What is Sperm Donation?
Sperm donation or sperm transplantation is a method of in vitro fertilization (IVF) using donor sperm in cases where there is no sperm production (azoospermia) due to any congenital or acquired cause, and in cases where the use of the sperm cells of the father-to-be poses a risk (genetic disease or infectious disease).
The chances of success in IVF with sperm donation vary depending on the age of the expectant mother, egg reserve and embryo quality. This success also varies between centers and the role of the embryology laboratory is of great importance. Sometimes couples who are going to try Micro-TESE, TESA and TESE for the last time choose Cyprus and have the chance to benefit from sperm banks immediately in case of no sperm. In this way, an advantage is provided in terms of time and cost, and the inconvenience of this process is not experienced again.
Who Can Receive Sperm Donation?
Those with azoospermia (no sperm in semen)
Those with undescended testicles whose sperm production has been completely damaged because they were not operated on in time,
Those whose testicles have been damaged due to childhood febrile illness (mumps), testicular inflammation
Those whose sperm production has been damaged by chemotherapy or radiotherapy
Those who have no testicles or have had their testicles removed due to trauma or other causes
Those who do not produce sperm due to a genetic disease (Klinefelter Syndrome)
When positive results cannot be obtained with applications such as Micro-TESE, TESE, TESA, MESA, PESA
Recurrent IVF failure due to poor sperm quality
Those who have not been able to conceive normally due to RH incompatibility in the blood
In cases where the father-to-be has an infectious disease (HIV, etc.).
Those whose children born due to consanguineous marriage are at risk
Single women
Women who are lesbians
Women Who Prefer the Ropa Method
This technique allows a couple of two women to actively share the IVF process, one of them is the genetic mother who provides the egg for the baby and the other is the biological mother who carries the pregnancy.
How to choose a sperm donor?
According to TRNC Laws, it is forbidden to perform IVF with sperm donation using an external sperm donor. However, IVF can be performed with sperm from internationally recognized and accredited sperm banks. Our center has an agreement with the world’s best sperm banks (Cryos or European Bank) in Denmark and has established its own sperm bank with sperm cells supplied from these banks. The selection of sperm from our bank, which has a rich stock from many ethnicities and blood groups, is carried out under the leadership of our expert embryologists. If it is not possible to select from our bank, sperm can be selected from our contracted banks abroad and specially imported. For this reason, sperm selection should be done before or during the first days of treatment and the sperm should be reserved until the day of the procedure. Of course, it should be known that this will increase the cost as it is an extra application.
Selection is done in two ways as open/closed profile. In open profiles, you can have more detailed information about the sperm donor and have the chance to reach him/her in case of need in the future. In closed profiles, there is no detailed information other than basic information and you will never have the chance to reach him/her. It is useful to consider this detail when choosing.
Sperm selection is based on these characteristics and the tests performed on the certificate.
Country/Ethnicity
Age
Blood type
Height/Weight
Eye color
Skin color
Hair color
Education status
Profession/Job
Hobbies
What are the tests performed on sperm donors?
Sperm samples taken from donors are washed and frozen in small tubes called vials. Six months after this freezing process, all tests related to infectious diseases of sperm donors are repeated. If these results are normal, the donor’s information is added to the bank’s website and the sperm is ordered.
Blood type
HBsAg
HIV 1/2
Anti HCV
Anti – HBC
HBV-NAT
HTLV 1/2
HIV 1/ 2 -NAT
HCV-NAT
Syphilis or syphilis
Gonorrhea or gonorrhea
Chlamidia
CMV(Cytomegalovirus)
Cystic fibrosis
Thalassemia
Chromosome (Karyotype) Test
Medical history of siblings, parents and family members
Psychological profile
HIV risk assessment, drug use
In addition to these tests, tests specific to common diseases according to the race or ethnicity of the sperm donor are also performed and the results are detailed in the certificate.
Tests Required for Sperm Donation Treatment
TESTS REQUESTED FROM THE EXPECTANT MOTHER:
FSH, LH, E2, Progesterone (to be done on the 2nd or 3rd day of menstruation)
AMH (In expectant mothers with a value below 0.5, an insufficient number of eggs may not develop and this may prevent successful completion of the treatment. If pregnancy occurs, there is a risk of miscarriage)
TSH, T3, T4, prolactin (morning on an empty stomach)
Complete Blood Count, blood type
Fasting Blood Glucose (morning on an empty stomach)
Urea, SGOT, SGPT
PTT, INR, APTT
Vit B12 and Vit D
HBsAg, Anti-HCV, HIV, VDRL (Infectious diseases test)
Karyotype (according to condition)
USG (Vaginal Ultrasonography) is preferred between the 14th and 20th days of the menstrual period. The appearance of the intrauterine lining, fluid accumulation, adenomyosis (a structure that looks like a black hole in the endometrium), fibroids, polyps are detected more accurately by ultrasound. The thickness of the intrauterine lining (endometrium) is particularly important and is preferably 8 mm or more. Fluid accumulation in the endometrium is usually due to intrauterine operations such as cesarean section and suggests adhesions. In addition, fluid accumulation may also develop due to enlargement of the tubes called hydrosalpenx. The ovaries (ovaries) are also evaluated with USG. It is checked whether the egg reserve is suitable for this procedure. In order to have a high chance of success, a target of 10-15 mature eggs is desired. In cases where the egg reserve is low, the pool method is applied. In the pool method, egg collection is usually performed 2-3 times. This method can be time-consuming as well as a bit costly and tedious. In such cases, egg donation may sometimes be preferred.
HSG (Hysterosalpingography) is the most important and indispensable test in investigating the causes of infertility. It is a kind of x-ray that allows the uterus and tubes to be visualized, a special device is inserted into the entrance of the uterus and a contrast fluid is given and taken. It is also known as a uterine film. Since it can be painful due to the pressure, we recommend that it is performed under anesthesia. Although it is performed with X-rays, the radiation dose is very low. With this X-ray, conditions such as swelling in the tubes (fallopian tubes), polyps, fibroids, adhesions in the uterus, which are known to adversely affect pregnancy and cause ectopic pregnancy, especially due to the fluid in the fluid touching the embryo, are detected. In principle, HSG is performed within 2-3 days following the end of menstruation. In cases where it is certain that there is no pregnancy, there may be flexibility on the day of the filming. In the presence of infection, the filming is postponed. The uterine film is valid for 2 years and if surgical intervention has been performed, it is recommended to repeat the film in terms of adhesions etc.
INFORMATION REQUESTED FROM THE EXPECTANT MOTHER:
Diseases and medications that may adversely affect the treatment or pose a risk to health must be notified to us in order for us to take the necessary precautions. In particular, blood thinners, diabetes medications, blood pressure and heart medications, as well as the use of harmful substances such as smoking and alcohol are also important information for us.
TESTS REQUESTED FROM THE FATHER-TO-BE:
According to the results of spermiogram (3-5 days of sexual abstinence), the following tests are requested for the last time in Cyprus, and it is sufficient to have only the blood group of the prospective fathers who are not considering tese and who will have direct sperm donation.
Blood Group
HBsAg, Anti-HCV, HIV, VDRL (Infectious diseases test)
FSH, LH, Testosterone hormone analyzes (on a case-by-case basis)
Karyotype (according to condition)
APTT-PT
Blood Count
INFORMATION REQUESTED FROM THE PROSPECTIVE FATHER:
If he has a disease that prevents him from giving sperm (such as diabetes) or if he is unable to give sperm due to stress, we should be informed. In such cases, supportive medication may be given or it may be necessary to remove the sperm from the testicles with a small operation. The presence of heart disease may pose a risk due to complications of the medication. Blood thinners may also pose a risk for the operation. Again, the information about whether he has undergone sperm-related treatment or operation (Tese, Tesa, varicocele, etc.), whether he has used harmful substances such as smoking and alcohol should be made to us fully as it will shed light on the course of treatment.
IVF Treatment with Sperm Donation
In line with the examinations, tests and examinations, a treatment plan is prepared for the expectant mother who is deemed suitable for this treatment method. Sometimes, if the planned treatment period is very important for the expectant parents, oral contraceptives are used as a pre-treatment and negative developments such as cysts are prevented. This prepares the ground for the definitive start of the actual treatment.
The treatment is started on the 2nd or 3rd day of the expectant mother’s menstruation. If there are no conditions such as asynchronous egg development, cysts, etc. as a result of the examination, treatment is preferably started by performing hormone tests such as Estradiol-Lh-Progesterone. A treatment protocol is determined according to the age, weight and egg reserve of the expectant mother. The most preferred of these protocols is the antagonist protocol known as the short protocol. In this protocol, egg enlarging and multiplying hormone injections are started at the dose deemed appropriate. This treatment, which lasts approximately 9-15 days, is completed by performing ultrasound every 2-3 days and checking hormones according to the situation.
In this treatment, it is also possible to have examinations in your country. If you have one, you can be under the control of your own doctor or a doctor we recommend.
When the eggs reach a sufficient number and size (18-20 mm), the egg collection process is planned after 34-36 hours by giving a hatching needle.
The last needle of the treatment is the hcg needle, known as the hatching needle. The day and time of the injection is very important and affects the success of the treatment. The time difference between countries should also be taken into consideration when determining the time of the injection. In cases where more than 20 follicles develop in the ovaries and the E2 (estrogen) hormone is 3000 or more, a special ligation needle is used to prevent the development of the complication known as OHSS. OHSS (Ovarian Hyperstimulation Syndrome) is a very serious complication in which the ovaries overgrow and fluid outflows out of the veins. In this case, embryos are frozen and transfer is planned in the following months.
Usually the trip to Cyprus starts on the morning of the hatching needle, i.e. the day before the egg collection.
Sperm Donation Treatment Process in Cyprus
0.DAY
Since it will be convenient for you to come to Cyprus 1 day before the egg collection process, your travel is planned with the organization carried out by our transportation team. At the end of your journey, which starts under the control of our team, you will be welcomed with our private vehicle when you land at Cyprus Ercan Airport. After your transfer to the hotel of your choice in Kyrenia or Nicosia, you can spend your day resting. During your journey in Cyprus, you will notice that the traffic is on the left lane and the steering wheel is on the right side. For this reason, crossing rules are also different and you need to be careful when crossing the road. Our team will call you or send you an information message to remind you about the points you need to pay attention to before the transaction. In particular, it is the most important issue that you should be hungry and thirsty 8 hours before your transaction time so that your transaction is not delayed or canceled. It is usually requested to fast after 00.00 (you should not eat or drink anything just like fasting).
DAY 1
You will be transported from the hotel to our clinic with our private car at the time we tell you. Due to the importance we attach to information security, all transactions are carried out with great care and confidentiality. After the interview with our doctor, you will be examined according to the situation. After the preliminary preparation (insertion of an IV drip, wearing a gown, signing information and consent forms), your egg collection (OPU- oocyte pick up) takes place in 10-15 minutes under anesthesia. The sperm sample taken from the father-to-be and the eggs are combined with the microinjection (ICSI) method by our expert embryologists in our laboratory. Our specialist nurses will start you on additional medication for the remainder of your treatment. If your treatment includes an injection procedure, our nurses will arrange for it to be performed at your hotel.
DAY 2
The egg and sperm cells are combined in the laboratory by microinjection and it is checked whether they are fertilized or not, or if so, how many of them are fertilized. We call the cell formed from this combination an “embryo”. Your phone should be on during the day as you will be informed by our embryologists after the controls.
DAY 3
Day 2 of your embryos. While you enjoy your vacation in the unique nature and beautiful sea of Cyprus, your embryos are safely monitored by our expert embryologists. In some special cases, transfer can be planned on the 3rd day of embryos. In this case, you will be informed by our nurses about your transfer time the next day and the issues you should pay attention to beforehand.
DAY 4
Your embryos will be transferred on the 3rd day and their quality and number will be evaluated. In some special cases, transfer can be planned on the 3rd day of embryos. If you do not have a transfer, you do not need to come to the hospital, you can enjoy your vacation or rest. Again, you will be informed by our embryologists.
DAY 5
It is the 4th day of your embryos and you do not need to come to the clinic again. You will be informed by our nurses during the day about your transfer time and the things you should pay attention to before the transfer.
DAY 6
Transfer day To achieve high success and reduce the risk of multiple pregnancy or increase the chance of multiple pregnancy, embryo transfer is usually done on day 5. We call this blastocyst embryo transfer. On the day of transfer, your emotions such as excitement and anxiety may peak. Our team is always with you in this process. In order for the embryo transfer to take place more easily, you need to urinate and therefore you are asked to drink about 1 liter of water 1 hour before the transfer. After the pre-transfer preparations are completed, you will be informed about your embryos and the transfer of your embryos will be completed. The embryo transfer process will take 10 minutes in total, and after 30 minutes of bed rest, you will be informed about your treatment and post-transfer considerations.
If you have remaining embryos, freezing is applied after the information. In this way, if there is any negative situation, you will have the chance to try again at a lower cost.
DAY 7
Now it’s time to return, hoping that your transaction went well. Our private car will pick you up from your hotel and transfer you to the airport in comfort.
The Process After Sperm Donation Treatment
It is the most exciting period that never passes. We hear so often that 12 days is worth 12 years. We are as excited as you are and we sincerely hope that this process will be successful. If your pregnancy test is positive, we recommend that you make an ultrasound appointment 10 days later. Depending on the result, you may sometimes be asked to repeat the pregnancy test 2 days later. If your pregnancy test is negative, the medication will be discontinued and a repeat test may sometimes be requested.
