In the U.S., there are several donor sperm banks. There are also multiple fresh egg donor agencies and frozen egg donor banks. Men who donate sperm undergo infectious disease screening, and the sperm are cryopreserved (frozen) and quarantined until re-testing of the male in more than six months demonstrates persistent negative infectious disease. Pre-cycle testing of the recipient would include a hysterosalpingogram, ovarian age testing, assessment of ovulation, and infectious disease screening, as well as a psychological counseling session.
Intrauterine (or artificial) insemination is used to enhance fertilization by the laboratory “washing” of sperm as well as to enhance conception by placing the sperm in the upper fundus of the uterus via a minor office procedure with an exceedingly rare complication rate. The cumulative pregnancy rate observed across up to 12 insemination cycles was 74% for women younger than 31 years and decreased to 62% for women aged 31-35 years and to 54% for women older than 35 years. (Schwartz D, Mayaux MJ. Female fecundity as a function of age: results of artificial insemination in 2193 nulliparous women with azoospermic husbands. Federation CECOS. N Engl J Med 1982;306:404-6.)
As an egg donor recipient, pre-cycle testing would include a practice embryo transfer, psychological consult, infectious disease screen, sperm analysis and uterine cavity evaluation. The options for the recipient are anonymous vs. known egg donation as well as fresh vs frozen egg donation and reviewed the pros and cons of both. There is evidence for an increased risk of preeclampsia (serious elevated blood pressure in pregnancy) for the egg donor recipient. In our clinic, we do not see a significant difference in outcome if a patient proceeds with a fresh egg donor or frozen eggs.
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