Screening of oocyte and semen donors: are we discriminating against sperm donors?

Abstract

Objective: The advent of IVF and other advanced assisted reproductive technologies has brought about greater demands for gamete donation. Furthermore, the criteria that are currently used or employed for screening oocyte and sperm donors seem to be deviating from each other because of significant variations in the ways that these gametes are preserved. Meanwhile, the ASRM is the only agency that has generated guidelines and recommendations for screening of gamete donors. The objective of this study was to describe current screening practices as it pertains to sperm and oocyte donations and to compare those screening practices with the ASRM published recommendations. Design: A prospective study collecting data from various gamete donation centers regarding their donor screening requirements and policies. Materials/Methods: A survey was conducted from ten ART or gamete handling programs that offer either sperm or oocyte donation services. Each program was asked to provide a list of screening tests that their prospective donors must undergo to become eligible for donation. Also the frequency of such screening was compared between sperm and oocyte donor groups versus the ASRM published recommendations. Results: There were no major differences in the medical screening tests performed and the percentage of centers performing these tests for both sperm and oocyte donors. However, the most apparent difference noted was in the quarantine period for oocyte donors (0 months) and sperm donors (6 months). Also, 90% of the centers tested perform continued screening tests on a regular basis (3 or 6 months) for sperm donors, whereas only 10% of the oocyte donation centers repeat screening every 6 months. In almost all of the parameters evaluated and compared in this survey, gamete donation centers performed more or an equal number of tests on sperm donors than on oocyte donors. There was no apparent difference between the percentage of centers performing genetic screening for sperm (60%) or oocyte donors (70%).Table TableCenters (%) performing various screening tests for sperm and oocyte donors.DonorPsychologicalGeneticRepeat ScreeningFamily HistoryQuarantineSperm50%60%90%100%6 monthsOocyte30%70%10%80%0 months Open table in a new tab Conclusions: The results clearly show that there is a difference in the screening procedures for sperm and oocyte donors, and the frequency of testing. According to ASRM guidelines for gamete donor screening, no quarantine period is needed for oocyte donors due to the inability to cryopreserve oocytes. The question now arises as to whether the oocyte carries less of a risk of transmitting infectious diseases than sperm, which are quarantined for at least 6 months before it can be used for insemination. Since the main reason for the 6 month quarantine is due to the “window period” of HIV testing, we propose that the use of PCR technology be used to quantitatively test for the presence of the HIV virus and does not require a 6 month waiting period. The ASRM clearly states that “screening for HIV should be performed using current standards of practice” and in our opinion, since PCR technology is the most advanced, currently available and is used by various centers, that the guidelines for gamete donation, especially with regards to quarantine periods, should be re-evaluated and reconsidered accordingly. Supported by: Andrology Institute of America and The Kentucky Center for Reproductive Medicine & IVF.