Donor insemination (DI) may be appropriate if a man is not producing any viable sperm. It may also be suggested if the man carries a genetic disease or for single women and lesbian couples. DI is not as successful as might be thought. Donated sperm has to be frozen for a quarantine period while tests are done to ensure the donor is free of serious illnesses. The freezing/thawing process undoubtedly reduces the fertility of the sperm, and few clinics achieve better than around 12 per cent chance of a pregnancy each month.
Donors are matched as far as possible to the physical characteristics of the woman’s partner, including his blood group, as well as his ethnic group and religion if requested and if possible. Sperm donors are not always of proven fertility. Most have not had children, are unmarried and are probably not ready for a long-term relationship. Nor, of course, is there a way of establishing whether a particular donor is free of all genes for serious inherited diseases, although it is now possible to screen them for cystic fibrosis.
Unfortunately, a genetic history of the donor’s family does not guarantee freedom from a particular genetic trait. Donor programmes are likely to have an extremely limited number of good fertile donors and inevitably clinics may repeatedly use semen from a donor of proved fertility. The fear that siblings conceived by DI might marry, unaware of their relationship to each other, resulted in a ruling that no donor should have his semen used more than ten times.
Despite countless breakthroughs in medical science, we still do not understand why some pregnancies will end in tragedy. For most of us, having a child of our own is the most fulfilling experience of our lives. All of us can imagine the desperation and sadness of parents who lose a baby, and the life-shattering impact that a disabled or seriously ill child has on a family.
Professor Robert Winston’s Genesis Research Trust raises money for the largest UK-based collection of scientists and clinicians who are researching the causes and cures for conditions that affect the health of women and babies.
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