Donation & Surrogacy

Donor Insemination Patient Information Leaflet

The leaflet is detailed below, or you can download the 'Donor Insemination Patient Information Leaflet' in PDF.

What is Donor Insemination (DI)?

Donor Insemination is a treatment option for women in same sex couples, single women, and heterosexual couples where the male partner may not produce sperm.  Couples may choose, due to life limiting heritable diseases in their family, to use donated sperm to avoid passing the disease on to their children.

Intrauterine insemination or IUI, is the least invasive form of treatment offered at our centre. IUI involves the introduction of prepared donor semen into the uterine cavity, following detection of the luteinising hormone (LH) surge. Following the LH surge, an egg is released from an ovary which travels down the fallopian tube to meet the sperm and be fertilised. The fertilised egg is now called an embryo and continues to travel down the fallopian tube, into the uterus, for potential implantation.

Before treatment can begin

• An initial appointment will be organised with one of our consultants. During this consultation your medical history and screening will be completed (AMH, CMV, rubella and viral screening for Hep B, Hep C and HIV). If applicable, we will also request your partner undergoes viral screening. You will also be provided with your consent forms and the consultant will forward your counselling referral.
• You will have a compulsory counselling appointment on the implications of using donated sperm. This appointment is used to discuss the legal and ethical aspects of using donor gametes and ways of discussing donor origins with any child born through donation.
• Your screening results and consent forms will be reviewed in a follow up consultation. A consultant will devise a personal treatment plan based on the type of treatment that you wish to pursue. Your details will be forwarded to the donation team who will assist you in sourcing your donor.
• Once you have selected your donor and your allocation is in place you can call the clinic on day 1 of your period to arrange treatment.

What happens during treatment?

This is a brief outline of an IUI cycle, not all cycles are regular or last the same period. If your cycles are irregular, your clinician may recommend your cycle to be triggered by medication. If you are ready to start treatment, call our nursing team and they will arrange for your medication prescription to be completed.

Please be reassured, our nursing team will guide you through each step.

• On day 1 of your period, call the nursing team at your selected clinic (contact numbers provided below). The nursing team will check your case notes to ensure all consent forms and screening results are in place. If a pre-treatment scan has not been performed, a scan will be booked for day 2 or 3 (a baseline scan) and on day 10 of your cycle. Please be aware, these will be internal scans.
• At baseline scan, the ultra-sonographer will review your ovaries and assess the lining of your womb.
• At your day 10 scan, the ultra-sonographer will look to see if a lead follicle is developing on your ovaries and check to see if the lining of your womb is thickening. Please be aware that if there are more than 3 lead follicles developing, treatment may have to be abandoned due to the risks involved in multiple pregnancies. This decision would be made by a clinician.
• From your Day 10 scan, the nursing team will ask you to test your first morning urine using the Clearblue^® ovulation kit; the solid smiley face will indicate your LH surge.
• Once an LH surge is detected, call the nursing team and you will be booked in for your treatment the following day and be provided with a time to attend.
• On treatment day, the neck of the womb is examined using a speculum; this is the same instrument used during a cervical smear. A very fine tube is used to introduce the prepared sperm through the neck of the womb into the uterine cavity. This procedure lasts about 5 minutes and is performed by a nurse or doctor.
• Two weeks following your procedure, you will be asked to perform a pregnancy test. Should your treatment be successful, a pregnancy scan will be booked. If your test is negative, you may wish to book in for a further cycle. A nurse will contact the donor team to organise further donor allocation for future treatment. Alternatively, you may wish to take a pause in treatment.

Use of ovulation stimulation

Ovulation stimulation can be achieved using Clomiphene (Clomid) in the form of tablets or injections. The use of stimulation means we can be more precise about the day of ovulation.

It is important that you also read the leaflet, Ovulation Stimulation, for further information on the side-effects of treatment.

 

What further counselling is available?

Fertility treatment can be demanding and stressful. Personal and independent counselling is available as we have experienced fertility counsellors you can see at any stage of your treatment. Any counselling you receive will be kept confidential. You can contact them directly on 0151 702 4075.

What information is shared with the Human Fertilisation & Embryology authority (HFEA)?

You should note that all treatment/s and outcomes are entered onto the HFEA Register. All details of the donor are entered onto the Register for future use and for informing enquiring 18-year-olds as to the identity of the donor.

Other important information

It should be noted that the current law indicates the maximum number of families that can be created with a single UK donor is 10. Some donors may stipulate a lower number than this. The total number of families created (globally) may be higher than 10 for donors imported into the UK from an overseas bank. You should also understand that a donor has the right to withdraw consent for the use of their sperm. This could mean that if you had a child through DI and you wanted a sibling pregnancy, and the donor withdrew their consent to use, then their sperm cannot be used.

HFC does not supply donor sperm for home insemination purposes.

 

Useful contacts

The Donation Team 0151 282 7516, Email: lwft.donorbank@nhs.net

The Hewitt Fertility Centre Counselling Team 0151 702 4075

Hewitt Fertility Centre Liverpool Nursing Team 0151 702 4123, option 1

Hewitt Fertility Centre Knutsford Nursing Team 0151 702 4078

 

Document Code: P-INFO-DI-2	Version No: 11	Document Title: Sperm Donation, Information for Recipients
Date of issue: 03.11.2023	Date of review: 03.11.2025	Owner: R Russell	Author: A Hall

 

 

 

 

The leaflet is detailed below, or you can download the 'Blood-borne Viruses (HIV, Hepatitis B, Hepatitis C)' leaflet in PDF.

What is a blood-borne virus?

A virus is a submicroscopic infectious agent that replicates itself only inside the living cells of an organism. Viruses can damage the cells they replicate in; this is one of the ways viruses can make an infected person ill. Blood-borne viruses include HIV, Hepatitis B and Hepatitis C (this list is not exclusive). If a person is infected with one of these viruses, it is carried in the blood and may result in severe disease in some people and very few symptoms in others.

Why do we test patients for blood-borne viruses?

Patients wishing to have fertility treatment require viral screening as part of their investigations. Viral status affects how your eggs, sperm and/or embryos are processed and stored in the laboratory. Viral screening is in place to ensure that the risk of passing blood-borne viruses on to others is as low as possible. Viral screening protects our patients and their eggs, sperm and embryos, in addition to protecting our staff. Patients who are seeking treatment with donated gametes or embryos can request information about the donor’s screening status (e.g viral, genetic). Patients can also request information on the sensitivity and suitability of any tests. It is important to note that screened gamete providers can still be a carrier of genetic disease or infection.

What is HIV?

HIV stands for Human Immunodeficiency Virus. HIV destroys cells in the immune system, in particular, the CD4 T cells. CD4 T cells are a type of white blood cell. These are important cells involved in protecting the body against various bacteria, viruses and other germs. HIV multiplies within the CD4 cells. HIV cannot be destroyed by the white blood cells as it continually sheds its outer coating.

Untreated HIV leads to a compromised and dysfunctional immune system. This is when AIDS (commonly now called late-stage HIV infection) develops. However, early detection and treatment with antiretroviral therapy means that people living with HIV can lead active, healthy lives, although they may get side-effects from the treatment

 What is AIDS?

 AIDS stands for Acquired Immunodeficiency Syndrome. This is a term which covers the range of infections and illnesses which can result from a weakened immune system caused by HIV.

 Please note: HIV and AIDS are not the same thing and people who get HIV infection do not automatically develop AIDS.

AIDS is unlikely to develop in people who have been treated in the early stages of HIV infection. Even in people who do not receive treatment, there is usually a time lag of several years between initial HIV infection and developing AIDS related problems. This is because it usually takes several years for the number of CD4 T cells to reduce to a level where your immune system is weakened. People with HIV can pass the virus on to others whether or not they have any symptoms.

What is Hepatitis B and C?

Hepatitis is the medical term that means inflammation of the liver. Hepatitis B & C are viruses that attack the liver and can cause it to become inflamed. People with Hepatitis B & C can pass the virus on to others whether or not they have any symptoms.

How do you become infected with blood-borne viruses?

• Sexual transmission. Semen, vaginal secretions and blood from an infected person enable viral transmission through the lining of the vagina, vulva, penis, rectum or mouth during sex. Having vaginal or anal sex with an infected person is the most common route of transmission. Oral sex is usually lower risk, however this risk can increase if you have a condition which affects the defence barriers of the mouth, such as ulcers, bleeding, damaged gums or a sore throat. You cannot be infected with blood-borne viruses by coming into contact with the saliva of an infected person (for example, through kissing). Coughing or sneezing is also not a route of transmission.
• Needle sharing. Blood-borne viruses can be passed on by people who are dependent on injectable drugs and share needles, syringes and other injecting equipment which is contaminated with infected blood. Needle-exchange services run by hospitals, clinics and drug dependency units have drastically reduced needle-sharing as a source of infection.
• Infected blood. In the past, quite a number of cases occurred from infected blood transfusions and other blood products. This is now rare in the UK, as all blood products are screened for blood-borne viruses before they can be used. It is still a significant problem in developing countries.
• From mother to child. Blood-borne viruses can be passed to an unborn child from an infected positive mother during pregnancy, child birth or breast-feeding. Appropriate treatment and management of blood-borne viruses can decrease the chance of blood-borne virus transmission from mother to baby. Treatments are now available for mothers infected with HIV, Hepatitis B and C. Early disease detection is important to prevent viral transmission. Having a caesarean section to deliver a baby reduces the risk of blood-borne virus transmission even further. Breast feeding is not recommended due to the risk of nipple irritation and bleeding.

NOTE: To become infected with blood-borne viruses, some infected blood, semen or vaginal secretions would have to get into your body. You cannot catch these viruses from ordinary contact, such as hugging, shaking hands or touching, or from sharing food, towels, utensils, swimming pools or telephones.

 How common is HIV?

The number of new people diagnosed with HIV in the UK peaked at 8,000 in 2006 and currently approximately 6,000 new diagnoses occur each year. The total number of people living with HIV in the UK in 2014 was 103,700. Of these, About 9 in 20 resulted from men having sex with men and about 9 in 20 were due to heterosexual sex. HIV infection is much more common in many other countries in the world.

How common is Hepatitis B?

Hepatitis B is defined as ‘chronic’ when an infection lasts longer than 6 months. Chronic hepatitis has an estimated prevalence of 0.3% with approximately 180,000 people in the UK with the condition. Its prevalence is considerably higher among high-risk groups such as first generation migrants from areas where Hepatitis B is endemic, people who have multiple sexual partners and injecting drug users. There are approximately 600 to 800 new cases of symptomatic (jaundiced) acute Hepatitis B infection in the UK each year.

How common is Hepatitis C?

It is not known for sure how many people in the UK have Hepatitis C, but it is estimated that around 400,000 people may be infected. Worldwide, more than 200 million people are estimated to be chronically infected.

What are the symptoms of HIV and AIDS?

Primary infection with HIV. When you first become infected with HIV it is known as the primary infection. About 8 in 10 people develop symptoms at this time. The three most common symptoms (sometimes known as the classic triad) are: sore throat, fever and a blotchy red rash. Other symptoms can include feeling sick, diarrhoea, swollen glands, headache, tiredness and general aches and pains. The symptoms can last up to three weeks and are often just thought of as flu or a mild viral illness.

After the primary infection. After any primary infection settles, you can remain without any symptoms for several years. Early testing and treatment has revolutionised our concept of HIV infection which is now considered a long-term disease. Even without treatment, there are often no symptoms for a long time (often up to ten years) and many people do not realise that they are even infected. However, the virus continues to multiply, the number of CD4 T cells tends to gradually fall and you can pass on the virus to others. During this time some people with HIV who are otherwise well may develop persistent swollen lymph glands and night sweats.

What are the symptoms of Hepatitis B and C?

Hepatitis B and C affects people differently; some people may have no symptoms at all and never know they have the virus. It can take several months for symptoms to appear for both diseases. Symptoms can include fatigue, anxiety, weight loss, loss of appetite, nausea, liver discomfort, inability to tolerate alcohol, difficulty concentrating, muscle aches, itchy skin, flu-like symptoms, jaundice, fever and dark urine/yellow bowel motions.

What tests are done?

Most sexual health clinics offer testing for all three blood-borne viruses. Rapid HIV tests are now available that can report results within 30 minutes. Standard blood test results may take up to a week to be reported.

GPs can also arrange blood tests to screen for all blood-borne diseases but the results will go on your health record. It is recommended that all people who frequently have sex without a condom, have multiple partners, have been diagnosed with another sexually-transmitted disease or develop suspicious symptoms should be tested for blood-borne diseases annually.

If you are confirmed to have HIV then your doctor may do a blood test to check the amount of virus in your blood (the viral load) and the number of CD4 T cells in your blood. These tests may be done from time to time to assess how far the disease has progressed (and the response to treatment).

What is the treatment for HIV infection?

There is still no cure or vaccine for HIV. However, treatment is now effective at allowing people with HIV to live their lives as normally as possible. Since the introduction of medicines to treat HIV, the death rates from AIDS have reduced dramatically. With effective treatment, very few people go on to develop AIDS. It is not uncommon for people with HIV to feel low or even depressed, especially soon after the diagnosis is made. (If you have any feelings of depression then you should speak to your doctor).

What is the treatment for hepatitis B?

If you think you have been exposed to the Hepatitis B virus, emergency treatment is most effective within 48 hours, and this is usually given in the form of a vaccine or a dose of Hepatitis B immunoglobulins. Treatment type depends on how long you have been infected. Short term Hepatitis B does not need specific treatment. Long term hepatitis B is often treated with medication to keep the virus under control.

What is the treatment for hepatitis C?

Chronic Hepatitis C involves taking anti-viral medication to fight the virus, testing whether your liver is damaged and making changes to your lifestyle to prevent further liver damage. Unfortunately, no vaccine is available for this virus.

How can infection with blood-borne viruses be prevented?

The main ways to prevent infection with blood-borne viruses is to avoid activities that put you at risk, such as sharing needles and having sex without a condom. Vaccination for hepatitis B if you are at high risk (e.g. health care/laboratory worker) is recommended.

What happens if my test is positive?

If your test is positive you will be contacted without delay by the Hewitt Centre and referred for specialist care, counselling and possible treatment.

 If my test is positive will I still be able to have treatment?

This depends on several things such as which virus you have and how well you are. Each case would be considered individually.

 Will I be able to undergo treatment without being tested?

If you wish for us to freeze and store any “spare” embryos created during your treatment cycle then you must be tested prior to treatment. The Human Fertilisation & Embryology Authority (HFEA) requires both of you to be screened before you start treatment to ensure the storage requirements for your eggs, sperm and embryos are possible.

 

Further help and information

HIV aware: www.hivaware.org.uk

National Aids Trust: www.nat.org.uk

Terrence Higgins Trust: www.tht.org.uk

Averting AIDS and HIV (AVERT): www.avert.org

NHS (2018) Hepatitis C https://www.nhs.uk/conditions/hepatitis-c/

NICE Guidelines: Hepatitis B: https://www.nice.org.uk/guidance/cg165/documents/hepatitis-b-scope2

Document Code P-INFO-GEN-18	Version No: 12	Document Title: HIV & Hep Screening
Date of issue: 07.01.2022	Date of review: 07.01.2024	Owner: J Mutch	Author: R Howard