Challenges in donor sperm treatment

Donor Sperm Treatment is the oldest effective fertility treatment for couples with involuntary childlessness due to male infertility. Nowadays, donor sperm treatment is an option for heterosexual couples, lesbian couples and single women.
Over the last decades many aspects of donor sperm treatment have undergone profound changes. At one time it was thought that new reproductive techniques would replace donor sperm treatment, but this has not materialized and donor sperm treatment is still a major part of the therapeutic reproductive armamentarium.
But there is a problem and that is the discrepancy between supply and demand. The supply side of the problem is the low number of suitable sperm donors caused by the prohibition of insemination of sperm of anonymous donors, the acknowledgement of the children’s right to know their genetic origin from the age of 16 and the mandatory use of frozen- thawed donor sperm. The demand side of the problem is the annual increase in the number of donor sperm treatment cycles.
In view of this, all our efforts should be directed towards establishing the most (cost)- effective insemination technique, which is the topic of this thesis. We found that intrauterine insemination in the natural cycle should be the first line treatment in women who start with donor sperm treatment, since it is more effective than intracervical insemination in the natural cycle. We highly recommend to develop a national guideline on donor sperm treatment with attention not only for the demand side, but also the supply side.