Donor Sperm

Why might people access donor sperm?

Within our community 10% of all relationships experience a fertility problem, that is, a pregnancy does not occur within 12 months of engaging in unprotected intercourse. Infertility may result from a number of medical conditions, many of which may be treated or circumvented enabling the couple to conceive and have a family.

Of the couples who suffer from some degree of infertility, one third is unable to have children because the male partner has a fertility problem. Male infertility may result from a number of conditions and some examples are listed below:

• Azoospermia or complete absence of sperm may result from a congenital abnormality of the genital tract, from some childhood disease which destroys the ability of the testes to produce sperm, (such as mumps), or from obstruction to the outflow of sperm. In the absence of sperm, fertilization of the egg cannot occur. Some men with fertility problems do produce some sperm but in such low numbers that the chance of fertilization and pregnancy are very low. In others, the sperm themselves have abnormalities which render them incapable of fertilizing an egg.
• A second group of men suffer from infertility because their immune system reacts to their sperm, as though they were foreign tissue, producing antibodies which bind to the sperm, impairing motility and preventing fertilization.
• In a third group, the male partner's sperm may be unsuitable for use in achieving a pregnancy because of an identified risk of transmitting a congenital defect to the offspring.

Counselling

All people are required to see the counsellor on at least two occasions before starting on the programme, to help you with decision making and to consider the implications for you and any child that may be born.

The initial appointment provides an opportunity to talk about the emotional impact of fertility difficulty on your lives as well as the implications of having treatment with the use of donor sperm.

In the subsequent appointment consideration is given to the implications of forming your family through donor conception for you and for a child.

We support the rights of children to have knowledge of the facts of their creation. The counsellor can talk with you about how you may wish to go about the telling of your family's story – how your family came to be. There are several helpful resources to support parents in these endeavours. See recommended reading.

There are many stresses associated with the donor sperm programme. Perhaps the greatest risk is to your emotional health. Sometimes months can pass without any success. Some people may find that their involvement with treatment places stress on existing relationships with family and friends when considering who should be told about it.

A man who has received a diagnosis of infertility may experience feelings of loss and responsibility.

Counselling and support are available from the nursing staff, medical staff and our unit counsellor to help you cope with these emotions. Our unit counsellor, Julie Potts, can be contacted through the clinic on 8204 4343.

Counselling is available at any time, at no cost to you. It is not a sign of weakness or inability to cope in anyone seeking this help, but a pathway for increasing your own understanding.

You may want to gather information about support groups, current status of adoption or about how others have dealt with different issues or decisions. The counsellor can also discuss a variety of relaxation options, planning techniques and other services which are available to you in the community. The same applies for relationship or family stresses.

Remember: there is no connection between a person's worth and his or her ability to have children.

Issues for people considering treatment using donor sperm

The unit is not able to accept sperm donation or provide treatment for recipients of donated sperm unless they fulfil the requirements of the legislation and comply with frm eligibility criteria.

According to present law, a child born as the result of sperm donation is the child of the woman who gives birth, and her partner (Family Relationships Act Amendment Act, 1984; s. 10c & s.10d). The partner's name is recorded on the birth certificate as the child's father. In addition, the donor of the sperm has no legal rights or duties with regard to the child.

At Flinders Reproductive Medicine it is policy that all donor records are kept indefinitely, in keeping with the NHMRC Ethical Guidelines on the Use of Assisted Reproductive Technology in Clinical Practice and Research.

It is the responsibility of the Director of the Unit or delegated officer to select suitable donors and provide security for confidential information.

Donor Register

In keeping with current convention, there have been changes to the legislation in South Australia to enable a register of donors, donor conceived children and recipients to be established. This enables those who are conceived through donors to seek identifying information about their donors. For cases where the child is conceived after the 1 September, 2010 (irrespective of the date the genetic material was donated), the changes will be retrospective. For cases where the child was conceived before the 1 September 2010, the changes will not be retrospective, however it is likely that a voluntary register of donors, recipients and children will also be established. Until the register is established the clinic is to act in the capacity of the Donor Conception Register by recording and keeping information.

Selection, Screening and Matching of Donors

Sperm donors come from the general community. An interview of potential donors is conducted and their reasons for wishing to assist the donor sperm programme are recorded. All donors are carefully screened. A history is obtained from each donor with special emphasis on inherited disorders as well as a personal history of physical or psychological disabilities. If any abnormalities are found in the history, the prospective donor is not accepted. A physical examination is performed to exclude obvious physical abnormalities.

The donor's semen is examined to ensure that sufficient numbers of motile, normal sperm are present to achieve a pregnancy, and that the sample is free from bacterial infection. The sperm sample is frozen and thawed to ensure that adequate sperm survive this procedure.

The donor has a genetic screening test to exclude the presence of the cystic fibrosis gene and blood karyotyping to identify any chromosomal abnormalities.

Blood samples are also taken for blood grouping and screening for thalassaemia, syphilis, hepatitis B, hepatitis C and HIV (AIDS). In addition, prospective sperm donors are required to sign a lifestyle declaration to indicate a low risk for hepatitis and HIV (AIDS) infection.

Semen is quarantined for 6 months and used only when the donor is re-screened for hepatitis and HIV infection and found to be negative. These stringent measures were introduced to prevent the transmission of hepatitis B, C and HIV through donated sperm. Although these precautions are as safe as we can make them, we cannot give an absolute guarantee that the hepatitis and HIV viruses cannot be acquired from donor semen.

Donors are required to meet with the counsellor on at least two occasions to discuss issues relating to the legal aspects of sperm donation, confidentiality and the possible implications for relationships now and in the future. Donor's partners are asked to attend at least one of these sessions.

The Clinic keeps a record of the following information as a confidential record of each donor. Similar data is also recorded where possible about the donor's parents, grandparents and great grandparents.

Physical Characteristics

• Height
• Build/Weight
• Eye Colour
• Hair Colour
• Skin Colour
• Race

Social History

• Religion
• Nationality
• Country of Birth
• Education
• Occupation
• Marital Status
• Number of Children
• Interests (Hobbies/Sports etc)

Medical History of the donor, the donor's children and the donor's parents and grandparents are also recorded.

Prior to commencing treatment with donor sperm, both partners are required to attend an information giving appointment with a member of the nursing staff. You will have the opportunity to view the donor information and to select the donor you wish to use.

Follow-Up

In the event of the clinic being informed of a hereditary illness being diagnosed in a former sperm donor, the Unit Director is responsible for advising the parents, or the offspring if over the age of 16 years, of this hereditary characteristic.

This advice will have regard to:-

- The potential severity of the disorder;
- Its possible prevention or cure;
- The likelihood of inheritance
- The possible anxieties that might be aroused in the family and offspring.

Donors of sperm are asked to agree that, in the event of a hereditary disease being diagnosed in him later in life, this information would be made available to the clinic.

Social Implications / Pregnancies per Donor

It is FRM policy that the number of pregnancies per donor is currently restricted to 10 families so that the chances of related donor conceived children marrying are extremely low. The donor has the right to be informed about the number and sex of children born as a result of his sperm donation.

How long will we / I have to wait?

The waiting period depends on the couple's/person's preparation for treatment, the number of persons requesting this service and the availability of sperm. It is usual to wait for a number of months before treatment is available.

We think it is undesirable for any couple/person to proceed too quickly, as time is needed to consider all the implications of this form of treatment.

At the end of the waiting period it will not be necessary to proceed straight away. You can choose your own time and pace for treatment.