Disclosure and Openness: To Tell or Not to Tell

Blog written by Director of Operations Fairfax Cryobank Michelle Ottey, PhD

It is the choice of a child’s parents to disclose the details of their conception, as well as to decide the degree of information that is shared. This is an incredibly personal decision. Since 2004 the American Society of Reproductive Medicine Ethics Committee, the national organization representing fertility specialists, has supported full disclosure. I agree with the committee and several other sources that state that disclosure is in the best interest of the child. Secrecy is not healthy and can lead to emotional stress.

Several options for donor selection are available, some for over 20 years. A prospective parent can choose from an anonymous sperm donor, an ID consent sperm donor or a directed (known) donor. Directed donors, because they are known to the recipient, allow an option for disclosure of the identity of the donor at the discretion of the recipient. The ID donor programs vary by sperm bank, but for the most part this means that upon reaching the age of 18 your prospective child will have the option to obtain contact information for the donor from the sperm bank. This does not guarantee a relationship or sustained contact with the donor, simply that they have agreed to be contacted.

It is important to understand that at most banks you can obtain all of the same detailed information about the anonymous donor with the only difference being the release of identifying information if you choose an ID donor. This means that regardless of the category of donor you choose you will have access to the same comprehensive medical history, personal profile, and usually some additional information via interviews or pictures.

An added advantage that using either an anonymous or ID sperm donor allows you is the opportunity to have half siblings connect. The natural curiosity that children have can in many ways be addressed by contact with a half sibling; these siblings discover their shared characteristics and interests that may be similar to the donor. Several sperm banks have developed their own online forums to discuss issues of disclosure, address common concerns and even facilitate these contacts among families that used the same donors.

As the use of donor insemination increases and families are more open there will be increased acceptance. We have already seen a growth in resources for families from the release of children’s books to a plethora of websites about and for DI families.

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New to Infertility

Blog written by Laboratory Staff MF

Infertility and the need for reproductive assistance are issues that not every person in the general public has to face, but those that do understand the heartache, worry, and pain that go along with it. As a relatively young and healthy twenty something, I never imagined that infertility would touch my life and become so integrated into what I do on a daily basis.

My introduction to infertility began seven months ago when I was hired as a Laboratory Technician at the cryobank. On a daily basis I process, freeze, and store the semen samples produced by donors and clients in the hopes that these specimens will be able to help in the conception and birth of a child at some point in the future. The steps that go into processing and preparing specimens for freezing may seem like simple and everyday tasks to some, but when I think about the hope and joy that the job I am doing will provide to others I couldn’t be more elated and proud of the work we do here. I never realized how many individuals are affected by the inability to have children, and am grateful that I am able to be a small part of what may help build families in the future. Fertility and its preservation are important issues.

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Fertility Options for Same Sex Options

Blog written by Michelle Ottey, PhD, CLI Director of Operations

When two women partner and decide to build a family, there is a lot to consider: known donor, sperm donor (anonymous or ID), foster, foster to adopt, adopt, etc. If the choice is made to proceed with a sperm donor, many couples first face the emotional and psychological issue of needing a third party in order to build a family.

Having a child is an intimate and incredible personal process, and bringing a sperm donor into that process can be a challenging part of the journey.

When ready to proceed, it is important to know that you are working with a company that is friendly, professional, and open. Sperm banks know that lesbians, single and partnered, make up a large percentage of their patient demographic. So, the majority of banks are well-informed, accepting, open, and able to serve all patients equally. Perhaps one day we will live in a society where sexuality or relationship status will not make a difference in how patients are treated, but for now we must each navigate our way through these processes ensuring equal treatment and sensitivity.

To proceed and use a sperm donor, women should consider what qualities are important: education, height, hair and eye color, ethnicity, ID option, etc. Finding the perfect sperm donor match varies for each individual or couple; some find that perfect sperm donor on their first visit to a Sperm Donor Search. For others, it takes weeks to go through the details.

For lesbians, like single women, the decision to disclose a child’s donor origin can be more obvious than for traditional heterosexual couples. Still, some opt not to disclose. This is an important consideration in the journey to parenthood. I have heard from many women — the decision to disclose is incredibly personal.

Overwhelmingly, the message has been that when this is a part of a child’s story from the beginning, the easier the message is received. There will always be questions, and there is no single right way to tell this story. Thankfully, over time more resources emerge that assist families in telling their story.

CLI BlogThough it often takes more effort, time and money to have children in this way, the end result is most often a beautiful and happy family.

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Fun on the Forum

The CLI Family Forums are a great place to connect with others going through the donor insemination process.

Check out some of these fun conversations from the forums:

Pregnant with 2961

“Hey there. I’m pregnant with 2961 and would love to be in touch with anyone who has also used 2961. Thanks so much.”

“I have a beautiful five month old girl with this donor and I could not ask for anything better! :D

“I have a 6 week old girl with this donor.”

“We have an amazing 1 year old daughter… Would love to hear from others with kiddos from 2961”

What to do, what to do…

“I am a single mom, with three kids… when I was little I always wanted a big family! I wanted 5-6 kids, see there was just me and my bratty sister, and I wanted more in my life!  I had my 3 with my ex-husband, and lets just say he is no longer in the picture… so my kids and I are doing great! BUT I still want those 2 more babies… ”

“Well, I for one do not think you are crazy! At least if you are, then I am much more so!! :lol:
I’ve been on my own now for almost four years raising my four boys. My oldest is 19, almost 20 – and my youngest is 10. I always wanted to have more kids, and love being a mom. ”

“I chose to have my son by myself with donor sperm. I jsut wanted to introduce myself and tell you that there is a HUGE support system out there for Single Mom By Choice.”

CLI BlogJoin the CLI Family Forums today and start your own conversations!

 

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We want to tell you about CLI

As a child or adult conceived with the use of donor sperm, you may have many questions. We would like to help you answer some of them by sharing some of the details about how our sperm bank selects donors, offers donor sperm to women and couples, and handles requests for more information about donors.

We want to tell you about CLI. We have been around a long time, since the early 1970s. CLI was the first sperm bank started in the US and has observed many changes over the years. In the early days before sperm banks were available, it was not unusual for a doctor to offer fresh semen from a donor he selected on behalf of an infertile couple. Information on the donor was often kept secret and little was known about his medical or personal history. The use of donor sperm today is very different. Sperm banks make every effort to select healthy, educated donors who share many health-related and personal details about themselves. Our sperm bank will receive some 200 applications for each donor we ultimately select. It is more difficult to become a sperm donor than it is to be accepted into Harvard! If you want to read about the way we screen donors, go to the webpage about donor screening. You’ll see that the donors undergo many blood, urine and semen tests as well as answer many questions about their family social and health history.

The typical family who uses donor sperm is changing. Originally donor insemination was offered exclusively to married couples who were experiencing infertility. Today, infertile couples are still helped by donor sperm but other types of families are as well. Single women are increasingly choosing to have children on their own with the help of donor sperm. Same sex couples are, too. Where 20 years ago it was easier to keep the donor sperm story a secret, it is now much more obvious when a father is not around while a child is growing up. Children born from donor sperm are learning about the circumstances of their conception in ever increasing numbers. We estimate that now about 4,000 to 5,000 children a year are born in the US as the result of anonymous donor insemination.

In 2005, Cryogenic Laboratories (CLI) started a new program called the ID Options program in which new donors agree to release identifying information. We created this special category of donors because of the increased interest by families to have this option available. Identifying information, such as donor name and address, is shared only with the children who were conceived by an ID Options donor, whose mother registered their birth with our sperm bank and who then go on to request the information themselves when they reach the age of 18 or older. About 20% of our current donor list is ID Options. The other 80% are donors that have chosen to remain anonymous. Before 2005, all our donors were anonymous. The first children eligible for this ID Options information will reach the age of 18 in 2023.

Today, we ask all new donors if they want to be known. If they agree, they become an ID Options donor. If they decline, they will remain anonymous. All donors who began donating prior to 2005 signed an agreement with us in which we agreed to keep their identifying information private. Many families were created with the understanding that their specific donor would be anonymous forever, and they very much want this information to stay private. We have very specific understandings with donors and families that we will protect the information of not only the donor’s identity but also the identity of the families who used that sperm donor. Our policy is that once a donor is designated as an anonymous donor or an ID Options donor, his status cannot be changed, e.g. from an anonymous donor to an ID Options donor, or vice versa. Therefore, for our anonymous donors, we are not mediating contact between families and their donors.

There is a considerable amount of information we do have on our donors, both anonymous and ID Options, that is extremely valuable in learning about the donor as a person rather than a cold statistic. Donors today have audio interviews recorded, childhood photos, some have adult photos, and all have detailed medical and personal histories. Their ethnicity, talents, interests, and even their favorite color and song are presented. Donors who are no longer donating also have information saved. (See more about donor information on this webpage about donor information.) In addition, half siblings who are interested are able to connect with each other via various sites third parties set up for this purpose on the web. Although the donor may be unknown, half siblings often find shared traits that they determine are likely from their biological fathers. This discovery of sibling relationships, along with the extensive information already available on the donor, may help some children as they seek to learn more about their genetic heritage.

You may have questions about your donor’s motivations to be in our program. Typically donors are college students or recent graduates who have an interest in helping others. Some are married and may even have children of their own. They do receive some compensation (usually about $500 a month) for their time and effort. They must visit the laboratory on average one to two times a week for at least 6 months to donate sperm and agree to take dozens of blood draws over the course of their commitment. In addition, they must have regular physical examinations and agree to several face-to-face interviews with our staff. Donors are selected because they have shown us that they are dependable, responsible, trustworthy people. We do not inform donors if pregnancies result from the use of their sperm. Donors often move on to other life events and stop donating after about 6 months to a year in the program, although some continue longer.

Donor sperm from one donor usually results in several pregnancies over many years. Some families store units from the same donor in order to have biologically full siblings, so the age range of all the children from the same donor may be considerable. In accordance with the guidelines set by the American Society of Reproductive Medicine (ASRM), we strictly limit the number of donor units sent to the same geographic area. But since donor sperm is shipped all over the US and several other countries, the donor usually sells out before he reaches our distribution limit. It is highly unlikely you would ever meet another one of your half siblings randomly, (i.e., someone who was conceived with the exact same donor).

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Why Choose Cryopreservation?

Choose Cryopreservation If…

…you’ve been diagnosed with cancer
Before you or someone you love begin any form of cancer treatment, consult with your doctor about the risks of sterility or infertility.

Many common cancer treatments such as surgery, chemotherapy and radiation may permanently affect your ability to father children. For over 30 years we have protected the future of cancer patients by cryopreserving and storing their sperm for future use. Even though treatment may have begun, many patients have been able to effectively store semen.

Thanks to recent advancements in infertility treatments, the successful use of sub standard semen specimens is a real possibility.

…you’re scheduled for testicular, prostate or similar surgery
The option to freeze and store semen prior to impending surgery may preserve a man’s reproductive capability.

…you’ve already had surgery and are going to have Chemotherapy or Radiation Therapy
The ability to cryopreserve your semen specimens between the time of surgery and the initial Chemo/Radiation therapy is most critical. CLI can arrange for the storage of semen specimens in this critical window, by either a personal appointment at our facility, or our unique Mail In Sperm Banking overnight collection kit.

With a Mail In Sperm Banking kit, you can send semen specimens to CLI from anywhere in the country – overnight, eliminating any treatment delay and making it easy to coordinate with your therapy schedule.

“Cryopreservation of semen should be offered to cancer patients irrespective of the type of disease.”

O. F. Pardon, M.D., et al.
Effects of cancer on spermatozoa quality after cryopreservation: a 12 year experience.
Fertility and Sterility, vol. 67, no. 2. February, 1997.

 

…you’re considering a vasectomy
Although vasectomy is a common method of birth control, many men prefer the peace of mind that comes from banking their semen prior to a vasectomy. This safeguard allows these men the possibility of satisfying future fertility needs.

…you’re involved in an Assisted Reproductive Technology procedure
By storing semen prior to IVF, GIFT, ICSI or similar procedure, the availability of the sperm sample at the critical time of the procedure is ensured.

…you’re not available when needed
When your sexually intimate partner wishes to continue with the couple’s reproductive plans and the husband’s schedule prohibits his availability, frozen semen specimens may be made available for insemination.

…you’re in a high-risk occupation
Many occupations put men at “high risk” of injury to their reproductive system and possible infertility. Sperm banking with CLI is an added measure of protecting the future of ….

  • People who work with environmental pollutants
  • Workers in X-ray or nuclear environments
  • Firemen, policemen and construction workers who are prone to falls and other accidents which could result in testicular injury
  • Men in military service
  • Hockey players, soccer, basketball and football players run a particularly high risk of testicular injury which may impair fertility

…you’ve been diagnosed with oligozoospermia
Sperm banking may help treat men with oligozoospermia, or low sperm concentration. We concentrate the semen specimens, cryopreserve and store them. The specimens are then pooled by the physician to increase the probability of pregnancy.

“Cryopreservation should still be considered even in cases of decreased semen quality because today’s assisted reproductive technologies have resulted in pregnancies using very low numbers of sperm.”

Fertility after cancer treatment – a guide for patients.
American Society for Reproductive Medicine, 1995.

…you are going to begin hormone therapies that might compromise your fertility.

This may be the case for example, in gender transition.

CLI BlogIf you would like more information about our services or would like to order a Priority Male- Mail In Sperm Banking Specimen Collection Kit, please call 1.800.466.2796.

 

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Genetic FAQs

What kind of genetic issues are screened for in the donor’s health history?

All donors will have a three-generation family history reviewed by a geneticist. The family history will present information on illnesses and birth defects noted in the individual family members, causes of death, history of miscarriage or reproductive failure, and any known hereditary disorder. Any donor at an increased risk for a genetic or hereditary disorder above that expected in the general population, will be excluded. Examples of disorders that would exclude a donor include alcoholism in a first degree relative, a sibling with spina bifida, a donor with a medical condition such as a heart defect or diabetes, and mental illness or mental retardation in a first degree relative.

Does the normal chromosome analysis on the donor tell me he has no genetic problems?

A chromosome study looks at the whole structure of the chromosome, detecting changes in chromosome structure. It does not look at the level of the genes, which make up the chromosomes like beads on a string. Thousands of genes make up every chromosome. A normal chromosome analysis tells us that no obvious chromosomal defects were found but does not tell us that the genes that make up those chromosomes are indeed normal. Individuals with abnormal chromosome structure (chromosomal rearrangements) are at increased risk for reproductive failure and having children with significant birth defects. They would be excluded from the donor register.

Do you look at the genes of the donor for abnormalities?

Yes, for a limited number of disorders. We do not do a general test that looks at all genes. See the list of genetic diseases tested. Not all genetic diseases known are tested, rather those that are common enough to cause concern, that involve a serious medical condition and that have a readily available genetic test may be selected for testing by our medical director in consultation with our medical advisory board. As gene research progresses, we are constantly evaluating this list of tests on our donors.

If my family history is normal and I am healthy, then what is the chance, if I use a CLI donor, to have a child with a birth defect?

We cannot guarantee that the risk is zero. We know that any healthy couple conceiving a pregnancy has a 3-4% chance of having a child with a birth defect. Family history, good prenatal health, folic acid supplementation prior to and during pregnancy (reducing the risk of neural tube defects), and the age of the mother are all factors that affect the risk for birth defects. Screening tests during pregnancy may be able to offer you important information on the health of your unborn baby. Please discuss any concerns you might have with your physician.

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CLI Pregnancy Pledge

CLI is confident we can help you achieve your goal of having a child. We are so confident in fact that if after 4 attempts you are still not pregnant, we’ll give you a vial for free.

Starting May 1, 2013,

  • if you are 38 or younger,
  • order at least 4 vials,
  • undergo 4 cycles of insemination procedures at your doctor’s office within 12 months*
  • and don’t achieve a pregnancy,
  • we will give you a vial for free.*

We recognize that this is an investment of time, emotions, and also of money. We are committed to you, our clients, and to the growth of healthy, happy families. Please take advantage of this limited time offer.

To see more special promotions we have available, visit our What’s New page. There is something for everyone!

*Full Guidelines here:

1. The patient must order at least 4 vials of donor semen from CLI. The orders may all be at different times. The earliest purchase date of a vial for purposes of this offer is May 1, 2013.

2. The patient must also have at least 4 cycles of assisted reproductive technology (ART) procedures, which include artificial insemination or in vitro fertilization (IVF) performed by a licensed physician

  • At home inseminations will not be counted as one of the 4 ART procedures
  • All ART procedures must occur within 12 months of the first procedure date and no earlier than May 1, 2013.
  • If 2 inseminations occur within one cycle, this counts as 1 cycle.

3. A completed Pregnancy Pledge Physician Verification form must be verified and signed by a physician or other relevant medical professional in order for patient to be eligible for 1 free vial. The form is available by contacting Client Services at 800-338-8407 who will fax it directly to the physician’s office filling out the form.

4. The patient who is receiving the ART procedure must not have reached her 39th birthday by the date of the first ART procedure

  • Proof of age will be verified by the physician completing the Pregnancy Pledge Physician Verification form.

5. If pregnancy is not achieved after 4 cycles of ART procedures as defined above, the patient will be able to receive one vial of equal or lesser value donor semen at no cost. Vials will be considered equal if they are in the same donor category (e.g. CLI, ID Option, Value).

6. If a client desires her ‘free’ vial from a different donor category and the vial cost is more expensive, the difference in cost will be the client’s responsibility.

7. Shipping costs of the free vial will be the patient’s responsibility.

8. If a client purchases vials in bulk, then proceeds to have 4 cycles of ART procedures without a successful pregnancy, and has at least one unused vial remaining, they will be refunded the cost of 1 vial.

9. If the patient becomes pregnant during one of the 4 sequential cycles of ART procedures, we recommend that the pregnancy be reported to CLI via our online pregnancy reporting.

10. If a pregnancy is achieved and is confirmed with ultrasound to show a fetal heartbeat, the free vial offer is no longer applicable for the ART procedures prior to that pregnancy.

11. The patient can apply for only one free vial.

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The History of Semen Cryopreservation

Sperm cryopreservation and banking has become a widely accepted part of our culture. Once looked upon with uncertainty, this practice has proven time and time again to be a successful method of keeping the hope of a family alive for many men. The reasons for storage are as varied as men themselves. Sports figures and those in high-risk occupations protect their future against the chance that an injury could affect their reproductive health. Vasectomy patients often store sperm prior to their procedure in case they may one day choose to father another child. Patients undergoing cancer treatments are urged to store sperm prior to these procedures since radiation, chemotherapy or surgery may render them sterile. The reasons go on and on, but one thing is clear; more and more men are choosing to protect their future from the loss of fertility – and semen cryopreservation offers a proven measure of protection.

As early as the 1940’s cattlebreeders and veterinarians had pretty much refined the process of cryopreserving bull semen and artificially inseminating heifers. It was obvious then, that the technology they were working with would be of great benefit to mankind. However it wasn’t until the 1950’s that the methods for cryopreserving human semen and artificial insemination were refined, resulting in the first human birth. Since then, careful ongoing research has aided in the development of more sophisticated procedures and techniques for the freezing and storing of human semen. Today, conservative estimates prove that more than 300,000 births have been achieved through artificial insemination with cryopreserved semen.

So far, no limit has been established for how long human semen can be frozen when maintained and stored in appropriate liquid nitrogen storage. Cryogenic Laboratories has maintained cryopreserved human semen in storage for over 30 years and semen stored for 19 years has been used to achieve a pregnancy. Scientific literature shows conclusively that sperm motility, viability and morphology are not affected by proper long term cryopreservation.

“The technology of assisted reproductive techniques (ART) in recent years has progressed at a tremendous pace. Today, cryopreservation of sperm with subsequent ART can provide most post-therapy infertile cancer patients an opportunity to father children. Men who once had little or no chance of producing a pregnancy through assisted techniques due to poor” semen quality now have fertility rates approaching that of couples undergoing standard IVF when there is no male infertility involved. As a result, cryopreservation of sperm should be attempted before therapy by all men who may want to father children in the future.”

Reprinted from CANCER, November 1, 1999/volume 86/number 9

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Cryogenic Laboratories Inc Company History

The Genetics & IVF Institute, founded by Dr. Joseph D. Schulman in 1984 in Fairfax, Virginia, is the first clinical and laboratory facility designed from inception to provide fully integrated, comprehensive outpatient services in the areas of human genetics and infertility. In addition to having one of the largest programs in the USA in infertility including in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) and in medical genetics and prenatal diagnosis, the Institute has developed one of the premier cryopreservation programs in the world.

In 1986, the Genetics & IVF Institute established a cryopreservation Division with one of the world’s outstanding cryobiology teams led by Dr. Edward F. Fugger. The Institute has become a pioneering center in the application of cryobiology having produced the first frozen human embryo twins in the USA, established one of the largest human embryo cryopreservation and storage laboratories in the country, founded one of the largest human sperm banks in the world, and initiated the first human ovarian tissue cryopreservation program in the USA.

Fairfax Cryobank was originally organized in 1986 to provide patients at the Genetics & IVF Institute with anonymous frozen donor semen that had a higher standard of genetic and infectious donor screening and sperm quality than could be obtained elsewhere. Physicians that visited the Institute and observed the results of the frozen donor specimens began to request the use of Fairfax Cryobank donor specimens in their own infertility practices. Although it was not the original intent to provide specimens outside the Institute, due to continued requests by physicians and patients Fairfax Cryobank now provides donor semen to physicians and university medical centers in all 50 states and many foreign countries. Upon request from patients, physicians, and numerous medical facilities, the Cryobank also began providing semen freezing and storage for patients desiring to have their specimens cryopreserved for future use.

Cryogenic Laboratories, Inc. joined the Genetics & IVF Institute family of Cryobanks in 2002. This affiliation provides patients even more choices when considering donor sperm. CLI donors are available through the Fairfax Cryobank search.

Fairfax Cryobank’s Embryo Storage Program has been storing long term reproductive specimens since 1986. Embryo storage has been available to patients at our IVF center for more than 15 years. We have extensive expertise transporting samples to and from physician practices in all 50 states and many countries throughout the world. Our facilities are equipped with the latest technology. Embryos are stored in state of the art liquid nitrogen tanks that are not dependent on electricity to keep your embryos frozen. These storage tanks are monitored 24 hours a day, 7 days a week.

Today patients, physicians, and medical centers around the world use donor semen from CLI because of their experience and confidence in the donor selection, screening, infectious and genetic disease testing, sperm quality standards and service of CLI.

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