Artificial insemination by donor (AID), IUI with donor sperm or heterologous insemination is defined as one of the simplest fertility treatments available nowadays. The process requires neither surgery nor complex instruments. Provided that the woman meets all the requirements regarding tubal patency and ovarian function, AID is expected to guarantee a minimum success rate. Another option would be buying donor sperm at a bank and using it at home.
A very common option chosen by single females and lesbian couples is that known as natural insemination (NI) by donor, which basically involves being inseminated through sexual intercourse. However, the chances for pregnancy do not increase, given that the sperm has not gone through a capacitation and washing process. Moreover, it involves a series of risks due to the absence of a sperm donor contract stating that he relinquishes all his rights to the resulting child.
The various sections of this article are assembled in the following table of contents.
What is artificial insemination by donor?
Artificial insemination (AI), commonly referred to as intrauterine insemination (IUI), is an infertility procedure that involves a low degree of complexity from a technical and procedural point of view: neither surgery nor special equipment is required.
Broadly speaking, the use of frozen sperm is the main difference between IUI with donor sperm and IUI with the husband’s sperm. This is because, in the case of AIH (artificial insemination by husband), fresh sperm can be used, as no quarantine period for each vial is required.
Indications and process
Artificial insemination by donor (AID) is the treatment of choice for a number of single females that decide to become single mothers by choice (SMC). Should you need any further information, please visit the following post: How to get pregnant without a man.
Also, lesbian and heterosexual couples can turn to this fertility option to become parents. To learn more about all the alternatives for lesbian couples to have a baby, we recommend you to read this: Baby options for lesbian couples.
In the case of heterosexual couples, sperm donation is used as a last resort in case the male partner suffers from a severe infertility problem, such as zero sperm production, presence of a genetic disease likely to be passed to offspring, or very poor sperm quality.
Regardless of the family type, in order for artificial insemination with donor sperm to be properly carried out, the woman should have normal menstrual cycles and present tubal patency.
The basic steps involved in a process of IUI with donor sperm are:
- Mild ovarian stimulation
- Ovulation induction, which takes place about 36 hours after taking the medications
- Donor sperm thawing process and preparation of the insemination cannula
- Insemination: the cannula is inserted vaginally in order for the sperms to be directly placed inside the uterus
In every sperm donation procedure, a sperm donor vial is provided once a week during a period of between three to six months. Blood tests are necessary at the very beginning of the process and again within 6 months with the purpose of making sure the sample is free from the HIV and other viral and infectious diseases.
Throughout this period of time, vials collected from the donor are screened and cryopreserved at the sperm bank for later use. The survival rate of sperm after going through the freezing-thawing process depends on the quality of the sample and the conditions at which it was defrosted.
Success rates and statistics
The chances for pregnancy with artificial insemination by donor depend on several factors, including the age of the patient, which is in fact determinant for the outcome of the treatment. In general, the chances can be classified into two age groups:
- Women younger than 40 years: 22%
- Women aged 40 years or over: 13% or less
Other factors such as the cause of infertility and how long she has been suffering from it have an influence on the outcomes of IUI. Also, endometrial thickness is crucial for the treatment to be successful. Not every woman might be a good responder, and subsequently the outcome might not be as satisfactory as expected.
For these reasons, adapting the protocol to follow to each patient, as well as the medications to be used for ovulation induction, is essential.
Pros and cons
Whether you are in a heterosexual or homosexual relationship, a number of pros and cons should be weighed before deciding to use donor sperm or not. It should be taken into account that it involves a series of both advantages and disadvantages from a medical, psychological and social point of view.
AID presents a series of advantages for every family type. The most obvious ones are summarized as follows:
- Single females: It allows them to share 50% of their genetic material with that of the baby and experience pregnancy.
- Lesbian couples: As in the case of single women, one partner can get pregnant and give birth to their child, which means she is the child’s biological mother.
- Male infertility: When male infertility is an obstacle to having a baby, IUI with donor sperm is considered to be the fastest and most effective method. Also, it allows the woman to continue being the biological mother.
Although sperm banks and clinics do their best to screen donors thoroughly, they might not be aware of a disease or condition present in the donor’s family history, or the donor could lie about it or hide information. This major con could cause offspring to inherit a disease or medical condition.
Another donor-related consideration is linked to the long-term pros and cons of the donation, especially when the donor is known. While some parents would accept a donor who plays an uncle-like role in the child’s life, others fear this relationship could end up damaging their relation.
In this sense, intended parents are encouraged to have no secrets with the person born as a result of sperm donation. Telling the child about his origin is not only beneficial, but necessary from a social and familial perspective, as he will wonder about his ‘bio-dad’ and biological roots anyway at some point.
Sperm donor agreement
A sperm donor agreement is a contract signed by both the intended parents and the sperm donor, without using a sperm bank as intermediary. In spite of the excitement of planning parenthood, and regardless of the family type, all patients are expected to have one in order for the role of each party to be clear.
The following are the different types of sperm donor profiles that can be found, depending on each country’s regulations on third-party reproduction:
- Anonymous donor: Identifying information about him is confidential, and only the sperm bank or fertility clinic has access to it. The intended parents cannot meet him, not vice versa.
- Non-anonymous or known donor: The man contributing his sperm cells remains known to the prospective parents (name, address, phone number…), who can be in touch with him or allow him to have a co-parenting role if they wish to.
If known sperm donation is the option of choice, it is strongly advisable to sign a sperm donor agreement to make it clear the donor—even if he is a member of the family—cannot seek parental or legal rights over the child born as a result of his donation, including visitation and child support.
Sperm donor agreements are expected to include the following aspects: financial responsibilities, legal parenting rights, visitation rights, relationship between the donor and the child, when will the child know about the donation, what will the child call him, etc.
Other types of donor insemination
Artificial insemination by donor is an infertility treatment which should be carried out by a duly qualified fertility specialist. There exist, however, two more types which are often considered to be another form of intrauterine insemination. We are talking about 1) at-home artificial insemination and 2) natural insemination (NI).
These DIY techniques offer lower success rates due to the following reasons:
- Ultrasound scan: Given that ovulation is not monitored by ultrasound, calculating the precise moment of ovulation is more difficult, which reduces the chances for the spermatozoid to reach and fertilize the egg.
- Sperm preparation: Semen vials are washed and capacitated at the fertility clinic to remove the seminal plasma and dead sperms that the sample may contain. If not done, we are unable to know about the quality and fertilization potential of the sample.
- Insemination cannula: Not using a cannula along with the fact that it is not done by an expert increases the likelihood for the sample to be inserted in the wrong place or incorrectly.
Natural insemination (NI)
By natural insemination by donor we mean basically having sexual intercourse with a man that agrees to act as a “sperm donor”. This option is quite common among single females and lesbian couples willing to create a family without visiting a fertility clinic.
This practice is unadvisable mainly because there is no sperm donor contract establishing that the “natural” donor agrees to waive all parental rights, as explained above. Also, in these cases, the donor has not been previously screened.
Woman and sperm donor could agree to undergo some blood tests in order to find out their blood types. Keep in mind that when a person who is Rh negative conceives with someone who is Rh positive, health problems in the fetus might appear. Tests for STDs are strongly advisable as well.
Using donor sperm at home
At-home artificial insemination or DIY insemination, commonly known as turkey-baster method, is an option for those women and couples who want to conceive a child without the need for sexual intercourse. It is, however, not advised by infertility physicians due to the reasons mentioned earlier.
At-home AI kits can be purchased at pharmacies and often include the following basic items:
- Ovulation detection kit
- Needleless syringe
- Medical gloves
Certain sperm banks offer the chance to buy sperm online, which will be shipped to the woman’s home so that she prepares the sample and self-inseminates in a few steps. On the other hand, there is also the possibility of choosing a “natural” donor who agrees to have his semen collected in a small jar with lid.
FAQs from users
What is the average cost of IUI with donor sperm?
In general, the cost of artificial insemination by donor ranges from €800 to €1,500, though it varies from clinic to clinic. It should be taken into account that this is the cost per cycle. Some clinics may offer special discounts to those who achieve pregnancy on the first or second try for future insemination cycles, though.
The cost of the medications prescribed to the patient for ovulation induction is not usually included in the overall cost. About €200-300 should be added to the above mentioned price on average.
Donor insemination vs. donor-sperm IVF, what are the main differences?
The IUI process is easier from a technical point of view, as no surgery or special medical equipment is necessary for the woman to be inseminated. It involves freezing the semen sample, thawing it for being use, and placing the sperms inside the woman’s uterus.
On the other hand, with IVF, the oocyte is inseminated using the donor’s vial, which have been thawed previously. Despite the use of donor sperm, the process does not differ from the conventional IVF process. The last step involved in embryo transfer (ET).
Can I give IUI with donor sperm a try after a failed IVF?
Yes, in fact, this is a common practice after having tried several times with the husband’s sperm. Nevertheless, it is only possible if the woman meets all the requirements in terms of age, egg supply, and tubal patency.
How many vials of donor sperm are required for IUI?
It depends on the quality of the semen sample and the type of vial used. If the standard process is followed and it is a high-quality sample, a single vial might be enough for an IUI cycle. Keep in mind that donor samples are of excellent quality.
In accordance with parameters such as quality and quantity, each sperm bank or clinic has a different criteria regarding how many vials should be thawed for each technique.
How many IUI cycles with donor sperm before success?
The success rate of IUI with the husband’s sperm is 12-16%, while it increases to 18-22% if donor sperm is used. The chances of getting pregnant are cumulative, that is, they increase after several cycles, with a maximum of fourth cycles before moving on to IVF. In the fourth cycle, women are expected to have a 31-35% chance of achieving pregnancy.
For more information, we recommend you to visit the following guide: What is artificial insemination (AI)?
How early will I feel pregnancy symptoms after donor insemination?
Each woman experiences a varied set of symptoms, or even no symptoms at all. Also, the moment when they start to appear might be different as well. As a general rule, it is uncommon to feel pregnancy symptoms such as implantation bleeding or sickness earlier than 15 days post insemination.
On the other hand, side effects and discomfort from hormone medications to induce ovulation are likely to appear during this period (i.e. two-week wait). They can be noticed as early as on the same day of the procedure.