Choosing a sperm bank carefully
Many parents focus on finding a donor with specific characteristics, but don't pay as much attention to the policies of the sperm bank they plan to use. And this can have a profound impact on the family and the child someday.
Do not pick a bank simply because it is the one recommended by your doctor (who might merely have the clinic's paperwork or a sperm bank's marketing materials in mind). Before you settle on a sperm bank, research its policies so that you can be assured it is one you will be happy with for the lifetime of your child.
We consulted with Alice Ruby, of non-profit The Sperm Bank of California, to learn how to make an educated choice about which sperm bank to use. She told us that banks differ significantly in terms of:
1. Providing open donation. Each bank has their own policies regarding what information they release, if and how donor information is maintained over the years, and how much support they provide for youth, donors and parents before and after birth. Many parents have reported disappointments, particularly if a child has become sick and the bank is unwilling or unable to find the donor to provide clues. Some banks are slowly changing policies to address some of these issues. Others are not. (This website will someday have a peer-review of sperm banks; for now note the link at right for a list of U.S. sperm banks and what basic services they provide as compiled by Choice Mom-in-the-making Jessica.)
Be direct in asking questions: Any sperm bank should be able to answer questions about whether and how it communicates with its donors over time, both anonymous and open-identity, and what the experiences of its families have been like so far.
2. Tracking Outcomes. After sperm vials are shipped, there is very uneven reportage of how many pregnancies or live births result. Some banks are much stronger than others at tracking this data. Only an estimated 40 percent of parents report a birth after the fact. Doctors don't always do the paperwork either. If there is a reason to make contact after the fact with families that share a donor's genes, currently it is nearly impossible to do so in a comprehensive way. It becomes difficult to measure the fertility of a donor's sperm: what is the miscarriage rate, inherited birth defects, live births? Limits on donor offspring (see below) also become rather meaningless without these reports.
3. Family Limits. There are no regulations that require sperm banks to limit the number of offspring per donor. The American Society of Reproductive Medicine recommends no more than 25 offspring per population of 800,000. But since all U.S. sperm banks ship nationally, this doesn't offer a significant limit. Some donors are known to have 50 offspring. Others are estimated to have as many as 150, based on how many years they donated (each donation is split into multiple vials).
Having a donor with proven pregnancies is a plus, but some women are uncomfortable not knowing exactly how many live births have been the result, especially since they don't know what cities they live in.
Each sperm bank will have a policy on its donor limits, and should be able to explain how they keep track of this. The Sperm Bank of California is one of the tightest ships in the business (it is a non-profit program), with no more than 10 families built from one donor (allowing for the fact that some families will prefer to have siblings from the same person) before he is retired from the program.
If an open donor is used, of course, he is likely to be much more cautious if the offspring is the 10th, or 30th, to contact him.
4. Who regulates the industry? -- The Food and Drug Administration provides some regulation, but its rules are primarily about safety protocol designed to prevent disease transmission, not related to factors that might come into play after a child is born. The nationally recognized accrediting organization in the U.S. is the American Association of Tissue Banks. The AATB has a rigorous inspection and accreditation program. Accreditation by the AATB is voluntary, and an expensive process for some of the smaller banks. State regulations vary widely and only the New York and California Departments of Health inspect the banks prior to issuing a license.
For any reliable sperm bank, all donors should be:
- Tested for sexually transmitted diseases. A donor's samples must be quarantined six months, at which time the donors are retested again. If they "pass," the original samples can be released to the public. This process must be taken for every donation, not simply done once per donor.
- Given an annual physical exam, and tested for a handful of genetic illnesses.
- Able to provide personal and family medical history to help evaluate the risk of hereditary illness. There is no guarantee, of course, that the donor (generally a college student) will know his history accurately. Many medical issues will not yet have come to light in his family background. And some donors aren't completely honest when they are trying to be admitted into the elite ranks of a paid donor program. A few sperm banks are discussing how to correct the imbalances of this system. Stay tuned to this website for updates.
One of the sticking points in the industry is that there are no regulations requiring sperm banks to track offspring health issues or make this information available to other families who used the same donor. Many health issues have complicated causes, so it's not always as simple as knowing whether a donor (and/or the mother) carries a certain gene. But there have been several complaints lodged by Choice Moms, and others, about lack of disclosure or assistance when health issues come to light. Some sperm banks are reluctant to get involved with a potentially litigious situation. (We don't know of many sperm banks who haven't had to deal with this; especially the larger ones have had many clients and donors, and thus inevitably issues to contend with.)
See this story about a fatal heart condition that was passed on to at least nine of a donor's 24 children. While screening for all genetic issues is not possible, the question is: if this came to light for your donor, how would you and the donor learn about it? Without a national donor registry, we rely on record-keeping -- and disclosure -- at institutions that don't necessarily have the high standards we would like. That's why Choice Moms need to press for a national donor registry. Stay tuned to the website as this issue develops further in 2010.
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