Sperm donation.

Sperm donation

Currently in Australia it is estimated that around one in every twenty five men are unable to father a baby. There are many causes for this, but it is mostly due to an inability to produce or deliver sperm. Some men produce very few, or no sperm at all, or the sperm they produce are abnormal. This makes sperm donation the only option for couples who are keen to have a baby.

Sperm donation can be used when:

• A man has had a vasectomy previously and now wants to father a child
• In same-sex relationships and for single women
• The man in a relationship is a carrier of certain genetic diseases
• There has been treatment previously which has altered sperm production such as radiation or chemotherapy for cancer
• Previous illness e.g. mumps have rendered the man in a relationship infertile

It is estimated that around one in eight couples who are having problems with infertility need to use donor sperm in order to have a baby.

Obtaining donor sperm:

• Couples may choose to do their own research amongst friends and family and make their own negotiations and arrangements about sperm collection and insemination. They may choose not to use a fertility clinic at all and do their own research and conception planning.
• Couples may elect to go with a fertility clinic and use donor sperm where the identity of the donor is unknown to them. Some information about the donor is made available but identifying information such as name and address are not shared.
• Another option is to use the services of the clinic to screen and organise insemination with the sperm of a known donor. The sperm is only used for one client and is the preferred option for single women who wish to conceive but who are not in a relationship.

How donor sperm is used:

If donor sperm is arranged through a fertility clinic, it can be used via insemination or as part of an overall In Vitro Fertilisation (IVF) procedure. Artificial insemination can be a very simple treatment for infertility; however, freezing and storing sperm is much more difficult and involves more cost. If donor insemination is done, the sperm is injected directly into the woman’s uterus and timed with her ovulation. If it is used during IVF, the sperm is used to create an embryo with the woman’s ova and then transferred into the uterus.

Many couples worry that using donated sperm to achieve a pregnancy will affect its success. But research shows that there is the same rate of pregnancy complications from using donor sperm as there are through natural conception. Sperm donation in itself does not add to any pregnancy risk.

If couples want to use sperm which has been arranged through the fertility clinic, careful screening procedures are done to ensure it is safe to use. Most clinics limit the number of times a donor's sperm can be used to a total of 5-10 families, depending on the clinic. In cases where the donor is known to a couple, the same checks are done as for anonymous donors.

What’s sperm worth?

Sperm donation needs to be done for altruistic reasons and not for monetary gain. In Australia, it is illegal to accept any payment for human tissue. However, travel costs, parking and compensation for time off work is paid by some fertility clinics. Some donors choose not to accept this; it is an entirely personal choice.

Some couples choose to access sperm donation through informal avenues, such as internet web-sites. This is potentially risky both for legal and health reasons. However, for couples who cannot afford fertility treatments through reputable clinics, this may be their only option of conceiving.

In Australia currently, sperm donors need to meet certain criteria to qualify. Each fertility clinic has its own guidelines but generally:

Men need to be:

• Aged between 21-45 years. If the donor is known, then he may be older than 45 years.
• Understand and comply with the relevant legislation regarding sperm donation. There are clear ethical and legal responsibilities in becoming a sperm donor and it is vital that the donor is well informed of these.
• Be prepared to provide genetic and family information which could influence the child.
• Be prepared to provide information which allows the child to identify him as their parent. Children have a right to know who their genetic parents are.
• Provide information on previous sperm donations. This is to ensure the limit of 5-10 families is not exceeded.
• Consent to a medical interview and check-up.
• Have counselling and be prepared to provide written consent for the use of his sperm. If the donor is married or in a relationship, it is often a requirement for his partner to come to counselling as well.
• Be prepared for semen to be frozen and quarantined for 6 months so it can be tested and retested prior to use. This is essential to ensure the HIV virus (in particular) is not present.
• Be prepared to provide information which does not identify him but will help the recipient make their own informed choices about accepting the donor sperm or not.
• Bring identifying information to the fertility clinic which includes photo ID as well as his name and address.

Collection

Initial testing and analysis of the donor’s sperm is done to check whether it is suitable to use. A fresh sample is necessary to gain an accurate analysis of the number of sperm present and to analyse how it stands up to the rigours of being frozen. Donors are asked to abstain from having sex for up to 3 days before they provide a sample.

Every clinic has a private room which is donors use to go and masturbate and collect a semen sample. It takes 1-2 weeks before the clinic can determine whether it is suitable and donations can proceed.

Each clinic has their own practices but generally, up to ten separate donations of semen are required once it has passed laboratory screening.

Medical checks:

It is also necessary for donors to have blood and urine tests to check they are not carrying any infectious diseases which could place the recipient or the potential baby at risk. This is also when screening tests are done to identify if there is any risk of passing on any genetic abnormalities.

Sometimes, sperm is not suitable for donation but this is not obvious until it has been analysed. Some of the more common reasons for this can be:

• If there is insufficient number of sperm being produced.
• Their sperm are abnormal or carry genetically-linked disorders.
• If the freezing process renders them unsuitable to use.

Most recipients are keen to have some say in the physical characteristics of the sperm they receive. Some choose to request sperm being stored for future pregnancies if they want to have future children with the same biological father.

Legal rights:

Sperm donors have a legal right to know if their donation has resulted in a live baby, what its sex is and if there were any abnormalities. Likewise, when the child legally becomes an adult, they have a right to access identifying information about who the sperm donor was. Fertility clinics keep this information on file in the event that one day this information may be sought.

Assisted Reproductive Technology (ART) is governed by different legislative authorities in each state/territory of Australia. Each has slightly different ways of operating, but most abide by the National Health and Medical Research Council (NHMRC) guidelines. Visit the NHMRC website for more information within your specific state. In NSW a donor register was commenced on 1 January 2010. This provides information on gamete (sperm and ova) donors whose descendants want to be more informed of their biological ancestry.