Screening of potential sperm bank donors

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In sperm banks, screening of potential sperm donors typically includes screening for genetic diseases, chromosomal abnormalities and sexually transmitted infections (STDs) that may be transmitted through the donor's sperm. The screening process generally also includes a quarantine period, during which samples are frozen and stored for at least six months after which the donor will be re-tested for STIs. This is to ensure no new infections have been acquired or have developed during since the donation. If the result is negative, the sperm samples can be released from quarantine and used in treatments.

Contents

The screening process and requirements vary significantly between jurisdictions. In the United States, the screening procedures are regulated by the FDA, the ASRM, the American Association of Tissue Banks, and the CDC. [1] The screening regulations are more stringent today than they have been in the past. In Europe, the screening procedures are regulated by the EU Tissue Directive.

Components

The CDC standards for sperm donor screening require: [1]

Cytomegalovirus

Screening for cytomegalovirus is not mandatory in all jurisdictions, and positive donors may still donate at sperm banks. [3]

Donor screening for cytomegalovirus (CMV) is carried out by testing for IgG antibodies against CMV that are produced if the donor ever has contracted CMV, which is the case in between 50% and 80% of adults. [4] Such antibody-positive individuals may potentially shed virus that remain latent in the body in the semen, infecting the mother and, in turn, the embryo/fetus. Most babies will not be harmed by the virus, but a small percentage may develop neurological abnormalities. [5] However, the risk of acquiring CMV infection from an antibody-positive sperm donor is believed to be extremely low, at least where sperm banks perform follow-up tests on antibody-positive donors for type IgM antibodies that indicate current or recent CMV infection, and where sperm preparations are performed that decrease the amount of white blood cells in the samples, e.g. in samples prepared for IUI. [5]

Quarantine

Washing techniques are developing that purify sperm from viral load of HIV and hepatitis C, [6] but nevertheless clinics do not offer sperm from carriers of significant STIs.

Sperm donation and reduced birth defects

Children conceived through sperm donation have a birth defect rate of almost a fifth compared with the general population. [7] [ unreliable medical source? ] This may be explained by the fact that sperm banks only accept donors who have good semen quality, and because of the rigorous screening procedures which they adopt, including a typical age limitation on sperm donors, often limiting sperm donors to the ages of 21–39 (see paternal age effect), and genetic and health screening of donors. In addition, sperm banks may try to ensure that the sperm used in a particular recipient woman comes from a donor whose blood group and genetic profile is compatible with those of the woman.

Sperm donation and rhesus incompatibility

Sperm donation is also used in cases of rhesus incompatibility. This particularly occurs where a woman has a blood type which is rhesus negative, and where her partner is rhesus positive. The woman's body may reject a fetus if it has rhesus positive blood. Anti D injections have been developed and may be used to attempt to avoid this, and these are usually automatically given to rhesus negative women immediately after they give birth to their first child. However, in the past this was either not possible or was not always routinely undertaken where a woman gave birth or had an abortion and she may have trouble carrying a child later in life. Furthermore, for some women, the anti D injection does not provide the entire solution, particularly where there is a medical history of complications during pregnancy which risk the woman's blood and that of the fetus becoming mixed. In such cases, sperm from a rhesus negative donor can provide the solution and a woman may be able to conceive and carry a pregnancy to full term when otherwise this would not be possible. For this reason, sperm from rhesus negative sperm donors is often in great demand, particularly those with the O negative blood group who are universal donors.

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<span class="mw-page-title-main">Blood type</span> Classification of blood based on antibodies and antigens on red blood cell surfaces

A blood type is a classification of blood, based on the presence and absence of antibodies and inherited antigenic substances on the surface of red blood cells (RBCs). These antigens may be proteins, carbohydrates, glycoproteins, or glycolipids, depending on the blood group system. Some of these antigens are also present on the surface of other types of cells of various tissues. Several of these red blood cell surface antigens can stem from one allele and collectively form a blood group system.

<span class="mw-page-title-main">Blood transfusion</span> Intravenous transference of blood products

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<span class="mw-page-title-main">Amniocentesis</span> Sampling of amniotic fluid done mainly to detect fetal chromosomal abnormalities

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Blood compatibility testing is conducted in a medical laboratory to identify potential incompatibilities between blood group systems in blood transfusion. It is also used to diagnose and prevent some complications of pregnancy that can occur when the baby has a different blood group from the mother. Blood compatibility testing includes blood typing, which detects the antigens on red blood cells that determine a person's blood type; testing for unexpected antibodies against blood group antigens ; and, in the case of blood transfusions, mixing the recipient's plasma with the donor's red blood cells to detect incompatibilities (crossmatching). Routine blood typing involves determining the ABO and RhD type, and involves both identification of ABO antigens on red blood cells and identification of ABO antibodies in the plasma. Other blood group antigens may be tested for in specific clinical situations.

In 1994, the Irish Blood Transfusion Service Board (BTSB) informed the Minister for Health that a blood product they had distributed in 1977 for the treatment of pregnant mothers had been contaminated with the hepatitis C virus. Following a report by an expert group, it was discovered that the BTSB had produced and distributed a second infected batch in 1991. The Government established a Tribunal of Inquiry to establish the facts of the case and also agreed to establish a tribunal for the compensation of victims but seemed to frustrate and delay the applications of these, in some cases terminally, ill women.

References

  1. 1 2 Comprehensive Donor Screening at Sperm Bank of California
  2. 1 2 Sims, C.; Callum, P.; Ray, M.; Iger, J.; Falk, R. (2010). "Genetic testing of sperm donors: survey of current practices". Fertility and Sterility. 94 (1): 126–129. doi: 10.1016/j.fertnstert.2009.01.139 . PMID   19342039.
  3. ↑ Cryos International --> Donor screening Retrieved on 20 June 2009
  4. ↑ Ryan KJ, Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed.). McGraw Hill. pp. 556, 566–9. ISBN   0-8385-8529-9.{{cite book}}: |author= has generic name (help)
  5. 1 2 California Cryobank -> CMV Testing Retrieved on 12 June 2009
  6. ↑ First report of the absence of viral load in testicular sperm samples obtained from men with hepatitis C and HIV after washing and their subsequent use Fertility and Sterility. Volume 92, Issue 3, Pages 1012–1015 (September 2009). Nicolás Garrido, Manuel Gil-Salom, Jose M. Martínez-Jabaloyas, Marcos Meseguer
  7. ↑ motherearthnews.com – The Sperm Crisis
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