Everything you need to know about donor sperm
Hello and welcome to the
second episode of Hatching a Plan with me,
Simon Tomes.
and me emma the embryologist
unbelievable we're supposed
to be a professional outfit
here um so yeah we're we're
married for those that
don't know us um I have the
pleasure and privilege of
being married to emma the
embryologist and this is
all about education so for
those who are unfamiliar
with emma she does
incredible things for the
world of fertility and I'm
here to amplify you and ask
lots of questions
and today we are going to
talk about everything you
need to know about donor
sperm so first of all thank
you to our listeners we see
we have 15 people with us
today which is wonderful
and that number keeps going
up so this is great um yeah
so we're based in
teddington uk uh we're
gonna have a uk focus today
as well so there are rules
uh they're different across
the globe but this is uk focus yeah
um so yeah if you want to
share on the chat where
you're dialing in from
that'll be lovely just so
we can get to know you a
little bit and do a bit of
interaction uh with the
folks who are listening
today so oh we see a
message coming in from
sidonia hi emma thank you
for hosting the session oh
great you're more than welcome
So yeah, so stick with us.
We've got an hour and this
is how it's gonna work.
We are going to, well,
you're gonna share some
slides and run through a
lot of information in a
short space of time.
If it's all too much,
you can come back to this session again.
It is recorded.
We will post links on where
you can find that.
This will eventually turn
into a podcast called Hatching a Plan.
And we'll talk about that in a bit.
And you can come back to it.
If at any point during
Emma's webinar you have a question,
just post it in the chat
and either you'll get to it
eventually with your presentation,
or if not,
you'll jump straight in and
answer a question as soon as possible.
Ah, Vivian, welcome from Edinburgh.
Lovely to have you here.
Oh, Marianne from Georgia, US.
And we have Imogen and John,
fellow Londoners.
Ah, good stuff.
That's lovely to have you with us today.
This is great.
So just before we dive into this topic,
yeah, why are we doing this?
And I don't mean that in a flippant way,
but just like, why are we doing this?
So the short answer is
because you told me I had to.
No, why are we doing this?
Because I don't think it
should be this hard to get...
the level of information you
need to understand whatever
your journey looks like and
all the bits and the
nuances that go with it.
I don't think it should be
that hard to be able to
access really clear
information before you delve in.
I also feel very,
very strongly that people
have information to make
informed consent.
I don't think you can give
consent and I don't think
you can know what information you are
reading getting all of that
thing unless someone
actually takes the time to
speak to you and I equally
don't think you should pay
for that because you are
going to potentially
infertility treatment pay
out a lot of money and I
just don't think it should
be this hard to access
information yeah so you're
saying there's lots of unknown uh
unknowns, essentially,
when you go into this journey.
You don't know what you don't know.
And actually,
I think what gets me time and
time again is some of the
things that I think come
really straightforwardly.
And I think,
doesn't everyone know that
because it's been in my
brain for so long?
And then you tell someone
something and they're
absolutely horrified
because nobody's ever told them.
And how many years have you
been an embryologist for?
22 in October.
I know I don't look old enough.
You don't look old enough.
I really do.
So Emma really knows her stuff.
So I don't have a medical background.
I work in community and technology.
But I've lived with Emma for many,
many years.
She's such a pussy.
So I hear everything.
So I have a little bit of knowledge,
but my role for today is to
host and to ask the
questions and make sure you
as the audience feel
welcome and enjoy this experience.
I appreciate it.
It's overwhelming.
It can feel scary.
It's a lot of stuff that's like, oh,
you know, what do we need to know?
So Emma is here to help.
We've got a few more folks
dialing in as well.
So Amy from Sussex.
Hello, Amy.
Sophie from Northern Ireland.
Wonderful.
And Catherine over in Norwich there.
So welcome.
OK, and well,
shall we jump into your presentation?
Let's bring that up.
But please just fire
questions at me because I'm
going to what I'm trying to
do is it's going to be quite generic,
but I'm going to try and answer.
some of the most common
stuff that I get asked.
And donor sperm is a minefield,
to say the least.
Yeah, let's jump on in.
Excellent.
Let's do it.
So everything you need to
know to get started.
Here we go.
Okay, so probably where we should start.
Who needs donor sperm?
I think the misconception
about who needs donor sperm
is that it's single women
or same-sex female couples.
It is so much bigger than that.
It's
trans couples,
it's heterosexual couples
with a serious male infertility.
It's actually people that
have had a vasectomy, for example,
and a reversal hasn't
worked and stuff like that.
And they've met later on in life.
It's people where
there is a genetic disease
where the male partner
carries a genetic disease
and they don't want to go
down the genetic embryo
testing route so they
choose to use donor sperm
so that that there's no
risk in carrying that
disease there's also a
choice thing in this
there's some people that
are in a relationship and
the partner of that
the male partner in that
relationship just doesn't
want to be a legal parent.
So there's that as well.
So I think let's start there.
Donor sperm is a massive need.
It is a huge concept.
It's a huge need.
And there's a lot more
people than you think that need it.
And I probably import about three or four,
maybe five samples of donor
sperm a week into a clinic.
Got it.
Got it.
Next slide.
Yeah, go for it.
Cool.
Oh, Mary,
Mary Anna has shared that you
must have started at age 12.
Oh, Mary, that's so sweet.
Well, your backstory, actually,
you were 15 when you went
to a fertility clinic in
Dorchester because your mum's a midwife.
My mum's a midwife.
your sister's a midwife yeah
and you there's nothing
weird about that no my my
dad was a funeral director
so I dealt with the end of
it right but you're so you
create life anyway um this
is about you so you're you
went to a clinic in
dorchester right and there
was something about that
yeah um yeah sorry there was
something about that so I
went to my work experience
in dorchester when I was 15
and I was completely
gripped and thankfully I
really enjoyed it because
otherwise I would have been
absolutely screwed doing
the job for 20 years
because I did all my
degrees based around being
an embryologist yeah yeah yeah
OK, we'll move on to the next one.
So types of donors.
So I think just to make this really,
really simple,
there are two for you as a
patient coming to this.
There are two ways that you
can access donor sperm.
There is anonymous to you.
Now,
I'm not going to use the word
anonymous very much because
you'll find out in a minute
that donors aren't anonymous.
But what I mean anonymous to
you is that you don't know who they are.
They have a code,
you buy them from a donor
bank or a depository or whatever that is,
but you don't know who they are.
Now,
the pros of doing that is that all
your testing is done,
all the legislation is adhered to.
the counseling is done,
the background checks are done,
the medical history is done.
But the cost of this,
and because of the amount
that goes into recruiting donor sperm,
it is massive.
You can pay anything between
sort of 600 and a thousand
pounds upwards per sample.
depending on the type of donor,
the availability, etc.
So there's also variable family limits,
which I'm going to get onto
in a minute because I think
it's a really important thing.
I'm going to interrupt.
Question appearing in my head already.
When you say per sample, does that mean...
you use the sample and then
you can do lots of stuff
with it or that's it the
one one on one seriously
I'm gonna get to that okay
this is good I genuinely
I'm I'm asking I genuinely
don't know the answer you
think I'm annoying to live with
okay um the only thing with
about using a donor that is
anonymous to you is they
have to consent to be used
but there has to be said
that consent can be
withdrawn so there are
there's never any
guarantees with any consent
with any couple
relationship or anything
but donor sperm is the same
um it's incredibly unlikely
that the consent will be
withdrawn because there is
a lot of counseling
involved so that's the type
of donor that you buy as a
code as a as an entity
The other type of donor is known to you.
You can actually use a donor known to you.
It can be a friend.
It can be... I've actually
done quite a lot of... So
an infertile heterosexual male couple,
with the male as infertile,
we've used his brother.
So you can use a donor known to you.
And there's some pros and cons about that.
The pros are that you are...
able to keep all those
samples for yourself you
can you only you are paying
for all the screening for
that donor and although it
sounds costly they all
belong to you and that is
one family unit which again
I'll come on to you so so
another naive question in
that scenario you just
described is the brother
the legal father no okay in
the uk absolutely not in
the uk you you hand over it
once you have donated
The legal parent, regardless,
even if it's a same-sex,
female same-sex couple,
the legal parent is the
people involved in the
treatment signing the consent forms.
When you donate something,
you donate the right to be
a legal parent.
So the surrogacy is the
thing where it's
complicated perhaps in the US.
Yeah, I'm not going to do that today.
Okay, we won't do surrogacy.
I'm not going to do that today.
So when you donate a sample,
you don't own it anymore.
It's a bit like you donating
your blood sample.
You're not going to go and
ask for it back.
Yeah, yeah.
You can't donate a kidney
and then ask for it back.
Excuse me, I've changed my mind.
can I have it back okay this
is getting really out there
already we've only just
started um so yeah so when
you donate your sample it
is um you are donating your
sample you hand over all
legal parentage rights and
you sign you sign a form to
say that it says I am not
you know this is okay
Next slide, please.
Next slide.
Sure thing.
And also if in the chat,
if you've got any questions
popping into your head right now,
because like they are
popping into my head,
please do put them in the chat.
We can bring the question up
onto the screen as well for
others to read.
And Emma, you can.
jump on in and answer anything.
But yeah, let's crack on.
So why do they donate?
Well, how long is a piece of string?
This is a really hard one.
So I used to work in a bank
where we recruited donors many,
many years ago.
And I'm going to get onto
the laws in the UK because
it's changed significantly
in the last 20 years.
Most of it was altruistic, to be honest.
And when I say altruistic, I mean,
they normally had like some
sort of background or some
sort of calling where they really,
really wanted to do this.
Abroad,
there is a little bit of financial gain.
You do not gain in the UK.
You are not allowed to be
paid in the UK for any donations,
be that blood, be that kidneys,
be that legs, arms.
You're not allowed to gain
anything from a donation.
You are allowed expenses,
but in other countries,
you are allowed to be paid
for certain donations,
but not anything that's
donated in the UK.
So there is a little bit of
financial element.
There is always the risk that it's an ego.
It's a thing about spreading your seed.
Yeah, yeah, yeah.
But let me be clear.
Donation is no small undertaking.
So it is massive.
It is such a big part of
their lives for such a long time.
They do have to make a massive commitment.
So why is that?
Why is it such a commitment?
Is it because you will
eventually help creating
like 70 families or?
Yeah.
So you're like literally
stealing my slides.
So it's because if you're
donating and so if you're
donating for one couple,
then you would your
undertaking would probably
be three samples.
You would probably give over
three samples of semen
ejaculate and then we would
break that down into, say,
12 usable samples.
But if you're donating for a donor bank.
depending on what that donor
bank is looking to get from
that donation or where they
are supplying to,
you could be donating with
that donor bank for 12 to 18 months,
and then you could be on a
recall register to come
back if they need any more from you.
So it's not a small undertaking,
it's a big deal.
So I think there are many
reasons that people donate,
but I think we need to be
very clear of how much they
have to commit to do it.
And the donor banks,
like maybe this is slightly off topic,
but I'm going to ask it anyway,
because some people might
be thinking the same.
Are they for profit or are
they funded by the
government and backed by
the government to help people?
How does it?
So a bit of both.
In the UK,
there's a couple of NHS donor banks.
But ultimately, yes, they're for profit.
They are big companies.
And the reason they charge
is because they have to
store it and the legal
stuff and all the testing.
The expense of it is massive.
But yes, ultimately, they're businesses.
Yeah, yeah, yeah.
And a clinic will pay that
donor bank via the... Can I
get onto that?
Okay, sure.
Sorry, folks, I'm getting ahead here.
But next slide.
Yeah, go for it.
Okay, here we go.
okay so what happened in the
uk so in before 2005 all
donors were anonymous and
then now this is my
favorite word which I
couldn't actually say for a
really long time the
anonymity was removed in
2005. it's like the most
ridiculous word um once the
anonymity said it twice
um was removed in 2005 there
was a massive decrease in
donations now the reason
that was removed was
because of the uh there was
a I think it was a big move
I can't remember I do
remember it happening
because I was working in
the nhs at the time and we
started trying to recruit
donors and it was it was
nigh on impossible because
there was this fear among
it but I think it came I
remember you saying it was
a real it was hard real
shift you were like oh
And before the donors could turn up,
they could donate.
I mean, go back to like the 1980s, 1990s.
Donors would turn up on the
day and do a fresh sample.
Students trying to make money, right?
And just donate.
Yeah, it was just like, that was it.
So then it got really strict
and we removed anonymity
and we had donors that were
donating for...
in the law that we've got now,
which is when the child is 18,
they can find out the last
known information of that
donor being their name and
address from what I can gather.
So that's quite scary.
It came from,
I believe it came from the
Scandinavian countries.
I'm not a hundred percent sure.
So don't quote me on that.
The donor is not allowed to
know the reverse.
Okay.
The donor is allowed to know
how many children have been
born and what genders they are,
but he doesn't get to know
who they are or where they
live and stuff like that.
Okay.
So it's really important
that when you're talking
about getting donor sperm,
especially when you're
getting donor sperm from abroad,
which is where the biggest
donor banks are,
you are dealing with donors
and it's called an ID release donor.
Okay,
now most of the banks are so good
with UK law that they will
have a British flag next to
their donors that are ID release.
And that means the donors, even in the US,
in Denmark, in Sweden,
wherever the donor bank is,
those donors have signed UK
consent forms.
Ah, okay.
I see what you mean.
So they can be shipped and
used on their database.
They know that they, you know,
they don't have to go through.
Okay.
So that was the biggest
shift in the UK law.
Oh, so a comment coming in from Mary Anna.
So for anonymous or let me
just bring this up on
screen and I'm just going
to switch the view.
So it's just come off the
slides for a bit.
So so Mary Anna,
thank you for sharing this comment.
So for anonymous,
there is a requirement to
quarantine the samples for six months,
which is also part of the
extended commitment.
Is there the same
requirement when dealing
with the known donors?
Yep, you've taken my next slide, I think.
But yes, yes, there is.
It's exactly the same.
So UK law is the same for
known donation as it is for
anonymous donation.
Like I said,
I'm using the word anonymous
loosely because it's not
really anonymous.
It is to you,
but it won't be in the future.
But yes,
so actually the UK donation laws
are identical.
So you don't actually, when you talk about
The HFEA code of practice,
which is our governing body
who have got a manifesto
that we all have to adhere to.
It is a legal document.
There is no, it's not just a suggestion.
It's an absolute thing.
The UK donation law doesn't
actually talk too much
about known versus anonymous.
It is, this is if you are donating sperm,
these are what you have to adhere to.
So is it an act in parliament?
Yeah,
it's an act in parliament that went
through in 1991 and it got
updated in 2008.
Okay, so only 2008.
So it hasn't been looked at.
No,
so the code of practice has been
changed a lot.
But I think there's been
fundamental changes in it in 2008.
But no, I mean,
it gets updated all the time.
But it's we get like alerts
when stuff have been
changed for modifications, but no,
no actual change in law, but just
So the code of practice is in law.
So as the code of practice change,
it becomes it's a rolling thing.
Yeah, gotcha.
But yes, so Marianne,
that is that is true for all we don't,
we don't really have a
difference between known and anonymous.
Everyone has I have the same
guidelines to follow
whether I am screening for a
a donor that I'm going to sell,
which I don't do myself,
but I have done before,
or a donor that we are
going to keep for a
specific patient who has
bought this man for her own donation.
Yeah.
Yeah?
Yeah, yeah.
Great, great comment and question there,
Mariana.
Thank you.
So let's bring up this one
from Sarah Jane.
Can donors approach the
sperm bank in 18 years time
to find out the address of born children,
if that makes sense?
No, they can't.
So no.
They can find out how many
children have been born and
what gender they are, as far as I'm aware,
but nothing else.
That's as far as they can go.
They're not allowed to hunt them down.
And I guess from the
altruistic side of thing,
that person can then just feel good.
Like, oh, I've helped 20 families.
Like that's, that's where they go to.
Yeah.
Or I've helped 30 families
or I've helped 10 families.
Isn't that cool?
Yeah.
Yeah.
Brilliant.
Yeah.
Good question there, Sarah Jane.
Thank you.
Should we jump back to the slides?
Cool.
So bring that one off and then.
I think the next one's UK law as well.
So that's why I was saying all donors,
regardless of where they come from,
have to sign our HFEA forms
and adhere to screening rules in the UK.
What's in a screening rule?
It's next slide.
Oh my goodness,
this is like quite painful
working with you this evening.
um okay so um all all
persons using donor sperm
so if you are receiving
donor sperm you have to
have implications
counseling it's mandated
again that's in the code of
practice and all donors
have to have counseling so
if you are donating you
have to undergo counseling
so so counseling is a big
word just very briefly what
would counseling include for the donor
So it's called implications counselling.
So it's implications of what
your donation is meaning.
So they're fully aware of the risks?
Yeah,
but actually a lot of the donor banks
now do,
obviously there's a lot of medical
history checks and stuff.
And actually the counselling is more,
I think from experience,
they actually have quite a lot of,
like mandatory conversations
as they go through the
recruitment process to make
sure that they're doing it
for the right reasons,
to make sure their mental health's intact,
all of those things.
And they have to have
implications to understand
what this means for them in
18 years time.
And if you are receiving donor sperm,
you have to have
implications counselling as well.
If you are bringing a known
donor to the clinic,
you all have to have group counselling.
So you have group counselling,
single counselling, single counselling.
There's a lot of it involved
and it's all mandated.
And so you can't go, no, not doing it.
And if you say, no, not doing it,
then you can't go.
You can't use it.
Okay, got it.
And for the mandated for any
person using donor sperm, is it, again,
just implications?
You used the word implications.
So people letting themselves
know what they're signing up for.
Sophie's asking me a
question that we'll get to in a minute.
Yeah, let's get... Yeah,
should we get Sophie's question up?
No, because I'm going to go to screening.
Oh, okay.
So I think I'm going to
cover Sophie's question in a minute.
Okay.
Screening!
Hey, there we go.
This isn't all of it, by the way.
This is like just to give
you a ballpark of what we
have to screen donors for.
So in the HFEA,
there are mandated screenings,
there are ethnic screenings,
and there are screening
that is being done by
certain donor banks as...
extra plus or minus too much
and that's that's very much
an opinion and a choice and
all of those things so
mandated by the hfea is
every donor must be
screened for all virology
so hiv hep b hep c they
must be screened for
gonorrhea chlamydia they
are also screened for the
carrier status of cystic
fibrosis because it's so
common in the population
they have a carrier type
which is to check that all
their chromosomes are in order
They also have CMV,
which is what Sophie's talked about.
And they have we do other
things like we check
infection in the semen and
there are other things.
But there's a whole list on
the HFPA code of practice
that is very much every
donor has to have this
before they donate.
Now, before they donate is.
is a bit loose so legally I
have to have hiv hep b hep
c hep b core before I store
I am not allowed to put any
samples in my tank before I
have those results oh of
course cystic fibrosis
karyotype cmv all the
others you can wiggle a bit
you can do them later but
you cannot use any donor
sperm I'm I suppose in my
head I'm thinking about a
known donor situation yeah
you can't use any known
donor sperm until you have
all those results and it's
been in quarantine
And you put them in a
separate tank for
cross-contamination risks
and all of that stuff?
Yes.
Okay, gotcha.
So in answer to Sophie's question,
CMV is cytomegalovirus.
Now,
I have a particular bugbear about
cytomegalovirus and I have
to put my filter on a bit
here because as people that know me know,
I don't have one.
Cytomegalovirus is a bit like chickenpox.
It's something that you
generally catch as a child.
It's like a common cold.
It's not a very nice virus.
The reason they talk about
it so much is because it's
absolutely tragic in pregnancy.
If you catch CMV in pregnancy,
it can be catastrophic to the pregnancy.
In all fairness,
it's the same as if you
catch chickenpox in pregnancy.
It's the same as if you
catch herpes in pregnancy.
All of these things are part of the...
the herpes varicella family
and they are really really
bad the problem I have with
CMV is we are told to
encourage patients that if
they are CMV negative so
most patients have
screening themselves before
they pick a donor okay so
if they're CMV negative
they should try and choose
a CMV negative donor I
can't understand that
because a CMV positive
donor does not have CMV it
means that he has had it as
a child because we do two
tests we do what's called
an IgG and an IgM
The IgM is for current
infection and the IgG is the,
or is it the way around?
I'm not a virologist,
I'm not gonna pretend to know.
One of them is for current infection,
one of them is for you have had it,
but you are not currently infected.
So you would never allow a
donor to continue to donate
with a current infection.
And because we know the difference,
we would say, well,
you've got a current infection,
you can't use those donors, right?
So my question to anyone is
how can someone who has had
CMV as a four-year-old give a woman CMV?
The answer is it's a theoretical risk.
It's never happened.
I can't see it ever happening,
but we are told to donate.
encourage you to pick a CMV
negative donor if you are
CMV negative I find it
mind-blowing that it hasn't
been removed but that is
what CMV is and that's what
Sophie is asking so I'm I'm
very much I sit in a clinic
now where we are doing the
guidelines we're sharing it
but it's not mandated you
can choose a CMV positive
donor and sign a waiver
because it's it's bonkers
if you ask me yeah you
can't give some it's like
me trying to give you
chickenpox I had chickenpox
when I was three years old
yeah I can't give you chickenpox so
i I don't get it I'm sorry I
don't get it anyway good
bit of honesty and and
sophie hopefully that has
helped answer your question
if you've got a follow-up
to what emma's just shared
then please do jump in the
chat and let us know um and
sarah jane thank you for
sharing um yeah we had our
implication counseling on
friday oh wow there you go
very recently counselor
just asked key questions
yeah uh ethical based ones
mainly was interesting okay
yeah it's really
interesting sharing that um
I've sat in on a couple of
them they're really good yeah
Back to the slides.
Back to screening.
So quarantine means a period
of time that has to pass
before you can release the
samples for use.
Now, Mary Jane said six months.
You can actually release
samples a bit earlier than
that if you're going to do
what's called NAT testing.
So there's two types of testing for HIV,
Hep B, Hep C, Hep B core.
You can either do antibody testing,
which is really effective,
but you then need a
six-month window to make sure.
The reason you have to have
these quarantine periods is
because the HIV, for example,
can take up to six months to
show up in the blood.
So once you're frozen a
sample and someone was then
to contract it, say, that day,
it wouldn't show up for six
months on a certain test.
There is a different test
called NAT screening that
we use in the UK,
and we release samples
after three months because
it's much more...
It's just more sensitive to HIV, Hep B,
Hep C and Hep B core.
So you can release samples
after three months,
but every sample has to go
through a period of quarantine.
So if you are thinking of
recruiting a known donor, for example,
you always have to factor
that into when you can use the sample.
So you're planning as far
ahead as six months.
You have to plan six months.
However,
if you're buying from a donor bank,
they will only release
samples to you once they're
out of quarantine.
They will only sell samples
that are out of quarantine, right?
So that's another one of
the... So the difference
between knowns and anonymous.
Yeah.
Okay, got it.
So if you're buying from a donor bank,
they are only selling what
has come out of quarantine.
They're not... They might
actually... If you really
wanted a donor and it's on their books,
but they've sold out of what... Like,
by the by...
it's a little bit like a catalogue.
They might say to you, I have got some,
but it's in quarantine for
another three months and
you can reserve some.
But he then has to have all
those bloods cleared.
And if those bloods don't
come back cleared,
those samples are destroyed.
And maybe because you don't
work in a donor bank,
but when you reserve,
do you literally pay a deposit and say,
right, I want to reserve that?
It's really different.
Different donor banks do different things,
yeah.
Fair enough.
And I think you're going to
share some example donor
banks a little bit later.
Yeah, yeah, yeah.
Okay, cool.
OK.
All right.
Next one.
So what do you find out about the donor?
Now, this is really,
really one of the biggest
questions I get asked.
And actually,
a lot of this is personal choice.
So especially in the UK,
you will not find out a lot.
The donor banks in the UK,
a lot of them are still in
the NHS or if they are, if they aren't,
it's not.
it's not quite the same as
buying from abroad so you
will find out hair color
eye color height you have
lots of background
information about them
you'll find out their
education um you might get
what's called a pen sketch
whereas the donor tells you
like might do a little
writing about themselves
and they might do that in
their own handwriting
that's encouraged um but
actually you get quite
limited information in the
uk blood group you get that
you get um again it depends
but you're not going to get
pictures in the uk from the
uk donor banks now if you go abroad
It's almost the sky's the
limit and you can actually
choose not to see it because you,
the donor banks are very
good at putting up the front information,
but you can then pay into
behind the paywall and you
can start looking at baby
photos of pictures and
teenage photos of these
guys and you can see pictures of them.
Oh my goodness.
So this has become the real
problem with the word
anonymous because now we
have AI and generations and all that,
and you can stick someone's
picture into Google and it
will come up with who that person is.
So it's a really challenging time.
However, it's not illegal.
So I always say to people,
how much do you want to know?
Because actually you get to choose that.
Okay.
Now a question back to you about that,
because that is utterly fascinating,
particularly where it's
much easier to find people
online if you dig a little deeper.
how what percentage of
people say I want to know
everything as much as
possible this and I ask
this question like you know
it's all anonymous but it's
more to for our audience
like how how comfortable
they feel about it and
You know, yeah.
So interestingly enough,
it's the demographic of
patient that wants to know more or less.
So generally,
if it's a heterosexual couple
where the man is infertile and tragically,
they've probably been
through a huge amount to
get to where they are now.
And they found out that
there is going to be no
possibility of conception,
like for a genetic disease
or for what we call azoospermia,
which is.
no sperm seen at all for
lots of different reasons
like when you get mumps as
a child or something like
that they don't tend to
want to know a lot actually
I think it's easier not to
and this isn't a black and
white answer by the way
this is just my general
what I've seen over the
years yeah and that's my
question whereas single
women same sex female
couples are very much more
want to know everything um
probably to get more
control over it yeah which
is again it's just an
observation absolutely yeah
um I don't think there's a
right or wrong answer to
this actually I think it is
very much but I think it's
really important that
you're comfortable with
what you see and what you don't see
So it really comes down to
personal choice and the
individuality of that
individual or that couple.
So also you can find out if
they've had previous pregnancies.
Some of the donor banks,
some of the donors have
been donors for a really long time.
So I might say that they've
got proven fertility.
and that I guess is is
awaiting like oh okay if
they've had success in the
past then it's more likely
that it will be successful
yeah but equally that
wouldn't put me off because
a lot of the donors that
donate abroad are quite
young so they won't have
had their own families oh I
see and they might not have
been used that much and
actually they're incredibly
well screened so I don't
think it would be the
reason I didn't know the
stats don't really matter
at that stage if it's like
someone in their early 20s or mid-20s
Yeah.
And this could be the first
time that and you've got to
remember the donor banks
are tracking it as well.
Yeah.
So they don't want to be
selling a donor that's not
making pregnancies, right?
So they will be tracking the
first 10 sales that they do
to and then getting
feedback from that as well.
Yeah.
Wow.
And so so the donor banks then go, right,
well,
this this person is not having success,
and they literally take
them off their books.
I think they probably investigate it.
But yeah,
it would have to be quite I've not,
I have seen it once, actually,
but it's many, many years ago.
As in, they went,
this donor's just not good enough,
and they're not having any success,
and therefore... It was in the UK,
but yeah.
There you go.
We never really did catch the bottom of it,
but there's always going to
be those ones that look okay on analysis,
and then...
The reality is different.
Yeah.
But that's a smaller percentage.
Tiny, which is why it wouldn't be my,
if I was choosing a donor
and people say to me quite a lot,
should I be looking for
someone with proven fertility?
I think you need to,
like what I will say is the
donor banks that we work with,
which I will name a few
just because I think it's
really good to have a view
of what's out there.
Most of them will have
someone at the end of the
phone that actually knows
these guys and they'll be
able to tell you a little
bit more about how long
they've been donating and
actually if it's a worry or
if like all of those,
they're actually really
good at communicating with you.
Yeah, they know these people.
They don't want you to feel
like this any more than you do.
Yeah, that makes sense.
Okay,
so let's just jump onto the chat to
see if we've got more stuff coming in.
Oh, yeah, good stuff, Sophie.
So thanks for answering the CMV question.
That's put me right at ease.
Oh, good to hear that.
And Sarah Jane also, CMV question,
the same as Sophie, I wanted to know too,
was fab.
brilliant um okay emma also
nature nurture debate comes
into play when choosing
donor sperm it did for us
anyway yeah absolutely I
mean it's so true yeah it's
so true and actually um I'm
a big believer in nurture
over nature to be honest I
think that there are
certain things that nature
absolutely plays a key role
in but ultimately you're
bringing that child up and
that's it's that's where
all your mannerisms come
from it's not from yeah I'm
a massive believer in that so
Absolutely.
Okay, let's bring up this from Sophie.
So we're doing treatment in
Southern Ireland and you
get everything and then
some extra when it comes to
knowing about the donor.
My husband has azoospermia
due to the mumps.
And we have gone through to
wanting an anonymous donor,
to wanting to a known donor
with all the information.
The process is a whirlwind.
Thank you for sharing that, Sophie.
So it's interesting you talk
about Ireland because
obviously Northern Ireland
is part of the UK,
so they come under the HFEA.
Ireland doesn't.
Of course.
So Ireland still have access
to anonymous donation,
which actually when you're trying to ship,
which I'll come on to in a bit,
when you're trying to ship
sperm between countries,
it can be quite challenging
because of the rules and stuff.
So especially when it's Ireland,
because it's so close.
Of course.
And actually their rules are
quite different.
Yeah.
Yeah.
Exactly what you say.
You go through waves of emotion, I think,
especially when you are in
a situation like you are
with azoospermia caused by mumps.
You go through waves of what
you want to know and then
how much more comfortable
you get with that process.
I think it changes.
And that's why I think
counselling is so key.
And I don't think it should
just be the mandatory stuff.
I think in situations like Sophie's,
it should be extensive and
I think actually should be funded.
yeah and and the point being
how you might feel in one
month can feel completely
different in month two yeah
and I get more you get more
comfortable with it a
little bit yeah yeah yeah
yeah thank you for sharing
that sophie I really
appreciate it um and a
comment from amy so my
husband wants to use a
donor that's the same
similarity so we like to
choose from photos yeah but
we are debating whether to
see adult photos of the donor
So again,
I would speak to the donor bank
that you're looking at.
If you find someone that you like,
it could be that the donor
bank will help you with
what photos you can and can't access.
I don't know, and I can't comment,
but I know that there's the
option to see children's,
like the child photo rather
than the adult photo.
Whether or not that can be split up,
I don't know.
But I would definitely get
in touch with them and be
really honest about what
you're struggling with.
And they can help you.
They're really good humans.
So, you know.
And just to add, Sarah, Jane,
appreciate you sharing this advice.
Amy, check out the European Sperm Bank.
We could hear our donor's
voice and see a pen sketch
of him as a grown-up and
saw baby pictures.
We also have free shipping
off at the moment.
We bought our sperm on Friday.
Well, that is new to me.
You just taught me.
I knew the donor voices were coming.
I didn't know it was out, actually.
Oh, wow.
Fascinating.
So yeah, it's getting,
it's getting different.
It's changing.
You know,
the landscape is changing and I
think it is very much about
how comfortable you are, but this,
the reason I'll be doing
this is to make sure that
you're aware that this is
what's coming because
actually there can be a lot
of shock involved in this.
Oh my God.
I wasn't expecting to see that photo.
Of course.
Yeah.
Okay.
Let's move back to the presentation.
Next slide.
How much do you need now?
This I can honestly say is
the most common question I get.
How much do you need?
I mean, yeah.
So if anyone,
and everyone here must follow
me on Insta because
otherwise you wouldn't have
known about the webinar
unless you've come from LGBT mummies.
But ultimately on my webinar,
on my Instagram last night, I put
let's talk about family, not just baby.
So when I talk to patients
about donor sperm and how much you need,
I'm constantly talking
about the need to think
bigger than the now.
Donor sperm is,
is not an endless supply.
And the worst thing I have
ever seen in my career is a
couple that came through,
used donor sperm, had a child,
and then there was nothing
left for a sibling,
and they had to then go to
a different donor for a sibling.
And the trauma that came with that,
is was massive so um sarah
raises a very good point
there how much can you
afford 100 and that's why I
think it was interesting to
put up the anonymous versus
known how much it all costs
which I'm going to get onto
in a minute but ultimately
the question you ask is how
much do I need yeah so one
sample is one cycle of treatment
So most people come to this,
depending on what
circumstances they're in,
thinking about doing IUI donor.
So IUI donor is insemination
with donor sperm,
and the success rates vary
depending on the age of the
woman being inseminated,
but it ranges from 8% if
you're in your late 30s,
to 15 if you're under 35
okay so on average it's
going to take you three or
four cycles of iui
potentially to have that
first pregnancy and that is
four vials of donor sperm
four vials or straws we
straw we either freeze them
in vials or we we freeze
them in stores depending on
where they come from it
doesn't really matter it
doesn't make any difference
to the quality of the sperm
it's just how they're
stored so by then you've
already gone through four
and then you've potentially
got to buy another four
because you might want a sibling later on
or you can reserve another four.
So how much you need is what
are you planning on doing with it?
So if you think that, like I said,
if you think about children
and all of that,
so a lot of donor banks
will allow you to buy a
group of sperm and ship it.
And some donor banks will
allow you to reserve some
and keep it in their bank
so that if you don't use it,
they'll buy it back or
they'll give you a partial refund.
Something like that.
Once it has left their clinic,
they won't buy it back.
Understandably,
because they don't know
what's happened to it.
Yeah, of course, they can't risk.
So there's that option.
But I will say that one
round of IVF where you
collect lots of eggs,
we only use one vial of donor sperm.
Just say that again.
So one IUI,
so one insemination where there
will only be one or two
eggs because you're using a
woman's natural cycle, right?
That will be one vial of one
straw of sperm.
Yeah.
One round of IVF where you
collect lots of eggs, one vial.
One treatment, one sample.
Yeah.
Okay.
All right.
So let's cost it out.
Yeah.
If you are looking between
8% and 15% per treatment cycle,
depending on age,
and you need four rounds or
three rounds of IUI,
by the time you've done
three rounds of IUI,
you've spent approximately 7,000 pounds.
Because you've done all the IUI treatment,
all the scans, all the lead up,
all of that, and you've bought your sperm,
right?
But you've had three goes,
and essentially you've
probably released three, maybe four,
maybe five eggs.
With me?
Yep.
100%.
Yep.
IVF, you do one cycle of treatment,
you collect lots of eggs.
When you say lots, what do you mean?
Well,
it depends on your personal
circumstances.
Between 5 and 25,
depending on your own
personal circumstances.
And in fact,
IUI for some people may be
better because they're not
going to collect any more
eggs than they would in an IUI.
That's a completely
different conversation I
haven't got time to get into.
In most people coming to
this at their mid to late 30s,
they will collect a
reasonable number of eggs.
My average number of eggs at the age of 36,
37 is 14.
that I collect in a cycle of IVF.
You then fertilize all 14 eggs,
or try and fertilize all 14 eggs,
with one vial of sperm.
And not only can you have
embryos to put back and have a baby with,
you've got embryos in the freezer.
And that is about 8,000 pounds.
So the question has to be, yes,
this is all a great idea if
you're gonna have one cycle
of IUI and it's gonna work,
but we need to get our
percentages in order.
Because actually when people
say it's cheaper, I'm gonna do IUI,
Is it?
Is it?
Yeah.
And to your point about
think beyond the now,
think family over baby,
then I can understand why
you encourage people to think,
just think beyond the initial cost.
Yeah.
It's beyond that.
Because it's bigger than that.
So I always urge people to say, yes,
in an ideal world,
I'd love you to have one
IUI for this baby and one
IUI for that baby.
But the realistic value of
that is that's just not how it happens.
yeah I get it so that's
fascinating but one sample
per treatment regardless of
that treatment yeah got it
if you have a question
about costing please go for
it in the chat appreciate
when it comes to numbers
and how much things cost it
can get quite confusing and
overwhelming I think
someone asked a really good
question up here and I
think we missed it oh did
we miss it okay let's have
a look this one
Okay, so let's bring this question up.
Yeah, apologies, Sarah Jane,
for missing this one earlier on.
So the question is,
we are using donor sperm,
but they made me complete
blood tests too.
Female profile for HIP, HEP, etc.
Why is this?
Seems strange because we are
doing IUI with donor sperm.
I would understand if we had
to create embryos.
Because IUI donor is a licensed treatment.
So with a licensed treatment,
so there's treatments that
we can do in the clinic
that aren't licensed.
So IUI partner is not a licensed treatment,
but IUI donor is a licensed
treatment governed by the HFEA.
So the same screening rules apply.
So when we are performing a
licensed treatment,
we have to have virology for both parties,
regardless of what we're doing.
I hope that helps.
But it's licensed.
It means we are regulated on it.
Yep.
We're not regulated on time
sexual intercourse.
We're not regulated on
ovulation induction.
We're not regulated on IUI partner,
husband,
because you're having intercourse anyway,
but we are regulated on IUI donor.
I see.
Yeah.
Yeah.
Yeah.
Hopefully that helps answer
your question there, Sarah Jane.
Thank you for asking.
And sorry,
we missed it a little bit earlier on.
Okay.
Let's bring that one down.
Okay, the acronyms.
So when you go onto any donor website,
what they're going to say,
it says things like IUI and
ICI and ART and MOT20 and MOT10 and ICSI.
Oh my goodness,
how is anyone meant to understand this?
So different donor banks
will do different things.
Ultimately,
what I'll tell you is that in a
clinic that we work in,
because the reason that the donor banks,
they don't tend to do this in the UK,
you tend to just get unwashed
or what we call ICI sperm.
ICI stands for
intra-cervical insemination.
It's unwashed, it's raw semen,
and it's just cryopreserved.
That's how we preserve most sperm.
In donor banks across the world,
you've got to remember that
they are able to send donor
sperm to doctors' surgeries
for insemination.
They do not need to go into
a fertility clinic in certain countries.
In the UK,
all treatment with donor sperm
has to happen in a
fertility clinic under a regulated body.
That is not the same in the
rest of the world.
So they are catering for the whole world.
So you will pay different
values for different things.
So an IUI sample is a washed sample.
It means it's already been washed out.
An ICI or an unwashed is
actually what I would
prefer because I'm going to
wash it anyway because it's
part of my process in my laboratory.
Yeah.
An ART and ICSI sample,
these might be cheaper
because they're just lower motility,
but you can more than
happily use them if you're
going to do egg collection and ICSI.
And the MOT20, MOT10,
it actually means how many
million motile sperm there
are in it after thawing.
So all of these things are options,
but I would speak to the
people that you're,
like when you know what
treatment you're having,
speak to the embryology
team because I'll tell you
exactly what to buy.
I got it.
So we have a question from
Sarah Jane again.
So thank you, Sarah,
for keep the questions coming.
This is great.
So with that,
to follow up on the previous point.
So would that mean an IUI
IVF baby is a safe way of conceiving?
And there's a follow up question here,
meaning less risk of disease.
No, there's no evidence for that.
So IVF, ICSI, all of those things now.
was a paper that came out in
2012 that's actually been
slammed a bit recently
because um going back to
when anonymity and I see I
told you I can't say it
it's a strong anonymity was
removed in 2005. the reason
they did it in 2005 is
because ixi had become this
really big thing so we were
actually using less donor
sperm because we were able
to treat more infertile men
yeah so they did it at that
stage where it was its
lowest use because they
were trying to impact like the less
In 2012,
a paper came out saying that IVF
and ICSI babies were
exposed to more disabilities.
You have to understand that
back in the day,
the ICSI babies that we
were using ICSI for back in 2010, 5,
six seven eight nine ten
before that paper was
published we were treating
the most infertile men with
ICSI right so you can't
question sticking a needle
in an egg you have to
question why were they in
why did they have such a
low sperm count in the
first place and a lot of it
is genetics if you did that
test again now with the way
we do fertility now and
people have done it there
is no difference between
natural conceived babies
and IVF and ICSI babies I see
The risk is the risk.
It's the same.
So no, I don't think that's,
it's not a thing anymore.
Okay.
Good question there, Sarah-Jane.
And another question coming
in from Samantha.
My IVF clinic makes you send
two over for one cycle in
case one has an issue.
How do you handle that as
you have to buy more,
which may not be used?
Depends what treatment you're having,
Samantha.
I think that's really mean.
I think if you were doing
IVF with your donor sperm
and we had prepared you for
the fact that on the odd
occasion it might not make
it to a good enough sample for IVF,
I would convert to ICSI
without any qualms at all.
I would have that conversation with you.
So yeah, she said she's doing IVF.
I would have the
conversation that if it
doesn't prepare well enough
for IVF you're happy to do
ICSI because if you look at
the cost difference there
you're talking about two
vials of donor sperm which
is actually quite a lot of
money and quite unnecessary
unless you're going to keep
that second vial for a
future cycle and I don't
think that's obviously what
we talked about earlier
about sibling use so I
think there's conversations
to be had there and they
just need to be a bit you
know work with you rather
than mandating stuff I
would never mandate someone
has two vials if they
understand that I might
need to convert to ICSI
Yeah.
Yeah.
Hopefully that answers your question,
Samantha,
and keep the questions coming if
you got any follow up on that.
Okay.
So I think I've gone through quarantine.
So I think we're clear on that.
The reason I want to skip on
to the next one is because
I've actually got a couple
of really important slides
and I'm running out of time.
As always, I talk too much.
Families.
Right,
this is a really big one that nobody
knows to ask and nobody
should ask and all of those things.
In the UK, every donor,
whether it's created in the
UK or being shipped in the UK,
is only allowed to create 10 families.
That does not mean 10 children.
That means 10 family units.
Ah, okay.
So one family can have three children.
They're still a family,
so they'll be brought up as siblings.
Yep.
So most of the UK donor banks,
as it stands,
do not have enough donor
sperm to ship out of the UK.
So most of it is kept in the UK, right?
So there are donor banks
throughout the UK.
A lot of donor banks keep
their donor sperm in house
because it brings patients to them.
I understand that there is a huge shortage,
right?
So in the UK,
you are only allowed to
create 10 families from a donor sperm.
If donor banks are shipping into the UK,
for example,
the European Sperm Bank or Zytex or Cryos,
they are only allowed to
ship in to 10 people for 10 families.
They sell it as a pregnancy slot.
But that does not mean that
they are only creating 10 families.
There are some donors that
have 75 families worldwide.
Because they're beyond the UK.
Beyond the UK because
they're selling it everywhere, right?
Yeah, I got you.
Now,
some donor banks will limit the family
of a donor and make you pay more for it.
Some donor banks are quite
open and will say this is a
50 family limit.
But these are the questions
you need to ask.
Is the donor you're being sold,
what is his family limit?
It'll only ever be 10 in the UK.
Categorically, it's against the law.
But how much further reaching is that?
Because I think a lot of
people need to get their
head around that.
But how do you ask that?
How do you find that out?
You just have to ask them or
they just tell you?
No,
the donor bank should have a family
limit.
But if they don't talk about it,
then your recommendation to
the audience today is to ask.
Just ask, what is your family limit?
For this donor.
They will have different family limits.
Across the globe.
It will only ever be 10 in the UK.
They can't sell anymore.
Yeah.
And if they say otherwise,
then you're like, oh, hang on a minute,
you know, you can't.
Yeah, they can't.
Yeah, legally they can't.
So they only sell it 10 times into the UK.
So you encourage... Unless
someone doesn't have a
child or any more embryos with that,
and then that person can
release that pregnancy slot
and someone else can buy it,
if that makes sense.
If unsuccessful.
Unsuccessful, yeah.
Ah, okay, so they report back and... Yeah,
yeah, we report back.
Oh, of course, you report back.
Yep, I understand, I understand.
So family limits is a really,
really big thing that I think people,
there are now donor banks.
I have certain opinions
about this as I do about everything.
Of course.
About exclusive donor
packages that are costing
extortionate amounts.
And I'm finding that hard to
get my head around.
I'm not going to say any
more on it because I'll get upset.
Okay.
Let's not get you upset.
But Sarah,
there's a comment coming from Sarah here.
Sarah Jane.
Apologies for not saying
your full name there.
So with the European Sperm Bank,
they made us pay £550 plus
VAT to buy a pregnancy slot.
The small print did say that
if we failed to get pregnant,
they will refund us the
pregnancy slot money,
which we thought was pretty decent.
Yeah.
And that's what I do quite a lot.
So if in the sad occurrences
where someone doesn't get
pregnant with a donor and
they've got no embryos and
there's no sperm left,
I will email the donor bank
and get that pregnancy slot
released and your refund given to you.
That's part of our
responsibility as
embryologists to do that.
Yeah.
Yeah.
That's part of your process.
And a question from Amy.
So is it best to buy 20 more than 10?
Depends what you're using it for.
If you were having if you're
already having ICSI for whatever reason,
then you don't need more than a MOT10.
But if you are looking to.
Oh, because of the process of ICSI.
It doesn't matter.
You don't need it.
I need 10 moving sperm.
I don't need to rely on the motility.
Yeah.
Yeah.
If you're having IVF,
then you've got a bit more
of a guarantee with a MOT20
that we're going to be able
to get it to a point where it's IVF-able.
So my ignorance here,
because if it's an ICSI treatment,
you are actually going in,
physically finding those
sperm and pulling them into your... Yes,
I've got 10 eggs, I need 10 sperm.
I see.
But with IVF,
you need a count of about 6
million motile post-washing
to be able to mix those
with those sperm and eggs
to be sure that you're
giving the patient a really
good outcome of IVF with
the eggs and the sperm mixing together.
So motility is less important in ICSI?
Yeah, 100%.
Okay, got it.
Thanks for your question, Amy.
Thank you.
Okay, let's jump back to the slides.
Next one.
Yeah.
So I haven't got as long as
I wanted on this because
it's expanded carrier
screening is what you're
going to see a lot about donors.
Now,
expanded carrier screening is what
some of the doesn't really
happen in the UK much.
It does in certain ethnic groups.
It's when we're looking for
recessive genes.
So a gene is something that
causes disease.
And when it's recessive,
you need two copies of that
to cause the disease.
Cystic fibrosis is the prime
example of this.
If mum carries a CF gene and
dad carries a CF gene,
you have a one in four
chance of having an affected child.
So what the donor banks are
doing now is offering
expanded carrier screening
on their donors.
And the thing is with
expanded carrier screening
in certain ethnic groups, it's a thing,
right?
It's certainly in Jewish
communities or in certain
Middle Eastern cultures
where they marry their
cousins quite frequently.
You end up with quite a lot
of genetic disease because
of the closeness of the breeding.
So a lot of donor banks are
offering expanded carrier screening,
which means you then get a donor,
but he carries...
i mean cystic fibrosis is
mandated because it's so
common but I'm saying
things like deafness or
they carry this or carry
that yeah and then you'll
put into the situation well
hold on a minute I know
that about that donor am I
going to get screened for
it what I will say
is we actually mandate
screening once you know
because not to do it feels
like negligence on my part
because I know something
and I need to help you
unknow it or at least deal with it.
But if you then have a
carrier screen that's not
the same as the donor's
carrier screen and they
range from 100 to 600 genes,
you get into this seesaw of
events where you might know
more about you than you
know about the donor.
And I will say that the bigger it gets,
the more you're gonna find.
It's a bit like looking harder,
you will find it.
And it's still quite rare.
But just be warned that they
are doing this now.
It is a very normal thing.
I actually don't think it's a bad thing.
I'm not a big fan of the
massive 600 gene panels
because a lot of them are
incredibly rare.
But I think that the best
way to handle it is if you
want to pick a donor that
has recessive carrier screening,
I would get tested for just
those genes rather than
opening yourselves up to a
bigger can of worms just to
know you're safe.
Yeah, that makes sense.
Sound advice.
Follow up from Amy.
Just to say,
it's just a statement as
opposed to a question.
But Amy, yeah, thank you for sharing.
Okay, thank you.
We'll be having ICSI.
I had 17 eggs last cycle.
So example banks,
I've just put a few on here
just to show you the difference.
I tend to work with the ones on the left,
Zytex, Fairfax, California Choir Bank,
European Sperm Bank Choirs.
The reason I work with them
is they actually are really
good at supplying ID release donors,
which UK ID release donors.
They're incredibly fair.
They ship very well.
No problems at all.
They're very easy to ask questions to.
They're very responsive.
And the UK donor banks,
we work with all of them
straightforwardly.
If they will release the sperm,
they definitely have less, less choice,
but they're all equally as good.
Like I said,
there are also clinics that
have their own in-house donor banks.
Yeah.
Great.
So Mariana, a comment from Mariana.
So Zytex does require a
three vial minimum to
secure a family slot.
However,
they do have a promotion with 10%
off of the vial price with mummies.
There you go.
Yeah.
You see,
these are the things that you'll
find out from working with
the donor banks.
That's really interesting to know.
Marianne, thank you for sharing that.
Um, and I love the shameless plug.
Get it in there.
Absolutely.
Keep, keep the shameless plugs coming.
They're all, uh,
we're all here to help each other.
Absolutely.
And that's it really.
We've only actually got a few minutes.
So I hope that's been
helpful because I could go
on about this all night.
And it's an incredibly nuanced topic,
but there's nothing worse
than feeling alone in this.
It is very hard to negotiate
and navigate donor sperm
buying and understanding it.
um and the uk is just so
heavily regulated it makes
it really really
challenging so I hope
that's been helpful and if
anyone does want to ask me
anything in the last couple
of minutes please do yeah
yeah well I mean I've
always got lots of
questions but yeah I really
appreciate you sharing um um
Yeah.
And oh, no worries there, Sarah Jane.
Huge thank you for tonight.
Sorry I joined a little late
and asked loads of questions.
No, Sarah Jane, keep the questions coming.
This is what this is about.
And to Emma's point,
just to amplify for those
who aren't following Emma on Instagram,
Emma the embryologist, you know, doing,
you know, your...
doing this because education
is important to you.
Yeah.
Um, and,
and you share lots of great information.
So, so any questions that you receive,
whether it's through like a
private message or direct
message can also inspire
your answer to then share
with more people.
So, you know,
if you're asking a question for yourself,
you're actually asking a
question for many more people out there.
So there's,
it's really important to reiterate that.
Um,
Yeah,
your question is only a question that
someone hasn't thought of
yet or probably needs to know.
And I'm a big believer in
all your DMs and all your questions.
Actually,
the reason this came around is
because someone asked me
about this and I realised
that actually this was a
whole topic that everyone
needed to talk about a little bit more.
which is why we're going to
do PGTA because that comes
up a lot and I could spend
a whole evening talking about PGTA.
So I, again,
all of your questions take
over in my brain is if you
don't know that,
then there's a hundred
other people out there that
don't know it.
So, and I know what I know,
but I don't know what you don't know.
So I'm always up for
questions because we are
all in this together.
yeah yeah keep it coming for
sure like we've got to help
each other out right that's
just that goes without
saying um ah thanks for the
comment there marianna uh
very kind of you you're
correct the banks are
available to answer
questions to help our
clients make informed decisions yep
Amy, thank you so much.
There's loads of terminology.
It's confusing, so I feel more informed.
Oh, brilliant.
That's wonderful.
Thanks so much for this.
We were just looking into
donor route after multiple
unsuccessful ICSI cycles.
All the info is so helpful.
So, Donia,
please could you do a session on low AMH?
Yeah, actually,
that is coming because I'm
trying to pull the data now
from my clinic in regards
to AMH levels because it's
something that no one's done before.
I give me a few months
because I've got a lot of
data to put in and pull and all of that.
But it is something that I
don't think anyone's ever done.
And it's something I'm
really keen to do because I
think our low AMH data is brilliant.
It obviously will be quite clinic specific,
but it is a massively
important topic that I want to get right.
I don't want to get it wrong
because it's very challenging.
Yeah, fascinating.
Catherine, lovely stuff.
Great news about PGTA.
We'll definitely join.
That's my baby.
I'm a genetic disease expert,
so this is my thing.
And Amy,
that'd be amazing to know about that.
And I know we are at the hour,
but we're going to break
all the rules if you want
to stick around and go slightly over.
So Sarah Jane asks this question.
Best part about your job?
Oh my God.
That's a great question.
I get to make people's dreams come true.
Yeah.
And don't get me wrong, it's really hard.
A lot of it's really hard
because it doesn't always
come true and it's hard.
But I get to be the person
that holds your hand and I
get to be the person that
hopefully makes it better.
And even if the outcome
isn't what we want it to be,
I always say that the main
part of my role as an
embryologist is to get you pregnant.
And if I can't do that,
I need to help you
understand why and help you
move forward to whatever
that looks like for you.
And I think that if you can
find that in in a job, then, yeah, I mean,
it's it's pretty, pretty bonkers.
So poor Simon has to listen
to me all the time.
I don't know about this.
You do.
Yeah,
you're doing incredible things and
you're helping humankind.
Right.
So, yeah.
I always say this,
I want our children to grow
up in a better and more informed world.
I want my daughter to grow
up not sitting in front of
someone and saying,
why did no one tell me that
my fertility was going to decline?
So if I can play part of her
world where she grows up
and doesn't have to ask
those questions and she's informed,
then I'm playing that for a
lot of people's children
and hopefully the children
I'm making now will have a
better future as well.
Yeah, absolutely.
And there is a whole side of it where
we want to try and get into
schools and universities
and educate so yeah if
there's if there's people
out there that you know
that are connected to that
world then please do let us
know this is a huge
opportunity there and also
going into businesses as
well that for some
companies that are offering
fertility treatment as part
of their benefits there's a
lot of education to be had there so
yeah just got to keep keep
on doing it um thank you so
much yeah really sarah
chain you literally are
santa claus that's
brilliant next time I wear
my hat yeah that's it uh so
don't you thank you for
everything you do uh and if
you want to if I wasn't
going through this myself
what a hundred percent work
in the clinic ah there you
go amy thank you emma you
are brilliant and so clear
100 agree with you there
katherine uh archner
uh you should go into
workplaces we do actually
go into workplaces we've
done a few big ones like
big um I've done a law firm
and I've done some so it is
there the the framework is
there it's just trying to
find companies that um I
think the talk was we've
we've spoken to companies
like meta and places like
that that do offer
fertility benefits so we're
on it arch now we're on it
it's very very much my um
it's our thing is to make
employees lives better as
well because fertility in
the workplace is also a
massive passion of mine
that people shouldn't have
to hide that they're going
through this because
they're worried about
career so that is something
that we're working with
with um my patient services
manager and stuff does
quite a lot of that as well
so that's a really big part
of it and that's a big
topic let me know if your
bank's up for it arch no
I'm totally I'm I'm there
Yeah.
Anyway, we'll let you go.
Thank you so much.
Yeah.
Thanks so much for joining us today,
folks.
Do keep the questions coming.
Please do continue to follow Emma,
the embryologist on Instagram.
And yeah,
it's a pleasure hosting today and
we will see and hear from
you another time.
But for now,
please do take care and we
will speak with you soon.
Bye for now.
Good night.
Take care.
Bye.