FACT SHEET
Donor Insemination (DI)
In approximately 30% of couples who complain of infertility, the cause of the problem lies with the male
partner.
This is usually due to low concentration, poor quality or totally absent spermatozoa.
Occasionally, there are enough normal motile sperm present to make in vitro fertilization (IVF) worth
attempting. Where the sperm count or movement is extremely low and in cases where the sperm has to be
collected surgically, micromanipulation techniques can be used. In these cases fertilization is achieved by
injecting the sperm into eggs - intracytoplasmic sperm injection (ICSI).
In many couples, the female partner is fertile and one way of achieving a pregnancy is with artificial
insemination of donor sperm, better known as donor insemination (DI). As the number of babies available
for adoption is limited, Dl often offers the only chance of a family. There are many centres throughout the
UK which are licensed to provide this treatment.
The decision to go ahead with Dl treatment is often a difficult one for the couple involved. There are many
medical, ethical, religious and legal aspects that need to be considered. Patients require thorough
counselling to discuss the implications of Dl and any reservations they may have about the treatment.
Patient support groups and contact with patients who have achieved pregnancies using Dl are often helpful.
Donor Screening
A number of different sources have historically been used for donor recruitment including medical
schools, local colleges and businesses and husbands of obstetric patients. The most important
criteria are that the donors should be healthy and have a good sperm count. It is ideal if the
prospective donor has had children of his own. Each donor is screened for sexually transmittable
agents (including HIV, hepatitis B & C, chlamydia, gonorrhea, syphilis and cytomegalovirus) and
some genetic defects. Screening for cystic fibrosis and chromosome abnormalities is also
performed. The Human Fertilisation and Embryology Authority (HFEA) require all centres to freeze
donated samples and quarantine them for six months prior to use. This allows time for all the test
results to be collected and HIV testing to be repeated.
Donor Selection
Clinics offering donor insemination try their best to match the male partner to those of the donor.
Characteristics usually matched are ethnic background, eye, skin and hair colouring, height of the male
partner and blood group if required. Although clinics do their very best, matching of characteristics is much
more difficult nowadays due to the severe shortage of donor sperm available.
Medical Aspects of Dl
The vast majority of couples are referred due to the husband's lack of sperm or low sperm count. Other
indications for treatment include genetic disease, paraplegia, rhesus incompatibility or following a
previous vasectomy. Male infertility needs to be fully investigated and all treatment options considered
before Dl is recommended.
It is important that the female partner is also investigated even if a male factor problem has been
diagnosed to know that she is ovulating regularly and that her fallopian tubes are patent.
Suitability for Dl
It is important that couples are interviewed together to ensure they have both come to terms with the
medical and legal implications of Dl. The male partner in particular should have come to terms with his
sub-fertility and realise that he will be the social rather than the biological father of any resulting
offspring. As the law in the UK states that donors must be willing to be identifiable and that any child born
as a result of donor treatments has a right to trace the donor when they become 18 years of age, it is
important that the couple have counselling and time to consider and discuss the implications of this on
their and any offspring’s future.
Requests for treatment from single women or lesbians are considered and treatment normally provided.
Independent counselling is required.
If the male partner is seriously ill or very much older than the woman, the possibility of her bringing up
her family alone has to be considered. The use of known semen donors is often discouraged as it may
create difficulties within the family. However, each case is assessed on an individual basis - the welfare of
the child being the most important issue.
Performing the Treatment
The treatment itself is straight forward and painless. Treatment requires a speculum examination in order
to place the donor sperm into the cervical canal or into the uterus. This should be done at the fertile period
each month - as close to the day of ovulation as possible. Sometimes fertility drugs are used to try and
increase the chances of conceiving in a single month, and cycle monitoring is usually performed via
ultrasound scans and blood tests in order to confirm the best day(s) for treatment.
Quoted success rates vary from centre to centre. Insemination of sperm into the uterus is thought to have
higher pregnancy rates in a single cycle than intra-cervical methods. Average pregnancy rates achieved with
Dl are 7% per treatment cycle and 15% per patient (HFEA statistics). The multiple pregnancy rate is higher
than with normal conception as Dl is often combined with ovulation induction.
Once conception has occurred the pregnancy should follow a normal course, and the same risks of
miscarriage and foetal abnormality apply as those in the general population. Dl has been practiced in this
country for many years.
Laws Governing Dl
Dl is legal in this country and provided it is carried out with the husband's consent, cannot provide grounds
for divorce on the bases of unreasonable conduct. Any woman carrying a baby is obviously the legal mother.
Her husband (or partner if unmarried) is the legal father as long as he consents to the treatment.
However, where a couple are not married, only the child's mother is automatically considered to have
"parental responsibility". For an unmarried father to be entitled in law to have a say in decisions on his
child's upbringing, he will need to establish "parental responsibility". This is done with the help of a
solicitor who should be consulted by couples in this situation. If a single woman is treated without a male
partner, the resulting offspring will have no legal father.
The sperm donor has no parental rights or legal obligation towards the child, but as previously stated, the
child, once they reach 18 years of age, has the right to ask for identifying information about the donor.
They would have to apply to the HFEA to access this information which is kept on a central register.
There is no legal requirement to tell the child how he/she was conceived, although it is recommended that
the child is told that it was conceived through the use of donated gametes. It is obviously important where
Dl is performed for a genetic reason that the child should know he/she is not at risk from inherited
disease.
Human Fertilisation and Embryology Authority (HFEA)
The HFEA has had a statutory obligation to:




License clinics
Set out and monitor standards of practice
Collect statistics regarding Dl treatment and its outcome
Record information about sperm donors, couples who are provided with donor insemination
treatment and children born as a result of donation
Information held by the HFEA is kept strictly confidential.
Infertility Network UK
Charter House
43 St Leonards Road
Bexhill on Sea
East Sussex TN40 1JA
Telephone: 0800 008 7464 / 01424 732361
Email: admin@infertilitynetworkuk.com
Website: www.infertilitynetworkuk.com
Charity Registered in England No 1099960 and in
Scotland No SC039511