What’s the difference between a sperm bank and a “donorsexual”?

October 8, 2011Carole 3 Comments »

Newsweek’s cover this week had an adorable baby with the headline, “You got your sperm where? How to get pregnant, fast, cheap -and in public“. Wow, talk about an eye grabber. In this article you meet a 40 year old virgin who calls himself a “donorsexual” and gives his sperm away (in a cup) to women who want to get pregnant. He likes the idea of “fathering”- I use the term loosely- dozens of children.  So, okay, setting aside all the possible social, cultural, religious and ethical issues that arise around his hobby, it might be useful to talk about medically approved sperm donation and what separates FDA inspected donor banks from “donorsexuals”.

The author of the piece, Tony Dokoupil (with illustrator Jamie Chung), skirts around very real health issues associated with private donor registries and fresh sperm donation. She says, “Most donors pledge to verify their health and relinquish parental rights, much like regular sperm bank donors.” No, actually, the donation of free sperm is not at all like buying sperm from a commercial sperm bank! Donors who donate to a commercial sperm bank are required to do much more than “pledging” to verify their health.  Commercial sperm bank donors are required by law to have a physical exam, answer a three generation health history and are subjected to a panel of infectious disease testing, and then the donated specimen is quarantined for 6 months (frozen and unavailable for sale) and the donor is retested just in case they had an early stage of infection at the time they donated that wasn’t detected in the first round of testing. Commercial sperm bank donors are tested for

  • Human immunodeficiency virus (HIV), types 1 and 2;
  • Hepatitis B virus (HBV);
  • Hepatitis C virus (HCV);
  • Human transmissible spongiform encephalopathy (TSE); including Creutzfeldt-Jakob disease (CJD)2 ; and
  • Treponema pallidum (syphilis)
  • Human T-lymphotropic virus (HTLV), types I and II
  • Chlamydia trachomatis; and
  • Neisseria gonorrhea.

I went on-line to the free donor registry, a site in which women looking for fresh free sperm can find a male willing to donate. The founder of this free registry is quoted as saying, ” If it is legal to go to an bar, get drunk, and sleep with a random stranger, than it can’t possibly be illegal to provide clean healthy sperm in a cup”.  But that is precisely the difference. Nowhere on this free donor registry site could I find any discussion of any means to ensure the safety of the recipients who receive this free donation. I did find a CYA statement that basically said it’s on the recipient to verify the donor is safe :“Using sperm from a sperm bank and conceiving with care of a physician has two primary advantages over private sperm donation: health screening and legal protection. These are not aspects to be taken lightly, and women who are interested in using a private sperm donor need to carefully research the health and legal implications. By not using a sperm bank and a physician, a woman is taking on the duty to carefully screen and verify the donor, as well as protecting her family and her child from future conflict.”

The bottom line is that the drunk in the bar has no expectation of clean healthy sperm. The recipient who is trying to produce a new life with the stuff should be able to expect more.

Have we all forgotten about AIDs? Infectious disease tests are fairly expensive and not always covered by insurance so it raises doubts in my mind whether men participating in the free donations have any testing done. Most people, I think,  would be willing to pay $200 for a vial of sperm bank sperm sold by  California Cryobank, Xytex International, Fairfax Cryobank or another FDA regulated commercial facility to get some assurance that the sperm won’t give them a possibly deadly disease. These commercial sperm banks, unlike free donors,  have  an actual stake in protecting their consumers and just roll testing costs into their business model.

The FDA requires written documentation of the steps in donor eligibility screening process for each donor that donates to a commercial sperm bank.  These records are inspected by the Food and Drug Administration (FDA) when they inspect the sperm bank. This federal oversight, even if imperfect, seems a safer approach than “pledging” that the free donor is healthy. The commercial sperm bank has real liability if these steps don’t happen, ranging from customer lawsuits to FDA sanctions. FDA sanctions include massive fines and jail terms for commercial sperm bank owners who don’t follow the rules. That, to me, seems much more rigorous than “pledging to verify their health”. You can read FAQs about FDA required donor eligibility determination here.

The author of the Newsweek article goes on to say, “But sperm banks, though regulated by the Food and Drug Administration, carry risk.” She goes on to cite a case where a donor had a rare aortic defect which was a genetic disease that he passed on to some of his 24 children, including those he fathered within his marriage and some of these kids died. What the article overlooks is that this donor answered the family history honestly and his disease wasn’t diagnosed until more than a decade after he finished donating sperm and had his own kids. This tragic story certainly doesn’t argue for LESS rigorous oversight, but rather MORE rigorous oversight of sperm donation. The sperm bank whose donor was involved in that case has now added a cardiac evaluation to their screening panel precisely to rule out this particular genetic disease.  Other sperm banks are voluntarily adding genetic screening tests, as available, to their screening process.

The use of fresh sperm in illegal in many states, precisely because  one-time testing without quarantine is not conclusive to determine that the sperm is safe to use. The quarantine period requires freezing of the sample and  a second testing event six months later to demonstrate that the donor didn’t show symptoms after donation and was actually non-infectious at the time of donation of that particular sample six months earlier.

The Newsweek article states that using commercial donor sperm is expensive, as much as $2000 dollars. We get lots of sperm shipped to our fertility program for our patients’ use. The patients buy the sperm and have it shipped to the lab where we process it for them and do a semen analysis to confirm that the sperm count and motility is as advertised. If it falls short of what was promised, we file a complaint with the sperm bank on the patient’s behalf. From the shipping records that accompany the sperm, we know that patients are spending about $200-400 per vial so $2000 would pay for a lot of sperm for insemination, not just one vial. Maybe “genius donor” sperm is more but we haven’t seen any gold-plated sperm sent to our program. Also, there is no customer recourse for substandard product through these free sperm agencies.

It is true that infectious disease testing is expensive. The panel of infectious disease tests can run to more than $1000, but $10,000 for one round of donation testing seems ridiculous and inaccurate. Insurance may or may not cover this testing. The potential out-of-pocket expense for these tests does raise the question as to how any of these “free” donors can afford to have any, let alone all, the testing done that commercial donors have and still give away their sperm for free? My suspicion is that there’s a lot of healthy “pledging” is going on,  along the lines of  “I feel fine so I must be healthy”.

Because the donation is free, free donors may not be legally subject to the same restrictions as a commercial sperm bank. Although the FDA did investigate at least one “donorsexual” on public health grounds. The FDA found that he was NOT providing adequate protections against communicable diseases and he is facing a fine of $100,000 and a year in jail. He is appealing the ruling on the basis that his donations are a form of sex and so not subject to FDA oversight. The attorneys can wrangle that one out. I hope this “donorsexual” can find a pro bono attorney. I doubt he’ll find an attorney who will take payment in traded services.

The other point that the article makes is that recipients like meeting their donor and possibly having a way for the donor to have some relationship with the child in the future or at least have a door open to establishing contact in the future. What the article doesn’t make clear is that open contact is also available through commercial sperm banks if you pick the right donor.

Although most donors prefer to remain anonymous, banks also sell sperm from donors who have agreed to allow any children conceived with their sperm to contact them in the future, although the child might have to be 18 to open this door with their donor. The days of the anonymous donor may soon be over because there is a generation of donor conceived kids who want to know about their biological origins for a variety of reasons and their concerns are being taken seriously. Some European countries have even outlawed anonymous donation (causing a huge decline in donations)  and require all donors to allow their offspring to reach out to them in the future if they so desire. One reason for the open-donation policy is medical. Donor-conceived offspring need to have a way of finding out what their risks are for various familial diseases. It is really a question of human rights. Commercial banks are responding to this pressure and offering sperm from donors who are open to future contact. I blogged about kids looking for their biological roots in an earlier post, “Who’s my daddy? The issues of sperm donation”.

The bottom line is that although this Newsweek  article provided some insight into the practice of free donation, it failed to highlight the real protections offered by paying for a donor and using a regulated commercial sperm bank. In the perfect world, we would all be able to procreate with a partner who would also be a great parent. In the real world, this is not always possible but you don’t have to settle for an unsafe “free” donation. It may cost you more in the end.

 

© 2011, Carole. All rights reserved.

3 Responses to this entry

  • What’s the difference between a sperm bank and a “donorsexual”? | Best Treatment For Infertility ? Says:

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  • Joe Donor Says:

    Hi, I think the author of the Newsweek article “You got your sperm where? How to get pregnant, fast, cheap -and in public“ that you refer to was Tony Dokoupil, not Jamie Chung. I am also curious what the name of the donor who was fined $100,000 and sent to jail for a year was?
    You are correct that free donors cannot really afford to do the same testing as a sperm bank, especially the hiv testing and 6-month quarantine. However, most children on the planet are conceived through unprotected sex in which neither partner has been tested, so the risls of using a free donor are no more than the risks of conceiving outside of a sperm bank, just as the dollar costs are no more than they are for conceiving outside the sperm bank. In your analysis of costs, you also fail to mention that most cases more than one straw is used in a sperm bank insemination, and that there are many testing costs, costs for shipping, deposits for nitrogen tanks, etc., that you have not included in your cost analysis, not to mention, it usually doesn’t tale the first time, so the expenses are likely to be incurred a few times before the woman gets pregnant.

  • Carole Says:

    You are correct regarding authorship which I have corrected above, the author is Tony Dokoupil .Jamie Chung was the illustrator for that piece. According to the Newsweek article, Trent Arsenault was the subject of an FDA investigation/charges which if he loses his appeal, would result in a $100,000 fine and a year in prison. That is the way the donor eligibility law is written- whether he actually does the time remains to be seen.. As you say, most children are conceived through unprotected sex but the difference is that most of the time, these partners are not complete strangers. Procreative sex occurs mostly in the context of a relationship, if not marriage, so you have a basis for knowing whether your prospective partner is promiscuous or monogamous.. That makes a difference in your disease risk. So in the absence of a relationship, testing of complete strangers before recipients are exposed to their gametes is the safest thing to do to prevent the spread of communicable disease, which is what the CDC is charged to do. Also, in the fertility lab setting, whether for insemination or IVF, we use one vial, not two per insemination. I do not disagree that having sex with a stranger may be a cheap way to get sperm; I argue that it is not a safe way to get sperm and paying for a tested donor to protect your health is well worth it, in my opinion.

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