Infertility is a challenging condition in which a person may be struggling or is completely unable to achieve pregnancy. Statistically, around 8 -10 percent of couples worldwide suffer from infertility, which accounts for 60 – 80 million couples. In India, around 10-14 percent of couples face issues with infertility. If you and your partner are having trouble conceiving, you should not lose hope. Today, a number of medical advancements have made it possible to get pregnant even if you are unable to get pregnant naturally. Out of these options, artificial insemination by donor eggs or donor sperm is an available choice in cases where there are abnormalities in the gametes of the respective partners or even donor embryos when both the partners have some underlying problem.
Understanding donor sperm & eggs
Donor sperms are obtained from a healthy male who has donated his semen to a governed sperm bank. This donor is anonymous and the sperms obtained can be used for procedures like donor sperm IUI or even IVF-ICSI. Donor eggs are unfertilized mature eggs that are retrieved from a fertile donor woman who is preferably young, has proven fertility and has healthy functioning ovaries, and are fertilized in an IVF lab with the sperm of the receiving couple’s partner or with donor sperm. The fertilized embryo is then transferred into the recipient’s uterus in an Embryo Transfer procedure, similar to what is done in routine IVF.
In all cases, donors are screening for common blood disorders like HIV, HbsAg, etc.
When to consider using donor gametes? / Who needs donor sperm / egg treatment?
This treatment can be done in two scenarios –
- Female infertility
- Male infertility
Donor eggs:
Female infertility
1. Elderly Infertile woman: It is well established that the ovarian function starts to decline after a certain age in the woman. It usually occurs at around 35 years of age, but is not fixed and can occur at any age. It can be diagnosed with the help of an AMH report or the antral follicle count which shows fewer follicles in the ovary. It is also well documented that the rate of genetic abnormalities in the embryo and the fetus like down’s syndrome also increases with increasing age and hence these women might benefit from donor egg treatments.
2. Diseases and surgery: Some diseases like endometriosis, tumors, etc might cause permanent damage to the ovaries and the follicles due to the disease by itself or its medications or even the surgery which has to be performed to correct the disease. In such cases, donor eggs might be the only way to get a pregnancy.
3. Abnormalities of the female reproductive organ: Doctors may suggest donor egg IVF process if you have non-functioning or even absent ovaries in conditions like Turner’s syndrome. As the ovaries itself are absent or under-functioning, donor egg treatment is necessary.
4. Premature ovarian failure: Premature ovarian failure is a disorder in which women’s ovaries stop functioning at an early age and they reach menopause much earlier than usual. When this happens, specialists suggest a donor egg IVF process in which the donor eggs are fertilized with the partner’s sperm (or donor sperm if needed) and are transferred into the woman’s uterus to help her attain pregnancy even with the condition.
5. Low ovarian reserve: Sometimes, irrespective of the age of the woman, the ovarian reserve is low. It can be genetically so or might be acquired due to various medicines like those used for cancer treatment or environmental factors. In such cases, a donor egg IVF process may be suggested.
6. Genetically transmitted diseases: Some women might suffer from some diseases that pass on from generation to generation in their family. Some examples are thalassemia, Fanconi anemia, Charcot-Marie-Tooth disease, etc. IVF is still possible in some scenarios using their own eggs and performing genetic tests on their embryos for selecting disease-free embryos, but this is not possible for all diseases and the treatment can get expensive. In this case, the couple can benefit from using donor eggs and prevent further spread of the disease in the subsequent generations.
Donor Sperms:
Male Infertility
Historically, infertility was often seen as arising from some problem with the woman, since she was the one who would carry the offspring to term. But according to statistics, up to 50% of infertility cases are attributed to some malefactor. Some of the cases in which an IVF with donor sperm might be required are:
1. Absent Sperm: Absent sperms in the ejaculate is a condition called ‘azoospermia’. As the male is not producing sperms of his own, the couple cannot get pregnant. It can occur due to various factors like congenital absence of vas deferens, undescended testes, testicular failure, cancer, etc. It can also occur due to environmental factors like hot temperature or drugs or even surgical procedures which have to be done for the problem. Using IVF with donor sperms is the only way to achieve a pregnancy.
2. Low sperm count: According to the World Health Organization, >39 million sperms/ml of ejaculate are required in order to get a fair chance of natural conception. When the sperm count is low, it is less likely that the couple can get pregnant on their own. IVF can be done in such cases but can get expensive. Hence, one other option is using IVF with donor sperm and performing an IUI using it so that the couple has a chance of pregnancy.
3. Sperm Morphology or Sperm Abnormality: Another vital parameter required to achieve pregnancy is the ‘morphology’ or shape of the sperm. Abnormally developed sperm may fail to dissolve the outermost surface of the egg and fertilize it. If a male has abnormal sperm morphology, it could lead to infertility. In such cases, artificial insemination by donor is a good option to achieve pregnancy.
4. Genetic or hereditary factors: Genetic or hereditary factors such as ovulatory disorders (Kallmann syndrome, primary ciliary dyskinesia, fragile x syndrome) or chromosomal abnormalities in the sperm can contribute to infertility. Couples with these factors may opt for artificial insemination by donor. Using self semen and performing advanced genetic testing with the help of embryo biopsy might help in some cases, but can get expensive. Using sperm donor insemination will help them achieve a pregnancy with a child-free of that disease and thus the subsequent generations can also benefit.
What all procedures can be done with donor gametes?
Donor inseminations can be done through the following procedures:
1. Intrauterine Insemination (IUI): If the woman is young and has a good ovarian reserve with open fallopian tubes and no other complicating factors, and the male is suffering from some of the aforementioned problems, performing an Intrauterine Insemination (IUI) using sperm donor insemination can help them get a pregnancy.
2. IVF-ICSI with donor eggs: When the woman is suffering from some problem which has damaged the ovary or if the woman had under-functioning ovaries or if she is elderly, performing IVF-ICSI with donor eggs provide a good chance to have a healthy pregnancy.
3. IVF-ICSI with donor sperms: When the problem is with the male partner such that getting sperms is impossible even with a testicular biopsy or in cases where the testes are absent or have been surgically removed, performing IVF-ICSI with sperm donor insemination gives a chance for the couple to become parents.
4. IVF-ICSI with donor embryo: If the problem is with both partners, treatment which involves procuring donor eggs and donor sperms, making embryos with those and then transferring them to the woman is an effective way to get a pregnancy.
Although infertility is a serious disorder, there are many treatments and solutions that can help you achieve pregnancy. Thus, if you or someone you know suffers from infertility and is looking for available options, consult your doctor or fertility specialist for advice or book an appointment with one of the best fertility specialists at Dr. Banker today.