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Contents
Anonymous
Donor Semen
1. 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.
2. 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. Fertility has
been seen by many insurance companies as an elective procedure,
and not a disease of the reproductive system. Please check your
insurance policy regarding coverage of these specific services.
3. 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.
4. 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
1. What is the process involved in banking my sperm?
a. 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.)
b. 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.)
c. 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.
d. 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.)
e. 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.
f. A complete semen analysis is performed. This
includes semen volume, liquefaction and viscosity, sperm count, motility,
forward progression, and morphology.
g. 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.
h. 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.
i. The results pertaining to your semen quality are
provided to your physician usually by the next business day.
2. 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.
3. 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.
4. 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.
5. How do you ensure that my specimens will not be mixed up with
another specimen?
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
1. 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.
2. What is the process involved in the directed donor program?
a. 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.
b. 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.
c. A technician will schedule an appointment for a
physical examination of the directed donor via one of the physicians
affiliated with Idant Laboratories.
d. 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.
e. 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 Neisseria
Gonorrhea.
f. 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.
3. 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.
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