Fertility Information

Third Party Options

My doctor says that the quality and quantity of my sperm isn’t good enough to father a child and we are not interested in IVF with ICSI. What are our options?

Using donated sperm is an option that, if successful, would allow you and your partner to experience a pregnancy together. Donor sperm can be purchased through a fertility clinic from an anonymous donor selected through a sperm bank. Anonymous donors undergo medical screening and provide a fairly detailed social and health history. Some also provide pictures. There are two types of anonymous donors: a) anonymous and b) open ID donors. Open ID donors differ from completely anonymous donors in that they agree to have their identifying and medical details released to the potential child after the age of 18, if the child decides that s/he wants or needs this information.

Some, but not all fertility clinics, offer the option of using sperm from a donor who is known to you (e.g., a friend or family member who has agreed to donate his sperm). In Canada, the sperm from a known donor must go through a six-month quarantine and screening process to ensure that there is no transmission risk of HIV infection. Consequently, there is a significant waiting period involved with this option.

Prior to selecting a donor, most fertility clinics will ask you and your partner to speak with a counsellor who can help you decide if this is an option you are both comfortable with. The counsellor will help you consider the short- and long-term implications of using donated sperm, for you and for your future child(ren).

My doctor says I’ve waited too long to have a child and that my eggs are too old. What are my family building options?

If going through a pregnancy is important to you, you may want to consider the option of using donated eggs from a younger woman. Some clinics have donors that you may feel are a suitable match. Where available, you may select a suitable donor from an egg bank. Or you may ask a younger woman you know (e.g. a younger sister or a friend) to be your egg donor. Once you have selected a donor, her eggs would be retrieved following a round of fertility medications, and be fertilized with donor sperm or the sperm of your partner to create embryos. In 3 to 5 days one or two of the embryos would be transferred to your uterus. Any remaining embryos can be frozen and used at a later time, if the first cycle doesn’t result in a viable pregnancy, or if you want to add to your family in the future.

Adoption is another family building option that you might want to consider. Check with your local adoption agencies for information about domestic and international adoption possibilities.

For more information about adoption in Canada, check out the Adoptive Parents website.

For information about international adoption for Canadians click here. 

I have been asked to be an egg donor. What does it involve and where can I get more information about the process?

In order to become an egg donor, you must first go through medical and psychological screening to determine your suitability. This involves undergoing medical screening, and meeting with a mental health practitioner to talk about your motivations, expectations, and the short- and long-term implications of this choice. If you decide to go ahead with the donation, you will take fertility medications to stimulate the development of multiple eggs in your ovaries. These eggs will be retrieved and fertilized with the recipient partner’s sperm. A few days later, one or two of these embryos will be transferred to the recipient’s uterus. Any remaining embryos will likely be frozen for the recipient couple’s future use.

Women who are considering donating their eggs should know that there are psychological and physical risks involved. Women who donate their eggs anonymously often wonder about the outcome of their donation and whether the donation resulted in the birth of a child or children. Role clarity and setting appropriate boundaries are issues that women commonly face when they donate to a friend or family member.

The physical risks of egg donation are related to the fertility medications that are used to induce the development and release of a number of eggs. GnRH Agonists such as Lupron, are used at the start of the process. These medications affect the functioning of the pituitary. There are a number of side effects associated with GnRH Agonists, with the most common being headaches, hot flashes, mood swings, insomnia, and short-term memory loss. The daily injections that are introduced later in the process to stimulate the development of multiple eggs (follicles) frequently can cause bloating and weight-gain. The most significant risk is a condition called ovarian hyperstimulation syndrome (OHS). OHS is relatively rare but serious. It can require hospitalization and may impact a woman’s future fertility. Some women also find the egg retrieval process physically uncomfortable. Similar to IVF, the long-term impact of the process on future fertility still remains to be determined. The risks are likely to increase with repeated cycles/donations.

Policies on egg donation differ between countries. In Canada, donors cannot be paid for their donation. However, they can be compensated for any expenses that are incurred during the donation process. In the United States there is no national legislation limiting compensation to egg donors.

Many egg donors feel proud of helping an infertile individual/couple, particularly in cases when the donation is to a close friend or family member. However, before considering donating their eggs, it is important for women to understand the risks involved, their motivations for donating, and their beliefs/desires about their future relationship with, and feelings about, their genetic offspring. These are the issues that are typically addressed in pre-donation counselling.

RESOLVE includes a helpful sheet about the questions that women should ask themselves when considering being an egg donor.

The New York State Task Force’s Advisory on Assisted Reproductive Technologies published a booklet called: Thinking of Becoming an Egg Donor? It provides some important information on the procedure and women’s experiences of being an egg donor. The information on legal and financial considerations are only relevant to the United States. Read it here.

To read more about the physical risks involved with egg donation, click here.

I have been asked to be a sperm donor. What does it involve and where can I get more information about the process?

Sperm donation is much less invasive, expensive and time consuming than egg donation – but it also has psychosocial implications. If you are considering donating your sperm to a friend or family member you must undergo medical testing, sperm testing, screening and quarantine, and psychosocial implications counselling. If it is determined that your donation is viable, your previously quarantined, frozen sperm will be defrosted after approximately 6 months, and used by the recipient or recipient couple using intrauterine inseminations or IVF. In the case of IVF, any additional embryos that have been created and not transferred to the female recipient, will usually be cryopreserved for later use by the recipient couple.

There are no known physical risks associated with sperm donation, although some men find it challenging to have to produce fresh semen samples in a clinic setting. In terms of psychological impact, you might experience short term regret or sadness after donating. Long term, you will likely feel a sense of pride and well-being for having helped someone you care about become a parent.

The National Gamete Donation Trust in the UK has put together helpful information for those considering being a sperm donor.

Additional considerations

Prior to becoming a donor it will be important to discuss and agree upon what role, if any, you will have in the life of a child or children produced through your donation. You will also want to reach an agreement with the recipients about whether or not your identity will be disclosed to any offspring produced as a result of your donation.

Due to a medical condition I am unable to carry a child. What are my options?

If you still have functioning ovaries, gestational surrogacy would be an option. You and your partner would go through a cycle of in-vitro fertilization (IVF) during which medications would be used to stimulate the development of some of the eggs in your ovaries. During a medical procedure, these eggs would be retrieved and fertilized in a laboratory with your partner’s sperm or the sperm of a donor. One or two of the resulting embryos would be transferred to the uterus of a surrogate – usually a friend or family member who has agreed to carry your baby to term. See our question about IVF in our section on Assisted Reproduction.

Gestational surrogacy requires tremendous trust and commitment on your part and on the part of the woman who carries your child – your surrogate. As well as the medical assessment required for this type of arrangement, most clinics require that you and your partner, and your surrogate and her partner (if she is in a relationship) meet with a counsellor to discuss the range of issues including roles and readiness, expectations, and short-and long-term implications during the pregnancy and after the child is born.

In Canada, the law prohibits payment to a surrogate, other than for basic expenses she has to incur prior to, during, and following the pregnancy.

Where can I learn more about donor eggs, donor sperm, and surrogacy?

You may want to check out the following websites:

The American Society for Reproductive Medicine has put together a booklet on third party reproduction, some of which is relevant to Canadian audiences.

The Organization of Parents Through Surrogacy has some helpful resources and personal stories about building a family through surrogacy.

Psychosocial and Legal Issues

Certainly if you are considering any of these third-party reproductive options, prior to proceeding with treatment you will need to meet with a mental health professional who specializes in assisted human reproduction. If you elect to work with a surrogate to help you create your family, you will also want to meet with a lawyer to have a legal contract drawn up between you and your surrogate.