Couples use donor sperm (DI) when the husband/partner has no sperm or a very poor semen analysis (azoospermia, oligospermia, poor motility), or when there is a genetic problem which could be inherited from the male. Single women who want a biological child also use DI.

One must be psychologically ready to proceed with DI. Most doctors recommend that any patients considering DI see a counselor who is skilled at clarifying feelings about infertility, and about trying DI. It is essential that both partners feel comfortable with the decision and that all fears and questions be openly discussed. For some, it may mean dealing with various moral and ethical questions; for others, exploring questions about donor selection and whether to be open about the decision to do DI and whether to tell a child conceived by DI how they were conceived.