Overcoming doubts
In many ways, physically at least, male infertility is comparatively easy to circumvent. After all, apart from his initial — admittedly vital — contribution, the next nine months are firmly in the woman's court. Therefore, doesn't it stand to reason that any healthy sperm will do? Not necessarily. The thought of raising "another man's child" can be a formidable obstacle to parenthood.
A man who copes readily with the idea of adoption may baulk at the prospect of his partner being involved in the intimate act of conception with someone else. Somehow, you feel your masculinity, even your relationship, is threatened.
There is no rational reason for this. Your partner does not engage in intercourse and you will be invited to be with her at the time of insemination, to hold her hand and tell her how much you love her. If both of you wish it, you can learn to perform the inseminations. As a couple, you will have the joy of experiencing pregnancy and the birth of a child whose genes are 50 percent yours.
When your partner is undergoing insemination, you may feel a range of emotions — envy, guilt, jealousy. Don't suppress them; rather, talk about them with her and with a counsellor. Once you come to terms with the fact that conception is but the first step towards a relationship that will last a lifetime, the means by which this miracle is achieved seem less relevant.
Providing the wherewithal to make conception possible does not automatically guarantee that a man will be a good father. Far more important are the values you instil in your child and the love you give him or her. The day you hold your newborn infant for the first time, all this will become clear; you'll wonder how you could ever have wavered.
How you qualify
To have reached the stage where DI is recommended, as a couple you will have been through myriad tests which have established that (a) the male partner is infertile or (b) there is an incompatibility which would make pregnancy between you dangerous or impossible.
By far the most common reasons for DI are a low sperm count or non-production of sperm. Problems with ejaculation and lack of motility of sperm are other indications for DI. Genetic problems, which could result in a child being born with a condition such as haemophilia, blindness, Tay-Sachs disease or Huntington's chorea, account for about two percent of cases.
Immunological problems often mean that neither partner is sterile — it's just that their reproductive cells are "allergic" to each other. Similarly, Rhesus incompatibility describes a situation where pregnancies in certain women with Rhesus negative blood, who are partnered by Rhesus positive men, end in stillbirth. Insemination by sperm from a donor who is Rhesus negative will produce a Rhesus negative embryo who will not be affected by antibodies in the mother's bloodstream.
To qualify for entry to a DI program, a woman must be ovulating regularly. You should have a healthy reproductive system, without tubal blockages or scarring, or any uterine conditions which would make it difficult to sustain a pregnancy. Most public hospital units have an upper age limit of 40 for women, although private clinics tend to be more flexible.
As well, providers of DI services need to feel confident that you have a stable relationship, and are psychologically and emotionally prepared to accept the child and provide him or her with a loving home.
For the most part, you have to be able to attend a clinic for the inseminations, which are performed by a doctor or nurse. However, if you live too far from a main centre to be able to turn up at the appropriate time, you may be given several "straws" of frozen semen, with detailed instructions on when and how to perform the inseminations. As will be seen, the procedure is quite simple; the most difficult part is learning to lie back and enjoy it. The more relaxed you are, the better your chance of conception.
It should be noted that, because of a shortage of suitable sperm — especially for people of certain ethnic backgrounds — there are waiting lists at some clinics.
All information © Media 21. This information first appeared in GoodMedicine magazine.
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