Assisted Reproductive Technology (ART) offers female couples multiple medical pathways to parenthood using donor sperm. These modern fertility treatments address the biological necessity of sperm while accommodating the health, financial, and emotional considerations of the intended parents. The process begins with careful preparation and selection of genetic material, followed by choosing the appropriate medical procedure.
Selecting and Screening Donor Sperm
The first step is securing a sperm donor, choosing between an anonymous donor from a certified sperm bank or a known donor. Sperm banks provide access to donors who have undergone extensive, standardized screening procedures mandated by agencies like the FDA. This rigorous process includes comprehensive infectious disease testing (e.g., HIV and Hepatitis), genetic carrier screening, physical examinations, and detailed medical history reviews.
The alternative is using a known donor, such as a friend or family member. This path requires the donor to undergo the same medical and psychological screening as an anonymous bank donor. Even with a known donor, the sperm must often be quarantined and tested for infectious diseases before use. While a known donor offers a personal connection, the legal complexities surrounding parental rights must be proactively addressed to protect the rights of the intended parents. Couples choose a donor by reviewing detailed profiles that include physical attributes, education, and family medical history.
Intrauterine and Intracervical Insemination
For couples without known underlying fertility issues, artificial insemination is often the first step. These procedures, Intracervical Insemination (ICI) and Intrauterine Insemination (IUI), involve placing donor sperm into the reproductive tract at the time of ovulation. Timing is managed by tracking the menstrual cycle through ovulation predictor kits or clinical monitoring. The goal is to maximize fertilization chances by introducing sperm close to the moment an egg is released.
Intracervical Insemination (ICI), sometimes called home insemination, is the simplest method. It involves placing unwashed sperm directly into the cervix using a syringe or similar device. Since the sperm is placed lower, it must swim through the cervical mucus and uterus to reach the fallopian tubes, mimicking natural conception. This procedure can be performed at home or in a clinic and is generally the most affordable option. However, the success rate per cycle is typically lower than IUI, ranging from 5% to 15%.
Intrauterine Insemination (IUI) requires the sperm to be “washed” in a laboratory process to remove seminal fluid and concentrate the motile sperm cells. A fertility specialist uses a thin catheter to bypass the cervix and insert the concentrated sperm directly into the uterus. This direct placement significantly increases the number of sperm reaching the fallopian tubes. IUI leads to higher success rates compared to ICI, often between 10% and 20% per cycle for women without fertility issues. Because of the need for specialized preparation and precise placement, IUI must be performed in a medical clinic.
The Role of In Vitro Fertilization
In Vitro Fertilization (IVF) is a complex, laboratory-based procedure used if IUI is unsuccessful, or if factors like advanced reproductive age or fallopian tube issues exist. Standard IVF involves stimulating the ovaries with hormone injections to encourage the development of multiple follicles. Once the eggs are mature, egg retrieval is performed under sedation to collect them.
The retrieved eggs are combined with donor sperm for fertilization, either in a petri dish or via Intracytoplasmic Sperm Injection (ICSI). The resulting embryos are cultured and monitored before one or two are selected for transfer into the uterus of the carrying partner. High-quality embryos not used immediately can be cryopreserved for future use.
Reciprocal IVF (RIVF), also known as shared motherhood, allows both partners to participate biologically. With RIVF, one partner undergoes ovarian stimulation and egg retrieval to provide the genetic material. The eggs are fertilized with donor sperm, and the resulting embryo is transferred into the uterus of the other partner, who carries the pregnancy. This method ensures one partner is the biological parent and the other is the gestational parent.
Preparing for Conception: Medical and Legal Steps
Preparation requires a comprehensive medical evaluation for both the carrying partner and the egg provider. This includes baseline fertility assessments, such as ovarian reserve testing and a uterine evaluation for the gestational carrier. Both partners may undergo genetic carrier screening to identify potential shared risks for heritable conditions, which informs donor selection. Adopting healthy lifestyle changes, such as achieving a healthy body weight and stopping smoking, are also prerequisites.
The legal groundwork must be established before insemination or embryo transfer. Couples should engage a reproductive law attorney to draft detailed donor agreements that legally terminate the sperm donor’s parental rights and responsibilities. Parental intent documents are necessary to confirm that both female partners are the legal intended parents, regardless of who provided the egg or carried the pregnancy. While a birth certificate may list both parents, a second-parent adoption after birth is often recommended to secure the parental rights of the non-biological, non-carrying partner across all jurisdictions.