The Science of Making Babies

Borrowing from the Bank — the Sperm Bank
Donor sperm has been used for artificial insemination for more than 100 years. About 50,000 children are born each year as a result of donor sperm insemination, also known as TDI (therapeutic donor insemination) or AID (artificial insemination — donor). Sperm banks are licensed by the state in which they’re located, and they have stringent requirements for donors. Sperm banks should be certified by the American Association of Tissue Banks.

Why fewer couples are using donor sperm
Use of donor sperm has decreased since 1992, when it became possible to inseminate an egg with a single carefully selected “ideal” sperm (as ideal as existed in the male’s sample, anyway) in a process known as intracytoplasmic sperm injection, or ICSI. (See Chapter 11 for more about ICSI.) Men whose sperm counts were very low, or those with poor sperm motility, or movement, could now become biological parents — as long as they could afford to do in vitro insemination.
Many couples, however, can’t afford, or don’t want to do IVF, so they use donor sperm. Also, those men who have no sperm at all, such as those with Sertoli cell only syndrome,still depend on donor sperm to become parents.

Picking “dad” from a catalog
Picking donor sperm can be similar to buying a house; it sounds like fun until you have to really do it! Then the “what if I choose wrong” fears start to set in and the process becomes more nerve wracking than fun. Choosing the right biological father for your future child is far more important than buying a house, but many of the same caveats apply. Don’t be too heavily swayed by externals, don’t let fear of the unknown keep you from making a decision at all, and don’t agonize over your decision once you’ve made it! These next sections can help you understand the donor sperm process and help you choose the best man for the job.

Reviewing donor requirements
In case you were thinking that sperm donation might be a way of making a little extra money, here’s a list of requirements for donors from some of the most popular donor sperm centers with the most stringent requirements:

_ Height: Most people request a donor between 5 feet 10 inches and 6 feet 2 inches.
_ Weight: The donor’s weight should be proportionate to his height.
_ Age: The donor should be between the ages of 19 and 39.
_ Education: The donor should be a graduate of a four-year college, or at least have completed two years of college.
_ Sperm specs: The donor must have 70 percent motile, or moving, sperm, 60 percent with normal appearance (morphology), and a sperm count of 70 million/milliliter. A donor must have better than average sperm because some will be lost in the freeze-and-thaw process.
Donor sperm can be frozen nearly indefinitely. They’re kept in liquid nitrogen containers and shipped out when requested. The cost for a vial of donor sperm runs about $150 to $300, or more if you have specific requests, such as a Nobel Peace Prize winner. Most clinics suggest that you order at least three
vials at a time.

Ordering sperm
You can choose between sperm that has not been washed, and is therefore only ready for intracervical insemination (ICI ready) or sperm that’s already been washed and is therefore ready for intrauterine insemination (IUI ready). The technique for IUI, which injects the sperm directly into the uterus, is more complicated, but most centers report a higher pregnancy rate with IUI than ICI. Pregnancy rates for women under 35 are about 10 to 20 percent per insemination; rates decrease for women over 40 to 5 to 10 percent per insemination.Some fertility centers prefer that the patients bring in ICI sperm, and then do the sperm washing themselves, because they feel that it gives them a better specimen; check with your center before ordering one or the other type.
Remaining anonymous
Estimates show that only one child in ten is ever informed that he or she is the result of donor insemination, but times may be changing. Some donor clinics now advertise that they have donors open to having some contact with any children born — some say after the child reaches age 18, and others are open to an ongoing relationship. Several recent court cases have questioned the sperm donor’s right to remain anonymous, and at least one country, Sweden, has made it illegal to keep the donor anonymous.

Asking someone you know to donate
Some parents-to-be choose a donor they know, perhaps a brother or close friend of the intended dad. In these cases, fresh sperm can be used. However, if the insemination is done by a doctor’s office, the doctor should insist on having all infectious disease testing up to date.
Fresh sperm have a higher pregnancy rate than frozen, and this fact may be a consideration if you have a relative or friend who’s willing to donate. Keep in mind that the donor will need to be tested for infectious diseases. Most clinics will still prefer that the sperm be frozen and quarantined, and in this case there will be a waiting period of six months before the sperm can be used. This gives the clinic time to retest for infectious diseases — many infectious diseases (like HIV) take up to six months to show up in the blood.