The 10 Step Therapeutic Donor Sperm (TDI) Process
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Step 1. TDI Consultation Appointment
The first step is to contact Seattle Reproductive Medicine (SRM) and schedule a comprehensive consultation with one of our providers. Tamara Tobias and Lindsay Wood, our nurse practitioners, will be able to perform the initial visit. Any follow-up appointment can then be made to review your results with the SRM physician of your choice. Your medical and genetic history, as well as the records from any previous fertility evaluations will be reviewed.
The details of the TDI program will also be discussed. To make an appointment with Tamara Tobias, please call 206-301-5000 or apply online.
Step 2. Recipient Psychosocial Education
There are many complex issues surrounding the use of donor sperm for both couples and single women. Our fertility counselors understand the complex and delicate nature of sperm donation as a means to starting a family. The appointment with our fertility counselors will enable you to discuss the unique legal, psychological, and social implications of using donor sperm. Please call 206-301-5000 to schedule an appointment at SRM's main office. This is a requirement of the American Society of Reproductive Medicine (ASRM).
Step 3. Screening Requirements Learn More
All potential TDI patients and partners are thoroughly evaluated before receiving donor insemination. The female TDI recipient should generally be of normal fertility potential. The US Food and Drug Administration (FDA) has implemented new mandatory regulations for patients utilizing donor sperm. The purpose of this regulation is to increase safety by minimizing any risk of transmission and spread of communicable diseases, as well as providing high quality care to the recipients of donated tissue.
Step 4. Determining CMV StatusLearn More
Cytomegalovirus (CMV) is a member of the very large family of viruses known as herpes. It is important to determine the CMV status of the recipient mother before selecting the donor sperm sample. Please see the CMV handout.
Step 5. Sperm Bank Selection Learn More
It is the policy of SRM for all patients who are using donor sperm to utilize sperm banks that have been registered and contracted with SRM and for all known or directed sperm donors to have the evaluation, testing and quarantine of the specimens be completed at a registered and accredited sperm bank recommended by SRM. Only banks which conform to ASRM, AATB, FDA guidelines and regulations, are certified by CLIA, and registered with the FDA can be used. SRM reserves the right to not permit utilization of a given bank. These sperm banks provide semen samples that have been frozen and quarantined for 6 months and then the donor is retested prior to releasing the sample, thereby reducing the risk of infectious disease transmission.
Step 6. Ordering and Shipment of the Semen Specimen
Sperm Bank Account Set Up
- Complete the Semen Authorization for your selected bank (pre-authorized form signed by Tamara Tobias, ARNP)
- Set up an account with your selected bank
Ordering Your Specimen
- Purchase specimen from your selected sperm bank
- Complete SRM's Donated Sperm Acquisition form and fax to 206-301-5096 Attention, Lab Administrator.
Samples are ordered from the sperm bank by the patient. Many patients order 3-4 samples for more than one cycle at a time to save on shipping costs. Usually one sample is sufficient for one insemination. Occasionally, your provider may recommend using two samples per insemination. SRM's initial shipping cost of approximately $300 includes up to 3 months storage. Donor sperm specimens may be stored at SRM for an additional year for approximately $480.00. Patients requesting longer storage (i.e. wishing to use same sperm donor for another child) will be referred to ReproTech, Ltd, a long term storage cryobank at 1-888-489-8944.
Donor semen samples used for TDI must be processed, or "washed", in order to separate the seminal plasma from the sperm. Washed (or IUI) samples are processed by the sperm bank and contain no semen. Unwashed samples, also called Intracervical Insemination (ICI) samples, contain semen and must be washed by our SRM Laboratory on the day of your insemination in order for placement into the uterus. ART samples are now being offered by some sperm banks. These samples have lower total motile sperm and may only be used with IVF (in-vitro fertilization). Unwashed IUI, ICI, or ART vials may be used with IVF.
Shipping Your Specimen to SRM, Seattle
Please call our Lab Administrator at 206-301-5015 or email to inform them of when your samples will be arriving. This is imperative so that someone will be available to receive your samples upon arrival. You will need to leave your name and telephone number so the lab can verify with you that the samples have arrived.
Samples need to arrive at the SRM Laboratory between 8:00am and 4:00pm Monday through Friday, excluding holidays. There can be no weekend or holiday deliveries.
*SRM will not receive or store frozen sperm without a signed consent (Receipt of Cryopreserved Sperm, Testicular Tissue and/or Epididymal Aspirate From Another Institution).
Step 7. Consent Signing and Risks
Patients who use donor sperm samples for their infertility treatment at SRM must sign consents related to the storage and use of donor sperm. In addition, for married couples, state law requires a physician to file the husband's written consent and date of insemination with the State of Washington if a child is born to a married woman as a result of donor insemination. The State maintains this record in a sealed file that can only be opened by a court order. The child of a donor insemination conception obtains a legal birth certificate listing the recipient's husband as the legal father.
The chance of obstetrical complications, spontaneous abortion (miscarriage), and having a child with physical or mental defects is the same with TDI as with a pregnancy conceived after intercourse. Donors' family histories have been reviewed by medical geneticists to eliminate those with a higher than average risk of passing known major genetic defects to their offspring. This screening, however, in no way entirely eliminates all risk to the offspring of genetic defect(s).
Although extensive precautions have been taken to minimize the chance of infection, there remains some risk, although very slight, of contracting an infection from TDI. Included are such sexually transmitted infections as hepatitis, herpes, Chlamydia, gonorrhea, acquired immune deficiency syndrome (AIDS), and others. The use of frozen semen from an approved bank carries a theoretically minimal risk of transmitting infection since the frozen samples are held in quarantine while donors are re-tested for infection.
Step 8. Determining your Treatment Plan
In most cases, women will time their inseminations by using a home kit designed to predict ovulation. The kit detects the rapid rise of luteininzing hormone (LH) in the urine. This is known as the "LH surge". The LH surge occurs at the middle of the menstrual cycle and triggers ovulation. One insemination is performed each month a day after a LH surge is detected in the urine.
The insemination itself is a relatively simple procedure. It is done with the insertion of speculum much like a PAP smear and takes only a few minutes to perform. A very small insemination catheter is passed through the cervical opening into the uterus. The donor sperm sample is then delivered in a small volume directly into the uterine cavity. The woman rests in the clinic for 15-20 minutes after the insemination and then may resume normal activity. Risks of the procedure include mild cramping and rare potential for infection.
Step 9. Pregnancy Test
If your period is delayed after an insemination cycle, you may perform a home pregnancy test. If it is positive, please call SRM to schedule a blood pregnancy test the following day. We usually repeat a blood level in 2-3 days to see if it is rising normally.
If so, we will recommend scheduling an obstetrical ultrasound to confirm a fetal heartbeat when you are about 7 weeks pregnant. Once everything looks positive, we send you back to your obstetrician or give you a referral. Please note that your OB/GYN provider will be informed that your conception was by donor sperm ONLY if you reveal this information yourself. However, if you request copies of your SRM record for an outside physician, references to the use of donor sperm may be contained in the SRM record.
Step 10. Follow-Up
You should schedule a follow-up appointment with your TDI practitioner after 3 months of inseminations to review your cycles and discuss any needed changes. If your menstrual cycle is delayed after an insemination cycle, you may call SRM to schedule a pregnancy test, or have the test done by any lab that you choose. We ask that you notify us if pregnancy occurs or if you decide to discontinue treatment. It is vital that we learn the outcome of your insemination(s) so that we may assess the effectiveness of the TDI program. More importantly, we greatly appreciate the encouragement of knowing that TDI worked for you, or being able to support you if you do not become pregnant.
