Patients seeking treatment with Donor Sperm

Using Donor Sperm for treatment at Cambridge IVF

Donor sperm is currently in very short supply across the UK with demand significantly outweighing supply. To ensure we provide high quality donors, we only source donors from reputable sperm banks in the UK and overseas and we will guide you through the process of selecting a donor who is right for you.

Donor sperm is available to the following patient groups:

• A heterosexual couple in which the male partner does not produce any sperm or the sperm he does produce are all abnormal or carry a risk of a serious inheritable genetic condition;
• A female same sex couple;
• A single woman.

There are many medical, ethical, religious, legal and moral aspects which need to be considered. Some of these will be covered in consultation with the staff at Cambridge IVF before you embark on treatment however, it is important that we highlight to you the need for all people considering treatment with donor gametes to see a fertility specialist counsellor for implications counselling. At Cambridge IVF implications counselling is now mandatory before treatment can commence. This is to give you the opportunity to talk through all aspects of donor conception, to protect you and any future donor conceived children and to ensure you are making an informed decision. Information on our counselling services is available from our website (opens in a new tab).

What is the HFEA and why does it have to be involved?

The Human Fertilisation and Embryology Authority (HFEA) is the body that regulates fertility treatment in the UK. They license all clinics providing IVF and donor insemination and keep a register of all licensed fertility treatments and children born as a result. This includes information about whether the treatment uses donated sperm, eggs or embryos.

What do I need to know before I choose my donor??

CMV:

It is important that we know whether or not you carry a virus called Cytomegalovirus (CMV) when we are considering selection of a sperm donor. CMV is one of the most common viral infections. It is estimated that around half of all adults in the UK have been infected by CMV. Most people develop the infection during early childhood or as a teenager and do not realise they have been infected as it causes few symptoms. Once you have been infected by CMV, the virus stays in your body for the rest of your life, but does not usually cause you any further problems.

It is important however to understand that CMV can cause serious problems if a woman has her first CMV infection during pregnancy as the infection can spread to the unborn baby (known as congenital CMV). It is estimated that 1-2 babies in every 200 will be born with congenital CMV in the UK. Of these, only about 10% will have problems, but they can be serious and include things such as hearing loss and learning difficulties.

A simple blood test will tell you if you carry CMV. If the result of this test is POSITIVE this shows that you already have the CMV virus and there is no risk of viral exposure during pregnancy. This means you can select either a CMV positive or CMV negative sperm donor for your treatment. If the result is NEGATIVE, you do not have the CMV virus and there is a risk that you could become infected by the virus during pregnancy. You should therefore limit your sperm donor selection to only donors who are clearly indicated as CMV NEGATIVE for your treatment.

This may sound confusing but don’t worry, we are here to guide you through the process. We can even arrange for you to have the CMV blood test taken here at Cambridge IVF although we may have to charge you for this. Some GPs are happy to take a CMV blood test for you so, if you wish, you can enquire with your GP who may do this for you free of charge.

Donor compliance with UK legislation

Fertility treatment in the UK is highly regulated by the HFEA and therefore donors recruited in the UK must meet the requirements of UK law. This also means that any donor sperm imported into the UK must also be compliant with UK legislation.

Timescales

The process of choosing a donor can take a little while as most people like to investigate their options and then narrow them down. We recommend that you allow one week from ordering the donor sperm to it being delivered to Cambridge IVF. Please also bear in mind that morally and ethically we cannot permit you to start your treatment until your donor sperm has arrived, been checked and is securely stored at Cambridge IVF.

How do I choose my donor?

Since a change in the law removing donor anonymity and changes in the manner in which donors can be compensated for their donations, availability of donors has declined to the point where UK centres need to import sperm from Europe and the US in order to manage ever increasing waiting lists for treatment using donor sperm. Unfortunately Cambridge IVF are not exempt from this situation and it is for this reason that we have established links with some of the best donor banks in the world to ensure that you are given the best possible selection and quality of donors we can offer.

Under UK law, all approved donors, whether they are recruited in the UK or overseas must be rigorously screened for infectious and genetic diseases prior to acceptance. In all cases, donors must be screened for the following conditions as a minimum:

• HIV 1 &nd 2
• Hepatitis B
• Hepatitis C
• Syphilis
• HTLV 1 and 2
• Gonorrhoea
• Chlamydia
• Cystic Fibrosis
• Karyotype (Genetic screening)

Despite these stringent checks, we can never rule out the possibility that a donor may be the carrier of a genetically inheritable condition which may only come to light after you have received your treatment. In situations where this information is presented to us following your treatment we will contact you to inform you and explain the implications of the information we have received.

Unfortunately, it may well be the case that we are unable to source a donor who exactly matches your requirements. In this situation the decision rests with you, we may be able to help you source another overseas bank with a donor who better matches your requirements (this is particularly relevant in some ethnic groups in which certain men’s sperm is more difficult to source) but any costs associated with the import and storage of the samples must be paid by you.

We will do everything we can to advise you on the options and help you source a donor who you are comfortable with.

We will provide you with a list of our recommended donor sperm suppliers. You can then visit the websites or make contact with the named individuals at each of the sperm banks to get up to date information about which individual donors are available to you.

We recommend that you look at donors who have sperm of a suitable quality for the type of treatment you are planning to have. We will guide you on this, so please do contact a member of the embryology team to discuss options available to you. If you decide to look at overseas donors please ensure you filter your search to include only UK compliant donors.

Beyond these aspects the choice of your donor is based upon desirable characteristics such as height, hair colour and eye colour.

Once you have selected a shortlist of potential donors we will work with you to ensure that your chosen donor is well matched for you and represents good value for money. We will also advise you on the number of units of donor sperm you should purchase based on the treatment you are going to be having and the number of treatment cycles you are planning to budget for.

Once you have selected a donor we will assist you in placing your order with the supplying sperm bank (we ask you to place the order direct with the sperm bank to keep costs to an absolute minimum).We will manage the delivery of your samples to our cryostore here onsite at Cambridge IVF and notify you of their arrival. The samples will be transferred to our main cryostorage facility where they will remain in a controlled and continually monitored environment until you wish to use them. We won’t ask you to pay for the storage of the samples for the first year, however if you have samples in storage beyond one year we will ask you to pay an annual storage fee. This fee covers the storage of all the donor sperm samples we are storing for you and does not therefore vary according to the number of units of sperm you store.

We hope it’s clear how seriously we take the selection and screening of donors. The HFEA have defined very clear criteria for the selection, screening and storage of donor sperm and our service is fully licensed in accordance with these standards.

It is important to realise that although we take every possible precaution to ensure that the donors we use are free of genetic disease or infection we cannot guarantee this as we are limited by the detection level of the tests currently available in medicine today.

What is the waiting time to start treatment?

Staff at Cambridge IVF will be able to give you our current waiting times when you contact them, but generally there is no waiting list. Before you can begin your treatment you will need to undergo a consultation with a doctor (if you haven’t had one already) and some tests. In some cases, where extra tests or counselling is needed, more time may elapse before treatment can start.

How often can I have treatment?

You can have treatment when you feel ready and when a suitable donor is available. We will do our best to accommodate appointments for your cycles around your personal life.

What are the success rates and how much does it cost?

As Cambridge IVF is a relatively new facility, we are still building data to give an accurate indication of success rates. To date our success rates are consistent with the national average reported to the HFEA. To discuss our success rates, please contact us and speak to a member of the team.

The costs for treatment, if you are not eligible for NHS funded treatment, are given on a separate sheet. Please ask for one if you have not already received it or see full financial information on our website (opens in a new tab).

What happens if we are successful?

It is important to let us know if your treatment is successful so we can arrange a scan at 7 weeks pregnancy to ensure all is well. If your scan is normal we will discharge you to your local antenatal clinic.

When should I tell my child about their origins and what should I say?

Before undergoing donor insemination treatment you will no doubt have thought carefully about the various aspects of having a child using donated sperm.

You might consider such matters as whether, how, and when you will tell any potential child about his or her origin by donor insemination.

There are no hard and fast rules about the best time to tell your child, but many experts say that it is better to start early, even before your child can talk or understand the facts of life. This allows you to become familiar with talking to your child about how they were conceived so that, by the time they are old enough to ask questions, it is already an accepted part of their life story.

We collect identifying information including the name and address of the donor at the time of donation and this is submitted to the HFEA as part of the donor registration process. Any child born as a result of the use of donated sperm has access to this full set of information including identifying information from the age of 18 (or to a non-identifying set information pertaining to genetic siblings from the age of 16 should they wish to marry) if they request this in writing from the HFEA. This information will include;

• Physical description (height, weight and colour of eyes, hair and skin)
• Year and country of birth
• Ethnicity
• If the donor had any genetic children at the time of donation
• Their marital status
• If they were themselves conceived using donor sperm (if known)
• Skills
• Reason for donating
• Goodwill message for offspring
• Pen portrait of themselves
• Any other information the donor wished to pass on (e.g. occupation)

And for children over the age of 18 will also include;

• Full name
• Date, town and district of birth
• Last known postal address at the time of donation
• Identifying information about genetically related siblings (with mutual consent)

Equally the donor themselves is allowed to request information on the number, sex and year of birth of any resultant children but no identifying information is given to the donor regarding the children born using his sperm.

Donors are encouraged to provide detailed information including a short description of themselves and a message of goodwill to any children conceived. This will be made available to you and you may find this helpful once your child starts to ask detailed questions. It is a good idea to talk to the clinic about how you could approach telling your child. The Donor Conception Network (opens in a new tab) also offer advice and information leaflets and personal stories from other people who have been through the same process you are considering.

Will the child be legally mine? What do I put on the birth certificate?

If you and your partner were treated together at a licensed fertility clinic in the UK and have accurately completed the appropriate treatment consent forms then you are the legal parents of the child and should put your names on the birth certificate. The donor has no legal relationship or financial responsibilities towards the child. The change in the law on anonymity does not affect this.

Information regarding legal parenthood following donor insemination can be complex and this information should be read in conjunction with our legal parenthood information for patients. It is important to ensure that your wishes are correctly represented in your consents to ensure that there is no confusion over the legal status of the parents after the birth of the child.

Can I use sperm for future siblings so my children have the same genetic origins?

You can if the sperm is available. Provided the donor agrees to his sperm being used, we are willing to store sperm from donors, even those who have reached the 10 live birth limit, to allow siblings to have the same genetic origins. Sperm can be frozen and stored for up to 10 years, although in practice samples tend to be used up fairly quickly. This is something we will discuss with you when you embark on treatment. It is a good idea to check on the terms of consent, including how long the donor has agreed to their sperm or any embryos created from them being stored.

Confidentiality

Just like all notes pertaining to assisted conception treatment, donor insemination notes are kept securely and separately from general hospital records in such a way that your confidentiality is preserved. We do not inform anyone about your treatment without your explicit consent.

Clinics are required to collect and pass on information about donors, recipients and treatment cycles to the HFEA for its confidential Register.

Is there anyone else who knows how I feel?

We know from experience how stressful your treatment can be and how this can affect relationships. We offer a counselling service to provide you with any additional support you feel you may need. Please telephone us to arrange an appointment. There are also several support groups that may help.

Support groups and Resources;

• Fertility Network UK (opens in a new tab). The largest network in the UK offering information and advice. It has groups throughout the country and also produces a range of publications on infertility. Tel: 08701 188088 or visit
• Donor Conception Network (opens in a new tab). A national support group for people who have conceived through donation and those considering it. They can give you advice and support and also the chance to meet parents with donor-conceived children. Call 020 8245 4369
• National Gamete Donation Trust (opens in a new tab). A national government-funded charity set up to raise awareness of and seek ways to alleviate the national shortage of sperm, egg and embryo donors. It provides useful publications for donors and recipients including information on donation and the law. Helpline call 0845 226 9193.
• Fertility Friends (opens in a new tab). An online information and support website for those undergoing fertility treatment.

Comment on Witnessing

We are all very aware there have been IVF mix-ups in other clinics in the UK and across the world. Cambridge IVF has taken every step possible to minimise the risk of mix up occurring here. In addition to stringent checking and procedural controls being in place, we have invested in an electronic system called RI Witness which prevents the mixing of sperm and eggs from different patients or the transfer of the incorrect embryos in your cycle. We are not saying we are likely to have made a mistake without it, this could not be further from the truth but we do believe in making our processes as safe and risk free as possible and we believe that RI Witness ensures this.

We hope you have found this booklet informative and interesting. We realise we may not have covered all of your questions so if you do have any other queries we are here to help so please contact us via any of the means below.

• Telephone: 01223 349010
• Email the CUH embryology team
• Our Cambridge IVF website (opens in a new tab)