Since Russian law allows using donor sperm if required, many couples and women from foreign countries where this technique has several restrictions decide to travel to Russia for undergoing artificial insemination with donor sperm.
Indications for AID
Artificial insemination by donor (AID), also known as heterologous artificial insemination, does not require too much involvement from the specialist. For this reason, it is indicated when women present the following characteristics:
- Women under 35-37 years old.
- Proven tubal patency.
- Normal ovarian reserve.
- Absence of uterine malformations.
Using donor sperm may become necessary when a man is unable to utilize his own sperm because he is at risk for transmission of a genetic disorder, in case of zero sperm count (i.e. azoospermia) or repeated implantation failure (RIF) using the partner’s sperm in previous IVF cycles.
Choosing motherhood without a partner
AID is also a fertility option for women who choose to be single mothers by choice. In Russia, sperm donation is authorized for infertile couples or in cases of single motherhood.
Whatever the case is, indications remain the same; therefore, the particular characteristics of the patient must suit the above mentioned requirements. Usually, women who choose single motherhood present a very good prognosis, since in principle they have no fertility problem.
Lesbian couples are not authorized to use this technique, as established by the Russian law.
Sperm donor identity
Within Russia, sperm donors normally remain anonymous. Even though some identity information can be revealed—such as main physical features, educational level, or blood type—, donor identity will always be protected.
Donors are subjected to a thorough medical screening process to verify they are actually healthy. Besides, information about the receiving couple or woman using their semen sample is never disclosed.
Although less frequently, non-anonymous sperm donation is an option as well. However, in this case the donor must be a close relative or friend of the patient.
Moreover, it should be clear that non-anonymous sperm donors must go through an identical medical screening to that carried out for anonymous candidates. The quality of donor sperm must surpass the semen analysis reference ranges. All in all, these samples must present an outstanding fertilizing potential. This is the reason why being a healthy man with normal semen analysis results may not be enough as to become a sperm donor.
The specialist is in charge of doing a mild ovarian stimulation to the woman, so that she can produce 1-2 ovarian follicles; therefore, the medications she has to take are prescribed in low doses. In case she is an international patient, most Russian fertility clinics will allow her to start the cycle in her country of origin. This way, she will only have to visit the clinic a few days before the insemination due date.
Thanks to ultrasound monitoring, ovarian response to ovulation induction drugs and ovarian follicular development can be evaluated. Once the follicles reach the adequate size, women are given a shot of hCG in order to trigger ovulation. Then, the final step will be visiting the clinic for being inseminated per se within 36 hours after triggering ovulation.
That same day, the semen sample is washed through sperm capacitation. Firstly, it is thawed and then sperm capacitation is performed. Donor semen samples are frozen right after being collected, since it is required for the quarantine period, necessary to make sure there is no risk of STD transmission. Sperm capacitation consists in selecting the highest quality spermatozoa and colocating them in the intrauterine insemination catheter.
Intrauterine insemination is a simple, painless procedure, without no type of anesthesia required. Aided by a vaginal speculum, the gynecologist inserts the insemination catheter, prefilled with the capacitated semen sample, inside the female reproductive system. Is is inserted gently in the uterine fundus and then the cannula and the speculum are removed.
The woman will have to rest for about 15 minutes. Later, she can continue with her normal lifestyle unless otherwise indicated by the doctor. Within 14-17 days after that, she can take a quantitative hCG blood test to check for pregnancy.