Abstract
The use of intracytoplasmic sperm injection (ICSI) has resolved many issues in male infertility management and abolished the need in many instances for donor insemination (DI). Despite this, clinics in the UK have, for some years, struggled to maintain the necessary infrastructure to recruit adequate numbers of sperm donors to provide for the national need. A significant proportion of treatment is for single women and same sex couples. Many patients now seek treatment abroad either to avoid waiting lists, or access care to which they are excluded in the NHS. In addition, many patients now have treatment using sperm imported from abroad. A number of solutions to the UK shortage might be considered, e.g. re-evaluation of the limitation of family numbers, paying donors, gamete sharing and exchange schemes or changing sperm quality thresholds for the acceptance of donors. The development of a centrally funded national service framework is being piloted at the present time.
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Declaration of interest: The author reports no conflicts of interest. The author alone is responsible for the content and writing of the paper.