What is Intrauterine Insemination or IUI with Donor Sperm?
Intrauterine insemination with donor sperm is a common treatment option for couples with severe sperm problems, for same-gender couples, and for single women wishing to build a family.
For safety reasons, the FDA does not allow the use of fresh donor sperm for insemination. After sperm donation, the sample would have to be frozen and quarantined for at least 6 months to allow sufficient time to test the sperm donors for communicable diseases since the immune system can take up to 6 months to recognize an infection.
At the time of sperm donation, sperm donors are tested for syphilis, gonorrhea, chlamydia, hepatitis B, hepatitis C, Cytomegalovirus (CMV), HIV-1/2, and human T-lymphotrophic virus (HTLV)-I/II, and these tests must be repeated 6 months after sperm donation. All results must be negative before the sperm samples can be released for use.
Designated or “known” sperm donors must go through the same screening process as anonymous donors to comply with FDA regulations. Because of the 6 months quarantine requirement, many recipients prefer to use anonymous donor sperm in order to save time.
Recipients can purchase donor sperm through any of the FDA approved sperm banks. Information on the sperm donors are available for viewing online and can include ethnicity, personal and family medical history, physical characteristics (height, weight, skin tone, hair texture, eye color), hobbies and interests, education, and profession. Some sperm banks may provide pictures, video, or audio clips from the donor for additional fees.
Sperm banks also routinely test donors for carrier status of genetic diseases such as cystic fibrosis, sickle cell anemia, and others. If the birth or genetic defects in the offspring are known, sperm banks are required to notify all recipients who had purchased sperm from the affected donor. What to consider when ordering donor sperm?
Your favorite sperm bank will be the one that has the sperm donor who fits your criteria.
If you live in the Dallas Fort Worth area, the nearest sperm bank to you is Cryobank America (CryobankAmerica.com). Based in Arlington, Texas, this sperm bank currently waives shipping charges for sperm delivery within the DFW metroplex.
What to Consider When Ordering Donor Sperm?
Washed vs. Unwashed sperm:
Washed sperm cost more than unwashed sperm and are best suited for clinics that don’t have the means to prepare sperm for intrauterine insemination (IUI). Washed sperm are frozen twice and may yield fewer motile sperm after the second thaw before IUI. The costs to prepare washed and unwashed sperm for IUI are the same at IVFMD fertility clinics in Irving, Grapevine, and Arlington.
The FDA requires screening the sperm donor and the recipient for cytomegalovirus (CMV) which can cause birth defects in the developing fetus. If you are not immune to CMV, you should choose a CMV negative donor in order to minimize the risk of CMV transmission.
When to order:
Sperm can be ordered during the first 5 days of the treatment cycle or at the initial baseline sonogram during menses. Waiting until the last minute to order might incur a higher shipping cost. How many samples to order: Sperm are shipped in a cryostorage container filled with liquid nitrogen and transportation cost can add up. To save on the shipping costs, you might want to order up to 3 samples and have the unused ones stored at our facility for a nominal fee.
Guarantee on sperm viability:
The chance of pregnancy with IUI using donor sperm is optimized when there are at least 3 million motile sperm after thawing. A refund or credit might be available in cases of poor sperm survivability.
IUI Options with Donor Sperm
To optimize the chance of success with donor sperm IUI, you would first need to undergo fertility testing. The female evaluation usually includes a thorough history and physical exam, diagnostic imaging to check the tubes and ovaries, and assessment of ovarian reserve. These tests can be completed within one cycle.
Once you have chosen a sperm donor, you can reserve the sperm samples and have them shipped to our clinics during the first 5 days of your treatment cycle.
Although donor sperm IUI can be performed during a natural cycle in which an ovulation kit is used to time the IUI procedure, we recommend a more proactive approach using ovulation induction medications to optimize your chances of success with every donor sperm sample.
Below is the diagram of a typical ovulation induction cycle for donor sperm IUI:
How Successful Is IUI with Donor Sperm?
Many studies have found that the average live birth rate from donor sperm IUI is about 15% per attempt, varying from 10% per cycle with one dominant follicle to 20% with 2-3 dominant follicles.
Success with IUI depends on many factors including the woman’s age and whether there are other infertility factors such as endometriosis, tubal disease, or pelvic adhesions. In general, a cumulative pregnancy rate of about 50-60% is expected after 5 IUI attempts in uncomplicated cases.
What Is the Cost of IUI with Donor Sperm?
The cost of a donor sperm IUI cycle depends on the type of medications used, the frequency of blood tests and sonograms, and the clinics.
Among the fertility clinics in the Dallas Fort Worth area, an IUI cycle using donor sperm can cost between a few hundred to several thousand dollars, not including the cost of a donor sperm sample which can cost $500-$800 plus shipping.
The least expensive type of IUI cycle involves a natural cycle in which no mediation or sonogram is used. Natural cycle IUI can work well if the woman has regular menses and LH surges between days 12 to 15.
The cost of donor sperm IUI can increase quickly when medications and monitoring sonograms are used. This is where the skills and experiences of the clinician matter- through efficient use of medications and monitoring, IUI success can be achieved without making the cost for an IUI cycle prohibitively expensive.
Since no clinic can consistently provide more than 10-15% rate of live birth per IUI cycle, it might be a good idea to inquire about the cost of the IUI cycle before proceeding.
When Should I Go Directly to IVF?
If you desire the fastest route to pregnancy and can afford IVF treatment cost, you should proceed directly to IVF, especially if you are at age 34 or older.
Moreover, if you have been diagnosed with tubal damage, pelvic adhesions, or severe endometriosis, you should consider IVF in order to have the best chance of success.
However, for many patients without these conditions, IUI can offer an affordable route to pregnancy with an overall pregnancy chance of 50% after 3-5 cycles, as long as the treatment cost per cycle is not very high.
When deciding whether to have the IUI before IVF treatment, it might be wise to look at the cost of the IUI cycles charged by the fertility clinic. If an IUI cycle costs thousands of dollars, the cost for IUI treatment can add up after several attempts to make IUI less cost-effective than IVF.
How many IUI cycles should I complete before proceeding to IVF?
After 5 rounds of IUI without success, you should consider IVF.
Is IUI painful?
IUI should be performed smoothly and gently and should not be painful.
Can I use a friend as my sperm donor?
FDA regulations do not allow the use of fresh donor sperm. In order for the man to be your sperm donor, he would have to undergo the same screening as an anonymous donor for communicable diseases and his sperm would have to be frozen and quarantined for at least 6 months, when he will undergo repeat testing. If the second screening is negative, the sperm can then be used; however, for many women, a 6 month waiting period might be too long.
What happen to the remaining sperm samples if I become pregnant?
If you have leftover sperm samples they can continue to be stored at our facility for an annual storage fee.
Are double inseminations more successful than single insemination?
Double insemination can be helpful if the first sample yields less than optimal sperm count for IUI. However, in most cases, single IUI gives the same result as double IUI (performed on consecutive days).
How long do the sperm remain viable inside my body after IUI?
Thawed frozen sperm can live for up to 24 hours after 24 hours after insertion. In contrast, fresh sperm can be viable inside the body for 3-4 days after IUI.
How much motile sperm are needed for IUI to be successful?
At least 3 million motile sperm are needed for best results with IUI.
When's the best time to have IUI?
In a natural cycle, IUI can be performed the day after the LH surge (positive ovulation test). If HCG is used to trigger ovulation, IUI can be performed between 24-48 hours after the injection.
What medications should I avoid before IUI?
Around the time of ovulation, you should avoid aspirin, ibuprofen, or other NSAIDs as these can inhibit ovulation. It’s also a good idea to avoid antihistamines after ovulation as they can impair implantation.
If I already ovulated, can I still proceed with IUI?
Yes, as long as there’s reasonable certainty that ovulation occurred within the last 24 hours. After ovulation, the egg is viable for only 24 hours.