As you look into your family building options with your fertility clinic, sperm donation may be a treatment option you’re advised to consider. In this article, we’ll go over the basics of what you should know about sperm donation, including who is a good candidate to consider it, the requirements donors must meet, a few legal considerations to keep in mind, and how to deal with the emotional aspect of the journey.

1. What is sperm donation?

Sperm donation is a family building option used in third-party reproduction where a man donates semen to help single women or a couple (same sex female couples, transgender, or heterosexual couples) conceive a baby. As far as the actual procedure, as the MayoClinic explains, donated sperm is injected into a woman’s reproductive organs through intrauterine insemination or used to fertilize mature eggs in a lab in a process known as in vitro fertilization (IVF).

Sperm donors can be known (often referred to as ‘directed’) to the recipient or anonymous. However, as Rich Vaughn, Esq., Founder of International Fertility Law Group, explains, ‘DNA testing for genetic diseases, ancestry-tracing websites, and sibling registries changed everything, and sperm donor anonymity is no longer a lifetime guarantee’.

2. Is sperm donation right for me?

There are various situations where sperm donation might be needed to achieve pregnancy:

• Male factor infertility, with specific causes including azoospermia (no sperm in the ejaculate), severe oligozoospermia (a sperm count between 0 and 5 million sperm/mL) and ejaculatory dysfunction.
• Prior failure to fertilize during an IVF cycle with intracytoplasmic sperm injection
• Risk of passing on a genetic disease
• When the female is rhesus negative and severely Rh-isoimmunized and the male partner is rhesus positive
• Single motherhood by choice
• Same sex female couples
• Females with transmale partners

3. Who can become a sperm donor?

Men who meet the below criteria can donate their sperm:

Age: The donor should be of legal adult age in their state, and ideally over 21 years old. The donor should be young enough to minimize risks to the child associated with older paternal age. Most sperm banks only accept donors between the ages of 18 and 39 – others cap this at 34. If the donor is under 21 years of age, the ASRM requires a psychological evaluation by a qualified mental health professional.

Health: Donors undergo a physical exam, semen testing (sperm samples are analysed for sperm quantity, quality and movement), and genetic testing. Their family and medical history is reviewed, together with their personal and sexual history. In addition to this, in its 2021 Guidance regarding gamete and embryo donation, the ASRM recommends that the recipient and their partner are tested for infectious diseases. Only donors in good health and with normal semen analysis results are accepted.

Proven fertility: Proven fertility is desirable but not required – a previous successful donation (or if the donor has his own children) shows that the donor has the potential to provide healthy sperm.

Restrictions: The ASRM adds that “no owner, operator, laboratory director, trainee, or employee of a facility providing donor sperm or performing DI [donor insemination] may serve as a donor in that practice”.

4. Is sperm donation regulated in the US?

Sperm banks are regulated by the US. Food and Drug Administration (FDA). The FDA requires a review of the sperm donor’s medical records to determine medical history and relevant social behaviour, a current physical examination, and screening for infectious diseases, including HIV Types 1 and 2, HTLV Types 1 and 2, Hepatitis B, Hepatitis C, Syphilis, Chlamydia, Gonorrhea, and Cytomegalovirus (CMV).

The FDA requires that anonymous sperm donations are quarantined for six months with repeat infectious disease testing – the donation can only be used, after this, once it is deemed as ‘eligible’.

While this is not an official requirement, the American Society of Reproductive Medicine (ASRM) recommends all donors undergo a psychological evaluation and counseling by a qualified mental health professional.

5. Are there limits on how many donations a sperm donor can make?

There is no uniform limit across the US on the number of donations a single donor can make – but there are best standards. The ASRM guidelines state that clinics and sperm banks should keep sufficient records to allow a limit to be set for the number of pregnancies for which a donor is responsible. It notes that while it’s hard to indicate a precise number, “it has been suggested that in a population of 800,000, limiting a single donor to no more than 25 births would avoid any significant increased risk of inadvertent consanguineous conception”.

6. Can I use a known (directed) sperm donor?

In a known or directed sperm donation, the sperm donor is known to the recipient. As long as all parties agree to the donation, and it is allowed in your state/country, then you can choose this donation option. Known donors must undergo the same screening process as anonymous donors, outlined above. However, the FDA exempts direct donations from quarantine – they are only tested within 7 days of donation. On the other hand, the ASRM recommends stricter guidelines – ie. that direct donor specimens are quarantined for 35 days, and then retested for infectious diseases. The process followed will depend on the sperm bank or fertility clinic you choose to work with, and regulations in your state.

While donor specimens that test positive for or have a risk of hereditary diseases are regarded as ineligible for anonymous donations, direct donations can still go ahead, provided that both parties are aware of the risk and have provided their consent.

Once you and the donor complete the necessary registration documents, your donor undergoes a physical examination, semen evaluation and processing, and infectious disease testing at your fertility clinic or a sperm cryobank. If you’re working with a cryobank, it is recommended that you discuss the process (including the number of samples needed) with your physician.

If you decide to obtain sperm from a family member or friend, you have to get comfortable asking a number of personal (and at times, tough) questions. Family Equality lists some topics you should consider asking about, including around:
– family health history
– the contact desired with any future child
– if they will tell others about the donation
– what kind of relationship other family members would want with the child
– if they’d consider donating again for a potential sibling

In all circumstances, it’s important to speak with a physician about medical testing and with an ART attorney to ensure that all parties involved are protected, both throughout the process and long-term.

7. Does a sperm donor have parental rights?

No, donors do not have parental rights over children born from their donations, provided that the process is carried out in accordance with the law, and with the necessary paperwork in place.

With this in mind, intended parents and sperm donors should be aware of the risks of participating in informal sperm donor arrangements. While the process might be faster and cheaper, there are legal and safety risks involved.

8. How many sperm vials will I need to get pregnant?

You will need one sperm vial per insemination. 30 year-old females with no infertility issues have a 20% chance of conceiving each month. Since there’s no foolproof answer as to how many vials you’ll need before you’re successful, it’s advisable to speak to your physician about your specific needs. You can then determine which number would be best for you, based on your physician’s advice, your budget, and if you’d like to plan ahead for a sibling journey. Ideally, you have enough vials in storage to cover multiple attempts as this saves you from having to start your search for a sperm donor all over again if the sperm bank runs out of samples from your prefered donor.

9. What is the difference between “washed” and “unwashed” sperm?

Washed sperm is prepared in a laboratory: ejaculate fluids are removed and a cryo-preservative is added. The sperm is then frozen in a plastic vial and ready to use for intrauterine insemination (IUI). An IUI is an office procedure in which sperm cells are placed directly into the uterus. This can be done with prior ovarian stimulation (to produce multiple oocytes) or without.

Sperm washing removes dead or non-motile sperm, enzymes, proteins, and fluids from semen. Some chemicals in unwashed sperm may cause an adverse reaction in the uterus, if the patient is undergoing an IUI.

Unwashed sperm is very close to its natural state – the sperm is not separated from semen, but cryopreserved as is. Unwashed sperm vials are used for intra-cervical or intra-vaginal insemination.

A 2000 study published in Fertility and Sterility found that “despite differences in TMC [total motile sperm count] and motility, most washed and unwashed specimens are of good quality and produce similar pregnancy rates when used in healthy, fertile women”.

Some fertility clinics advise patients to purchase unwashed sperm vials even if the intention is to undergo an IUI. The clinic then performs its own washing process prior to insemination. You should always seek advice from your fertility clinic to identify which option is best for you.

10. Coming to terms with building your family through sperm donation

Deciding to go ahead with sperm donation and then choosing your ideal donor can be an emotional process, especially if this is not how you imagined your family building journey to unfold. There may be an element of grief, worries about affording treatment, and even concerns about if, how, and when to tell your future children they were donor conceived.

Marc Sherman, Co-Founder and CEO of Organic Conceptions notes that men and women process emotions differently – how the struggle is communicated is different, but it should be addressed. In his guest post for GoStork, he outlines five suggestions for future dads to support their journey.

In addition, Aaron Buckwalter, a Los Angeles-based marriage and family therapist says that there’s grief and loss involved: “you’re constantly confronted with what you thought you would have, and thought you could have so easily”. While in many cases, the process of donor insemination goes smoothly, Buckwalter encourages men to acknowledge any anxiety, pain, or shame and this can be done by working with a therapist.

Women pursuing solo motherhood may also experience an element of grief as they come to terms with their potentially new vision of parenthood. In her guest post for GoStork, Ravid Israel, founder of Embie, shares how she had to give up on her vision and how that loss was “devastating”. She writes: “My turning point happened when I asked myself, what is it that I really want? What was the purpose behind my vision? The answer was simple: I want a family. And in acknowledging purpose over vision, it freed me. My family could look like anything, as long as there was love. And with that thought process, moving forward as a single mom by choice became an easy choice.”

Regardless of your status, or reasons for pursuing sperm donation, it’s important that you have a good support system around you – and this includes individual or couple’s therapy. As Marilyn Gomez, Founder of the stylish and empowering apparel company Infertile Tees, says, “when you’re trying to conceive, the best gift you can give yourself is going to therapy with your spouse or your partner”.

In Conclusion

There is a lot to take into consideration when you’re mapping out your family building journey. Regardless of your path to parenthood, know that you are not alone in this process. Finding a fertility provider you trust can help you identify if sperm donation is right for you, as well as which treatment option to pursue once you’ve found your ideal donor.

At GoStork, we’re here to support you as you research your options, connect with providers that may be your ideal match, and make your final decision about which to move forwards with.

If you’re considering IUI or IVF with sperm donation and haven’t chosen a fertility clinic yet, watch out for our first of its kind Fertility Clinic Marketplace launching soon! You’ll be able to find, compare and connect with top US fertility clinics all in one, free marketplace. Stay tuned for more announcements to come!