Sperm banks
Sperm banks are medical facilities that provide sperm for individuals and couples seeking to conceive, particularly when traditional methods may not be viable. They are often utilized by women in heterosexual relationships where the male partner is infertile, women in same-sex relationships, or single women wishing to become mothers. Sperm banking also plays a crucial role for men facing medical treatments, such as chemotherapy, that could impair their fertility.
The primary function of a sperm bank is to collect, preserve, and distribute sperm from qualified donors, ensuring that thorough medical and genetic screenings are conducted to minimize the risk of transmitting infectious or genetic diseases. Sperm is preserved using cryopreservation, allowing it to be stored safely until needed. While many recipients opt for anonymous donors, some may choose known donors, which can complicate legal and psychological dynamics.
The process of artificial insemination involves careful timing and medical intervention to increase the chances of conception. Sperm banks have evolved significantly, contributing to advancements in reproductive technology and expanding services to include embryo and egg banking. As a growing industry, sperm banks are integral to modern fertility solutions, facilitating family planning for diverse populations.
Sperm banks
Anatomy or system affected:Genitals, psychic-emotional system, reproductive system, uterus
Definition:The identification of suitable sperm donors and the evaluation, processing, storage, and distribution of their semen for use in assisted reproductive technology.
Indications and Procedures
Sperm banks exist primarily to help women with normal adult premenopausal reproductive function to become pregnant. A woman seeking pregnancy may need the services of a sperm bank if her male partner is infertile, if she is in a same-sex relationship, or if she chooses to be a single mother. When a man in a heterosexual relationship produces too few sperm for his female partner’s pregnancy, or the sperm is not viable, sperm from a sperm bank can help the couple become pregnant through artificial (or donor) insemination. An additional purpose of sperm banking is to allow men who have cancer to preserve their sperm before undergoing chemotherapy or radiation, which might render them infertile or compromise the quality of their sperm.
A sperm bank makes available sperm from a number of qualified donors. The primary task of a clinical sperm bank is to preserve sperm and identify suitable donors based upon medical and biological criteria. The sperm bank does a medical, physical examination of donor candidates and obtains an extensive medical and family history from them. Special attention is given to semen quality and to the risk of transmitting infectious or genetic diseases.
Semen quality has two major components. The first component is whether the semen has enough fertile sperm with appropriate motility and morphology to create a pregnancy. The second component is whether enough sperm in the semen survive freezing. Freezing in a special way (cryopreservation) to keep sperm alive is the only way a sperm bank can store its semen inventory. Another important reason for cryopreservation is related to infectious diseasetesting. For example, a donor is tested for acquired immunodeficiency syndrome (AIDS) at the time he produces the semen, but the test is repeated six months later to increase its certainty. The cryopreservation allows the semen to be stored during this “quarantine” period. Donors are tested for a variety of diseases that can be transmitted through semen: AIDS, gonorrhea, chlamydia, syphilis, trichomonas, and well-known sexually transmitted infections (STIs); and viral hepatitis, cytomegalovirus, and human T-lymphotropic virus (HTLV).
The genetics of a donor is very important. Genes are responsible for each person’s positive attributes and negative ones (genetic diseases). There are no genetically perfect persons, and there are no perfect donors. There are only a few hundred genetic tests for more than five thousand genetic conditions; therefore, comprehensive testing for genetic disease is impractical. Sperm banks usually screen donors routinely for a few very common diseases with a genetic component, such as diabetes, gout, and high cholesterol. Additional tests may be done on donors of certain ethnic backgrounds for diseases linked to specific ethnicities: cystic fibrosis, Canavan disease, Gaucher disease, sickle cell disease, and Tay-Sachs disease. Each sperm bank will have its own list.
Fortunately, both parents determine a child’s genetics. The genetic attributes of one often will compensate for the liabilities of the other. A person choosing a donor would be wise to seek the help of a certified genetic counselor. A genetic counselor will help match the genetics of the woman with the genetics of possible donors.
Considering all that is involved in identifying each suitable donor, a sperm bank requires donors to provide many “samples,” not only of semen but also of blood. Additionally, there are annual physical exams, perhaps psychological exams, and other tests. It is understandable that the bank compensates donors for their time and effort in participating; this is different from “buying sperm.” Similarly, sperm banks receive a fee for their efforts in recruiting and evaluating donors, plus their work in evaluating, processing, and providing semen to physicians and their patients.
Semen is normally available to a patient through a physician or other medical clinician trained in artificial insemination. Sometimes a patient will request self-insemination at home. This is possible with physician authorization, meaning that the physician retains responsibility for mistakes that might occur. The requested semen is delivered frozen by the sperm bank in a shipping container similar to a thermos. The semen is thawed immediately before insemination.
Uses and Complications
There are many personal decisions to be made regarding artificial insemination. Often there are psychological effects on the woman being inseminated and her partner. Usually, artificial insemination is done with semen from an anonymous donor, thus preventing any social contact between donor and recipient. The use of an anonymous donor usually conveys full parental rights and responsibilities to the partner of the recipient, relieving the donor of any responsibility. Sometimes the recipient or her partner wants to use a donor known to them, a directed donor. Although this is possible, it raises legal and psychological issues that are not fully understood. These issues about the kind of donor also have implications for the psychology of the offspring. There are many medical decisions to be made regarding artificial insemination. The procedure must be done at the time of ovulation, an event occurring between menstrual periods. The occurrence of ovulation can be determined in several ways, often by hormonal tests. The physician must decide whether to do one or more inseminations at ovulation. If the timing is off, the patient will not become pregnant. Another attempt can be made on the next monthly cycle.
Although many women will become pregnant with semen placed in the vagina at the entrance to the uterus, many physicians and other clinicians will increase the success of insemination by placing the semen into the woman’s uterus. Intrauterine insemination (IUI) requires removing the semen from the seminal plasma, administering substances that cause the uterus to contract strongly, and discharging the sperm into the uterus through a catheter.
Other complications include the possibility of infection or genetic problems. Although the sperm has been properly tested, tests are not perfect. The patient must remember that even when all aspects of insemination are technically perfect, the complex biology of making a baby from a fertilized egg can go wrong.
Perspective and Prospects
Horse breeders may have successfully used artificial insemination as early as the fourteenth century. In 1776, John Hunter, an English surgeon, may have been the first person to successfully artificially inseminate a woman. Cryopreservation of bull semen was developed in England in the early 1950s. An American urologist, Raymond H. Bunge, was the first physician to successfully use cryopreserved human semen. Many sperm banks were established in the early 1980s so that semen could be quarantined to prevent the transmission of AIDS. Sperm banks are also being used to guarantee male fertility for men with medical problems as well as to allow women to reproduce. Sperm banks have expanded to become embryo banks. New technology allowed for the cryopreservation of human eggs and their subsequent storage in egg banks. In the 2010s, this technology became widely available in American In Vitro Fertilization clinics. These banks contribute to genetic medicine, but they also allow for men, women, and couples to delay child-rearing until they feel they have reached appropriate life circumstances, which often involve socioeconomic factors. In the 2020s, fertility in the United States has become an over $8 billion business.
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