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Frequently Asked Questions

Contents

Anonymous donor semen

How do I order donor semen?

Donor semen orders may be placed only by the physician's office or by the patient who has an account with IDANT Laboratories.

Physicians: If you are a physician and want to open an account, please complete the Physician/Clinic Account Application form and submit it to IDANT Laboratories along with a copy of your license. The completed application and copy of your license may be faxed to IDANT provided that the original paperwork is received within one week. An account can be opened for you the next business day after these documents have been received.

Patients: If you are a patient and want to establish an account in your own name so that you may deal directly with IDANT Laboratories, please complete the Patient T.D.I. Request Application. The completed form and the copy of your physician's license may be faxed to IDANT provided the original paperwork is received within one week. An account can be opened for you the next business day after these documents have been received. IDANT's accounting department will contact you for your account number. In the event you change physicians after establishing an account with IDANT, you will need to complete a new application.

Can you bill my insurance company directly for reimbursement?

Please note that IDANT Laboratories does not accept insurance as payment; however, the IDANT staff can assist you in completing the insurance claim form for reimbursement. The treatment of infertility may not be considered a medical necessity by insurance companies. Please check your insurance policy regarding coverage of these specific services.

Can I perform the insemination at home, or can this only be done at the doctor's office?

IDANT Laboratories requires its clients to be under a physician's care, and the decision to inseminate at home should be discussed with your physician. IDANT will only ship specimens to a physician's office or clinic unless your physician supplies written authorization indicating that specimens should be shipped to your home.

What is an IUI unit? An ICI unit?

An IUI (intrauterine insemination) unit is a semen specimen that is processed (i.e., washed) through a density gradient to isolate the most motile and morphologically normal sperm from the other ejaculate contents. IDANT uses a two-layer gradient-medium, IsolateR, to process raw semen samples, which effectively reduces cellular contaminants such as dead sperm, white blood cells, and miscellaneous debris. The resulting sample contains predominantly motile sperm.

IUI procedures have a slightly higher success rate (i.e., about five percent) per cycle because the sperm cells are placed closer to the fallopian tubes where fertilization usually takes place. Semen must be washed of cellular contaminants for IUI use because raw semen contains prostaglandins that cause the uterus to contract, sometimes violently. Most physicians will use only one unit of sperm per cycle. These specimens are concentrated into a smaller volume than the ICI specimens - 0.5cc versus 1.0cc - so that the physician can place the entire volume into the uterus, which will only hold 0.5cc.

An ICI (intracervical insemination) unit is a raw semen sample that is not processed further. ICI units are simply cryopreserved with a cryoprotectant medium composed of twelve percent v/v glycerol, egg yolk, and buffer. These specimens can contain all of the naturally occurring ejaculate fluid and cells. The sample contains plenty of motile sperm, but all of the dead sperm as well.

ICI procedures have a slightly lower success rate because the sperm cells are placed in the cervix, and thus have farther to travel. Many patients undergoing intracervical insemination will normally use multiple (i.e., two to four) units of sperm per cycle.

Semen banking

What is the process involved in banking my sperm?

  1. A referral from your physician is required before you make an appointment with IDANT Laboratories. Appointments can be made Monday through Sunday. (Note: There is an extra processing charge for Saturday and Sunday appointments.)
  2. When you make the appointment, a technician will advise you to observe a period of three to five days of abstinence from ejaculation, if possible, before producing a specimen for storage. (Males usually require three to five days to achieve their optimal sperm count. The quality of the sperm may deteriorate over shorter or longer periods of abstinence.)
  3. During your first visit, you will be required to complete additional paperwork. Next, a technician will draw a blood sample and obtain a urine sample for testing. Screening will be performed by a licensed independent laboratory used routinely by IDANT Laboratories. Testing includes HIV-1, HIV-2, HTLV-I, HTLV-II, hepatitis B surface antigen, hepatitis B core antibody, hepatitis C viral antibody, syphilis, cytomegalovirus (CMV), and gonorrhea culture.
  4. You will be required to produce a specimen. You may opt to produce the sample at home; however, the semen sample must be collected in a sterile container, which you may obtain from IDANT Laboratories, and brought to IDANT within sixty (60) minutes of production. It is essential that the specimen be kept at body temperature during transit. It is preferred that the specimen be obtained by manual stimulation (i.e., masturbation). (Note: Please do not use any lubricants, as these products may compromise the quality of the sample.)
  5. Upon receipt of the semen specimen, the specimen is accessioned. An accession number and a canister number is assigned to your specimen to ensure accurate identification.
  6. A complete semen analysis is performed. This includes semen volume, liquefaction and viscosity, sperm count, motility, forward progression, and morphology.
  7. The specimen is processed either as intracervical insemination (ICI) units or intrauterine insemination (IUI) units and stored in sterile 0.5 ml straws. Each straw is labeled with the donor's name and social security number, date, accession number, and canister number. A small portion of the specimen is drawn into a separate straw for a post-thaw analysis, which is performed the following business day to assess the specimen's cryosurvival. The evaluation of the thawed specimen will give you a general idea of what the quality of the sperm will be when you later attempt to achieve a pregnancy.
  8. The straws are placed in a metal storage canister labeled identically and stored under liquid nitrogen at -321 °F. The tanks are kept constantly filled with liquid nitrogen and are monitored daily. In addition, IDANT Laboratories maintains an adequate supply of liquid nitrogen on reserve to keep the specimens cold for up to three weeks should some problem arise with shipment of additional liquid nitrogen. Because the nitrogen-cooled tanks do not require electricity, there is no danger of samples being compromised because of a power failure or blackout.
  9. The results pertaining to your semen quality are provided to your physician usually by the next business day.

How many units should I store prior to my surgery or therapy?

It is recommended that you store at least fifteen to eighteen (15-18) units of semen, which can be derived from three ejaculates or as many as possible prior to your surgery and/or therapy. You should store an amount of semen to provide reasonable assurance of one or two pregnancies. A healthy, fertile woman usually gets pregnant within three months of artificial insemination. However, the average woman does not have ideal fertility, and often requires three to six months to become pregnant by artificial insemination. Women who are between the ages of thirty and forty may require six to nine months (if not more) of artificial insemination. A physician usually performs two or three inseminations per month.

If the units are of good quality, each unit should theoretically contain enough sperm to produce a pregnancy. If the semen is of poor quality, multiple units may be required for each insemination to provide a reasonable chance of pregnancy. For extra assurance, particularly if you hope to have several children, you should store as many as thirty (30) units. However, with the advanced reproductive technologies available today, in many cases a thawed specimen with even a few motile sperm can be used to successfully initiate a pregnancy.

How long can you effectively store my frozen sperm?

The length of time that frozen sperm cells remain viable will vary from patient to patient. There have been normal pregnancies from sperm stored frozen for over twenty years here at IDANT Laboratories. However, studies have indicated that the efficacy of the freezing is questionable when it has been frozen for over ten years. Each individual's sperm responds differently to the freezing process. The result of the post-thaw analysis can give you some indication of how your sperm cells responds to the freezing process.

Does insemination with frozen sperm increase the likelihood of having a child with birth defects?

All available data indicates that frozen semen does not increase the risk of birth defects. Since the first successful attempt at artificial insemination in humans in 1953, more than 250,000 children have been born from artificial insemination with no increase in birth defects. In fact, the freezing process tends to kill off weaker sperm, and may thus lead to fewer birth defects.

How do you ensure that my specimens will not be mixed up with other specimens?

Only one semen sample is processed at a time to avoid specimen mix-ups and labeling errors. Each semen specimen is assigned a unique identification number, which is used to identify the sample during steps of collection, processing, storage, and distribution. For donors and client depositors giving multiple specimens, a secondary code is assigned to distinguish between dates of collection.

Processing areas are cleaned and disinfected with a ten-percent bleach solution after each processing cycle between patients, donors, and client-depositors to prevent infectious disease contamination or cross-contamination.

Directed donor semen

What is a directed donor?

A directed donor is a donor whose identity is known by the recipient. Directed donors are screened in the same way as anonymous donors. Like an anonymous donor, a directed donor must be tested for HIV 1/2, HTLV-I/II, hepatitis B, hepatitis C, syphilis, chlamydia, and gonorrhea. In addition, the New York State Department of Health and the American Association of Tissue Banks require that specimens deposited by directed donors be quarantined for a period of at least 180 days and released only after the directed donor is retested and tests non-reactive for HIV-1/2, hepatitis B, hepatitis C, HTLV-I/II, syphilis, and chlamydia.

What is the process involved in the directed donor program?

  1. A referral is first required from your physician to make the appointment. Appointments can be made Monday through Sunday. (Note: There is an extra processing charge for Saturday and Sunday appointments.) We recommend that the directed donor have a semen analysis performed with cyrosurvival to evaluate the quality of his specimens before proceeding any further.
  2. The directed donor and the intended recipient must be present during the initial visit. Both parties are required to complete the directed donor paperwork, which includes the medical, genetic, and sexual history information about the directed donor. Blood and urine samples are then collected from the directed donor for testing.
  3. A technician will schedule an appointment for a physical examination of the directed donor via one of the physicians affiliated with IDANT Laboratories.
  4. When IDANT Laboratories receives the results of the testing and physical examination, the directed donor file is then reviewed by the Medical Director and Tissue Bank Director for approval.
  5. If the directed donor is approved, he may begin depositing semen. Each semen sample is analyzed, processed, and stored under quarantine. Each semen sample deposited is tested for gonorrhea.
  6. Please note that if a directed donor tests reactive for any of the tests for infectious diseases or if his alanine transaminase (ALT) levels are outside acceptable levels, IDANT Laboratories will discard the specimens and will do so without authorization from the depositor or the recipient and need not give prior notice to that effect.

Can the recipient waive the 180-day quarantine period?

For directed donors who are blood relatives of the recipient's husband, the recipient may waive the quarantine period after being advised by her attending physician of the risks involved in doing so. The recipient is required to complete a Quarantine Waiver form, and her attending physician must complete the Physician Consent to Waive Quarantine form. In such cases, testing for HIV 1/2, HTLV-I/II, hepatitis B, hepatitis C, syphilis, chlamydia, and gonorrhea must have been performed after a date one month prior to the first donation and every three months thereafter, while the directed donor is engaged in donations. For all other directed donors, semen samples must be quarantined for 180 days.