Transcription:
Donor Sperm FAQs

Bill Klaproth (Host): So, when it comes to donor sperm, what are the pros and cons of a known donor versus an anonymous donor? Well, let’s find that out along with other answers from Dr. Sara Reid, Co-Director, Third Party Program at Reproductive Science Center of San Francisco Bay. This is Fertile Edge, a podcast by Reproductive Science Center of San Francisco Bay. I’m Bill Klaproth. Dr. Reid, thank you for your time. So, let’s jump right in to this. Known sperm donor versus anonymous sperm donor. So, what are the pros and cons?

Sara Reid, MD, REI (Guest): Yes. So, big questions. So, for a lot of people out there who are planning to use donor sperm to conceive either through insemination or IUI or in vitro fertilization, also called IVF; they have choices of where the donor sperm is going to come from. The two main choices are a known donor, so this is somebody you know, a friend, an acquaintance, perhaps a family member of your partner; so, somebody that is know to you who is interested in providing sperm to help you conceive versus a donor sperm or anonymous sperm from a bank where there are people you do not know who have taken the time to donate sperm into a sperm bank system and then you are able to purchase that previously frozen donor sperm to use to try to conceive.

There are some pros and cons obviously, to the two different methods. Some people really like the idea of knowing who their sperm donor is potentially having a relationship with that person, their children being able to have a relationship with that person. So, that can be a big plus for some people. That can also be a negative. So, that includes all of the other things that go along with having an extra person in your child’s life which could be grandparents, or other relatives that want to be in your child’s life, whether that is or is not part of your plan. It’s something that you want to consider going in.

Host: Yeah, that makes a lot of sense.

Dr. Reid: Another potential thing to think about is the medical screening that needs to go into it. Is this known person who wants to donate sperm to you, are they really a good donor? So, the donors that are screened through donor sperm banks go through extensive medical testing, fertility testing, a family history, genetic history is taken to make sure that there aren’t any major issues that we need to be aware of. They also go through really rigorous infectious disease screening to make sure there’s no risk of passing on infectious diseases like hepatitis or HIV, when you actually go through the procedures.

A sperm bank is going to do all of this for you in advance. If it’s a known person, we still recommend you do all that testing but then you’re going to be asking that person to come into a clinic or a bank to do that testing. So, there’s going to be some cost and some inconvenience to that person going through that process.

Host: I could see where that’s a really tough and interesting decision to make. Do you have any tools or ways to help that person ultimately make that decision?

Dr. Reid: Of course. We always recommend starting with just a conversation with the person that’s helping you get pregnant. So, if you are seeing a midwife or a physician who is going to help you with insemination or with IVF; they can help go through the pros and the cons and really talk to you and if you have a partner about all the specific things that you are prioritizing, what your goals are, what your desires are and we can help you make the best decision for you.

Host: Well that’s really good information to know. So, let’s talk about the procedure itself. In office versus home insemination. What can you tell us about that?

Dr. Reid: Sure. So insemination is essentially putting the sperm either into the vagina or into the uterus at the appropriate time when it has a good chance to fertilize the egg. And it’s true, this is something that can be done at home. There are certainly opportunities, if you are using a known sperm donor to do what we call a fresh insemination. This is something that does carry a lot of additional risk in terms of infectious diseases. So, not generally something that’s recommended but does tend to be something that works out for some people.

But typically, what’s done is you would have a frozen sample that you would have delivered or would pick up directly and then there are instructions provided with it on how to do the thaw at home. There are even some practitioners particularly midwives or nurse practitioners who may come to your home and do the insemination and the thaw for you at home which can be a nice opportunity to kind of keep things feeling “less medical” which is very appealing to some people.

Versus doing this in an office. So, coming into either your gynecologist’s office or a fertility clinic’s office like ours where we receive the sperm, we evaluate it when it comes in. We do the thaw for you and include analysis, so we make sure the sperm looks really good before we do the insemination and then when we do an insemination in the office; we are actually placing the sperm closer to where the eggs are going to be. Because we can do an exam. We can use an instrument called an insemination catheter where we can place the sperm through the cervix, into the uterus really close to where the eggs are going to be which does boost chances.

Host: And success rate is an important consideration. So, for someone saying to themselves, do I really need a pro for this, can I just follow the thaw instructions at home? Someone can do this, right, but what are your thoughts on that?

Dr. Reid: You certainly can and there’s no harm in trying that except the sperm is expensive. So, if you are using frozen sperm from a bank; it tends to run about $1000 a vial, plus or minus depending on some details. But it’s pretty pricey stuff. And so, like I said, when we do the thaw in the office, we are actually taking a look at it, making sure it looks like it’s good quality. The vast majority of the time, it is, but if there were some issue in shipping or handling along the way where the sperm thawed partially or lost any viability; we’d be able to tell you that and would be able to help you get reimbursement from the sperm bank.

And then we are also going to take the pressure off you having to be the scientist at home and handle everything. That way, you can really just focus on taking care of yourself and staying healthy and think positive in trying to get pregnant. So, we like to think that we can take care of the nitty gritty details and let you relax a little bit and take some of that pressure off of you.

And if you really do want that home environment; I encourage you to seek out one of those providers that’s willing to come to the house so that they can add that extra layer of sort of support and expertise so that you know you’re getting your best opportunity out of your insemination.

Host: Right and what about success rates? That would probably be good to know too.

Dr. Reid: Sure. So, insemination, putting sperm in the uterus at the right time of the cycle for conception, in general, has a success rate of around 15%. And this often sounds low to people when they initially hear it. But when we put that in perspective for a heterosexual couple trying to conceive on their own at home; pregnancy rates are about 15% per cycle. So, insemination is pretty similar to that. Previously frozen donor sperm does degrade a little bit after having been frozen and then thawed. So, even though we’re maximizing the timing and we’re putting everything as close together as we can with the process; there’s still a little bit of a drop off. So, that’s why we don’t really get better than sort of unassisted trying to conceive at home. So, around 15% per cycle is about what you should expect.

Caveat to that being of course your unique medical situation can adjust all of those factors. So, speaking to your doctor about what your individual success rates would be is a good idea.

Host: Right, well that’s good to know and keep in mind.

Dr. Reid: And then another thing to think about is that’s a per cycle try. So, that’s each month that you are trying. So, if it doesn’t work the first time; no big alarm bells should go off. It’s very reasonable to simply try the same thing again. And what I usually tell people is think about this as a process that you are going to try for three to four months. If after three to four months it hasn’t worked; then that’s a good time to check back in with your provider and see if there’s anything that you’re missing, anything else that should be checked or if it’s time to consider other options. About half of people trying insemination will conceive within the first three to four months. And so, if you haven’t in that timeframe; that’s sort of the time to reevaluate. It may still be reasonable to continue down that path; or it may be time to change things up.

Host: Well Dr. Reid, thank you for your time. So, any final thoughts on this? Anything else we should know about donor sperm, IUI?

Dr. Reid: I think we have covered a lot. But of course, once it gets down into your individual situation; there can be more little details to help you make your best decision and come up with your best plan. So, first place to start is always either with your gynecologist or with a fertility clinic just to talk through what you’re hoping to do and make sure that your plans align with your goals and that we’re doing everything that we can to give you your best chance of moving forward.

Host: Dr. Reid, this has been really informative. Thank you so much for your time.

Dr. Reid: Thank you. I appreciate it.

Host: And to get connected with Dr. Reid or another physician please visit www.rscbayarea.com, that’s www.rscbayarea.com. And if you found this podcast helpful, please share it on your social channels and check out the entire podcast library for topics of interest to you. This is Fertile Edge by Reproductive Science Center of San Francisco Bay. I’m Bill Klaproth. Thanks for listening.