Sometimes life throws you curve balls.  You desperately want a baby, and there is no man in your life or the man you are madly in love with has had a vasectomy.  Whatever reason there is for not having a Sperm source, you can still conceive with donated sperm.  There are two types of  sperm donors: anonymous and known donors.  As tempting as it may be to ask your friend or a relative of your partner for his sperm, you need to think carefully about that decision as it can lead to some unintended consequences.  As the baby's biological father, the person you ask will have certain parental rights whether you put his name on the birth certificate or not.  You may not think he will ever want to have anything to do with the child, but remember that life throws you curve balls.  Several years from now, his situation may change and he may want more involvement in the child's life.  If the donor is a relative, will it be awkward at family gatherings?  What if he disagrees with the way you are raising the child?   There is also the issue of infectious diseases.  He is not likely to admit to you his entire sexual, surgical, and drug history.  You are taking a risk of being infected, even if you use the "turkey-baster" method.  Studies show, for instance, that blood that's donated by friends and family of a patient is more likely to contain infectious diseases than blood donated anonymously by the general public.  It's counterintuitive, but your friends and family want to help you and therefore may not be as forthcoming about a risk factor they have.  These are all things you need to think about and discuss before you make a decision.

Using anonymous donated sperm in this country is very safe.  The FDA has stringent rules and regulations about the testing of sperm donors.  They inspect all FDA-registered sperm banks on a routine basis to make sure they are following the rules.  They require that the sperm donor be tested for infectious diseases like hepatitis, AIDS, syphillis, gonorrhea, etc.  The sperm is then frozen and quarantined for 6 months.  The donor must come back 6 months later and be retested for all those infectious diseases to make sure that he was not in the window period where he had contracted the disease, but the test had not yet turned positive.  This works extremely well at protecting you from infectious diseases.  Most sperm banks will also do genetic and psychological screening on their sperm donors too.  The FDA does allow more leeway when it comes to donors who are known to the recipients (e.g. friends, family, etc).  Although the original testing must still be done, the clinic can decide wether to follow the quarantine policy.  They cannot decide on an individual basis.  They must make one policy for everyone and then follow it.  Most clinics, because it is safer, have decided to follow the quarantine policy.  Which leads to one more disadvantage of using your friend as the donor.  You may have to wait 6 months before you can have any of his sperm.  There are, of course, times when all of these disadvantages may be worth it.  You will have to decide that for yourself.

 There are many excellent sperm banks in this country, if you decide to go with an anonymous sperm donor.  California cryobank (http://www.cryobank.com/), Cryogam Colorado  (http://www.cryogam.com/),     Fairfax Cryobank (http://www.fairfaxcryobank.com/), and Xytex (http://www.xytex.com/) are the 4 main ones we use.  When you are looking for a sperm bank, the first thing you should check is that they are an FDA-registered bank.  Most will have a certificates page where you can actually check their FDA registration.  This ensures that your sperm donor will be tested in the appropriate manner.  Next you can look and see if they do any other testing on their donors, beyond what the FDA requires.  Some banks will test their donors for genetic diseases for which their ethnicity puts them at risk, like cystic fibrosis or sickle cell disease.  This can give you peace of mind.  Some banks will also allow you to see baby photos and even current photos of the donor.  You may or may not find that helpful.  Finally, look at the costs.  They are going to vary bank to bank.  Even within a bank, they may have different costs for donors with a college degree or proven fertility.  So shop around.  This may not work on the first try, so you may end up having to buy multiple samples.  That can start to add up.

Now that you have the bank you want, it's time to start looking at donors.  You will find that they give you all kinds of information on the donor.  One of the pieces of info that you will see is their CMV status.  CMV is a virus that children usually get.  It is not a particularly dangerous virus unless you contract it while you are pregnant.  If you do get CMV in a pregnancy, it can lead to birth defects.  Because there is a possibility of CMV being transmitted through the sperm sample, the donor is tested.  Our policy is to test you as well.  If you have had CMV already, then the chance of reinfection and subsequent birth defects is very low.  In that case, you may use CMV positive or negative sperm donor.  If you have not had CMV in the past, then you need to use CMV negative sperm donor.  The test on you is a simple blood test that looks for the antibodies to CMV.  If you don't know your CMV status, ask your doctor to test you or pick a donor that is CMV negative.

You will also see the donor's blood type as well.  This is less important, unless you are trying to match your partner's blood type.  There is no medical reason to do that, but some couples don't want to tell their offspring that they were conceived from donor sperm.  Matching the male partner's blood type will make it less likely the child accidentally figures it out when he learns about the genetics of blood types in  his high school science class.  This happens a lot in soap operas, but may or may not be an issue in real life.  If the recipient female is Rh negative (i.e. her blood type is O, A, B, or AB negative), then she will need an injection of something called Rhogam at 28 weeks of pregnancy and again at delivery, if the baby is Rh positive.  Rhogam protects the baby's blood from being attacked by the mother's blood.  If she picks an Rh negative sperm donor, then she will avoid the Rhogam shot at delivery.  The injection is not a terrible one though, so this is probably not worth the hassle of finding someone you like who is also Rh negative.

The majority of the information given is going to be on physical characteristics and personality traits.  You are on your own with picking out which of those are important to you.  You may also have information on whether they have helped conceive a pregnancy or not.  Proven fertility is obviously nice to see, but these guys are going to have a full analysis of their sperm before they are allowed to be donors.  So the vast majority of them are going to be fertile, proven or not. 

Once you find the donor you like, you need to figure out what type of specimens and how many you need to order.  You will see that most donors will have ICI, IUI, and sometimes ART-type specimens.  This relates to how the sperm is going to be used.  ICI  (Intra-Cervical Insemination) specimens are meant to be placed in the vagina or mucus of the cervix.  They are samples of semen with about 10 million sperm.  That may sound like a lot, but it actually is not.  The mucus in the cervix acts as a barrier to most sperm.  99.9% of that 10 million sperm will never make it to the egg.  Therefore the pregnancy rates with intra-vaginal or intra-cervical inseminations are fairly low.  Although these techniques are still used for home inseminations, most physicians prefer to do intra-uterine inseminations (IUI) instead.  IUI's bypass that mucus in the cervix and get all 10 million sperm into the uterus.  These specimens are washed to removed the seminal fluid.  The semen contains substances called prostaglandins.  When put in direct contact with the inside of the uterus, they can cause fairly painful contractions of the uterus.  So the specimen is washed to remove the fluid with the prostaglandins.  To put the sperm into the uterus, your doctor or nurse will insert a speculum (the device used to do a PAP smear) into the vagina.  A small tube with the sperm is then thread through the canal in the cervix and into the uterus.  The sperm is deposited at the top of the uterus and the tube and speculum are removed.  The entire procedure usually takes just a few minutes.  It is no more uncomfortable than a PAP smear, either.  If your cervix is very curvy, then it can take a little longer to get the tube through and may be more uncomfortable.  This is unusual, though.  Most fertility centers are open 365 days a year, so that inseminations can be done even if you are ovulating on a weekend or holiday.  The final type of sperm specimen is ART (assisted reproductive technology) specimens.  These are meant to be used with IVF (in vitro fertilization or the test-tube baby procedure).  They contain significantly less sperm and shouldn't be used for vaginal, cervical, or uterine inseminations. 

Ask your doctor's office whether they can store sperm for you.  If they can, you may want to order 2 specimens to start.  That way, if one specimen has a problem, you have a back-up specimen.  Your doctor's office will look at the specimen after it thaws it to make sure it has enough sperm.  If it does not, then they can use the second specimen.  Your doctors office can then contact the sperm bank and ask them to refund your money for the poor specimen.  Some sperm banks will also give you a discount if you order multiple specimens at one time.  This may save you some money.  Also, remember that if you want more than one child, you should order extra specimens when you conceive.  The donor may stop donating and not be available, if you wait until you are ready to try again for a second baby.  The sperm bank itself will usually store these specimens for you until you are ready to try again.

Beware of any internet sites that deviate from the above description of how donor sperm is handled in this country.  If they are offering you fresh sperm, they don't seem to have done any testing on the sperm, or it hasn't been quarantined for 6 months;  it could be very dangerous.  I have seen men offering their sperm via the internet to women they want to "help".  You have no idea what you are going to be sent.  He could have multiple infectious diseases or it may not even be sperm that is sent to you.  Please, please, please stick to FDA-approved sperm banks.  You do not want to put your own health at risk just to save money.  It is not worth it!  If you have more questions about donor sperm or you are ready to get going, see if there is a reproductive endocrinologist in your area.  They are the most likely to have the facilities to store and use donor sperm.  If not, your local OB/GYN may be able to help.  Good luck!!