The introduction of Assisted Reproduction Technology has brought with it procedures that allow couples who cannot conceive using their own gametes, the alternatives of achieving pregnancy through the use of donated oocytes, donated sperm, or even donated embryos. The donation of oocytes by reproductive-age women or embryos to perimenopausal or menopausal women have made childbearing possible without the limitation of age. Donor insemination has long been an option for addressing the male factor infertility or other related problems.
Artificial Insemination with Donor Semen
Donor insemination involves the placing of a donor's semen into the interior of the vagina of desirous woman. The procedure enables a couple to achieve pregnancy even though the husband is not the biological father. Donor insemination is not proceeded very soon after the husband has been confronted with his infertility. Adjustment of both partners takes time and both donor insemination and adoption are discussed extensively at our centre leaving the choice entirely to the couple. It is necessary for the infertility centre to get the informed consent of both the partners after they are counseled about the possible psychological conflict they may face later in their life with the knowledge that one of them is not the biological parent of their child.
The conditions of anonymity and screening of the donor is met and only frozen sperm samples that have passed appropriate quarantining for infectious diseases such as HIV, hepatitis B and C are used. Every effort is made to match phenolytic characteristic of the recipient and the donor such as race, hair, eye colour, height and body built up etc.Common indications
- Husband has non- obstructive azoospermia.
- Husband has a hereditary genetic defect.
- The couple has Rh incompatibility.
- The woman is iso-immunized and has lost previous pregnancies and intrauterine transfusion is not possible.
- Husband has severe oligozoospermia and the couple does not wish to undergo any of the sophisticated ART procedures such as ICSI due to cost factor or otherwise.
Oocyte donation is a procedure in which the donor oocytes are fertilized with husband's semen of the desirous couple and the resultant embryos are transferred to the infertile female partner.
Donors should be a healthy woman in the age group of 18-35 years. She should be screened for HIV, hepatitis B and C. Oocytes may be obtained for donation from other young women.Indications for Oocyte donation
- Gonadal Dysgenesis.
- Premature ovarian failure.
- Iatrogenic (due to ovarian surgery or radiation or chemical castration) ovarian failure.
- Women who have resistant ovary syndrome or who are poor responders to ovulation induction.
- Women who are carriers of recessive autosomal disorders.
- Women who have attained menopause.
Embryo donation can be carried out in menopausal women with no surviving child but desiring to have a child. It is wonderful that the endometrium of menopausal woman has the ability to respond to sex hormones and provide a receptive environment for the implantation of an embryo. The indications of embryo donation are the same as that of oocyte donations.
Adoption vs Donation
It is important to discuss the option of adoption before perusing the donation of gamete/embryo
- No genetic relationship of husband/wife/couple(as the case may be) with the child in both cases.
- The sperm/oocyte/embryo is anonymous , biological history is not known to the child in both cases.
- As the secrecy is commonly related to donor, recipient may feel it morally or ethically wrong and develop feeling of guilt, shame or fear.
- It is important to discuss the child's right to know his genetic father/mother/parent(except identification).