10 Things You Should Know before picking a sperm donor

By: Aimee Eyvazzadeh, MD MPH

1. Not all donor sperm banks are the same.

Ask your fertility doctor for a recommended list of sperm banks that she or he considers reputable. You will not know who has consistently high quality specimens without this information. Ask your physician if she or he will review your prospective donor’s information before you purchase the vial(s). Having a medical doctor review your donor’s history may help you make the wisest donor choice.

2. Pregnancy rates with frozen sperm may not be as good as with fresh sperm.

The amount of motile sperm after being thawed can be lowered by as much as 50%.  Additionally, frozen sperm when thawed doesn’t live as long as fresh sperm, and pregnancy rates are lower using frozen sperm when compared to fresh sperm. And while the data supporting the use of more than one insemination in a given cycle is controversial, do ask your physician whether two inseminations or combining multiple vials of sperm is appropriate for you. 

3.   Medicated vs. Unmedicated: I generally recommend medicated cycles for patients over 30, but this is not a requirement.

If you’d rather try natural cycle inseminations, let your physician know.  The use of a fertility pill like Clomid or Femara will potentially increase your chances of getting pregnant sooner in any given cycle. Fertility medications do come with side effects. The biggest risk is the increased rate of twins (25-30% versus background rate of 1%)  Additional side effects can range from hot flashes and vaginal dryness, to mood swings, to others. While not everybody has side effects, you should talk to your physician about whether you would be a good candidate for fertility drugs.

4.   Make sure your fallopian tubes are open.

Intrauterine insemination (artificial insemination) depends on your fallopian tubes for sperm and egg to meet. If your fallopian tubes are blocked, then the only fertility treatment that is likely to be successful is In Vitro Fertilization (IVF).  Given the potential expense (financially, emotionally and otherwise) of fertility treatments, confirming open fallopian tubes is an important part of any fertility evaluation. Even if you don’t have any risk factors for blocked tubes (Chlamydia, Endometriosis, a history of appendicitis to name a few), it doesn’t mean your tubes aren’t blocked. It’s worth checking and certainly won’t hurt your chances of conceiving if you try right after your tube test. Your doctor may recommend a hysterosalpingogram or a saline infusion sonogram to check your tubes.

5.   Know your body.

If you are not doing a medicated cycle, then your insemination will occur near the time of your natural ovulation. Track your ovulation as you are getting close to your first insemination cycle. This way, you will know when you’re ovulating and how to plan your life around your treatment. If you are under 30 and your ovulation is not regular, you may want to add a fertility pill. If you are over 30 and are hesitant about using fertility pills, the fact that your ovulation is regular may give you reassurance that you can try a couple of natural cycles before adding medication (if necessary).

6.   See your doctor for a preconception counseling appointment.

Even if you are using donor sperm, you should still sit down with your doctor for a preconception counseling appointment. Review your medical and family history with your doctor.  Consider genetic testing for cystic fibrosis and other diseases that you could possibly be at risk for based on your ethnicity and family history. You can visit www.counsyl.com for more information about testing, but this test has to be done through your doctor. Don’t forget to start folic acid.

7.   Known vs. Anonymous donor.

If you’re planning to use a known donor, be sure to have a legal contract in place, and discuss your situation with a psychologist with expertise in this area. If you are using an anonymous donor, I still recommend talking to a psychologist, but a legal contract is obviously not necessary unless you are in a same sex relationship. I recommend a legal contract to protect both partners when starting a family.

8.   Required lab work.

Talk to your fertility physician about the required lab work. States have different rules and clinics also set their own different rules.  For example, some clinics will require both partners to have infectious disease testing even though donor sperm is being used. If you know the requirements up front, there won’t be any surprises.

9.   Do your research about which type of sample you should buy.

There are different types of vials that you can buy. Ask your doctor which type of sample would be the best for the type of treatment you are doing.

10. Know your insurance benefits.

Just because you are using donor sperm, doesn’t mean that your insurance won’t pay for your treatment. Being a same sex couple does not prevent you from using insurance to pay for your treatments. Get all the information first, then start treatment. Being well-informed about costs upfront will allow you to just focus on treatment as you’re hopefully going through a successful treatment cycle.