Intrauterine insemination with donor sperm(IUI-D)is an assisted reproductive technology(ART)offered to couples with definitive male infertility or risk of genetic disease transmission.Here,we sought to evaluate our pr...Intrauterine insemination with donor sperm(IUI-D)is an assisted reproductive technology(ART)offered to couples with definitive male infertility or risk of genetic disease transmission.Here,we sought to evaluate our practice in IUI-D and identify factors that influenced the success rate.We performed a retrospective,single-center study of all IUI-D procedures performed at Lille University Medical Center(Lille,France)between January 1,2007,and December 31,2017.Single and multivariate analyses with a mixed logistic model were used to identify factors associated with clinical pregnancies and live births.We included 322 couples and 1179 IUI-D procedures.The clinical pregnancy rate was 23.5%,and the live birth rate was 18.9%per IUI-D.In a multivariate analysis,the women’s age was negatively associated with the live birth rate.The number of motile spermatozoa inseminated was the only factor associated with both clinical pregnancies and live births,with a chosen threshold of 0.75 million.The clinical pregnancy and live birth rates were,respectively,17.3%and 13.0%below the number of motile spermatozoa inseminated threshold and 25.9%and 21.0%at or above the threshold(all P=0.005).The number of motile spermatozoa inseminated was the only factor that significantly influenced both pregnancies and live-birth rates after IUI-D.Indeed,below a threshold of 0.75 million motile spermatozoa inseminated,those rates were significantly lower.Application of this number of motile spermatozoa inseminated threshold may help centers to allocate donations more effectively while maintaining reasonable waiting times for patients.展开更多
164 previous sperm donors completed an online survey regarding health and genetic experiences and views. Results highlight that donors desire to act responsibly with recruiting facilities is not always possible. Objec...164 previous sperm donors completed an online survey regarding health and genetic experiences and views. Results highlight that donors desire to act responsibly with recruiting facilities is not always possible. Objective: Obtaining the views and experiences of sperm donors regarding health and genetic matters. Design: Online survey. Setting: Not applicable. Participants: 164 previous sperm donors. Interventions: Not applicable. Main outcome measures: Views and experiences on health and genetic issues. Results: A variety of approaches are adopted by recruiting facilities in regard to selection and post-donation factors. The vast majority of donors said they had not been contacted by the facility they donated at to update their medical information, while almost one quarter of donors indicated that a health or genetic risk factor had occurred. A great majority of donors felt that they had not received any education or counselling on the potential curiosities of donor conceived people. Donors sought to be honest and open with staff but often found there were difficulties in doing so. Conclusions: Overall, donors indicate that they see donating as involving responsibilities to the offspring and families. The study highlights however that their ability to act responsibly is limited by some of the interactions or lack of them with the facilities where they donated. Implications for recruiting facilities need to be considered.展开更多
Sperm donation in China is different from that in other countries due to cultural, social and political factors. This research presents the current status of sperm donation in China's Mainland and highlights some ...Sperm donation in China is different from that in other countries due to cultural, social and political factors. This research presents the current status of sperm donation in China's Mainland and highlights some problems. Between January 2003 and December 2009, 19 471 sperm donors were screened totally and 6467 donors （33.2%） were recruited. The primary reasons for non-recruitment were either inadequate semen parameters （55.0%） or positive results for sexually transmitted diseases （7.9%）. There were 327 （1.7%） qualified donors who withdrew from the program because of frustration related to failed semen parameters, participation merely for free medical tests or job transfer. A questionnaire investigating donor intention, as well as other concerns associated with sperm donation, was distributed to 516 potential donors. All potential donors indicated their primary motivation as altruism, while 90.9% mentioned monetary reward as a second motivating factor. Approximately 93.4% of donors expressed some apprehension about the risk of consanguineous mating and the protection of their identity. Over the past 7 years, 488 389 vials of donors＇ semen have been cryopreserved. In 36 438 artificial insemination with donor sperm （AID） cycles, the clinical pregnancy rate was 23.9% and the live birth rate was 16.6%, In 7148 in vitro fertilization cycles, the clinical pregnancy rate was 45.8% and the live birth rate was 35.2%. Human sperm banks have been strictly monitored to ensure that each sperm donor can only impregnate five women nationwide. There is still a large gap between the supply and demand for sperm donation which may be solved by updated guidelines.展开更多
Beyond the scientific progress in assisted reproductive technologies （ART）, it is necessary to discuss the ethical considerations behind these advances. Ethical issues concerning sperm donation have been considered ...Beyond the scientific progress in assisted reproductive technologies （ART）, it is necessary to discuss the ethical considerations behind these advances. Ethical issues concerning sperm donation have been considered and discussed by government and non-governmental agencies, the public, media and academic institutions in many countries. Recommendations and guidelines concerning sperm donation issues vary from country to country and between professional groups within countries. This paper attempts to present an overview of findings and reports from various agencies concerning the ethics of sperm donation. The following topics are considered： limiting the number of donor offspring; minimizing risk of infection and genetics from sperm donors; age requirements for sperm donors; and anonymity versus non-anonymity of sperm donors. The diversity of policies shows that each country has its unique set of guidelines tailored toward its own specific needs. Similarly, countries designing their own procedures and guidelines concerning reproductive medicine must tailor them toward their own needs and practical considerations. In China's Mainland, the anonymous policy for sperm donation should still be carried out, and the number of donor offspring should be revaluated. ART procedures must be conducted in a way that is respectful of those involved. Ethical principles must respect the interests and welfare of persons who will be born as well as the health and psychosocial welfare of all participants, including sperm donors.展开更多
文摘Intrauterine insemination with donor sperm(IUI-D)is an assisted reproductive technology(ART)offered to couples with definitive male infertility or risk of genetic disease transmission.Here,we sought to evaluate our practice in IUI-D and identify factors that influenced the success rate.We performed a retrospective,single-center study of all IUI-D procedures performed at Lille University Medical Center(Lille,France)between January 1,2007,and December 31,2017.Single and multivariate analyses with a mixed logistic model were used to identify factors associated with clinical pregnancies and live births.We included 322 couples and 1179 IUI-D procedures.The clinical pregnancy rate was 23.5%,and the live birth rate was 18.9%per IUI-D.In a multivariate analysis,the women’s age was negatively associated with the live birth rate.The number of motile spermatozoa inseminated was the only factor associated with both clinical pregnancies and live births,with a chosen threshold of 0.75 million.The clinical pregnancy and live birth rates were,respectively,17.3%and 13.0%below the number of motile spermatozoa inseminated threshold and 25.9%and 21.0%at or above the threshold(all P=0.005).The number of motile spermatozoa inseminated was the only factor that significantly influenced both pregnancies and live-birth rates after IUI-D.Indeed,below a threshold of 0.75 million motile spermatozoa inseminated,those rates were significantly lower.Application of this number of motile spermatozoa inseminated threshold may help centers to allocate donations more effectively while maintaining reasonable waiting times for patients.
文摘164 previous sperm donors completed an online survey regarding health and genetic experiences and views. Results highlight that donors desire to act responsibly with recruiting facilities is not always possible. Objective: Obtaining the views and experiences of sperm donors regarding health and genetic matters. Design: Online survey. Setting: Not applicable. Participants: 164 previous sperm donors. Interventions: Not applicable. Main outcome measures: Views and experiences on health and genetic issues. Results: A variety of approaches are adopted by recruiting facilities in regard to selection and post-donation factors. The vast majority of donors said they had not been contacted by the facility they donated at to update their medical information, while almost one quarter of donors indicated that a health or genetic risk factor had occurred. A great majority of donors felt that they had not received any education or counselling on the potential curiosities of donor conceived people. Donors sought to be honest and open with staff but often found there were difficulties in doing so. Conclusions: Overall, donors indicate that they see donating as involving responsibilities to the offspring and families. The study highlights however that their ability to act responsibly is limited by some of the interactions or lack of them with the facilities where they donated. Implications for recruiting facilities need to be considered.
文摘Sperm donation in China is different from that in other countries due to cultural, social and political factors. This research presents the current status of sperm donation in China's Mainland and highlights some problems. Between January 2003 and December 2009, 19 471 sperm donors were screened totally and 6467 donors （33.2%） were recruited. The primary reasons for non-recruitment were either inadequate semen parameters （55.0%） or positive results for sexually transmitted diseases （7.9%）. There were 327 （1.7%） qualified donors who withdrew from the program because of frustration related to failed semen parameters, participation merely for free medical tests or job transfer. A questionnaire investigating donor intention, as well as other concerns associated with sperm donation, was distributed to 516 potential donors. All potential donors indicated their primary motivation as altruism, while 90.9% mentioned monetary reward as a second motivating factor. Approximately 93.4% of donors expressed some apprehension about the risk of consanguineous mating and the protection of their identity. Over the past 7 years, 488 389 vials of donors＇ semen have been cryopreserved. In 36 438 artificial insemination with donor sperm （AID） cycles, the clinical pregnancy rate was 23.9% and the live birth rate was 16.6%, In 7148 in vitro fertilization cycles, the clinical pregnancy rate was 45.8% and the live birth rate was 35.2%. Human sperm banks have been strictly monitored to ensure that each sperm donor can only impregnate five women nationwide. There is still a large gap between the supply and demand for sperm donation which may be solved by updated guidelines.
文摘Beyond the scientific progress in assisted reproductive technologies （ART）, it is necessary to discuss the ethical considerations behind these advances. Ethical issues concerning sperm donation have been considered and discussed by government and non-governmental agencies, the public, media and academic institutions in many countries. Recommendations and guidelines concerning sperm donation issues vary from country to country and between professional groups within countries. This paper attempts to present an overview of findings and reports from various agencies concerning the ethics of sperm donation. The following topics are considered： limiting the number of donor offspring; minimizing risk of infection and genetics from sperm donors; age requirements for sperm donors; and anonymity versus non-anonymity of sperm donors. The diversity of policies shows that each country has its unique set of guidelines tailored toward its own specific needs. Similarly, countries designing their own procedures and guidelines concerning reproductive medicine must tailor them toward their own needs and practical considerations. In China's Mainland, the anonymous policy for sperm donation should still be carried out, and the number of donor offspring should be revaluated. ART procedures must be conducted in a way that is respectful of those involved. Ethical principles must respect the interests and welfare of persons who will be born as well as the health and psychosocial welfare of all participants, including sperm donors.
