The Approach of Fertility Physicians to Donor Sperm Treatments: A Worldwide Survey.

Objective: Many women presenting for treatment with donor sperm have never attempted conception, and are therefore presumed fertile. With no clear guidelines, treatment can be influenced by factors like patient age and costs. We aimed to explore fertility physicians' attitudes and clinical practices regarding donor sperm treatments through a global survey.

Methods: We conducted an anonymous international web-based survey of fertility clinicians. The survey addressed various aspects of donor sperm treatment in women without previous infertility.

Results: A total of 211 clinicians participated, with 63% working in private settings. The survey presented clinical scenarios for women aged 32, 37, and 40. Most clinicians (80%) recommended artificial insemination with donor sperm in a natural cycle (NC-AID) as the first-line treatment for a 32-year-old woman (52% suggested up to 3 cycles, 28% up to 6 cycles). This approach was favored by 45% for a 37-year-old and 25% for a 40-year-old. Variability was noted regarding the second-line treatment for a 32-year-old after one failed NC-AID varied (equal recommendations for ovarian stimulation with oral agents, gonadotropins, or IVF). For older women, active management was preferred: 24% recommended gonadotropins and 15% IVF for 37-year-olds, and 16% gonadotropins and 55% IVF for 40-year-olds.

Conclusions: This survey highlights the controversy surrounding the optimal approach for women with no history of infertility seeking to conceive with donor sperm. Our findings emphasize the need for further research and the development of comprehensive guidelines in this area.