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Semen Banking
What is artificial
insemination with Donor sample (AID) or Donor Insemination
(DI)?
In as many as 30 % of infertile couples the male is responsible
for infertility. A significant percentage of these males do
not father children despite various treatments including ICSI.
The solution is inseminating their wives with semen of another
male (donor) at the time of her ovulation. This procedure
is called AID or DI.
Who can benefit from AID?
1. AID (Artificial Insemination Donor ) is generally advocated
for males with low semen counts (Oligospermia
or zero counts) (Azoospermia),
where treatment with drugs, surgery and ART treatments like
AIH, IUI and ICSI have proven unsuccessful. It is an acceptable
alternative to adoption.
2. It is also suggested to males who may have a genetic disorder
that could get transmitted to their progeny.
3. It may be used as a backup to the procedure of TESE (Testicular
Sperm Extraction) and ICSI that is done for males with non-obstructive
Azoospermia, especially when no sperms are found in the testicular
biopsy. (see Nonsurgical Sperm Retrieval)
How is the Semen obtained in Semen Banking?
A donor male donates the semen after he is screened and tested
as safe for various infections such as HIV, Hepatitis and
other Venereal Diseases. At
BabiesandUs lab, we test the donor for infections every 3
months. The semen thus obtained can be used in two ways:
1.Fresh Semen Insemination:
It is insemination where the donated semen is used within
an hour of ejaculation. The semen can be placed on the cervix
without processing or can be placed in the womb after processing
as is usually done with IUI. This is done commonly in India.
However, there is always the remote chance of a donor carrying
the latent infection of HIV that may manifest itself as a
positive after 2 to 3 months of the insemination. It is due
to these reasons many ART units have given up this technique.
2. Frozen Semen From Semen Bank:
After collecting the semen from an HIV negative donor, it
is processed, added to straws or vials. These are then stored
in liquid nitrogen containers called semen banks, of -196ºC
for six months. In short, it is quarantined. After 6 months
the donor is retested for HIV. If the second HIV test is negative,
this sample is released from quarantine and insemination takes
place only at that time.
Which of the two is a better alternative?
The success rate of both fresh as well as frozen AID is almost
similar. However in case of frozen AID it is important to
accurately pinpoint the timing of ovulation. This is because
the motility of frozen thawed sample decreases rapidly within
12 hours, in contrast to fresh insemination, where the sperms
stay alive in the body for 48-72 hours.However, the biggest
advantage of frozen samples are its minimal risk of HIV transmission.
What is the Success rate of AID (Artificial Insemination
Donor) ?
The success rate is in the region of 15-20%. That means if
10 couples undergo AID every month, 1 or 2 couples would become
pregnant every month. At the end of 6 months 5 to 6 couples
become pregnant. The remaining 4-5 couples who do not become
pregnant, can undergo further AID for 6 months. During this
time 2 more will become pregnant. At the end of one year around
80% (8 out of 10 started couples)will acheive pregnancy. The
two couples who fail to become pregnant at the end of one
year can either opt for IVF/ICSI with donor sperm or go in
for adoption.
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