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Treatment with a sperm donation

Sometimes a sperm donation is a way of fulfilling your wish to have children. Before starting treatment with donor sperm, it is advisable to find out about legal issues and seek psychosocial advice.

A fertility treatment with donor sperm is possible as semen transfer (heterologous or donogenic insemination) or as part of artificial insemination (IVF / ICSI). The sperm of the sperm donor is obtained frozen from a sperm bank.

Reasons for treatment with sperm donation

Donor sperm transfer is an option for couples if

  • the partner is sterile or fertile to a very limited extent and procedures of artificial insemination with the partner's sperm (homologous insemination) have not yet been successful, or if so
  • During a genetic counseling, it is found that the partner has a hereditary disease that should not be passed on to the child.

For a semen transfer (insemination) the fallopian tubes of the woman must be open. If both fallopian tubes are closed or if several inseminations remain unsuccessful, donor sperm can also be used for artificial insemination (in vitro fertilization or ICSI).

Who can use sperm donation?

As a rule, treatment with donor sperm is only carried out in Germany for heterosexual couples who are married or live in a long-term partnership if the (future) social father recognizes the child. Many sperm banks and fertility clinics require a contractual or notarized commitment from the man.

In Germany, different regulations apply from state to state. Therefore, some fertility clinics and sperm banks also allow lesbian couples to receive treatment after appropriate contractual coverage.

Selection of sperm donors

According to a medical assessment, the donor must be suitable for the sperm donation based on his age, state of health and medical history. Health risks for others due to the sperm donation must be excluded.

All sperm donors are screened for infectious diseases such as HIV 1 and 2, hepatitis, syphilis and chlamydial infection. Additional testing may be required in certain circumstances. Which tests are carried out results from the "Ordinance on the requirements for quality and safety in the removal of tissues and their transfer according to the Transplantation Act" (TPG tissue ordinance).

First, the men give some semen samples, which are frozen in liquid nitrogen (cryopreservation). The sperm is stored in a sperm bank. After six months, the donors will be examined again. If they are still free of infection, their semen can be used for fertility treatment.

At German sperm banks, couples or women with an unfulfilled desire to have children can usually choose a donor based on hair and eye color, size, weight, level of education and blood group.

Treatment with a sperm donation

The doctor usually transfers the semen through a thin tube (catheter) that he or she inserts into the uterus (intrauterine insemination). Treatment is almost always accompanied by hormonal stimulation of the ovaries. At the appropriate time, drugs trigger ovulation. The insemination is carried out no later than 36 hours afterwards. Before this, the frozen semen is thawed and specially prepared. The insemination is usually painless.

If sperm donation is used as part of artificial insemination (in vitro fertilization or ICSI), doctors fertilize the egg outside the body. The procedure is no different from IVF or ICSI treatment with your partner's semen.

Treatment with donor sperm is offered by specialized medical practices and reproductive medicine centers.

chances and risks

The chances of success after treatment with sperm donation depend in particular on the woman's age and possible fertility problems.

After sperm donation insemination, the average chance of pregnancy is around 16 to 19 percent per attempt. However, this only applies to women under 40 years of age and without any recognizable fertility problems. In women older than 40, it drops noticeably.

The birth rate after insemination with donor sperm is given as an average of around 14 percent per attempt. After IVF or ICSI treatment with donor sperm, it is 15 to 20 percent per treatment cycle and thus just as high as with artificial insemination (in vitro fertilization or ICSI treatment with the sperm of one's own partner.

The birth rate after insemination with donor sperm is given as an average of around 14 percent per attempt. After IVF or ICSI treatment with donor sperm, it is 15 to 20 percent per treatment cycle and thus just as high as with artificial insemination (in vitro fertilization or ICSI treatment) with one's partner's semen.

The donor's medical examinations cannot rule out all diseases. In the unborn child, accidental gene mutations can cause physical or mental disabilities or illnesses during pregnancy or disorders during childbirth. Most children, however, are born healthy: the risks are just as low as for couples who become parents without medical help.

Hormone stimulation prior to treatment can be physically stressful and associated with health risks. In rare cases it leads to the so-called overstimulation syndrome, in which the woman's body "overreacts" to the hormone preparations. Abdominal pain, nausea, feelings of tension in the abdomen and shortness of breath can occur. Clinical treatment is necessary in rare, severe cases.

If several follicles mature as a result of the stimulation, the likelihood of a multiple pregnancy also increases. For a pregnant woman, it entails a significantly higher level of physical strain. The risk of premature labor and premature birth is also significantly increased in multiple births.

Psychosocial Challenges

The decision to father a child using sperm donation brings with it a lot of emotional uncertainty. They affect not only the parents-to-be, but also the child born after the sperm donation. In addition to the advice and education that doctors are obliged to provide, experts therefore recommend psychological or psychosocial counseling before donor sperm treatment. It is expressly required by some fertility centers.

Legal Aspects

It is common for a contract to be concluded between the sperm bank, the doctor treating you, and the couple who wish to donate sperm. It is advisable to seek legal advice before concluding a contract.

A very important legal question is to what extent children conceived by sperm donation are later entitled to know who the donor is.

On July 1, 2018, the “Law regulating the right to know parentage in the case of heterologous use of semen” came into force. Since then, everyone who knows or suspects that they have been conceived through the heterologous use of semen during medically assisted artificial insemination has a right to information from the German Institute for Medical Documentation and Information (DIMDI) from the nationwide sperm donor register established and maintained by DIMDI . Anyone over the age of 16 can submit an inquiry. In the case of younger people, their parents can contact DIMDI as legal representatives. Whether DIMDI can provide information about the sperm donor to those affected depends on when the donor sperm was used heterologously for a medically assisted artificial insemination. There is an obligation to send the data required to fulfill the request for information to DIMDI only in cases in which the donor sperm is used from July 1, 2018.

People who were conceived as part of a medically assisted artificial insemination, in which the donor sperm was used before July 1, 2018, now have the opportunity to claim knowledge of their own parentage, at least from the extraction facility, even after more than 30 years apply: Since the law came into force, all collection facilities and medical care facilities have been obliged to store the personal data of the sperm donor and the recipient of a sperm donation 110 calendar years after the sperm was obtained or used.

The law also excludes judicial determination of the legal paternity of the sperm donor if he donated his semen to a sperm bank and the semen was used in a medically assisted artificial insemination after the law came into force. In this way, the sperm donors are in particular exempt from maintenance claims of the children conceived with a sperm donation. The children are also not considered as legal heirs.

You can find more legal information on the Sperm Donor Register Act at the Federal Ministry of Health.