Medical Letter

More Questions To Ask:
 

Is the cryobank properly licensed by the state?
A number of organizations and societies have put forth suggestions and recommendations for a standard in cryobanking. These are only suggestions, whereas, the State sets forth requirements which have to be followed.

Does the cryobank comply with the State requirements for screening of donors?
Request confirmation of observance of requirements.

Is the history and credentials of the cryobank available?
Some cryobanks come and go in rapid sequence. Others have been around for many years, obviously providing good service.

Are the donors subjected to thorough physical examination by a physician?
Even if the history given by the donors is quite detailed, the donors might not be aware of a health problems and thus a review of the donor's history and physical examination by a qualified physician is essential.

Is the medical history of a donor and several generations of his family reviewed by the physician?
Besides the obvious hereditary and familial diseases in a particular family, there might be a tendency to develop one or two health conditions which might be transferable to the offspring through donor insemination. A qualified person should review the family history for such situations.

What genetic screening and information is available?
There is no examination which can guarantee a 100% clean bill of health. Careful review of donors and his family medical history and chromosomal analysis will get as close to 100% as possible.

Is registry of donors kept?
Registry of donors and recipients of particular donor sperm should be kept indefinitely for future use if needed. Some medical condition of the donor or the offspring conceived by the donor insemination can be showing later in life.

Is information on ethnic, educational, physical characteristics and professional career of donors available?
The bank should be willing and able to produce this information since certain preferences of the recipient might be important for them, realizing that there is no straight, firm and unbreakable inheritance of most of these factors.

Was the freezability of sperm tested?
The cryobank should perform a "test freeze ". The major insult to the sperm happens through the freezing and thawing process. The time between these two procedures is of lesser significance. Some semen does not freeze well and the sperm viability loss may not be acceptable.

What cryoprotectant is used?
Various cryoprotectant's are used to provide the best result of freezing. Some of them are used in trace amounts, thus, diluting and lowering the sperm number only to an insignificant degree, whereas, others might dilute the semen as much as 50%. Also, some of the cryoprotectants are known to have a tendency to cause allergic reactions which sometimes might be serious. For example, Glycerin dilutes the semen only by 10% and causes no allergies, whereas, egg yolk dilutes the sperm by 50% and can cause significant allergic complications.

General information and data on the cryobank and individual donors:

Is there a cut-off number for inseminations per donor?
Some cryobanks have provided hundreds of samples for inseminations from one donor without reasonable checking on the number of pregnancies conceived. Selling this high number of samples opens the door for a high number of offspring conceived through this particular donor and the danger of consanguinity or selling samples which do not produce satisfactory rate of conception. Either of these is not recommended.

Is there a restriction of how many cycles/inseminations will be done using a particular donor?
The rule of thumb indicates that if pregnancy does not happen after 3-4 months of inseminations, a different donor should be used in cases where there is no suspicion that female problems exists.

If more than one insemination per cycle is needed, can the cryobank provide a specimen on short notice?
If the cryobank location is far from the place where insemination is done, it might be difficult to obtain another specimen for insemination purposes in cases where the original one proves to be of less than optimal quality. Sending replacement specimens by messenger service is expensive. For the patient traveling back to the cryobank and then to the place of insemination, it is time consuming, assuming that it can be done during "working hours" of the cryobank. The best circumstance is insemination at the site of the cryobank.

Is there a mechanism to replace an insufficient sample when insemination needs to be done the same day?
Less than excellent sperm samples should be promptly replaced at no charge to the patient.

Would the recipient be notified about important medical information regarding the donor becoming known at a later time? And how?
Same health problems might appear at a later age. Since the donors are used usually when they are in their 20's, the cryobank should have a mechanism and evidence of all the recipients to be able to notify them in case such an event happens since some condition can be successfully prevented or the treatment is more successful if started in a timely fashion.

Availability of services - hours, weekends, holiday?
Ovaries do not respect working hours, weekends and holidays and might be ready to release a mature egg at a less than convenient time. The cryobank should be available to supply specimens at the times when it is needed and not only at the times which might be convenient.

Is the cryobank willing/able to preserve sperm after successful insemination for use at a later time?
Some couples might want to have real siblings as an outcome of donor insemination in which case the cryobank should be able to provide a directed storage of additional sperm specimens for future use after the initial conception.

What is the fee for this service?
This information should be available and the fee reasonable.

How is the privacy of the donor and recipient protected?
Privacy should be guaranteed in the contract between the parties and adhered to at all times. No one would like to have somebody knocking at their front door introducing himself/herself as "your child" nor would the married couple want to see a stranger coming and claiming that he is the father of their child.