A common concern of Choice Moms-in-the-making is how the success rate differs when using fresh or frozen sperm. Do you diminish your chances of success when using frozen sperm? I asked three experts, with different perspectives, about their thoughts.
Alice Ruby, executive director of The Sperm Bank of California, says, “It is hard to answer the fresh or frozen question in a general way, as there are many variables. Frozen sperm from a program donor is from someone selected in part for his high fertility, and available with legal precautions in place, compared to fresh sperm from a known donor who may not have the same fertility strengths, require logistics of timing to work out, and end up having a different approach to building a family.
“There is no research that I am aware of on success rates using fresh sperm for insemination. There is little research on IUIs that is relevant, since what exists is largely male partner sperm rather than donor sperm selected for high fertility. TSBC info shows success rates of frozen program donor sperm. For the chart on vaginal vs. IUI, virtually all the vaginal inseminations were done at home, and the majority (though not all) of IUIs in clinics. What we can say is vaginal insemination with frozen sperm can be successful, especially for women under 35. AND, for women 30-44, IUI doubles success rates compared with vaginal.”
Kristin Kali, a licensed midwife who provides fertility consultations at Maia Midwifery and Fertility Services in Berkeley, Seattle, and online, recommends fresh sperm over frozen, assuming the important safety precautions are in place, because of higher success rates: “Fresh sperm is more effective for achieving pregnancy than sperm that has been frozen and thawed,” she says. “Many women don’t realize that the quantity of semen they are receiving from a bank is 0.5cc, while the normal volume of a man’s ejaculate is 3-5cc. And fresh sperm that is inseminated vaginally lives for up to 72 hours, or three days. When sperm is frozen for quarantine, or purchased from a sperm bank, the lifespan of the sperm is reduced to about 24 hours when inseminated vaginally. With intrauterine insemination, excellent timing is imperative, as sperm [live less than a day] once they are placed directly into the uterus.”
There are legal issues involved in using fresh sperm, of course, as well as the safety and how-to concerns. If fresh sperm is used in a home setting, even if it is not through intercourse, the known donor is considered to be a legal parent of the child in the eyes of the law. Anonymous donors, on the other hand, legally give up parental rights and responsibilities to children conceived by their sperm specimens. Directed donors whose sperm is used in a clinic insemination also affords more legal protection. [Parentage laws vary by state, so it is important to know the laws in your state.]
Another expert I asked was long-time Choice Mom adviser Dr. Charles Sims, of California Cryobank. His response: “The fresh versus frozen sperm controversy has been going on a long time. The real issue is does previously frozen sperm work? That answer is yes. There is only about 1 day in a month where fertilization can occur. If this time frame is not met then it doesn’t matter how long sperm will live in the reproductive tract.
But back to your question. The freezing-thawing cycle does cause some level cell membrane damage. Usually this is relatively mild. There are both differences between individuals and between species in tolerance to the freeze-thaw process. In general human sperm are quite durable and somewhat similar to bovine sperm in that respect. When previous frozen sperm is thawed about 50% of the motile sperm are lost. The average survival time is almost certainly lower than fresh sperm but the differences are not significant. Most sperm will lose their fertilizing capacity before their motility is lost. Sperm can live in the reproductive tract for 6-10 days but their ability to fertilize an egg may not exceed much more than 48 hours.
If the ovulation timing was off and the insemination was performed to early, there might be some theoretical advantage to fresh sperm. If the timing is correct, it would not make any difference. On the other hand, if the timing was late it really doesn’t matter whether you use fresh or frozen sperm. Nor would it matter how many sperm were used. Pregnancy will not occur in that cycle.
When using donor sperm it would be reckless to use sperm from a donor that was not subjected to quarantine and re-testing. I hope this is useful.”