AART DOC CLIN003 Sperm Donation Information-HC_20201029
Sperm Donation Information For Sperm Donors and Intended Parents
Introduction
This information package is designed to answer some common questions surrounding sperm donation and gives an overview of the process. It is important for both donor and intended parents to have and understanding of what sperm donation entails. Please take the time to read the information and if there is anything you are uncertain about you should contact an AART team member by calling 902-404-8600 and leaving a message with your specific question, as well as your contact information.
What is sperm donation?
Sperm donation is the process in which one individual (donor) produces a sperm sample, with the purpose of donating the sperm to another individual (intended parent) or couple (intended parents). The sperm are then used to fertilize ova in the lab, using ova belonging to the intended parent(s). The resulting embryo(s) will be transferred into the intended parent’s uterus or into the uterus of a gestational carrier (GC). This process must be undertaken of the donor’s own free will, without undue pressure from the intended parent or other individuals (family, friends, etc.) and without the promise of gifts or financial compensation for the sperm donation.
Sperm donation can be directed, where a sperm donor known to the intended parent(s) provides sperm or anonymous, where sperm from an anonymous sperm donor is obtained from a sperm bank by the intended parent(s). If you are considering anonymous donor sperm please refer to our TDI Brochure for instructions on ordering donor sperm.
Why is sperm donation used?
Some of the reasons for using donor sperm: a) Medical treatments have damaged the testicles and the sperm have been destroyed. (e.g. Chemotherapy) b) Intended parent has no sperm or sperm is unsuitable for use in assisted reproductive therapies. c) Genetic disease which would result in abnormal baby if own sperm used. d) No male partner (e.g., same sex female couple, single female)
What is the first step in the sperm donation process?
The first step is to meet with one of our physicians. Your family doctor can send a referral to AART, or you can self-refer by calling to book and appointment. To book an appointment, please call 902-404-8600 and wait until you are prompted to press 3. Please leave a detailed message with your contact info and state that you would like to book an appointment.
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AART DOC CLIN003 Sperm Donation Information-HC_20201029
What screening and testing will the sperm donor undergo?
As a registered primary establishment with Health Canada, AART screens and tests all sperm donors for suitability, according to Health Canada’s Safety of Sperm and Ova Regulations. The Donor will be required to undergo screening for genetic and infectious diseases which are reviewed by the attending physician and/or the medical director. These documents, along with all medical records, are kept strictly confidential. A physical examination by a physician is required. Blood tests for infectious diseases will be ordered initially and then within 3 days prior to sperm freezing.
If a known donor is used, the above tests are performed at AART. If you are using an anonymous donor the testing will have already been completed by the sperm bank.
Why are same-sex male couples and single men considered donors?
All patients, regardless of their sexual orientation and relationship status, undergo infectious disease testing prior to undergoing treatment at AART. According to Health Canada’s Safety of Sperm and Ova Regulations, a same-sex male couple or a single male must undergo the same testing as a sperm donor because their sperm will be used to fertilize the ova of a third-party. Additionally, any resulting embryos will be transferred to a gestational carrier. This presents risk of infection so the intended parent(s) are required to undergo testing as a sperm donor would, even though they are not a donor. Similarly, same sex female couples and single females undergo testing when using a sperm donor as well.
What happens in natural conception?
In nature, a menstrual cycle usually happens each month. A menstrual cycle is considered to start on the first day of one period and ends on the first day of the following period. At the beginning of the cycle, a number of ova start to mature in the ovaries. These ova are contained in fluid filled sacs called follicles. The pituitary gland, situated below the brain, produces 2 hormones: FSH (follicular stimulating hormone) and LH (luteinizing hormone). The FSH causes follicles to grow and mature. The follicles produce a hormone called estrogen. As the follicles grow, more and more estrogen is released. When the estrogen level is high enough it signals the pituitary gland to release a large amount of LH. This sudden rise of LH is called LH surge. About 24 hours after LH surge the follicle releases the Ova. Usually only one follicle will completely mature and release an ova. Once the ova is released from the ovary, it enters the fallopian tube, where fertilization occurs. Fertilization is the joining of ova and sperm to form one cell. The cell will divide and grown and become and embryo. The embryo will reach the uterus 4-5 days after the ovum was released. The ovary at this point is producing the hormone progesterone which is preparing the uterine lining (endometrium) to receive the embryo. Once the embryo has implanted in the uterus it begins producing HCG (Human Chorionic Gonadotropin). It is the detection of this hormone which provides the basis for all pregnancy tests.
What is in vitro fertilization?
In vitro Fertilization (IVF) is a technique which involves removing ova from the ovaries and fertilizing the ova with sperm, in the laboratory. One to two of the fertilized ova (embryos) are then transferred into the uterus, with the goal of achieving a pregnancy, or the embryos may be cryopreserved (frozen) for later use.
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AART DOC CLIN003 Sperm Donation Information-HC_20201029
IVF was originally developed to help couples with blocked or inexistent tubes or disease to the point where pregnancy was unlikely to occur. Today, IVF is used by individuals and couples with a variety of fertility needs.
How are the sperm used?
If a known donor is used, before the sperm is used for treatment, the sperm donor produces a sperm sample by masturbation at the clinic in a private room. The sperm is then analyzed by our andrology lab in a process called a Sperm Functional Analysis (SFA). This analysis will allow our team to determine what treatments the sperm can be used for (if any). Once the SFA results are reviewed by a physician they will be discussed with the donor and the intended parent(s).
If the sperm donor meets testing requirements as outlined by Health Canada and the SFA results indicate the sperm is suitable for use in treatment, the sperm donor will produce another sample by masturbation at AART and the sperm will be frozen for later use in a treatment for the intended parent(s). In order to meet Health Canada testing requirements, the appointment for sperm freezing will be booked three days after infectious disease testing. This will allow enough time for a second semen sample to be frozen within seven days of the testing if a second sample is required.
If an anonymous donor is used, the sperm that is shipped to AART will be stored until it is time to use it.
All donor sperm is frozen in order for Health Canada testing to be completed before it is used in treatment. Given this, the ova will be fertilized using a procedure called intracytoplasmic sperm injection (ICSI). ICSI is sometimes used with fresh samples from an intended parent, in cases where the Sperm Function Analysis (SFA) indicates it. In the ICSI process, a tiny needle, called a micropipette, is used to inject a single sperm into the center of the ova. The ova are checked the next morning to see if fertilization has occurred. Once fertilization occurs, the fertilized ova (now called embryos) grow in the laboratory until ready to be cryopreserved (Day 5 or 6 post ova retrieval).
What are the problems associated with IVF?
• Not every cycle of IVF results in a pregnancy. • Not all patients respond to the medication as expected and a cycle may need to be cancelled. • With sperm donation, if anything deviates from the strict parameters set by Health Canada the cycle will be cancelled. • There is the risk of OHSS. • There is, on rare occasion, despite good-looking follicles on ultrasound, situations where no ova are obtained. • There is no guarantee that fertilization will occur, even with normal appearing ova and sperm. • There is no guarantee that the embryos will implant into the uterus. • Miscarriages do not occur more commonly in IVF than in natural conceptions. Following IVF pregnancy tests are done very early on (14 days post transfer) and a number of
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AART DOC CLIN003 Sperm Donation Information-HC_20201029
pregnancies are detected which will ultimately fail. It is just that they are being detected much earlier than in most spontaneous natural conceptions. • It is currently believed that birth defect do not occur more commonly in IVF babies. Since 1978 there have been thousands of babies born in the world as a result of IVF.
When and how will the embryo be transferred?
All sperm donation cycles at require the embryo to be frozen. The next steps depend upon the individual or couple who is/are the intended parent(s). Here are the possibilities: a) Transfer into the intended parent’s uterus b) Transfer into a gestational carrier’s uterus
Once the embryo(s) are frozen and all of Health Canada’s conditions are met, planning for the Frozen Embryo Transfer can begin. There exist a few different protocols to prepare the uterus for transfer. The physician will decide which protocol is appropriate.
What are the side effects and complications of sperm donation?
There are no known medical side effects or complications of sperm donation. However, there are psychological considerations which are outlined below.
Should I consider sperm donation?
The decision is not an easy one. There are emotional aspects to consider for both the intended parent(s) and the sperm donor. It is important for the donor not to feel pressured or obligated to donate. It is important for this person to make their own decision without any pressure from family, friends or others. Even though the individual has not been asked directly, they may feel there is an expectation to help. This could result in future problems and ill feelings. The sperm donor needs to consider how they will feel about someone else carrying a pregnancy and raising a child created from their sperm. The intended parent(s) need to consider how they are going to feel about raising a child created from sperm donation. If the donor is a relative or close friend, you will need to give some thought to how you or your partner (if one exists), expect them to relate to the child resulting from the sperm donation. It is recommended to have at least one session with a counsellor, who will go into some of these and other issues more in depth. It is recommended that the donor and intended parent(s) have separate sessions and then a session together. Everyone involved should take as much time as they need to decide if sperm donation is right for them. You may need several sessions with a councillor, appointments with your physician, appointments with your lawyer or discussions with a nurse before deciding whether or not you are comfortable with the donation process. Above all, it is essential that all persons involved make their own decision.
Do I need to consult a lawyer?
Yes. You will be required to have legal documents drawn up and signed prior to donation.
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AART DOC CLIN003 Sperm Donation Information-HC_20201029
Can sperm donors be paid in exchange for donation?
No. It is important to remember, that according to Canadian law, there can be no payment for the services of a sperm donor. However, the intended parents are expected to pay for drug costs and direct costs of the Sperm Donor Cycle. For more information on this subject, please visit the following link on the Health Canada website https://laws- lois.justice.gc.ca/eng/regulations/SOR-2019-193/index.html
Can the sperm donor change their mind?
The sperm donor has the right to withdraw their consent to donate the sperm until the ova have been fertilized with sperm. After that point in time, consent can no longer be withdrawn. This is as per the Canadian assisted reproduction act.
Conclusion
We hope that this information package has been informative. If there is anything you are uncertain about you should contact an AART team member by calling 902-404-8600 and leaving a message with your specific question, as well as your contact information. You can email us at [email protected]
References
Guidance Document Safety of Sperm and Ova Regulations Effective Date 2020-Feb-04
AART INSTRU Clin028 TDI Brochure
https://laws-lois.justice.gc.ca/eng/regulations/SOR-2019-193/index.html
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