The principles of sperm donation


Like any donation of elements of the human body (tissues, organs, gametes), the donation of sperm is framed by the law of bioethics. Like any gift it is voluntary, free and anonymous. The donor and the recipient couple can not know their respective identities, and the child born of the sperm donation can not know the identity of the donor.

To be able to give his sperm, the man must fulfill certain conditions:

to be between 18 and 45 years old (no age limit is imposed by law but after this age, it is estimated that the fertility of the man decreases and the risks of genetic abnormalities increase);
to be in a good health ;
have the agreement of the other member of the couple if necessary;
since 2016 (1), it is no longer necessary to have a child to give his gametes. A man who has never procreated can now give his sperm.
In case of infertility, the needs of a sperm donation
Sperm from a sperm donation is intended for couples who can not have children either because:

the man does not naturally have spermatozoa (azoospermia) or a treatment (chemotherapy in particular) has affected his spermatogenesis;
his spermatozoa have severe abnormalities (severe OATS);
the couple risks transmitting a serious illness to the child.
How is the sperm donation?
When a man wishes to give his sperm, he must contact a CECOS (Center for the study and conservation of eggs and human sperms). The sperm donation is performed only in these structures implanted in some UHCs. A donor can only donate in a single CECOS.

The procedure involves different steps:

a first information meeting: all questions relating to the donation are discussed;
Consent : the donor signs a consent form, as well as the other member of the couple, if applicable. This consent may be revoked at any time until the use of the gametes;
a medical report: this report includes an interview on the personal and family history, blood group and rhesus determination, serological tests (hepatitis, HIV, CMV, syphilis), a genetic consultation and a karyotype by blood test;
an interview with a psychologist for the donor and possibly the other member of the couple;
a first collection of sperm : this collection, which sometimes takes place during the first appointment, allows to check the characteristics of the spermatozoa and the absence of infection;
freezing : spermatozoa are packed in flakes, frozen, and transferred to liquid nitrogen at -196 ° C. A straw is then thawed in order to evaluate the tolerance of the spermatozoa to the freezing / thawing process. Depending on the results, the donor is informed of the number of collections to be made;
the collections : each collection is done by masturbation after 3 to 5 days of sexual abstinence. Sperm is controlled at each collection;
a blood test : at least 6 months after the last collection of semen, serological tests are performed again.
Only about half of the donor candidates are ultimately selected. The others are excluded mainly because of genetic criteria; others because they do not do the blood test at the end of the 6 months of quarantine.

All expenses incurred by the donation are supported.

Sperm donation on the receiving side
To qualify for a sperm donation, the couple must fulfill certain conditions:

to be a heterosexual couple;
to be on the list before age 39 for women, 57 for men. The age limit for benefiting from an MPA is set at 42 for women (with a tolerance in some cases, following the decision of the multidisciplinary team).
The donation request process is done in several stages, all organized by CECOS:

a first interview : the couple makes a request for sperm donation to CECOS;
an interview with a psychologist ;
a consultation with a gynecologist to perform a review and decide on the technique of MPA (insemination or IVF);
additional examinations (serology, blood group determination ...);
a request for consent to medically assisted procreation requiring the intervention of a third party donor to the court or a notary.
Given these different elements, the multidisciplinary commission validates or not the donation request. It may also request additional information before validating the request. Once the application has been validated, the waiting time for obtaining the sperm donation varies according to the CECOS, but also certain characteristics of the parents. It is on average 1 to 2 years.

Frozen spermatozoa are retained until assigned to recipient pairs. They can then be used in two MPA techniques:

artificial insemination with donor sperm (DAI): the simplest MPA technique, artificial insemination involves depositing in the uterus (intrauterine insemination) or in the cervix (intra-cervical ) donor sperm previously prepared, 36 hours after initiation of ovulation by ovarian stimulation treatment;
in vitro fertilization : classical IVF consists of reproducing in the laboratory the natural stage of fertilization, by putting the oocytes previously collected from the woman (after ovarian stimulation) in contact with several donor spermatozoa. One or two quality embryos are then transferred to the uterus. Any supernumerary embryos may be frozen for a subsequent FET (Frozen Embryo Transfer). IVF-ICSI (intra cytoplasmic sperm injection) consists, at the stage of fertilization, to inject a single sperm directly into the oocyte membrane, to optimize the chances of fertilization.
Success rate of procreation following a sperm donation
In 2014, 238 men donated spermatozoa to freeze more than 11,378 straws. 1,107 children are born from a sperm donation (2).

Side effects

  • for the donor, no adverse effects are to be noted. Its fertility is not impaired because the process of spermatogenesis is continuous and does not depend on a pre-defined stock;
  • on the side of the recipient, the adverse effects are those related to ovarian stimulation and oocyte retrieval.
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