Sperm Donation and its Procedure

Sperms are collected from semen and are protected in a safe environment of a lab and then are transferred into the woman’s womb according to the need. This is called intrauterine insemination. This is a common, safe, effective, and natural process. It helps many couples having issues with fertility to have a child. The meta-analysis of three studies showed that there is no risk of low birth weight (less than 2500g) or preterm ( less than 37 weeks) or no increased incidence of birth defects when compared to a spontaneously conceived child [1].

Sperm donation is commonly chosen by:

1. A single individual like a single woman may decide to get pregnant using sperm donors. As per research, it was determined that there is a significant increase in the usage of donor sperm by single women with advanced maternal age [2]
2. Couples of same-sex like a female-sex couple
3. A heterosexual couple, when the husband is suffering from fertility issues or when both partners have fertility issues. For these couples, fertility problems due to sperm issues can be overcome with the In-vitro fertilization process IVF

Sperms can be donated directly to the intended couple or can be donated to a sperm bank. If you donate semen to a sperm bank, you will likely be paid for each donation that goes through the sperm bank's screening process. The purpose of payment is to compensate you for your time and any related expenses. This amount is generally low given that money is not the main incentive to donate. The facility where the sperm is collected from the donor and then stored and is later used for the woman who is in need of donor sperm to achieve pregnancy is called a sperm bank. Sperms are placed into women’s reproductive tract either by artificial insemination or by IVF.

If you are considering donating sperms, then you should be prepared for the long-term impact of your decision. You should think about the following and be prepared mentally if you decide to be an anonymous donor.

An anonymous sperm donor should consider that:

• Are you prepared to be the biological father of a child or multiple children whom you may or may not meet in his entire lifetime.?
• What if a child born out of donor sperm may wish to see the donor parent one day?
• Will you tell your current or future family informed about your decision of donating sperm?
• If the donor is known to you, then it is highly important to make a legal contract stating the parental and financial rights in order to avoid any future legal problems for the child.

Once the donor is clear with the above procedures, he may proceed with donating his sperms.

Steps Followed Before the Sperm Donation Procedure

Before you are ready to donate sperms, the following steps are taken into consideration. The steps taken by the doctor before collecting sperms are:

• Complete medical history that includes age and weight, past surgeries, allergies to any medicines, and presence of any previous personal or familial history of any disease, heart diseases, diabetes, or any other adverse medical conditions.
• During the physical examination, any specific signs and symptoms of the donor are carefully examined by the doctor.
• Blood tests are also done to check for any bleeding disorders or any other issues that may be hidden in the donor.

There are specific criteria or screening to be fulfilled by the sperm donor be it a directed donor (when the donor is known to the recipient) or an anonymous donor.

The criteria are:

• Age: Most of the sperm banks accept the donation of sperms at 18 to 39 years of age so that potential hazards related to aging are diminished. While some sperm banks stick to a donor age of less than 34.
• Physical exam: Your blood and urine will be tested for any infectious diseases like HIV or Hepatitis C. in case of a regular sperm donation, a physical exam is needed every 6 months and any changes in health are to be reported to the doctor on time.
• Semen testing: The quality, quantity, and motility of sperms are tested by taking a semen sample. Before you provide your semen sample you are asked to avoid sex to prevent ejaculation for at least 48 to 72 hours.
• Genetic testing: To test for any genetically carried disease like cystic fibrosis carrier screening, chromosome analyses, and hemoglobin evaluations your blood sample is tested in a lab. Some sperm banks conduct extensive genetic testing to screen the donor that will help the recipients to keep informed on the decisions of using semen samples from an anonymous sperm donor [3].
• Medical history of the family: Detailed medical history of at least two previous generations is collected by the doctor. You may be disqualified to donate your sperms if there is any presence of hereditary disease.
• Psychological evaluation: To assess your mental fitness, you will be asked a few questions by the psychotherapist. The questions asked to the donor are whether he wishes to share this information with his future children or if he wishes to be contacted by his biological children. If you have a female partner, then counseling for her would be considered. If the recipient is known to the donor, then the relation between them is asked.

In an electronic survey study that was done on 1012 male students to know their attitudes and willingness to donate their sperm, it was found that 85% had positive thoughts to donate and that relational factors and social view of donors need to be considered when recruiting donors [4].

• Personal and sexual history: All of your sexual health activities should be provided to the doctor. Addiction to drugs, alcohol, smoking, etc. needs to be known because the donor can develop the risk of any infectious disease like HIV, syphilis, and gonorrhea, or chronic disease. Complete details of personal habits, hobbies, interests, and education are taken either in audio or video recordings.

If any abnormal findings are there in screening tests, you will be informed about them and maybe referred for counseling and treatment. If the findings are normal, then you may provide a sample of semen for further testing.

Steps Followed During the Procedure

Before you give the sample you are asked not to ejaculate for at least 2 to 3 days. The steps to be followed during sperm donation are:

• Sperm is donated at specific sperm banks.
• You will be sent to a private room along with a sterile container having a lid.
• Semen is to be collected into the container by doing masturbation.
• The container with semen is then given back to the sperm bank person to be kept in a safe and special environment.

Steps Followed After the Procedure

Once your sperm sample is collected in a container,

• The sample is covered properly and is allowed to be frozen or cryopreserved for at least 180 days or 6 months. Then you may need to attend the test for any infectious diseases like HIV.
• If all the test findings are normal, then the frozen sperm sample is thawed and is evaluated for sperm quality, quantity, and movement. Some semen samples can be damaged while the cryopreservation process. This damage at the time of freezing may differ from time to time with the samples of the same donor.
• If all the required standards and criteria are met by your sperm, then you will be selected as a sperm donor.
• The children born out of your sperm sample are limited according to the guidelines of the sperm bank where you provide the sample.

There are certain benefits and risks to both the intended parents and the sperm donor with the process of sperm donation. Let us first discuss the benefits.

The benefits for recipients include:

• There is a chance for you to get conceived and start a family of your own.
• You can get healthy sperms from the donors as the sperm banks provide you sperms after genetic, psychological, and medical tests. In some countries, sperm banks even give you details like photo, height, hair color, educational background, IQ of the donor.

The benefits of sperm donors include:

• You will be financially paid for your sperms
• You are helping a woman or couple who cannot have a baby due to medical or personal issues.
• You are offered valuable genetic and medical testing of your sperm prior to donation at the sperm bank.

As we are now aware of the benefits of sperm donation, let us also get some idea of the risks that are linked to it. Both the intended woman or parents and the sperm donor have few risks with sperm donation. The downsides for woman recipient include:

• You need to wait for a long time, as sperms are kept freezing in sperm banks for 180 days before they are used for insemination.
• You and your partner might need psychological counseling to get your questions clarified about raising a child born out of donor sperm. Genetic counselors can also help to clear your doubts about whether or not to include a known donor in your child’s life.
• There is a risk of the unknown donors getting involved in the life of your child unless the laws are made strict and a contract is signed before you decide to use anonymous donor sperm.

The downsides for man donating sperm include:

• You will need to prevent yourself from ejaculation for at least 2 to 3 days before collecting semen samples.
• You will not get a chance of meeting your biological child in the future.
• Your relationship with your future partner and future children may be affected if you wish to disclose the information of your donated sperms.
• There is a need to get psychological counseling, which you don’t like, before deciding to become a sperm donor.
• There is a limit that is decided by the sperm bank for the number of children born out of your sperm donor. This is to avoid the risk of half-sibling unions between the children of anonymous sperm donors [5].

The average cost of a sperm donor falls between Rs. 8,000 to Rs. 12,000 in India. There are a few factors that decide the value of your donated sperm. The factors include:

• The couple or woman that is accepting your donated sperm
• The sperm bank where you donate sperm
• Your height and weight, education, interests, hobbies, and health of sperms also make variations in the amount that a donor gets.

When your partners’ sperm count is less or the quality of sperms is poor, then you may need sperm donated from other healthy men to get your egg fertilized into an embryo. When natural or surgical sperm retrieving procedure is not possible in your partner, there is an increased chance to accept a donated sperm. These donor sperm are either inseminated with intrauterine insemination (IUI) or get conceived by in-vitro fertilization (IVF) or fertilize your egg for Intracytoplasmic sperm injection (ICSI) procedure.