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Donor insemination

Elizabeth S Ginsburg, MD
Serene S Srouji, MD
Section Editor
Robert L Barbieri, MD
Deputy Editor
Kristen Eckler, MD, FACOG


Artificial insemination refers to the introduction of semen into the vagina, uterus, or oviduct by a means other than sexual intercourse. When the procedure is performed using sperm from a man other than the patient's partner, it is termed therapeutic donor insemination (TDI) [1-3].

Therapeutic donor insemination (TDI) has been in use longer than any other artificial reproductive technique for treatment for male infertility. In 1987, over 170,000 women in the United States were treated for infertility using donor insemination, and in 1990, it was estimated that TDI produced 11,400 to 23,400 pregnancies annually [4].


Historically, TDI was primarily a treatment of male factor infertility. However, the indications for TDI have expanded such that it has become an alternative approach to fertility for some women [5]. The procedure can be considered in:

Couples in whom one or both partners are carriers of a heritable disease

Couples who are serodiscordant for sexually transmissible viral infections

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Literature review current through: Nov 2017. | This topic last updated: Nov 14, 2017.
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  1. Mascola L, Guinan ME. Screening to reduce transmission of sexually transmitted diseases in semen used for artificial insemination. N Engl J Med 1986; 314:1354.
  2. McWhinnie A. Gamete donation and anonymity: should offspring from donated gametes continue to be denied knowledge of their origins and antecedents? Hum Reprod 2001; 16:807.
  3. Anger JT, Gilbert BR, Goldstein M. Cryopreservation of sperm: Indications, methods and results. J Urol 2003; 170:1079.
  4. Shapiro S, Saphire DG, Stone WH. Changes in American A.I.D. practice during the past decade. Int J Fertil 1990; 35:284.
  5. Practice Committee of American Society for Reproductive Medicine, Practice Committee of Society for Assisted Reproductive Technology. Recommendations for gamete and embryo donation: a committee opinion. Fertil Steril 2013; 99:47.
  6. Garrido N, Zuzuarregui JL, Meseguer M, et al. Sperm and oocyte donor selection and management: Experience of a 10 year follow-up of more than 2100 candidates. Hum Reprod 2002; 17:3142.
  7. Araneta MR, Mascola L, Eller A, et al. HIV transmission through donor artificial insemination. JAMA 1995; 273:854.
  8. Klein J, Peña JE, Thornton MH, Sauer MV. Understanding the motivations, concerns, and desires of human immunodeficiency virus 1-serodiscordant couples wishing to have children through assisted reproduction. Obstet Gynecol 2003; 101:987.
  9. Gorrill MJ, Burry KA, Patton PE. Pregnancy outcomes using donor sperm insemination after failed in vitro fertilization with intracytoplasmic sperm injection cycles in couples with complex infertility disorders. Fertil Steril 2003; 80:936.
  10. Ethics Committee of American Society for Reproductive Medicine. Access to fertility treatment by gays, lesbians, and unmarried persons: a committee opinion. Fertil Steril 2013; 100:1524.
  11. Curie-Cohen M, Luttrell L, Shapiro S. Current practice of artificial insemination by donor in the United States. N Engl J Med 1979; 300:585.
  12. Ferrara I, Balet R, Grudzinskas JG. Intrauterine donor insemination in single women and lesbian couples: A comparative study of pregnancy rates. Hum Reprod 2000; 15:621.
  13. Stern JE, Cramer CP, Garrod A, Green RM. Access to services at assisted reproductive technology clinics: A survey of policies and practices. Am J Obstet Gynecol 2001; 184:591.
  14. Ethics Committee of the American Society for Reproductive Medicine. Interests, obligations, and rights in gamete donation: A committee opinion. Fertil Steril 2014; 102:675.
  15. Koh SA, Sanders K, Deakin R, Burton P. Male age negatively influences clinical pregnancy rate in women younger than 40 years undergoing donor insemination cycles. Reprod Biomed Online 2013; 27:125.
  16. Ghuman NK, Mair E, Pearce K, Choudhary M. Does age of the sperm donor influence live birth outcome in assisted reproduction? Hum Reprod 2016; 31:582.
  17. Nagy ZP, Chang CC, Shapiro DB, et al. Clinical evaluation of the efficiency of an oocyte donation program using egg cryo-banking. Fertil Steril 2009; 92:520.
  18. Serre JL, Leutenegger AL, Bernheim A, et al. Does anonymous sperm donation increase the risk for unions between relatives and the incidence of autosomal recessive diseases due to consanguinity? Hum Reprod 2014; 29:394.
  19. Jurema MW, Vieira AD, Bankowski B, et al. Effect of ejaculatory abstinence period on the pregnancy rate after intrauterine insemination. Fertil Steril 2005; 84:678.
  20. Ravel C, Berthaut I, Bresson JL, et al. Prevalence of chromosomal abnormalities in phenotypically normal and fertile adult males: Large-scale survey of over 10,000 sperm donor karyotypes. Hum Reprod 2006; 21:1484.
  21. Sims CA, Callum P, Ray M, et al. Genetic testing of sperm donors: Survey of current practices. Fertil Steril 2010; 94:126.
  22. Callum P, Iger J, Ray M, et al. Outcome and experience of implementing spinal muscular atrophy carrier screening on sperm donors. Fertil Steril 2010; 94:1912.
  23. Maron BJ, Lesser JR, Schiller NB, et al. Implications of hypertrophic cardiomyopathy transmitted by sperm donation. JAMA 2009; 302:1681.
  24. Broder S, Sims C, Rothman C. Frequency of postinsemination infections as reported by donor semen recipients. Fertil Steril 2007; 88:711.
  25. Bresson JL, Clavequin MC, Mazeron MC, et al. Risk of cytomegalovirus transmission by cryopreserved semen: a study of 635 semen samples from 231 donors. Hum Reprod 2003; 18:1881.
  26. Practice Committee of American Society for Reproductive Medicine. Recommendations for reducing the risk of viral transmission during fertility treatment with the use of autologous gametes: a committee opinion. Fertil Steril 2013; 99:340.
  27. US Food and Drug Administration. Recommendations to reduce the risk of Zika virus transmission by human cell and tissue products. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm488612.htm (Accessed on March 04, 2016).
  28. Practice Committee of the Society for Assisted Reproductive Technology, Practice Committee of the American Society for Reproductive Medicine. American Society for Reproductive Medicine/Society for Assisted Reproductive Technology position statement on West Nile Virus. Fertil Steril 2005; 83:527.
  29. Practice Committee of the American Society for Reproductive Medicine, Society for Assisted Reproductive Technology. Society for assisted reproductive technology position statement on donor suitability of recipients of smallpox vaccine (vaccinia virus). Fertil Steril 2004; 81:1172.
  30. Purpura LJ, Soka M, Baller A, et al. Implementation of a National Semen Testing and Counseling Program for Male Ebola Survivors - Liberia, 2015-2016. MMWR Morb Mortal Wkly Rep 2016; 65:963.
  31. World Health Organization. Interim advice on the sexual transmission of the Ebola virus disease. Geneva, Switzerland: World Health Organization; 2016. http://www.who.int/reproductivehealth/topics/rtis/ebola-virus-semen/en/.
  32. Polansky FF, Lamb EJ. Do the results of semen analysis predict future fertility? A survival analysis study. Fertil Steril 1988; 49:1059.
  33. Johnston RC, Kovacs GT, Lording DH, Baker HW. Correlation of semen variables and pregnancy rates for donor insemination: A 15-year retrospective. Fertil Steril 1994; 61:355.
  34. Ombelet W, Deblaere K, Bosmans E, et al. Semen quality and intrauterine insemination. Reprod Biomed Online 2003; 7:485.
  35. Navarrete T, Johnson A, Mixon B, Wolf D. The relationship between fertility potential measurements on cryobanked semen and fecundity of sperm donors. Hum Reprod 2000; 15:344.
  36. Polyzos NP, Tzioras S, Mauri D, Tatsioni A. Double versus single intrauterine insemination for unexplained infertility: A meta-analysis of randomized trials. Fertil Steril 2010; 94:1261.
  37. Zarek SM, Hill MJ, Richter KS, et al. Single-donor and double-donor sperm intrauterine insemination cycles: Does double intrauterine insemination increase clinical pregnancy rates? Fertil Steril 2014; 102:739.
  38. Khalifa Y, Redgment CJ, Tsirigotis M, et al. The value of single versus repeated insemination in intra-uterine donor insemination cycles. Hum Reprod 1995; 10:153.
  39. Chavkin DE, Molinaro TA, Roe AH, et al. Donor sperm insemination cycles: Are two inseminations better than one? J Androl 2012; 33:375.
  40. Scott RT, Opsahl MS, Leonardi MR, et al. Life table analysis of pregnancy rates in a general infertility population relative to ovarian reserve and patient age. Hum Reprod 1995; 10:1706.
  41. Shenfield F, Doyle P, Valentine A, et al. Effects of age, gravidity and male infertility status on cumulative conception rates following artificial insemination with cryopreserved donor semen: Analysis of 2998 cycles of treatment in one centre over 10 years. Hum Reprod 1993; 8:60.
  42. Brown CA, Boone WR, Shapiro SS. Improved cryopreserved semen fecundability in an alternating fresh-frozen artificial insemination program. Fertil Steril 1988; 50:825.
  43. Richter MA, Haning RV Jr, Shapiro SS. Artificial donor insemination: Fresh versus frozen semen; the patient as her own control. Fertil Steril 1984; 41:277.
  44. Yogev L, Kleiman SE, Shabtai E, et al. Long-term cryostorage of sperm in a human sperm bank does not damage progressive motility concentration. Hum Reprod 2010; 25:1097.
  45. Nielsen NC, Risum J, Bogaard Hansen K, Nissen U. Obtained pregnancies by AID using frozen semen in relation to specific qualities of the semen. Gynecol Obstet Invest 1984; 18:147.
  46. Keel BA, Webster BW. Semen analysis data from fresh and cryopreserved donor ejaculates: Comparison of cryoprotectants and pregnancy rates. Fertil Steril 1989; 52:100.
  47. Campana A, Sakkas D, Stalberg A, et al. Intrauterine insemination: Evaluation of the results according to the woman's age, sperm quality, total sperm count per insemination and life table analysis. Hum Reprod 1996; 11:732.
  48. Blockeel C, Knez J, Polyzos NP, et al. Should an intrauterine insemination with donor semen be performed 1 or 2 days after the spontaneous LH rise? A prospective RCT. Hum Reprod 2014; 29:697.
  49. Centola GM, Mattox JH, Raubertas RF. Pregnancy rates after double versus single insemination with frozen donor semen. Fertil Steril 1990; 54:1089.
  50. Matilsky M, Geslevich Y, Ben-Ami M, et al. Two-day IUI treatment cycles are more successful than one-day IUI cycles when using frozen-thawed donor sperm. J Androl 1998; 19:603.
  51. Besselink DE, Farquhar C, Kremer JA, et al. Cervical insemination versus intra-uterine insemination of donor sperm for subfertility. Cochrane Database Syst Rev 2008; :CD000317.
  52. Peek JC, Godfrey B, Matthews CD. Estimation of fertility and fecundity in women receiving artificial insemination by donor semen and in normal fertile women. Br J Obstet Gynaecol 1984; 91:1019.
  53. Lansac J, Thepot F, Mayaux MJ, et al. Pregnancy outcome after artificial insemination or IVF with frozen semen donor: A collaborative study of the French CECOS Federation on 21,597 pregnancies. Eur J Obstet Gynecol Reprod Biol 1997; 74:223.
  54. Brewaeys A. Review: parent-child relationships and child development in donor insemination families. Hum Reprod Update 2001; 7:38.
  55. Golombok S, MacCallum F, Goodman E, Rutter M. Families with children conceived by donor insemination: A follow-up at age twelve. Child Dev 2002; 73:952.
  56. Nachtigall RD, Tschann JM, Quiroga SS, et al. Stigma, disclosure, and family functioning among parents of children conceived through donor insemination. Fertil Steril 1997; 68:83.
  57. Chan RW, Raboy B, Patterson CJ. Psychosocial adjustment among children conceived via donor insemination by lesbian and heterosexual mothers. Child Dev 1998; 69:443.
  58. Golombok S, Brewaeys A, Giavazzi MT, et al. The European study of assisted reproduction families: The transition to adolescence. Hum Reprod 2002; 17:830.
  59. Golombok S, Jadva V, Lycett E, et al. Families created by gamete donation: Follow-up at age 2. Hum Reprod 2005; 20:286.
  60. Kovacs GT, Mushin D, Kane H, Baker HW. A controlled study of the psycho-social development of children conceived following insemination with donor semen. Hum Reprod 1993; 8:788.
  61. Manuel C. Les risques psychologiques de la conception par IAD pour l'enfant. Neuropsychiatrie de l'enfance 1990; 38:642.
  62. Lycett E, Daniels K, Curson R, Golombok S. Offspring created as a result of donor insemination: A study of family relationships, child adjustment, and disclosure. Fertil Steril 2004; 82:172.
  63. Scheib JE, Riordan M, Rubin S. Adolescents with open-identity sperm donors: Reports from 12-17 year olds. Hum Reprod 2005; 20:239.
  64. Daniels K, Gillett W, Grace V. Parental information sharing with donor insemination conceived offspring: A follow-up study. Hum Reprod 2009; 24:1099.
  65. Ethics Committee of the American Society for Reproductive Medicine. Using family members as gamete donors or surrogates. Fertil Steril 2012; 98:797.
  66. Marshall LA. Ethical and legal issues in the use of related donors for therapeutic insemination. Urol Clin North Am 2002; 29:855.
  67. Ethics Committee of American Society for Reproductive Medicine. Informing offspring of their conception by gamete or embryo donation: A committee opinion. Fertil Steril 2013; 100:45.
  68. Scheib JE, Cushing RA. Open-identity donor insemination in the United States: Is it on the rise? Fertil Steril 2007; 88:231.
  69. Golombok S, Murray C, Jadva V, et al. Non-genetic and non-gestational parenthood: Consequences for parent-child relationships and the psychological well-being of mothers, fathers and children at age 3. Hum Reprod 2006; 21:1918.
  70. Jadva V, Freeman T, Kramer W, Golombok S. The experiences of adolescents and adults conceived by sperm donation: Comparisons by age of disclosure and family type. Hum Reprod 2009; 24:1909.
  71. Mahlstedt PP, LaBounty K, Kennedy WT. The views of adult offspring of sperm donation: essential feedback for the development of ethical guidelines within the practice of assisted reproductive technology in the United States. Fertil Steril 2010; 93:2236.
  72. Daniels K, Lalos O. The Swedish insemination act and the availability of donors. Hum Reprod 1995; 10:1871.
  73. Daniels K, Blyth E, Crawshaw M, Curson R. Short communication: previous semen donors and their views regarding the sharing of information with offspring. Hum Reprod 2005; 20:1670.
  74. Wang Y, Leader A. Non-Anonymous (ID-Release) Donor Sperm Is Not the Preferred Choice of Women Who Are Undergoing Assisted Human Reproduction. Fertil Steril 2005; 84:S204.