Sperm/Andrology Lab: Donor Sperm/Therapeutic Donor Insemination

We realize that most of you have already invested a large amount of time and thought into your decision to consider therapeutic donor insemination (TDI). We also understand this has probably been a stressful decision.

We welcome you to our program and we look forward to working with you. We encourage you to ask questions about your care. Both your physician and clinic nurses are good resources.

Your First Appointment

Your physician will ultimately be in charge of your care, but one of our nurses will be arranging and performing the actual inseminations.

Forward to us any medical records pertaining to your previous infertility care or bring with you at the initial appointment.

During the initial appointment, your physician will take a family and medical history and do a physical examination including a pelvic examination. This will help your doctor consider the possibility of any female factors that would hinder the chances of success.

The doctor may order laboratory tests to help in diagnosis, if necessary, and will also include several blood screening tests that have been recommended by the Society for Reproductive Endocrinology for all recipients of TDI.

During this appointment you will meet with one of the clinic nurses. The nurse will explain our program to you and answer any questions you may have. Please feel free to express your concerns. Since consent forms must be signed by both husband and wife, we request that your husband come with you for this visit. He is certainly welcome at all insemination appointments as well.

Choosing a Donor Profile and Bank

Soon after we have obtained the results of your screening tests and physical characteristics and blood types for both you and your husband, we will help you identify the best possible donor or donors available from our participating banks.

Duke has approved Cryogenics Laboratories sperm bank for our patients’ use. We will have information available to you in the clinic about this sperm bank.

We will ask you to contact the bank of your chosen donor and arrange to have the specimens sent to our laboratory for storage until you are ready for an insemination. There will be a clinic charge for the insemination procedure at each insemination visit and an annual storage fee for the sperm samples.

Since shipping is costly, we recommend that more than one sample is shipped at a time.

We recommend that you contact our financial representative at 919-572-HOPE with any financial questions. She will be able to help determine your individual insurance coverage and the expenses for which you will be personally responsible.

Preparing for Insemination

It is important to establish your particular ovulatory pattern before proceeding with the actual inseminations.

If you have irregular menstrual cycles, we may ask that you take your Basal Body Temperature and use an ovulation predictor test for one or two cycles to determine your ovulatory pattern. Instructions for taking a Basal Body Temperature are on the reverse side of the charts we will give you.

Instructions for the predictor tests will vary with manufacturer and will be included in each kit. Questions can be addressed to the clinic nurse. There are several on the market, and we will do our best to keep you informed as to their availability, cost and correct use.

Remember that these tests are predictors of impending ovulation and your insemination may be done the same day or day after the test is positive, depending on the results of your test cycle.

Inseminations are done Monday through Friday. We may be unable to provide this service on weekends depending upon staffing. Patients should call the clinic at 919-572-HOPE at the onset of menses to plan an insemination for that cycle. One of the ovulation predictor tests should be purchased and the directions followed for that particular test.

If our staff is busy with other calls, please leave a short message and a phone number where you may be reached during the day.

Urine testing should be done in the morning to allow time to call that day to set up an appointment for the same or next day. Inseminations will not be done on Saturday. Sunday morning inseminations may be performed if appropriate staffing is available.

Please call our office and notify the triage nurse before noon on Friday if you believe that you might have your luteinizing hormone (LH) surge over the weekend. They will be able to notify you if staffing will be available that weekend for a possible insemination.

Since there is no one in the office on Saturday or Sunday, positive test results may be called in Monday morning and the appropriateness of an appointment discussed with one of the clinic nurses.

Insemination

Frozen semen will always be used. The advantages and disadvantages of frozen semen will be explained to you at the initial visit. Basically, freezing allows optimal screening of each donor prior to the use of the semen.

The insemination can be accomplished quickly with very little discomfort, similar to a Pap smear. The insemination will be one of two techniques; a cervical cup or an intrauterine insemination. Occasionally cycles will be delayed secondary to semen sample availability.

What Next?

We request that patients call the clinic with the onset of menses following an insemination if pregnancy does not occur. This will help to determine if the timing of the insemination was correct and if changes should be made in future cycles. Pregnancy tests are not recommended until 18 days after the insemination if no period has ensued.

We want to assure you that we will do our best to maintain confidentiality at all times. All our staff realize the importance of this.

Insemination cycles do not have to be consecutive. The program does need a commitment from you, and we ask your cooperation with the requests stated earlier.

We advise patients to keep their daily routine as normal as possible and not allow their infertility to compromise the other meaningful aspects of their lives. We will certainly do our best to minimize your inconvenience and frustration.