation, we have adopted a limit of a maximum of 6 Belgian women for whom one donor may fulfil their wish for children (possibly different pregnancies per family). If the other partner in a lesbian relationship wishes to become pregnant, this is only possible with the same donor if the limit of 6 women becoming pregnant has not yet been reached with this donor.
Is it possible to obtain donor sperm from the same donor for subsequent pregnancies? This is possible. A donor is free to decide at any time to stop making donations. This means that a guarantee can never be given that a donor will remain ‘active’ in the future. Therefore, at the moment that pregnancy occurs, the recipient will be asked whether a certain amount of donor sperm should be ‘reserved’. The number of straws can be freely determined but is, of course, limited by the number of samples that the donor has provided. We mention here once again that the inseminating doctor must also take into account the legally stipulated maximum of 6 women per donor, regardless of this reservation request.
Are there problems related to official paternity after sperm donations? When using donor sperm in the context of a fertility problem in a male/female relationship, the man must also sign for consent at the start of the treatment. In doing so, the man explicitly declares that he is also responsible for the child who is hoped to be the end result of this treatment. For the registration of the birth, no information regarding the fertility treatment must be provided. It is sufficient that the child
is registered and that the paternity is recognized just as it is in a spontaneous pregnancy. In a female/female relationship or in the case of a single mother, the child will be registered under the name of the women who gave birth to the child. In these cases, the birth registration will state â€˜father unknownâ€™.
Dr. Tom Coetsier
Team members: Gynaecologists:
Dr. Tom Coetsier
Dr. Isabelle Meire
Dr. Nele Van Renterghem
Dr. Luc Merckx
Dr. Katrien Klockaerts
Team of psychologists: Psypunt
Fertility Centre AZ Sint-Lucas