Donor Sperm
No sperm cells
In some cases, and during routine testing, we may find that tests confirm that men have no viable sperm cells (called spermatozooa),This usually comes as a surprise. For men, there may be no other symptoms suggestive of a problem. These men are usually otherwise healthy and fit. They have no problems with potency or intercourse, and usually have no major history of illness or disease. This usually has no relationship with age.
Sometimes men come and suspect they may have an issue. They may have complained of ED, potency issues in the past, or may be noticed low libido and very low volumes of semen. Sometimes men may have some medical disorders that present with other manifestations. And part of these disorders may be problems with sperm production.
Tests
For men, if no sperm cells are found in semen analysis, we usually start by repeating the test to confirm it is true, with no issues in processing the sample or so. Next we arrange blood hormones levels, and usually a Karyotyping test, or chromosome test.
Then, depending on the cause of the problem, whether it is an obstruction problem or a production problem, Urologists may try one or the other of sperm aspiration procedures. We may even need to do a testicular biopsy (minor surgery) to get a firm confirmation, if there is sperm calls at all or not.
We prefer to have this procedure done at IVF Canada OR, so that, if we find sperm cells, we freeze the sample immediately.
Sperm Banks
There are a few available sperm banks. What they do is, they screen the donors by asking for details medical history, familial known diseases, etc. They then proceed with some public health screening tests, like HIV, Hep B, etc. They typically then obtains a semen sample, and then freeze it in very cold storage. Six months later the test the donor again, and if tests are still negative, they release the sample.
IVF Canada works with semen banks, and does receive samples all the time. Make sure you contact IVF Canada to inform them that you have ordered the sample.
Who can order Sperm from Sperm banks
Well, anyone can. The specimen needs to be shipped to a fertility clinic, though. The answer, actually, clarifies that a male can ask for a semen sample if his test results show no sperm cells. A single female can order a sample if she chooses to become pregnant without a partner, using donor sperm. Two female partners can also use this service.
Can I choose the donor
For sure. The websites have detailed info about the donor. Their physical characteristics, their ethnic background, education, etc. Patients are encouraged to take their time and browse through the available donors early in the process. This will give you time to educate yourself well, and make an informed decision.
Counseling
We will go through some specifics about use of donor material when we see you in the office. Basically, the regulations mandate that you need to go through a session with a Psychologist who needs to go over a few things with you. This is a routine step, but it needs to be cleared before we proceed with the actual treatments, so, do plan your timing accordingly.
Donor Eggs
Childbearing period in women
Women get pregnant. They carry their babies themselves. This puts a lot of pressures on their bodies. They may have diabetes with pregnancy, high blood pressure, or a lot of many other issues that occurs with pregnancy and childbirth. Also, the pelvic bones needs to stretch a little bit and dilate to allow the baby to pass through.
For this reason, nature has it that women can only get pregnant during a certain age period. After age about 42-43 natural pregnancy can be very difficult as the ovaries start losing their eggs.
Of note is that some women lose their eggs at an earlier stage, with no explanation. We have seen this happen as early as age 24-25.
What do FSH and AMH results mean?
FSH is the hormone that your brain secretes, to talk to the ovary and instruct it to grow eggs. When the ovaries are young, a gentle reminder is enough. So, low levels of FSH are usual when the ovaries are responsive. When the ovaries are old, and they cannot make enough eggs, the brains 'yells' at the ovaries, so the FSH hormone is typically high.
AMH is the background 'noise' that the eggs make. So, the higher the ovarian reserve, the higher the AMH level. When the ovaries have very low reserve, the AMH is low.
Please note they these two hormones answer different questions, and sometimes their results may be conflicting.
What to do if I have no eggs
One of the available option is to use donor egg. These eggs are usually available through egg banks. These banks will screen the donors and make sure they are free from infectious diseases like HIV, Hep B, etc. The eggs are usually donated by younger women with appropriate levels of hormones. In most cases, the website will also advise you if that particular donor's eggs had been successful in achieving pregnancy and childbirth before or not.
How much will it cost?
There are different egg banks, and they will each offer you a different package. Some will charge a flat rate for 8 eggs. Some will charge you a fee for whatever number of eggs are produced by the donor her stimulation cycle. Others may charge you a higher fee but they offer a guaranteed number of fertilized eggs.
Can I be pregnant at any age?
Again, as nature goes, women usually do not get pregnant after 43-45 or so. But then again, as science and medicine progressed, we now treat men with heart attacks and make them live longer. We treat children with diabetes and make them live nearly normal live styles. We currently can also make women who are say, 52 or 55 year old, we can get them pregnant.
This is regarded as a high risk pregnancy, same as the diabetic mother or the mother with high blood pressure; they need to see a high risk pregnancy obstetrician to follow their pregnancy.
Of note is that the pregnancy will end up by C Section, as the female pelvic structures are not likely as stretchable as a 25 yer old, for example.
We will support you in your decision to carry your own baby, for sure. But we might caution you against that, if we think there may be some issues in your medical history that might make us urge you to change your mind.
Counseling
We will go through some specifics about use of donor material when we see you in the office. Basically, the regulations mandate that you need to go through a session with a Psychologist who needs to go over a few things with you. This is a routine step, but it needs to be cleared before we proceed with the actual treatments, so, do plan your timing accordingly.
Surrogacy
What does this mean?
The word surrogacy is used to describe a situation when a female get pregnant, by carrying a baby for someone else. A surrogate can carry the baby for another women who had her uterus removed, for example. Or may be someone has abnormalities in the uterus that caused them to have many miscarriages, etc.
Where can I find a surrogate?
If you have someone you know, a friend, relative, who will carry the baby for you, you can bring them along and we can have this arranged for you.
If you do not know anyone who can help with that, there are some agencies that can help. There may be a bit of a wait depending on the time you need this to happen.
Can I pay the surrogate?
The short answer is NO! For a detailed answer of what you can reimburse them, we will need to have a detailed discussion.
Agencies do charge a fee for arranging the paperwork, including the legal documents needed.
What will the birth certificate say?
in Ontario (check with local authorities if you plan to have your treatment done in a different jurisdiction) the birth certificate has the names of the intended parents of the child, not necessarily the biological parents.
Remember you will need some legal advise. If you proceed with an agency, they usually include a lawyer drafted contract with the service.
Counseling
We will go through some specifics about use of third party when we see you in the office. Basically, the regulations mandate that you need to go through a session with a Psychologist who needs to go over a few things with you. This is a routine step, but it needs to be cleared before we proceed with the actual treatments, so, do plan your timing accordingly.
Next steps
This information is meant to educate you a little bit on the topic, and to explain to you some steps of the process. The practical details and steps of treatment are meant to be dealt with in the office.