Therapeutic Donor Insemination (TDI)

 

Therapeutic donor insemination (TDI), enables pregnancy in women who are single or in same-sex relationships. For other couples with severe, untreatable male factor infertility, or in the cases when the male carries a hereditary disease that he doesn’t wish to pass on, TDI becomes the treatment of choice as well.

At First Steps Fertility, we accept donor sperm from a few, regulated and reputable sperm banks. Women considering TDI should know that thorough screening is carried out and documented on all donor sperm samples available according to Canadian Federal Regulations. This screening involves a thorough family history, complete medical, social and sometimes psychological history, blood group information, genetic screening and screening for transmissible diseases.

As part of the regulated guidelines, all donated sperm must be quarantined for a period of 6 months to ensure that the donor still screens negative for infectious diseases such as HIV after initial testing.

You will have the opportunity to select your own donor from available samples. Catalogues are available online, and can be requested by mail as well. Donor choice can be based on racial or ethnic background, physical or social characteristics, or previous history.

As part of the TDI process, all women or couples considering this option must meet with our reproductive counselor. This is an important step in the process as it allows for discussion of the decision making process as well as consideration of the impact the choice may make on the individual or couple.

The Process:

When you first present seeking information on TDI, you will meet with a doctor who will take your entire gynecologic and fertility history. Baseline investigations will be performed to rule out any fertility issues.

Once this is completed, you have met with our counselor and you have chosen a donor, you will begin in our cycle monitoring program

This monitoring, using trans-vaginal ultrasound, and blood measures of your circulating levels of estrogen, luteinizing hormone and progesterone will allow your doctor to determine exactly when ovulation is about to occur so that you can return to the clinic the following day for your insemination.

Inseminations are performed early mornings, 7 days a week. Typically 2 inseminations are performed each cycle to ensure the maximum chance of conception.

The intrauterine insemination process is simple and quick. Once you arrive in the clinic the day of the insemination, the lab will start to thaw the sperm. When it is ready, you will be asked to come into the exam room. Just as with a routine Pap test, a speculum is placed into the vagina to clearly see the cervix. The sperm is labeled with your identity which you verify for us with a signature.

The sperm is then loaded into a small syringe with a soft plastic-tipped catheter.   The catheter is passed through the cervix and into the cavity of the uterus, where the sperm is injected slowly. Once the insemination is completed, you will be asked to rest for 5-10minutes and then you carry on with your usual daily activities.

Success rates of TDI:

Published rates of success in women under 40 years are about 10-15% per cycle. After 6 months of inseminations, about 50% of women are pregnant.

After 3-6 cycles with no success, it may be important to consider some fertility treatments to maximize your chances in a shorter time period. Your doctor will discuss this with you during the course of your treatment if necessary.

Once a pregnancy occurs, it is no different than one that occurs naturally in any other woman of the same age. The risk of miscarriage, or congenital abnormalities is also the same as others in the same age group.

You will be asked to sign consent forms which include acknowledgement that a child born through TDI is considered to be the legal child of the mother, and her partner (if applicable).

If having future pregnancies is important, some women or couples choose to use the same donor. We can store multiple samples at First Steps Fertility in these cases for future family planning.