Center for Sacramento (Point West) Clinic Roseville Clinic Vacaville Clinic 1650 Response Road, Suite 1A 1600 Eureka Road, MOB 2, 3rd floor 1 Quality Drive Sacramento, CA 95815 Roseville, CA 95661 Vacaville, CA 95688 (916) 614-5005 (916) 614-5005 (707) 624-3215

INTRAUTERINE - DONOR Kaiser Permanente Center for Reproductive Health offers intrauterine insemination for Kaiser members that are patients when this procedure may enhance fertility.

Donor Insemination is an option for some patients/couples for a variety of circumstances, such as very low sperm counts or when no sperm is available. Donor Insemination does not refer to sperm provided by the husband or steady partner of the patient. Kaiser Permanente Fertility Clinics follow the guidelines for donor insemination specified by the following national organizations: • American Society for Reproductive Medicine • Center for Disease Control • American Association of Tissue Banks

In summary, these guidelines require that used for donor insemination from an anonymous donor be frozen and quarantined. Both prior to freezing and prior to release from the quarantine interval, the sperm donor must be tested for the following listed sexually transmitted infections: (HBSAG), Hepatitis C (HCV AB), Human Immunodeficiency Virus (HIV 1&2), Human T-cell Lymphotropic Virus (HTLV 1&2) and (T.Pallidum or RPR). Only after the test results are known to show no evidence of these diseases will a Kaiser Permanente provider perform the insemination (this STI information is usually on the Donor Summary of Records which accompanies the packing slip with the vial). Typically, the commercial sperm banks only list donor sperm that has passed the quarantine.

According to California State Law (HSC §1635) only anonymous donor sperm from cryobanks licensed with the State may be used for insemination, therefore the clinics cannot accept sperm from non-licensed cryobanks (or sperm banks). Most cryobanks (or sperm banks) located in California are licensed with the State and should be able to send you a copy of their license. A few sperm banks outside of California are licensed with this state. Each commercial cryobank (or sperm bank) has policies and procedures for screening and selecting healthy sperm donors. Specific questions about donor screening should be addressed to the individual cryobank (or sperm bank). Since Kaiser Permanente is not involved in screening commercial sperm donors, we cannot guarantee the quality of sperm shipped from a commercial cryobank (or sperm bank), or that the donor has no infectious or genetic disease.

There are many commercial cryobanks (or sperm banks) in the United States. Kaiser Permanente has no commercial or other interest in any particular cryobank (or sperm bank) organization. We recommend the American Society of Reproductive Medicine as a resource, which can be accessed at www.asrm.org (click on “Fact Sheets and Booklets” then “Intrauterine Insemination (IUI)”).

WHEN ORDERING DONOR SPERM FROM A CRYOBANK

• When ordering sperm, choose Intrauterine Insemination (IUI or washed) specimens only (i.e. not Intracervical, ICI or unwashed as these will be rejected by the clinic). • Choose (CMV) negative donors if you are CMV negative. If you are CMV positive, any donor is fine. • All frozen sperm specimens should be delivered to your home in liquid nitrogen (LN2) vapor containers. These tanks will keep the sperm frozen for seven days, so they can be ordered to be delivered your home a couple of days before the anticipated day of ovulation (in case ovulation occurs a few days earlier or later than expected). • Since we cannot store the donor semen vials at the clinics, please only order one vial at a time (which will be used the day of your insemination).

CONSENT FORMS California State Law (FC §7613) requires that a signed Consent for form be placed in your medical record prior to insemination.

SCHEDULING THE INSEMINATION It is important to call the clinic as soon as possible after you detect a positive ovulation test in order to schedule your insemination for the following morning. Ideally, you should call us before 11:30 am to schedule an appointment. In Sacramento, IUI appointments are offered every morning, seven days a week at the Kaiser Point West Center for Reproductive Health. The clinic will be closed on New Year’s Day, Thanksgiving Day and Christmas Day. If your OPK gives a positive result during the week (Monday- Friday) call our nursing staff at (916) 614-5005 (and select option #2) before 2:00 pm to schedule your insemination for the following morning. On the weekends call before 11:30 am to schedule your insemination for the following morning.

In Roseville, the clinic is only open Monday through Friday. The Roseville and Sacramento clinics share an IUI request telephone line so to make IUI appointments follow the directions above.

In Vacaville, the clinic is open Monday through Friday with the exclusion of Holidays and weekends. IUI's are scheduled between 6 am and Noon Monday through Thursday. On Fridays, IUI's are scheduled between 6 am and 9 am. For weekday IUI or ultrasound appointments, please call the Vacaville office at (707) 624-3215 to schedule. Please call the clinic before 11:30 am to schedule an appointment. For weekend IUI or baseline appointments to start an injection only treatment cycle, please follow the Sacramento clinic instructions above.

INSEMINATION DAY You are responsible to bring in your tank with your frozen donor specimen on the day that you will be having your insemination. Containers are typically referred to as “dry shipper” tanks, which contain liquid nitrogen vapor (LN2) and are usually guaranteed to keep the donor vial cold for seven days but please check with your particular cryobank when you order the donor vials.

Please arrive at least 30 minutes prior to your IUI appointment time to allow time for thawing and preparing the donor sperm for your insemination. Please do NOT open the box or tank that contains the donor vial (frozen specimens may thaw very quickly and the quality of your donor sperm may deteriorate). Also, do not remove any of the paperwork that accompanies the vial (if any forms are missing the clinic will not be able to perform the IUI procedure). You are responsible for returning the dry shipper tank to the cryobank (it will be returned to you the day of insemination once the vial has been removed).

**PLEASE BRING YOUR KAISER CARD TO YOUR APPOINTMENT**