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                   Donor Insemination
                           DI
                   A GUIDE FOR PATIENTS




           Direct Telephone Services Leicester Royal
  Directorate of Women’s and PerinatalNumbers:
  Infirmary


Doc 021 Issue 03


Doc 540 issue 1
Who is this leaflet about and who is it for?
This leaflet is produced to inform couples undergoing DI (donor
insemination) treatment and what is involved.

Your consultant in clinic will inform you that donor insemination would
be the next treatment of choice to be considered for some suitable
couples.

                     Once you have been referred for treatment you will be
                      invited to a Patient Information Evening
                     At the patient information evening you will be given the
                      opportunity to arrange an appointment with the nursing
                      or medical staff to plan your treatment.

Why am I having DI?
DI is one of the methods of assisted conception, which may be
considered for couples where the male has low or no sperm production
of his own or carries a genetic condition that he does not want his
children to inherit, or where both partners are female. The object of DI
is to introduce a quantity of semen into the female partner’s womb and
thereby encourage fertilisation.

Who can be a sperm donor?
A sperm donor must be

         Between 18 and 40
         Fit and healthy
         No history of transmissible disease
         No personal or family history of inheritable disorders

What will I know about the donor?
You will be told about the physical appearance (e.g. build, complexion,
eye and hair colour) of your donor and their blood group and
cytomegalovirus status. You may read the pen portrait and goodwill
message that they have written for any future offspring. You will not
receive any identifiable information.




Doc 540 issue 1
What follow up care is available?
We would like to see you and your partner after the first 3 cycles of DI if
your treatment has not been successful by then. We understand that
this is a very difficult time for you both emotionally. Should you wish to
access any supportive counselling during your fertility treatment you
may contact the Assisted conception unit to arrange an appointment
with the counsellor.

Our commitment to patients

We are constantly striving to improve our services to patients and we
will welcome your comments or suggestions for improvement.

Useful addresses:
NICE guidelines:                      www.nice.org.uk
NHS - Response line:                  0870 1555 455
NHS - Smoking Helpline:               00800 1690 169

www.givingupsmoking.co.uk

Do you feel that you are at risk of verbal or physical abuse? If so,
you may find the following numbers useful:

Domestic Violence Helpline: 0116 255 0004

Women’s Aid:                  0116 285 8079

Refuge (24 hour crisis line): 0870 599 5443

Any resulting child will be allowed to contact the HFEA once they are
16 years old and starting a sexual relationship with a partner to
establish if they are genetically related, or at 18 they can receive
information about their donor. They can be informed about his physical
characteristics, medical history, hobbies and interests, as well as
reading a short ‘pen portrait’
If they wish they can also receive the personal details such as name,
date of birth, last known address of the donor. The donor has no legal
or financial obligations born to the children resulting from donated
sperm.

Doc 540 issue 1
What preparation is needed to receive donated sperm?
You and your partner will need to have some blood tests taken to
ensure that you are healthy and to enable us to match you to a donor.

These include:

Screening for infections such as hepatitis B&C, HIV, Syphilis, and
cytomegalovirus.

Your blood group, thalasseamia or sickle cell status (if you are from an
AfroCaribbean , Asian or Southern Mediterranean background),

Screening to ensure you have been vaccinated against German
Measles (rubella).

You will also need swabs taking for screening for sexually transmitted
diseases.

To ensure the best response to treatment and for your safety your BMI
(body mass index) must be between 19 and 30. Your BMI is calculated
by your body weight in kilograms divided by your height in metres
squared. If your BMI is above 30 or below 19 you will be offered help
and advice to reach the required weight before commencing treatment.

What risks are involved?
There is no anaesthetic risk as no general anaesthesia is required.
There is little risk of internal damage since the catheter used is very
fine and not likely to cause damage as it is introduced into the womb.

Clomid or Gonadotrophins may lead to more than one follicle
developing and you are therefore are risk of a twin or triplet pregnancy.
If you are producing more than 2 follicles your treatment will be
cancelled to reduce this risk.

What side-effects are there?
Clomiphene
Hot flushes
Double vision –this is rare but you must contact the clinic if it occurs.


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Clomiphene and Gonadotrophins
Ovarian hyperstimulation – this occurs when there are too many
follicles produced in the ovary.
Symptoms are:

     1. Enlarged painful ovaries which hurt when you sit, bend or walk
     2. Breathlessness, puffiness of ankles, bloated tummy, weight
        gain.
     3. Persistent headache, dizziness, drowsiness, severe malaise

If you develop any of these symptoms then you should contact the
Fertility Specialist Nurses on (0116) 258 5922. If outside of clinic hours
please use the emergency mobile number on answer phone.


What happens next?
If your investigations show that you are suitable to under go treatment
using donor sperm then we will arrange a counselling appointment to
discuss the implications for you and your family of using donated
sperm.

What is the procedure?
Once you are ready to commence your treatment you will be instructed
to phone ACU on 0116 258 5922 on Day 1 of your period.

Natural DI
If you are having natural DI you will attend the unit on day 10 of your
cycle for a scan to check the lining of your womb and how many
follicles (fluid filled cysts containing your eggs) are developing on your
ovaries.

Clomid DI
If you are taking clomid tablets you will commence your tablets from
day 2 of your period until day 6 at the dose prescribed for you.
You will then attend the unit on day 10 for a scan to check the lining of
your womb and how many follicles (fluid filled cysts containing the
eggs) are developing on your ovaries.

Both natural and clomid DI

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From day 10 you will start using the Ovulation Prediction Kit with the
first urine sample of each day. On the morning you surge (two blue
lines in the window) you are asked to phone ACU before 10.00am.

Gonadotrophin DI
You will attend the unit on day 4 for a scan to assess your ovaries. You
will be prescribed Follicle stimulating hormone (FSH) injections to
commence from day 4 of your cycle.

These injections stimulate the ovaries to produce eggs.

You will attend again on day 8 and then on alternate days for scans. If
you are not responding to the injections then your dose may be
increased– you will be advised of this when necessary.

Once your ovary is ready to produce an egg, you will be given an
injection (hCG) to release this egg. This takes about 36-44 hours to
work. You will then be advised when to attend for your IUI.

Is there an alternative treatment?
NICE Guidelines recommend 6 cycles for couples with the diagnoses
already mentioned. If this is not successful then the next step is to
move onto IVF (in vitro fertilisation). Funding of treatment depends
upon which Strategic Health Authority area you live in.

What happens next?
After your surge the nurses will inform you of a suitable date/time to
perform your DI.

    On the day of DI we will telephone you to tell you the time and
     place for you and your partner to attend for your DI treatment.
    The procedure will involve an examination of the female partner. A
     speculum will be inserted into the vagina. The neck of the womb
     accessed through the speculum will be swabbed. A fine tube
     containing the sperm will be passed through the cervix into the
     uterine cavity and the sperm will be expelled.
    You may experience some cramp pains, and you will be advised to
     remain on the bed for a further 10-15 minutes, then you will be
     allowed home.
Doc 540 issue 1
    If you are taking Clomid then you will receive an hCG injection to
     ensure that the egg is released.

What happens next?
One week after the insemination you will be required to have a blood
test performed to check that you ovulated. If 16 days after your
treatment you have not had a period you should carry out a home
pregnancy test and contact the clinic if it is positive.


If a bleed does occur, this indicates that the insemination has not been
successful this time and arrangements will be made to repeat the
procedure, when you are ready. It is not necessary to have treatments
one after another.




Doc 540 issue 1
If you would like a copy of this information on tape, in large print,
in Braille or in another language, please contact the Service
Equality Manager on 0116 258 4382.




Haddaad rabto warqadan oo turjuman oo ku duuban cajalad
ama qoraal ah fadlan la xiriir, Maamulaha Adeegga Sinaanta
0116 258 4382.




Eĝer bu broşürün (kitapçıĝın) yazılı veya kasetli açıklamasını
isterseniz lütfen servis müdürüne
0116 258 4382 telefonundann ulaşabilirsiniz.

December 2009 - Due for review December 2011

Directorate of Women’s, Perinatal & Sexual Health Services



Doc 540 issue 1

								
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