‘It takes a village’ – fertility treatment using donor gametes, embryos and/or surrogacy TOG 2022

Question 1

What are the reasons needed for donated sperm?

Answer 1

Male factors:
- Azoospermia
- Recurrent failure of oocyte fertilisation with IVF/ICSI or unsuccessful cycles

Same-female sex relations 6.4%

Single female women 3.2%

Question 2

How is Dx of azoospermia made?

Answer 2

No sperm on 2 semen samples
Usually sperm retinal before confirming absolute azoospermia

Question 3

What proportion of azoospermia is from obstructive causes? Causes of obstructive azoospermia?

Answer 3

40%
Congenital - CF, congenital bilateral absence of vans deferent
Acquired: Infection, surgery. inguinal hernia repair with mush

Question 4

How can obstructive azoospermia be managed?

Answer 4

Surgical sperm retrieval

Question 5

HFEA denotation priorities? 5 statement. Can donor conceived people find information regarding donor?

Answer 5

1. People should be given nonidentifying information about the donors.
2. Donor-conceived people in the UK can find nonidentifying information about the donor from the age of 16 and identifying information from the age of 18.
3. Those who donate their gametes can find nonidentifying information about the children born due to donation.
4. There is specific direction from the HFEA regarding the compensation for both UK and overseas donors.
5. All egg and sperm donors must be medically screened and assessed according to the screening requirements set out in the code that fulfil the licence conditions.

Question 6

What proportion of IVF/ICSI used donor sperm? Any different in pregnancy outcomes?

Answer 6

5%
Lower risk low birth rate

Question 7

Indication for donor oocytes

Answer 7

Ovarian insufficiency (most common age related)
Absent ovaries
Same-sex male couples

Question 8

What proportion of IVF includes women who are > 40 years?

Answer 8

21%

Question 9

What is definition of POI?

Answer 9

Cessation of menus for 1 year < 40yrs
FSH >25 (other sources say 40), 4 weeks apart

Question 10

How common is POI? Causes?

Answer 10

1%

Idiopathic 90%
Genetic (Turners, Fragile X)
Autoimmune (TFT, addisions)
Infection (mumps)
Iatrogenic (Surgery, radiotherapy, chemotherapy)

Question 11

In the UK, what age must egg and sperm donors be?

Answer 11

Egg: 18-35
Sperm: 18-45

Question 12

What infections are gamete donors screen for?

Answer 12

Syphilis
Gonorrhoea
Chlamydia
HIV
HTLV 1 and 2
Hepatitis B & C
CMV IgM, semen CMV IgG should only be used for +ve recipients.
Consider herpes, HPV, Zika and ebola

Question 13

What information can a intended parent access regarding the donor?

Answer 13

Physical description (height, weight, eye and hair colour)

The year and country of birth

Ethnicity

How many and the gender of any children at the time of donation

Marital status

Medical history

A personal description and goodwill message to any potential children (if they chose to write one at the time of their donation)

Question 14

What is the UKs ‘rule of 10’?

Answer 14

preclude any donor from being the genetic parent ro children inmate than 10 separate family units.

Question 15

What information can the donor access after donation?

Answer 15

Whether their donation was successful
The number of children born from their donation
The gender and year of birth of any children born