Conectar
by Lina Thirup, Anne-Bine Skytte, Ulrik Schiøler Kesmodel, Ida Vogel, Guido Pennings, Allan Pacey, Stina Lou
PurposeThe demand for sperm donation is increasing, yet only a small percentage of applicants are accepted, and little attention has been given to those who are rejected. The application process may reveal new medical or genetic information with potential personal and emotional consequences. The aim of this study was to explore how men experience rejection as sperm donors, including how they cope with the rejection and integrate potential new information into their lives.
MethodsWe conducted qualitative, in-depth interviews with 19 men rejected as sperm donors. Data was analyzed using thematic analysis.
ResultsSome men received new medical information that raised significant concerns, particularly regarding their health, fertility, and family. However, for most it was not the reason for rejection that affected them most, but the rejection itself. They had begun to identify as donors, and being turned down felt like a blow to their sense of self. Over time, participants used different coping strategies: information seeking, actionable reasoning, positive reframing, normalizing, and postponing. Although the experience was personally and emotionally challenging for many, it ultimately did not have a lasting negative impact on their lives.
ConclusionsSperm donation is not only a medical act but also tied to social identity, with rejection having personal and emotional consequences. For men whose rejection is based on new medical information that causes significant concerns, sperm banks should support rejected donors and help them exit the process positively. Further research is warranted to find out how this can be done.
To investigate whether treatment with oral corticosteroids and intravenous immunoglobulin (IVIg) improves pregnancy outcomes in women with unexplained recurrent pregnancy loss (RPL) following assisted reproduction technology (ART) treatment.
A randomised, double-blinded, parallel-group, placebo-controlled trial conducted from January 2021 to February 2024.
A single-centre trial at a Danish tertiary clinic for RPL management.
80 women with at least two consecutive early pregnancy losses following ART, age 18–41 years, body mass index below 35, and no identified cause of RPL. Forty participants were allocated to each group, with 37 fulfilling the protocol criteria in each group.
Participants were randomised to receive either a combination of low-dose oral prednisolone starting on the first day of menstruation and IVIg given the first time around the time of embryo transfer; or matching placebo tablets and albumin infusions. Treatment continued until gestational week 8+4 in those who conceived with a total of four infusions.
The primary outcomes were the ongoing pregnancy rate (OPR) defined as a living fetus in gestational week 13 among all randomised participants and in those who conceived after embryo transfer, respectively, based on intention-to-treat (ITT) and per-protocol (PP) analyses. Secondary outcomes included safety outcomes related to pregnancy complications and neonatal health.
OPR was equal to live birth rate. Among all randomised participants (ITT), the OPR was 25.0% in the treatment group and 15.0% in the placebo group (relative risk 1.67; 95% CI 0.67 to 4.15; p=0.26). Among participants without major protocol deviations (PP), OPRs were 21.6% and 16.2%, respectively (relative risk 1.33; 95% CI 0.51 to 3.47; p=0.55). Among participants who became pregnant following embryo transfer, ongoing pregnancy occurred in 83.3% of the treatment group and 42.9% of the placebo group (relative risk 1.94; 95% CI 1.01 to 3.75; p=0.05). No differences in adverse events or neonatal outcomes were observed between the two groups.
The combination of oral corticosteroids and IVIg did not improve overall pregnancy rates in women with RPL after ART. However, among those who achieved pregnancy after embryo transfer, the risk of pregnancy loss appeared reduced. Larger randomised trials are needed to confirm these findings.
ClinicalTrials.Gov: NCT04701034. Registration date: 5 January 2021
EudraCT number: 2020-000256-35; Registration date: 11 November 2020
The North Denmark Region Committee on Health Research Ethics: N-20200066, Registration date: 16 December 2020
The Data Protection Agency: 2020-156; Registration date: 4 November 2020
WHO universal trial number: U1111-1273-8585
Date of first patient’s enrolment: 28 January 2021.
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