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Sperm donation
Sperm donation is a method of treating infertility in couples where the male partner does not have his own sperm, where there is some genetic disease on the male side or sperm deformities.
Sperm is obtained from a known or unknown donor, depending on the laws of the country where the donation is made.
The terms sperm donation and semen donation are also used, although sperm donation is the correct name since only spermatozoa are used for fertilization of the egg, without other substances and fluids found in sperm.
Sperm donation is done in case of:
- azoospermia - when the male partner has no spermatozoa in the ejaculate or after surgical interventions to obtain spermatozoa from the testicles (PESA, TESE, TESA , micro TESE).
- pronounced oligoasthenospermia - that is, when there is a very low number of spermatozoa, a lack of motile spermatozoa and normal-looking spermatozoa;
- after several unsuccessful IVF-ICSI attempts when there is proof or strong suspicion that the cause is in the spermatozoa;
- in men who have a genetic disease that is passed on to the offspring, and it is not possible to do a genetic analysis of the embryo.
- in women who do not have a male partner.
The sperm donation process at the Gyn. Feretility Clinic Milenković
A couple or a woman without a partner comes for the first consultation.
The woman is examined in the same way as before any other infertility treatment:
- conversation
- gynecological examination
- ultrasound examination with a vaginal probe
- hormone analysis: anti-Müllerian hormone (AMH), thyroid-stimulating hormone (TSH) and, if necessary, other hormones if necessary
- cervical swab for chlamydia and gonococci by PCR method
- blood tests for hepatitis B, hepatitis C, HIV and syphilis.
If the sperm donation is financed by the Republic Health Insurance Fund, additional analyses are required (see sperm donation at the expense of the Republic Health Insurance Fund).
- The man brings documentation that he has azoospermia, that is, there are no spermatozoa in the ejaculate (minimum of two semen analysis s) as well as possible surgical intervention (PESA, TESE, TESA, micro TESE).
- Donation can be done even if no surgical intervention was performed.
- A man talks to a psychologist, a lawyer and a gynecologist and receives important information about the sperm donation process.
At the same time a psychological assessment is done and after that a decision is made whether the process of sperm donation can be done.
- The donor is chosen so that the color of the skin, eyes and hair, height and body weight matches the male partner with azoospermia as closely as possible.
- or at the request of a woman without a partner who needs donor material
- It is also possible to get information about education and hobbies (sports, music).
Sperm are ordered from sperm banks in Denmark.
Fertilization and IVF with donated sperm
After obtaining frozen sperm, insemination or in vitro fertilization (IVF) is performed.
- Sperm are thawed on the day on the day of egg aspiration;
- When IVF is performed with pre-frozen spermatozoa, the method of intracytoplasmic sperm injection (ICS) is always performed in the laboratory.
- The preparation and stimulation of the woman as well as the transfer of the embryo is the same as when the insemination procedure or IVF with the partner's spermatozoa is performed.
- Embryos that meet the criteria are frozen.
Criteria that must be met by a sperm donor
The sperm donor is a psychophysically healthy person, 21-45 years old, with no hereditary diseases in the family.
The condition is that the semen analysis shows all normal parameters.
After a medical examination and after filling out a detailed questionnaire about his health, the donor has an interview with a psychologist, where the psychological assessment of the donor (among other things, the motives for donating) and the so-called psycho-education about donating is done. The donor also familiarizes himself with the legal system of the country where the sperm are donated.
Genetic analyses are performed on sperm donors
- karyotype;
- cystic fibrosis;
- alpha-thalassemia;
- spinal muscular atrophy;
- Tay-Sachs disease (hereditary neurological disease);
- beta-thalassemia;
- deafness
Before freezing the sperm, the donor is tested for:
- hepatitis B infection
- hepatitis C
- human immunodeficiency virus (HIV)
- syphilis and chlamydia
The same tests are repeated after 6 months to avoid the risk that the donor was in the incubation phase, that is, in the early phase of the infection when the sample was frozen.
Donation at the expense of Republic Health Insurance Fund for couples and for women without a partner
The Republic Health Insurance Fund finances IVF procedures for having the first common child in couples where the man has no spermatozoa in the ejaculate and in whom the spermatozoa were not obtained from the testicles by surgical methods such as PESA, TESA, TESE and micro TESE. The condition is that the woman is at most 45 years old.
Republic Health Insurance Fund finances the IVF procedure with donated spermatozoa in women under 45 who do not have a partner.
Couples and women without a partner apply for the Commission that approves procedures with donated sperm via E-uprava on the website www.euprava.gov.rs
This applies to all those who apply for the donation Commission for the first time, and later the appointment for the Commission will be scheduled by phone.
- A woman must be registered on the e-government website.
- After registration, the next step is to apply for an appointment with the Donation Commission in the section marked as in vitro fertilization.
- The system will automatically offer the Commission to which you belong to, on the basis of your location.
Within a few days, an appointment for the Commission is scheduled. The woman must have a certified health insurance card.
A woman should do the following analyses:
- Cervical swab and vaginal swab for bacteria, cervical swab for chlamydia and bacterial vaginosis swab;
- Hepatitis B, Hepatitis C, HIV, syphilis, rubella, toxoplasma gondii (blood tests);
- PAP smear, colposcopy;
- Ultrasound examination with a vaginal probe;
- Hormone analyses on the 2nd to 4th day of menstrual bleeding (FSH, LH, estradiol, progesterone, testosterone, TSH, T3, T4, prolactin, AMH)
The male partner should submit the following analyses:
- Semen analysis (not older than 12 months);
- medical documentation confirming azoospermia, as well as that no spermatozoa were obtained from the testicles through surgery.
The findings of smears and ultrasound are valid for 6 months.
Hormone analyses are valid for 6 months, while other analyses cannot be older than one year.
Referrals from the health center are required for the commission:
For a woman:
- Referral for the Commission for Biomedically Assisted Fertilization for the institution where the appointment is scheduled;
- Referral for the ultrasound examination performed as part of the assessment at the Commission (and this referral should be addressed to the Clinic where the Commission is being held)
For a man:
- The referral for the semen analysis performed during the assessment procedure of the Commission for Biomedically Assisted Fertilization addressed to the Clinic where the commission is scheduled.
If you are referred to the commission outside your branch - all references must be certified by the Republic Health Insurance Fund to which you belong.
If the couple is not married - the declaration of extramarital union is certified by a public notary.
For the Commission, it is necessary to bring the original documentation, as well as the copies that are submitted to the Commission.
A couple or a woman has the right to choose the clinic where the in vitro fertilization process will be performed with donated spermatozoa.
The Gyn-Fertility Clinic Milenković performs IVF with donated sperm at the Gynecology Hospital Jevremova in Belgrade.
Insemination with donated sperm
Insemination with donated sperm can be done when the woman is younger (most often younger than 35, although the exact age limit cannot be defined).
The chance of pregnancy after insemination with donated sperm is about 20%.
Insemination with donated sperm financed by Republic Health Insurance Fund
Republic Health Insurance Fund does not finance insemination with donated sperm.
Expert advice: frequently asked questions
Answered by Milan Milenković, MD, PhD.
Can I choose the characteristics of the donor?
A couple or a woman without a partner can choose eye color, height and other physical characteristics as well as education and hobby (music, sports). After filling out the form, the inquiry is sent to the sperm bank in Denmark, which selects the donor according to the required characteristics. Sometimes not all conditions are met, so the woman or the couple decides for themselves whether to accept the procedure with the existing characteristics of the donor.
How safe are donors in terms of genetic diseases?
After a detailed medical and psychological evaluation, sperm donors undergo genetic tests:
- karyotype;
- cystic fibrosis ;
- alpha-thalassemia ;
- spinal muscular atrophy ;
- Tay-Sach disease (hereditary) neurological disease);
- beta-thalassemia ;
- deafness.
If in the family donor there is a hereditary or psychiatric disease, that person cannot be a sperm donor.
Do donors undergo a psychological assessment?
Donors go through a psychological assessment and psychological education about the sperm donation process.
Can a child born with the help of sperm donation in Serbia find out the identity of the donor in the future?
Sperm donation is anonymous in Serbia, so the child cannot find out the identity of the donor. Sperm in Serbia are currently imported from Denmark, although the law allows the complete donation process to be done in Serbia. Sperm donation in Denmark is also anonymous.
Is sperm donation anonymous in all countries?
Donation of spermatozoa is not anonymous in all countries, that is, a child born after the procedure with donated sperm has the right to find out who the biological father is when he/she turns 18, if the parents inform the child about the donation procedure. The donor has no legal obligations towards the child.
Are there any additional costs for sperm storage?
If the sperm donation process is financed by Republic Health Insurance Fund, there are no additional costs for storing frozen sperm or embryos that can be frozen.
When the IVF process with donated sperm is financed with own funds, additional storage of the material is paid on an annual basis.
Are pregnancies created after insemination and IVF with donated sperm classified as high-risk pregnancies?
Pregnancies resulting from insemination with donated sperm have no additional risk related to the donation.
Also, pregnancies created after IVF with donated sperm do not carry additional risk related to sperm donation itself.
What does the success of insemination or IVF with donated sperm mostly depend on?
The success of insemination and IVF with donated sperm mostly depends on the age of the woman.
For how many couples or women can one donor donate sperm?
According to the law in Serbia, one donor can donate sperm for one couple or one woman who wants to achieve pregnancy without a male partner.
In most countries, the law allows one donor to donate sperm for 4-10 families.
Does the donor receive monetary compensation when donating sperm?
The donation should be altruistic, that is, out of a desire to help others. In practice, the donor receives a certain monetary compensation that differs from country to country.
Is there a risk that offspring of one donor will meet later in life and start a family?
The risk of offspring of one donor becoming partners is very small and, according to an analysis from France, lower than when it comes to false paternity. In order to further reduce that risk, in some countries (Sweden, Great Britain, Switzerland) the donation is not anonymous, that is, children at the age of 18 can find out who the biological father is.
Can a donor donate sperm to a person they know?
A donor can donate spermatozoa to a person he knows only in countries where the donation is not anonymous. The donor must go through the same process of evaluation and tests as when donating to an unknown couple or woman.
Should the parents tell the child that the pregnancy resulted from the sperm donation procedure?
Whether the parents will inform the child about the donation procedure depends on the parents and it differs a lot from country to country, that is, the mentality of the environment in which they live. The advantage of being informed is to eliminate the minimal risk that the child will later be in a relationship with a blood relative.
