THERAPEUTIC DONOR INSEMINATION (TDI)
Who is a Candidate for TDI?
Insemination using donor sperm is an option for couples when the male partner has an absence of sperm or has abnormal sperm. Causes of male infertility include:
- Irreversible azoospermia (no sperm)
- Previous vasectomy
- Previous chemotherapy or radiation
- Inability to ejaculate normally
- Other irreversible male factor problems.
Becoming a Part of the Program
Couples interested in donor insemination first meet with one of the infertility physicians for an interview and examination of the female partner. Once you know the date of your appointment, please forward to us all of your related medical records. This allows the evaluation to be as complete as possible. During this appointment we will answer your questions and discuss benefits and risks. Consent forms will be signed either at this or at a future appointment.
The decision to proceed with TDI is one that requires a great deal of thought and planning. Counseling is helpful to everyone in a TDI program. Our clinical psychologists counsel our patients on any and all emotional aspects of donor insemination. Before utilizing donor sperm we require one visit with one of our clinical psychologists. There is no additional charge for this screening visit. To make your appointment, call 720-848-1690 and choose option 1.
Here is what to expect during your initial screening:
- Medical history
- A physical, including a pelvic exam of the woman
- Routine screens
- a Pap smear, unless there has been a negative one within the past year
- cervical cultures for potential infection
- Blood tests
- blood type of the woman
- screen for hepatitis and HIV, rubella (measles) and varicella (chicken pox), and other infections
- genetic screening for cystic fibrosis, sickle cell anemia, and Tay-Sachs depending on family history
- possible blood type of the male partner which may be helpful in choosing your donor.
We will accept written proof of blood type if you have had that done before.
Selection of Donor
You will select the donor from a catalog provided by commercial sperm cryobanks. There are many factors to consider when choosing a donor. Characteristics, such as race or ethnic group, height, body build, complexion, eye color, hair color and texture, interests, education, profession, and blood type are given on each donor. You should discuss which characteristics seem most important in a prospective donor. The cryobanks have web sites where additional information on the donors can be accessed including family history and sometimes, photos of the donor. There is usually a fee for in-depth additional information.
The cryobanks follow guidelines of the American Society of Reproductive Medicine. They maintain strict quality control standards including testing all donors for hepatitis, HIV, syphilis, cytomegalovirus, and blood type. The semen has been cultured for transmissible diseases including gonorrhea and chlamydia. The donors are periodically rescreened for all such communicable diseases. Their testing also includes genetic screening.
You will need to open a donor account with the cryobank that you choose. Each bank has its own requirements and there may be paperwork your doctor needs to sign. Please let our nurses know how we can help you with this process. You are responsible for having donor sperm in our lab for each TDI cycle. You probably should consider ordering specimens for more than one cycle at a time. Please be aware that any sperm stored in our lab for more than 1 year is subject to an annual storage fee.
Please see “TDI Specimen Ordering Information” for specifics on ordering. Our lab can only receive specimens on normal business days, not on weekends or holidays.
Insemination TDI is performed by intrauterine insemination. After inserting a small catheter through the cervix and into the uterus, washed sperm is gently injected into the uterus. Nurses and physicians do inseminations. TDI can be done any day of the week.
For a TDI cycle:
- Call the nurses at 720-848-1690 as soon as you get your menstrual period. If your period begins on the weekend, call on Monday.
- At the same phone call, please confirm that we have received your donor sperm sample.
- Usually one insemination is performed per cycle. The timing of the insemination is determined by
- Serial urinary LH measurements using ovulation predictor kits or serial ultrasounds of the ovaries help us determine the timing for the insemination. When using ultrasounds, your physician decides the timing of your insemination based on the size of your follicles.
- If HCG is used for ovulation, the insemination will be determined by the time of the HCG injection.
If you are using urine LH kits to time the insemination:
- You MUST call with the onset of menses to inform our office you will be LH testing this cycle (to help with timing the insemination).
- If you expect that you may ovulate over the weekend, please call Thursday to be sure that we know you may need a TDI on Saturday or Sunday.
- On the WEEKEND, please LH test by 8:00 a.m. and phone the physician on call (720-848-1690) by 8:15 a.m. if you see a surge.
- During the week, call the nurse (720-848-1690) anytime between 8:00 and 10:00 a.m. with your LH surge to get an appointment for your insemination.
Remember, if you do not call the office with the onset of menses to inform us when you will begin LH testing, we may not be able to perform your insemination that cycle.
Healthy women without any reproductive or gynecologic problems have a 60% chance of achieving a pregnancy within six (6) months. Due to the high success rate, we do not routinely schedule a large number of fertility tests initially unless you have any risk factors for infertility. If you do not become pregnant in three to four months, we will consider additional testing. We strongly encourage you as a couple to discuss your desire for screening tests before insemination. Generally we do not recommend such testing unless risk factors for infertility exist.
All insemination records are strictly confidential. Any child born through TDI after written consent your legal child. Check the cryobank policies regarding the child's future access to information regarding the sperm donor.
Please contact our Financial Counselor at 720-848-1670 if you have questions regarding:
- billing procedures
- payments required at the time of service
- any other financial matters.
Although we try to be open as many days as possible throughout the year, we do not do inseminations on the following days:
- Thanksgiving and the Friday after Thanksgiving
- Christmas Eve day and Christmas Day
- New Year's Eve day and New Year's Day
TDI Nurse Coordinator
Our nurse coordinator will be happy to answer questions and provide support throughout the TDI process. You can reach her by calling 720-848-1690.