Not surprisingly, the movie Delivery Man made the rounds on a Choice Mom discussion board recently. The movie is about a former sperm donor who discovers he has 500 offspring – the revelation of which, Hollywood style, helps make him into a man.
On the board, there was a mixture of myth and reality as women commented. As someone who has closely connected with members of the sperm bank industry for about seven years – paid attention to policies, management and customer service issues reported by women over time, as well as issues raised by researchers, offspring and donors – I sought out input of four banks I know and essentially trust, to help separate the myths from the facts.
Women were both concerned, skeptical and certain that a sperm donor could produce 500 offspring in today’s unregulated industry.
Wrote one: “Consider the fact that each ‘donation’ is actually split up into at least 10 units. Since donors can donate at least 3 times a week, that many samples can easily be produced in ONE single year and many donors are active for several years (three on average which is the time necessary to finish their undergrad degree) and some donors have admitted to donating at more than one bank at the same time.
Responds Seattle Sperm Bank (Eric Kendall):
On average, our donors create 1.8 vials/units per donation and they typically make one donation per week. A small percentage of our donors do posses the fecundity and make the necessary lifestyle accommodations to donate 3 times per week, which is the maximum we allow, but this is the exception not the rule. The average age of the women/clients using donor sperm is 39 and many of them, of all ages, are struggling with infertility. This means that only a fraction of the vials will actually result in live births.
Responds The Sperm Bank of California (Alice Ruby):
While there is no generally agreed upon limit for the appropriate number of families or offspring per donor, I think we can all agree that if you are talking in the hundreds of children you are talking way too many. The Sperm Bank of California has a limit of 10 families per donor as part of our ethical approach to donor-assisted family building. This conservative approach was initiated out of concern that too many offspring would overwhelm donors participating in our Identity-Release® Program. This lower number of families is also a benefit for families who participate in our Family Contact List, so are in contact with other families who have the same donor.
The reality is that sperm donation is a human process. A low family limit is important if unanticipated medical concerns arise in donors or offspring—just as they can arise in any genetically linked group. TSBC’s low family limit is an essential part of our aim to minimize this potential health burden for our families, as well as for concerns about possible consanguinity. Telling children about the family’s donor origins also greatly reduces consanguinity risks.
A critical element of maintaining the low family limit safeguard is parents reporting their pregnancy promptly to their sperm bank. Over the years we have developed systems to encourage reporting and to follow up with recipients. A recent review of these systems indicated that fewer than 10% of our donors had more than 10 families reported. But without parents fulfilling their responsibility to report (in TSBC’s case – their signed agreement to report), the system works less effectively. Two moms who each wait a couple of months to report their pregnancy can mean the difference between a donor with 10 families and a donor with 12 families.
Are there ever 500 offspring per donor? The logistics of the donation process will vary from bank to bank. The majority of donors at TSBC donate for a period of 6-18 months resulting in 25-100 samples collected per donor. At TSBC the majority of sperm samples are split into two vials. When a sample has sufficient sperm count, we are sometimes able to split a sample into three or four vials without sacrificing the quality of each vial but that is less common. It is very important to us to meet our guaranteed sperm count of 20 million motile per CC; accordingly, we receive less than five complaints a year about the quality of our samples.
How does this translate into number of births? If a donor donates once a week for a year, that will result in about 50 samples. If every sample meets our minimum sperm count that would be roughly 100-150 vials. TSBC’s overall success rate is about 14.6% per cycle attempt (one pregnancy per seven attempts). Most recipients use one or two vials per attempt. Based on these numbers the expected outcome for one year of donation is between 7 and 22 conceptions (expected live births would be lower). Using numbers like these, TSBC limits the number of vials collected per donor as a secondary check on the number of families per donor even if not all families report their pregnancies and birth outcomes. However, the system works best when both sides – the sperm bank and the prospective parents – approach family building guided by the best interests of the children, this includes communicating with each other and parents sharing with their children about the family’s donor origins.
Says California Cryobank (Scott Brown):
The California Cryobank has had a long-standing policy of limiting the number of vials collected and distributed for each donor in order to meet a maximum goal of 25-30 families with offspring per donor. The average families per donor is actually approximately 15. We have maintained these numbers by utilizing the following tactics:
1. Limiting the total number of vials collected per donor (regardless of the number of vials produced per donation): We use a formula based on the average number of vials used per insemination; the average number of inseminations per successful pregnancy; the average percentage of spontaneous losses per pregnancy. Utilizing many years of research data, we are able to predict the total number of expected live births based on the number of vials collected. Data on the Donor Sibling Registry (number of registered families per donor), as well as our own additional tracking methods demonstrate that our formula is extremely accurate.
2. In addition to the vial limits, we monitor outcomes of insemination through proactive contact with clients who have stopped shipping vials and not already reported a pregnancy. We have significantly increased pregnancy reporting over the last four years by making it easier to report, sending automated emails to clients who have not ordered in 3 months, and offering a Keepsake Packet with donor information as an incentive to report pregnancies.
3. We also do periodic spot checks that involve tracking the outcome of 100% of all vials shipped for a specific donor over a specific time frame.
4. We compare pregnancy reports to total number of vials shipped.
5. While it is not a specific tactic, by operating multiple locations around the country, we keep our donor selection high without “over using” individual donors. Smaller regional banks rely on a small pool of local donors and often collect more vials on each to keep their catalogs from dwindling.
We believe it is the responsibility of the recipient to choose a sperm bank that has an established track record and transparent business policies and practices. Our experience is that people often lump all sperm banks together without doing the proper research. All doctors are not the same. All auto mechanics are not the same. All hotels, restaurants, dry cleaners, or grocery stores are not the same. Sperm banks range in policy, service, experience, reputation, price, etc. The individual consumer needs to find the bank that best fits their personal needs, just like you would with any other professional service provider.
Donor applicants are asked about participation with other sperm banks during the screening process. If an applicant has donated previously he is disqualified. If we learn that an active donor has donated elsewhere, we work with the other bank to restrict further sales of specimens to new families. California Cryobank is in the process of forming the National Donor Gamete Registry (along with other national sperm banks) which will allow donor tissue banks to verify that an applicant has not previously donated sperm or eggs.