Therapeutic Donor Sperm (TDI) Process
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The following steps will help guide you through your TDI treatment at Seattle Reproductive Medicine. Please review the information as you prepare to begin your cycle. If you have any questions or concerns, please contact your TDI Coordinator.
Step 1 - Provider Initial Consult
The first step is to meet with a provider to review your medical and genetic history and any records from previous fertility evaluations. Your provider may perform a trial IUI, as well as develop a treatment plan. In general, the process takes approximately 2 months. The first month is testing and evaluation and the following month is the actual insemination treatment.
Step 2 - TDI Coordination or Follow-up Appointment
This is a consultation with our TDI Coordinator. The details of the TDI program will be discussed. *Please note that the one-time coordination fee of $200 for anonymous donors will be collected at this appointment.
Step 3 - Consent Signing and Risks
Patients and partners who use donor sperm samples for their infertility treatment at SRM must sign consents related to the storage and use of donor sperm. The consents must be signed prior to any treatment and are valid for one year.
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 4 - Psychosocial Education Appointment
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 SRM's policy per American Society of Reproductive Medicine's (ASRM) guidelines.
Step 5 - Screening Requirements
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) have 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. Please refer to list of the required laboratory tests.
Step 6 - Determining your Treatment Plan
In most cases, women will time their inseminations by using ovulation predictor kits (OPK's) 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. Risks of the procedure include mild cramping and rare potential for infection.
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.
Follow-Up
You should schedule a follow-up appointment with your provider after 3 months of inseminations to review your cycles and discuss any needed changes. 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.
Success Rates
The success rate of TDI varies depending on patient age. In general, the TDI pregnancy rate is around 10% with each cycle. It is recommended that most patients undergo at least 3-6 TDI cycles to give the treatment an adequate opportunity to be successful, depending on your medical situation.
