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Hobbs CL, Gadson AK, Sadikman S, Tsai S, Enemuo F, Raker C, Eaton JL. An investigation of racial and ethnic disparities in donor sperm availability in the United States. Fertil Steril 2024:S0015-0282(24)00452-7. [PMID: 38750876 DOI: 10.1016/j.fertnstert.2024.05.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 05/01/2024] [Accepted: 05/06/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE To determine whether the racial and ethnic distribution of sperm donors contributing to US sperm banks differs from the demographics of the US population and those of US donor sperm recipients undergoing treatment with in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). DESIGN Cross-sectional study. SETTING United States donor sperm banks, US Census, and fertility clinics reporting to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System. PATIENTS Sperm donors from 18 banks, men aged 18-39 years on the basis of the 2021 Census Current Population Survey, and recipients of donor sperm for IVF and ICSI treatments in clinics reporting to the Assisted Reproductive Technology Clinic Outcome Reporting System from January 1, 2018, to December 31, 2020. INTERVENTION None. MAIN OUTCOME MEASURE Proportions of sperm donors and donor sperm recipients undergoing IVF and ICSI treatments identifying as each racial and ethnic group. RESULTS Eighteen donor sperm banks were identified, encompassing 1,503 donors. Of these donors, 60.9% identified as White compared with 55.1% of the US male population and 67.7% of donor sperm recipients. Proportions of donors identifying as Asian or 2 or more races were larger than those of US men and donor sperm recipients (Asian: 18.6% vs. 6.5%, and 18.6% vs. 10.2%; 2 or more races: 11.6% vs. 2.2%, and 11.6% vs. 1.7%). In contrast, Black donors were underrepresented when compared with the US population of men and donor sperm recipients (2.8% vs. 12.9% and 2.8% vs. 13.0%). Hispanic donors were underrepresented when compared with the US population of men (6.0% vs. 22.2%). The percentages of Hispanic sperm donors and donor sperm recipients were similar (6.0% vs. 7.0%). CONCLUSION The racial and ethnic distribution of sperm donors differs significantly from the demographics of the US male population and donor sperm recipients undergoing IVF and ICSI treatments. These findings suggest a need for targeted recruitment efforts for Black sperm donors.
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Affiliation(s)
- Cassie L Hobbs
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Women & Infants Hospital, Providence, Rhode Island.
| | - Alexis K Gadson
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Women & Infants Hospital, Providence, Rhode Island
| | - Sophia Sadikman
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Women & Infants Hospital, Providence, Rhode Island
| | - Shelun Tsai
- Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, New York
| | - Franklin Enemuo
- Department of Obstetrics and Gynecology, Division of Research, Women and Infants Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Christina Raker
- Department of Obstetrics and Gynecology, Division of Research, Women and Infants Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Jennifer L Eaton
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Women & Infants Hospital, Providence, Rhode Island
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Ronen M, Kaufman S, Kedem A, Avraham S, Youngster M, Yerushalmi G, Hourvitz A, Gat I. Sperm Donors' Identity Disclosure: Is It REALLY Crucial? For Whom? JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2024; 46:102337. [PMID: 38160797 DOI: 10.1016/j.jogc.2023.102337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 12/02/2023] [Accepted: 12/03/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE To study the preference of sperm donors with identity disclosure (ID) versus anonymous donors (AD) and to understand if this selection affects clinical outcomes in an Israeli population. METHODS This retrospective study included patients who chose imported sperm donation during 2017-2021. Of these, 526 used their own (autologous) oocytes and 43 patients used donated oocytes (DO). The primary endpoint was the type of chosen donor with ID versus AD. We examined the tendency toward ID according to demographic parameters and the theoretical impact of donor-type selection on reproductive outcome and compared patients who performed cycles with autologous oocytes with those using DO. RESULTS Single women had a significantly higher probability of choosing sperm donors with ID than heterosexual couples (55.6% vs. 33.3%, OR 2.5, CI 95% 1.52-4.11, P < 0.001). Although not significant, same-sex couples were more likely to choose sperm donors with ID than heterosexual couples (49.1% vs. 33.3%, OR 1.93, CI 95% 0.97-3.85, P = 0.06). Sperm donor samples, 2501 vials, were imported. It was performed 698 intra-uterine insemination and 812 in vitro fertilization cycles were performed, respectively, resulting in 283 pregnancies without differences between patients who chose sperm donors with ID versus AD sperm. No significant differences were observed regarding the option for sperm donors with ID between patients using DO (44.2%) and those using autologous oocytes (51.3%). CONCLUSION While ID is important for a certain section (mainly single) of recipients, it is far from the only dominant factor during donor selection. Sperm donation type does not impact clinical outcomes.
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Affiliation(s)
- Maya Ronen
- Sperm Bank & Andrology Unit, Shamir Medical Center, Zrifin, Israel.
| | - Sarita Kaufman
- Sperm Bank & Andrology Unit, Shamir Medical Center, Zrifin, Israel
| | - Alon Kedem
- IVF Department, Shamir Medical Center, Zrifin, Israel; Faculty of Medicinel, Tel Aviv University, Tel Aviv, Israel
| | - Sarit Avraham
- IVF Department, Shamir Medical Center, Zrifin, Israel
| | | | | | - Ariel Hourvitz
- IVF Department, Shamir Medical Center, Zrifin, Israel; Faculty of Medicinel, Tel Aviv University, Tel Aviv, Israel
| | - Itai Gat
- Sperm Bank & Andrology Unit, Shamir Medical Center, Zrifin, Israel; IVF Department, Shamir Medical Center, Zrifin, Israel; Faculty of Medicinel, Tel Aviv University, Tel Aviv, Israel
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Gat I, Ronen M, Avraham S, Youngster M, Hourvitz A, Levtzion-Korach O. Israeli students' perceptions regarding sperm donation: dilemmas reflections with dominant demographic effect. Reprod Health 2024; 21:37. [PMID: 38500168 PMCID: PMC10946193 DOI: 10.1186/s12978-024-01767-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 03/02/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Sperm donation has undergone significant medical and social transformations in recent decades. This study aimed to explore Israeli students' perceptions towards sperm donation and investigate the potential influence of demographic characteristics on these perceptions. DESIGN The study encompassed 254 students from Tel-Aviv University, who completed an anonymous online survey in January-February 2021. This cross-sectional quantitative online survey, comprised 35 questions categorized into three sections: demographic data, assessment of prior knowledge, and perceptions of sperm donation (general perceptions related to both positive and negative stigmas associated with sperm donation, the roles and activities of sperm banks, and considerations surrounding identity disclosure versus the anonymity of sperm donors and their offspring). RESULTS Participants exhibited a relatively low level of prior knowledge (mean 31.2 ± 19 of 100). Scores for positive and negative stigmas ranged from 1.3 to 2.2. Notably, the statement "Donors' anonymity preservation is crucial to maintain sperm donation" received a mean of 3.7. Seeking for anonymous sperm donation identity both by recipients and offspring was ranked with low means (1.5 and 1.7, respectively). However, the pursuit of half-siblings by mothers or siblings themselves received higher ratings ranging from 2.7 to 3. Women's stigma ranking were notably lower, while men emphasized the importance of donor anonymity. CONCLUSIONS Sperm Banks hold a position of medical authority rather than being perceived as being commercial entity. The preservation of donor anonymity is widely accepted as a crucial element, prioritized over the requests for identity disclosure from recipients and offspring. Demographic parameters exhibit a strong and precise effects on participants' perceptions.
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Affiliation(s)
- Itai Gat
- Sperm Bank & Andrology Unit, Shamir Medical Center, Zrifin, Israel
- IVF Department, Shamir Medical Center, Zrifin, Israel
- Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Maya Ronen
- Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel.
- Obstetrics and Gynecology Department, Shamir Medical Center, Zrifin, Israel.
| | - Sarit Avraham
- IVF Department, Shamir Medical Center, Zrifin, Israel
| | | | - Ariel Hourvitz
- IVF Department, Shamir Medical Center, Zrifin, Israel
- Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Osnat Levtzion-Korach
- Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel
- Shamir Medical Center, Zrifin, Israel
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Klock SC. Sperm donors and information sharing: Where are we now? Fertil Steril 2024; 121:256-257. [PMID: 38007084 DOI: 10.1016/j.fertnstert.2023.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 11/20/2023] [Indexed: 11/27/2023]
Affiliation(s)
- Susan C Klock
- Departments of Obstetrics & Gynecology and Psychiatry, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Nam CS, Campbell KJ, Acquati C, Bole R, Adler A, Collins DJ, Collins E, Samplaski M, Anderson-Bialis J, Andino JJ, Asafu-Adjei D, Gaskins AJ, Bortoletto P, Vij SC, Orwig KE, Lundy SD. Deafening Silence of Male Infertility. Urology 2023; 182:111-124. [PMID: 37778476 DOI: 10.1016/j.urology.2023.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/07/2023] [Accepted: 09/23/2023] [Indexed: 10/03/2023]
Abstract
Think about 6 loved ones of reproductive age in your life. Now imagine that 1 of these 6 individuals is suffering from infertility. Perhaps they feel alone and isolated, unable to discuss their heartbreak with their closest friends, family, and support network. Suffering in silence. In this editorial, we discuss the infertility journey through the lens of the patients, the providers, and the scientists who struggle with infertility each and every day. Our goal is to open a dialogue surrounding infertility, with an emphasis on dismantling the longstanding societal barriers to acknowledging male infertility as a disease. Through education, communication, compassion, and advocacy, together we can all begin to break the deafening silence of male infertility.
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Affiliation(s)
- Catherine S Nam
- Department of Urology, University of Michigan, Ann Arbor, MI
| | | | - Chiara Acquati
- Graduate College of Social Work, University of Houston, Houston, TX; Department of Clinical Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, TX; Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Raevti Bole
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH
| | - Ava Adler
- Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | - David J Collins
- Department of Urology, University of Southern California, Los Angeles, CA
| | - Erica Collins
- Department of Urology, University of Southern California, Los Angeles, CA
| | - Mary Samplaski
- Department of Urology, University of Southern California, Los Angeles, CA
| | | | - Juan J Andino
- Department of Urology, University of California Los Angeles, Los Angeles, CA
| | - Denise Asafu-Adjei
- Department of Urology, Department of Parkinson School of Health Sciences and Public Health, Loyola University Chicago Stritch School of Medicine, Chicago, IL
| | | | - Pietro Bortoletto
- Boston IVF, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Sarah C Vij
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH
| | - Kyle E Orwig
- Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Scott D Lundy
- Glickman Urological and Kidney Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH.
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Koh AS, Bos HMW, Rothblum ED, Carone N, Gartrell NK. Donor sibling relations among adult offspring conceived via insemination by lesbian parents. Hum Reprod 2023; 38:2166-2174. [PMID: 37697711 DOI: 10.1093/humrep/dead175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 08/13/2023] [Indexed: 09/13/2023] Open
Abstract
STUDY QUESTION How do adult offspring in planned lesbian-parent families feel about and relate to their donor (half) sibling(s) (DS)? SUMMARY ANSWER A majority of offspring had found DS and maintained good ongoing relationships, and all offspring (regardless of whether a DS had been identified) were satisfied with their knowledge of and contact level with the DS. WHAT IS KNOWN ALREADY The first generation of donor insemination offspring of intended lesbian-parent families is now in their 30s. Coincident with this is an increased use of DNA testing and genetic ancestry websites, facilitating the discovery of donor siblings from a common sperm donor. Few studies of offspring and their DS include sexual minority parent (SMP) families, and only sparse data separately analyze the offspring of SMP families or extend the analyses to established adult offspring. STUDY DESIGN, SIZE, DURATION This cohort study included 75 adult offspring, longitudinally followed since conception in lesbian-parent families. Quantitative analyses were performed from online surveys of the offspring in the seventh wave of the 36-year study, with a 90% family retention rate. The data were collected from March 2021 to November 2022. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants were 30- to 33-year-old donor insemination offspring whose lesbian parents enrolled in a US prospective longitudinal study when these offspring were conceived. Offspring who knew of a DS were asked about their numbers found, characteristics or motivations for meeting, DS terminology, relationship quality and maintenance, and impact of the DS contact on others. All offspring (with or without known DS) were asked about the importance of knowing if they have DS and their terminology, satisfaction with information about DS, and feelings about future contact. MAIN RESULTS AND THE ROLE OF CHANCE Of offspring, 53% (n = 40) had found DS in modest numbers, via a DS or sperm bank registry in 45% of cases, and most of these offspring had made contact. The offspring had their meeting motivations fulfilled, viewed the DS as acquaintances more often than siblings or friends, and maintained good relationships via meetings, social media, and cell phone communication. They disclosed their DS meetings to most relatives with neutral impact. The offspring, whether with known or unknown DS, felt neutral about the importance of knowing if they had DS, were satisfied with what they knew (or did not know) of the DS, and were satisfied with their current level of DS contact. This study is the largest, longest-running longitudinal study of intended lesbian-parent families and their offspring, and due to its prospective nature, is not biased by over-sampling offspring who were already satisfied with their DS. LIMITATIONS, REASONS FOR CAUTION The sample was from the USA, and mostly White, highly educated individuals, not representative of the diversity of donor insemination offspring of lesbian-parent families. WIDER IMPLICATIONS OF THE FINDINGS While about half of the offspring found out about DS, the other half did not. Regardless of knowing of a DS, these adult offspring of lesbian parents were satisfied with their level of DS contact. Early disclosure and identity formation about being donor-conceived in a lesbian-parent family may distinguish these study participants from donor insemination offspring and adoptees in the general population, who may be more compelled to seek genetic relatives. The study participants who sought DS mostly found a modest number of them, in contrast to reports in studies that have found large numbers of DS. This may be because one-third of study offspring had donors known to the families since conception, who may have been less likely to participate in commercial sperm banking or internet donation sites, where quotas are difficult to enforce or nonexistent. The study results have implications for anyone considering gamete donation, gamete donors, donor-conceived offspring, and/or gamete banks, as well as the medical and public policy professionals who advise them. STUDY FUNDING/COMPETING INTEREST(S) No funding was provided for this project. The authors have no competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Audrey S Koh
- Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Henny M W Bos
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
| | - Esther D Rothblum
- Department of Women's Studies, San Diego State University, San Diego, CA, USA
- Williams Institute, UCLA School of Law, Los Angeles, CA, USA
| | - Nicola Carone
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Nanette K Gartrell
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
- Williams Institute, UCLA School of Law, Los Angeles, CA, USA
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Youngster M, Luz A, Baum M, Hourvitz R, Reuvenny S, Maman E, Hourvitz A. Artificial intelligence in the service of intrauterine insemination and timed intercourse in spontaneous cycles. Fertil Steril 2023; 120:1004-1012. [PMID: 37490977 DOI: 10.1016/j.fertnstert.2023.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 07/06/2023] [Accepted: 07/18/2023] [Indexed: 07/27/2023]
Abstract
OBJECTIVE To develop a machine learning model designed to predict the time of ovulation and optimal fertilization window for performing intrauterine insemination or timed intercourse (TI) in natural cycles. DESIGN A retrospective cohort study. SETTING A large in vitro fertilization unit. PATIENT(S) Patients who underwent 2,467 natural cycle-frozen embryo transfer cycles between 2018 and 2022. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Prediction accuracy of the optimal day for performing insemination or TI. RESULT(S) The data set was split into a training set including 1,864 cycles and 2 test sets. In the test sets, ovulation was determined according to either expert opinion, with 2 independent fertility experts determining ovulation day ("expert") (496 cycles), or according to the disappearance of the leading follicle between 2 consecutive days' ultrasound examinations ("certain ovulation") (107 cycles). Two algorithms were trained: an NGBoost machine learning model estimating the probability of ovulation occurring on each cycle day and a treatment management algorithm using the learning model to determine an optimal insemination day or whether another blood test should be performed. The estradiol progesterone and luteinizing hormone levels on the last test performed were the most influential features used by the model. The mean numbers of tests were 2.78 and 2.85 for the "certain ovulation" and "expert" test sets, respectively. In the "expert" set, the algorithm correctly predicted ovulation and suggested day 1 or 2 for performing insemination in 92.9% of the cases. In 2.9%, the algorithm predicted a "miss," meaning that the last test day was already ovulation day or beyond, suggesting avoiding performing insemination. In 4.2%, the algorithm predicted an "error," suggesting performing insemination when in fact it would have been performed on a nonoptimal day (0 or -3). The "certain ovulation" set had similar results. CONCLUSION(S) To our knowledge, this is the first study to implement a machine learning model, on the basis of the blood tests only, for scheduling insemination or TI with high accuracy, attributed to the capability of the algorithm to integrate multiple factors and not rely solely on the luteinizing hormone surge. Introducing the capabilities of the model may improve the accuracy and efficiency of ovulation prediction and increase the chance of conception. CLINICAL TRIAL REGISTRATION NUMBER HMC-0008-21.
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Affiliation(s)
- Michal Youngster
- IVF Unit, Department of Obstetrics and Gynecology, Shamir Medical Center, Zerifin, Israel; Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel.
| | | | - Micha Baum
- Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel; FertilAi, Ramat Gan, Israel; IVF Unit, Herzliya Medical Centre, Herzliya, Israel; IVF Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat-Gan, Israel
| | | | | | - Ettie Maman
- Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel; FertilAi, Ramat Gan, Israel; IVF Unit, Herzliya Medical Centre, Herzliya, Israel; IVF Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat-Gan, Israel
| | - Ariel Hourvitz
- IVF Unit, Department of Obstetrics and Gynecology, Shamir Medical Center, Zerifin, Israel; Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel; FertilAi, Ramat Gan, Israel
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Ronen M, Kedem A, Avraham S, Youngster M, Yerushalmi G, Hourvitz A, Gat I. Motivational stimuli to donate sperm among non-donor students. Basic Clin Androl 2023; 33:29. [PMID: 37845630 PMCID: PMC10580632 DOI: 10.1186/s12610-023-00201-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 07/14/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Sperm banks face a continuously evolving gap between the increasing demand for sperm donation (SD) vs. limited available reserve. To improve donors' recruitment and increase supply, motivations towards SD should be investigated specifically among young men who have the potential to become donors. Our aim was to evaluate factors which increase and decrease predisposition to donate sperm among non-donor students, who represent a "potential pool" for possible donors' recruitment. RESULTS Ninety-three men fulfilled the questionnaire with mean age of 28.2 ± 4.5 years. The most powerful incentive to donate sperm was financial reward followed by a willingness to help others to build a family (3.8 and 3.4, respectively). The most dominant consideration to decline donation was the fear of anonymity loss and future regret (4 and 3.8). While participants' willingness for anonymous SD was fair (2.8), the open-identity donation was rated significantly lower (1.75, p < 0.01). Familiarity with recipients and offspring had lower scores (1.9-2.2) as well. CONCLUSIONS Young single men represent a suitable cohort for anonymous donation. Financial reward and willingness to help others are important positive incentives while anonymity preservation is crucial to maintain their willingness towards SD. Regulatory shifting towards open-identity SD necessitates the establishment of an alternative "potential pool" population as a reliable source to recruit donors.
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Affiliation(s)
- Maya Ronen
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
- Shamir Medical Center, Zrifin, Israel.
| | - Alon Kedem
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- IVF Department, Shamir Medical Center, Zrifin, Israel
| | - Sarit Avraham
- IVF Department, Shamir Medical Center, Zrifin, Israel
| | | | | | - Ariel Hourvitz
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- IVF Department, Shamir Medical Center, Zrifin, Israel
| | - Itai Gat
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- IVF Department, Shamir Medical Center, Zrifin, Israel
- Sperm Bank & Andrology Unit, Shamir Medical Center, Zrifin, Israel
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Diego D, Medline A, Shandley LM, Kawwass JF, Hipp HS. Donor sperm recipients: fertility treatments, trends, and pregnancy outcomes. J Assist Reprod Genet 2022; 39:2303-2310. [PMID: 36089627 PMCID: PMC9464617 DOI: 10.1007/s10815-022-02616-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/05/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose To report fertility treatment use and outcomes among patients who use donor sperm for intrauterine insemination (IUI), in vitro fertilization (IVF), and reciprocal IVF (co-IVF). Methods This is a retrospective review of patients who used donor sperm at an urban, southeastern academic reproductive center between 2014 and 2020. Results Among the 374 patients presenting for care, 88 (23.5%) were single, 188 (50.3%) were in a same-sex female partnership, and 98 (26.2%) had a male partner with a diagnosis of male factor infertility. Most patients did not have infertility (73.2%). A total of 1106 cycles were completed, of which there were 931 IUI cycles, 146 traditional IVF cycles, and 31 co-IVF cycles. Live birth rates per cycle were 11% in IUI, 42% in IVF, and 61% in co-IVF. Of all resulting pregnancies, hypertensive disorders were most commonly experienced (18.0%), followed by preterm delivery (15.3%), neonatal complications (9.5%), gestational diabetes (4.8%), and fetal growth restriction (4.8%). Of the 198 infants born, fifteen (8.3%) required admission to the neonatal intensive care unit and three (1.7%) demised. Pregnancy and neonatal complications were more likely to occur in older patients and patients with elevated body mass index. Conclusion The use of donor sperm for fertility treatment is increasing. These data show reassuring live birth rates; however, they also highlight the risks of subsequent pregnancy complications. With the expansion of fertility treatment options for patients, these data assist provider counseling of patients regarding anticipated cycle success rates and possible pregnancy complications.
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Affiliation(s)
- Daniela Diego
- Department of Gynecology and Obstetrics, Emory University, Atlanta, GA, USA.
| | | | - Lisa M Shandley
- Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Emory Reproductive Center, Atlanta, GA, USA
| | - Jennifer F Kawwass
- Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Emory Reproductive Center, Atlanta, GA, USA
| | - Heather S Hipp
- Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Emory Reproductive Center, Atlanta, GA, USA
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Carone N, Gartrell NK, Rothblum ED, Koh AS, Bos HMW. The stability of psychological adjustment among donor-conceived offspring in the U.S. National Longitudinal Lesbian Family Study from childhood to adulthood: differences by donor type. Fertil Steril 2021; 115:1302-1311. [PMID: 33541691 DOI: 10.1016/j.fertnstert.2020.12.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 12/11/2020] [Accepted: 12/11/2020] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To study differences by sperm donor type in the psychological adjustment of the U.S. National Longitudinal Lesbian Family Study (NLLFS) offspring across three time periods from childhood to adulthood. DESIGN U.S.-based prospective cohort study. SETTING Paper-and-pencil questionnaires and protected online surveys. PATIENT(S) A cohort of 74 offspring conceived by lesbian parents using an anonymous (n = 26), a known (n = 26), or an open-identity (n = 22) sperm donor. Data were reported when offspring were ages 10 (wave 4), 17 (wave 5), and 25 (wave 6). INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Achenbach Child Behavior Checklist administered to lesbian parents when offspring were ages 10 and 17 and the Achenbach Adult Self-Report administered to offspring at age 25. RESULT(S) In both relative and absolute stability, no differences were found in internalizing, externalizing, and total problem behaviors by donor type over 15 years. However, both externalizing and total problem behaviors significantly declined from age 10 to 17 and then increased from age 17 to 25. Irrespective of donor type, among the 74 offspring, the large majority scored continuously within the normal range on internalizing (n = 62, 83.8%), externalizing (n = 62, 83.8%), and total problem behaviors (n = 60, 81.1%). CONCLUSION(S) The results reassure prospective lesbian parents and provide policy makers and reproductive medicine practitioners with empirical evidence that psychological adjustment in offspring raised by lesbian parents is unrelated to donor type in the long term.
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Affiliation(s)
- Nicola Carone
- Department of Brain and Behavioral Sciences, Lab on Attachment and Parenting - LAG, University of Pavia, Pavia, Italy.
| | - Nanette K Gartrell
- Williams Institute, School of Law, University of California Los Angeles, Los Angeles, California; Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, the Netherlands
| | - Esther D Rothblum
- Department of Women's Studies, San Diego State University, San Diego, California
| | - Audrey S Koh
- School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California
| | - Henny M W Bos
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, the Netherlands
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Adult offspring of lesbian parents: How do they relate to their sperm donors? Fertil Steril 2020; 114:879-887. [PMID: 32631697 DOI: 10.1016/j.fertnstert.2020.05.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 03/25/2020] [Accepted: 05/04/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To study how adult offspring in planned lesbian-parent families relate to their unknown or known donors. DESIGN Qualitative analyses of the sixth wave of online surveys from a longitudinal study of adult offspring in planned lesbian families, enrolled at conception. SETTING Community-based United States national study. PATIENT(S) The 76 participants were 25-year-old donor insemination (DI) offspring whose lesbian parent(s) enrolled in a prospective longitudinal study when these offspring were conceived. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Offspring were asked about donor type, feelings about permanently unknown donor, satisfaction with and role of known donor, whether relationship with known donor was ongoing, and age of meeting open-identity donor. RESULT(S) This cohort (n = 76) of DI offspring with lesbian parents was among the first generation to reach adulthood. Thirty participants had permanently unknown donors and most participants felt comfortable about not knowing them. Sixteen participants had open-identity donors they had not met. Thirty had currently known donors-met in childhood (n = 22) or after open-identity donor disclosure (n = 8)-of whom two thirds had ongoing relationships with donors, half considered their donors as acquaintances, and nearly half had good feelings about their relationship, although a minority expressed conflicted feelings. CONCLUSION(S) This study of adult DI offspring from planned lesbian families shows that those who knew their donors mainly felt positively about these relationships. Qualitative analyses offered insight into offspring-donor relationships, whose numbers are increasing due to historical and demographic trends.
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