Dr Robert why are sperm donors currently needed in Australia?
For many decades, we needed sperm donors to assist couples where the male partner had no sperm. This is approximately one in every hundred couples. Without donor sperm, they won’t be able to fulfill their dream of having a family. In recent years, there has been an increasing use of donor sperm by single women and same sex couples. They also seek a safe way to start a family using screened donor sperm. But whilst the demand has increased, the number of new donors coming forward has not, so there has been a shortfall. That is why Monash IVF has developed a new website called Australia Needs Your Sperm, along with a streamlined donor evaluation process, in order to meet the needs of Australian couples and women for new donors. We hope this will help in providing all these folk with the sperm they need to help start their families.
What is your experience as a fertility specialist in the area of sperm donation?
I have been involved with sperm donation for 35 years and have seen its evolution from an anonymous donation to the current model where the interests of the donor conceived child are paramount, including the ability to make contact with their genetic father later in life.
My particular role is in male infertility so I see many men with Klinefelter’s syndrome, which is a common genetic condition where sperm are often absent and donor sperm is then used. I often continue to see these men over the years as they usually go onto testosterone replacement therapy. I get to see and hear from them about their new family that the donor program has helped create. They proudly show pictures of their donor-conceived offspring and their intention to have a second or third child. All this really underscores to me that donor sperm will always be a critical part of our fertility treatment program and is a source of great joy to our patients.
In your opinion why has there been a decrease in the number of men donating their sperm?
Over 30 years ago, there was a fundamental ethical change in Australia’s donor sperm practice. Previously donor anonymity was the approach. Then the right of the child to be able to know its genetic origin, including the ability to contact the genetic father when they achieved adulthood, became the paramount consideration. For a period after this change, there was a decrease in the number of men coming forward to donate sperm. This has changed over the decades as society has opened up about assisted reproduction, methods of conception and alternate family structure.
Nowadays I do not believe the fact that donor offspring may contact their donors in their adult life accounts for the current shortfall. I believe it a lack of awareness and knowledge. Men who learn about the donation program, and the happiness they can bring though the gift of life, they are happy to participate under the ethical principles that now apply.
I think there are many altruistic men who lack of awareness that donor programs exist in the city or region. Nor do they know that streamlined process for potential donors through well-structured counseling and evaluation processes. Certainly, financial gain is not a motivation as Australian laws prevent donors receiving more than reasonable out of pocket cost. So it is really altruism that underscores Australian men coming forward to help in this special way.
Have you personally seen how the shortage has impacted your patients?
Recently we have all at Monash IVF been concerned about the reduced choice of sperm donors. New donors quickly reach their maximum number of families and need to be withdrawn from the list. A lack of available choice leads to delay in my patients accessing treatment or even having to go on a waiting list. Having come to the point in their lives when they want to use donor sperm, it is frustrating to then have to delay is a matter of great frustration.
Who can become a sperm donor?
Any healthy man aged between 21 and 44 years of age is eligible for sperm donation. From a medical point of view, the key issues are whether the individual has any personal or family history of genetic problems, such as familial cancers, diabetes or heart problems. Obviously we want to ensure that the donor-conceived offspring is not at particular risk of such problems coming through from the donor’s side.
The second issue is potential infectious agents that might come through the sperm donations.
Accordingly there is a system which involves a brief medical examination and history and the completion of questionnaires which ask relevant questions about serious illnesses that would make the man ineligible. In addition to sperm samples, blood is taken for genetic and infection testing. If any abnormalities are found, these are discussed with the donor. This might mean that he cannot be a donor or perhaps that he needs specific treatment or referral to another doctor for consultation. The health of the donor is always a priority during the evaluation process as we want to ensure any potential donor-conceived children do not have any health risks later in life.
What is the difference between a clinic recruited donor and a known donor?
Clinic-recruited donors are men who come forward for altruistic reasons to donate sperm for use in a defined number of recipients. This number varies between five and ten according to the state (for state specific information speak to one of our fertility nurses). Recipients are given non-identifying information in order to make their selection but identifying information is not provided. This can only be released on the request of the offspring after they reach adulthood. We need more of these clinic-recruited donors in particular as most couples choose this type of donor.
The other type of donor is the known donor, wherein the couple are aware of the identity of the donor and have chosen him for different personal reasons.
However, when it comes to counseling compliance with state laws, screening for genetic and infectious disease and provision of relevant health information about the donor to recipients, there is no difference between a clinic recruited and a known donor.
Why should someone donate their sperm?
1) They want to help others to start a family because they have known the joy of children in their own lives and want to share the experience.
2) They know as someone who has experienced or knows someone who has fertility issues the problems that they face and want to assist and relieve that problem for people in a similar situation.
3) They want to know that, even if they don’t have their own children, that their genes will be carried forward through this contribution to a donor conceived child.
What information is given about a donor to a prospective recipient?
Prospective recipients receive important non-identifying information about their donor, including things like ethnic origin, height, weight, interests and general health information, occupational group and similar information to help them choose the donor. They do not receive identifying information; this can only be provided to the offspring on request when he or she reaches adulthood.
What are the donor’s rights?
Sperm donors do not have legal responsibilities to donor-conceived children in terms of issues relation to raising the child, inheritances or other related expenses, however, they are entitled to know (if they wish) that their donation has led to a pregnancy, a birth and the number and gender of the children and whether those children have encountered any health problems.
Is the donor’s identity released?
At Monash IVF we strongly believe that the mental and physical health of donor-conceived children is of the utmost importance. Therefore it is important that donor-conceived children can find out their biological origins.
Identifying information may include the donor’s name, date of birth, donor code and contact information (including address, telephone number and email address).
How can people find out more?
If you are interested in becoming a sperm donor then you can make an enquiry and speak to one of our fertility nurses today. Our trained fertility nurses can talk you through the process in more depth. Once you are interested, there is a health questionnaire to help screen out obvious issues, followed by clinical evaluation, questionnaires, semen and blood testing. That whole evaluation process takes a few weeks and the number of appointments is kept to a minimum so as not to inconvenience the potential donor.
After that men are required to provide about 10 ejaculates over 1-2 months and then return 3 months later on one occasion for a final blood test to give the ‘all clear’ to put the donor on the available list