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Fertility for Lesbian Women Becoming Moms

Lesson 2 of 6

Selecting Sperm Donors

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Types of Sperm Donors

Whether a person elects for an at-home insemination, an intrauterine insemination or some version of in-vitro fertilization, she will need to use sperm to conceive.

The person who provides the sperm is referred to as a “donor” though, counter-intuitively, they are usually paid. We characterize donors into three buckets:

While there are many decisions to be made here, we think of there being a few primary ones, namely:

  • Will you procure sperm from someone you know or from a sperm bank?
  • If using a bank, will you elect for an open identity (or "open") or nonidentified (or "anonymous") donor?

Using a Directed (or "Known") Donor (Instead of a Sperm Bank)

A directed (or "known") sperm donor is typically someone who is a part of the future parents' lives. This could be a friend, an acquaintance, or, frequently, a brother or relative of the woman who will not be using her eggs.

Positives

There are lots of positives to using a directed (or "known") donor. First, if the donor is a relative, it gives both parents a chance to have a genetic connection to the child.

Second, you’ll have a good sense of who this person is—they’ve been personally vetted by you. This matters because, as you’ll see with donors from sperm banks, many women feel they’re given limited information and can’t formulate a sense for what kind of person the donor is.

Third, you can also take extra steps that make you feel more comfortable with this donor, like doing any specific genetic screening that you want performed. Alternatively, many patients wonder whether sperm banks do a thorough job medically vetting donors (more on this to come).

Fourth, using a directed (or "known") donor also minimizes the risk of surprises later, like learning this same donor has fathered 50+ children who are genetic siblings to your child.

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Fifth, you can create a unique family structure, whereby a directed (or "known") donor can also be a part of a child’s life from early on if that’s what the parents want.

Sixth, it’s typical to need more sperm than expected. That’s because fertility treatments seldom work the first time and because many parents want more than one child. Many lesbian couples who acquire sperm from a bank come to learn it’s hard to get ongoing specimens from a donor they like. A directed (or "known") donor is more likely to be able to provide additional samples when needed.

Seventh, presumably the sperm from a directed (or "known") donor can be acquired more cheaply than through a sperm bank; however, this will likely be counterbalanced with additional costs.

Eighth, unlike sperm sourced from a sperm bank, a directed (or "known") donor can contribute fresh samples (compared with sperm banks which only offer frozen samples). In treatments like IUI, this delivers better results.




Negatives

Of course, there are also drawbacks to using a directed (or "known") donor.

Most importantly, there can be legal risks, especially if the donor has involvement with the child. Some of these risks can be mitigated through legal agreements and making sure to do the insemination at a clinic so that it’s well documented that they’re a donor not a father.

Second, there can be complications if, down the road, you and the donor don’t see eye-to-eye on what the relationship should be between the child and the donor.

Next, you will likely need to contend with a number of logistical hurdles that can delay treatment. These include psychological counseling and evaluation for you and the donor, and clinics requiring that such sperm be quarantined for a period of time to protect moms from communicable diseases like STDs.

Additionally, not all clinics and sperm banks are prepared to accommodate directed (or "known") donor situations.

Lastly, you’ll likely need to cover the costs to have the donor’s sperm tested and his physical and mental health assessed, and possibly any costs he accrues for attorneys to review documents relinquishing any claims of parentage to the child. These costs may supercede the cost of having simply purchased sperm from a sperm bank.

Using a Sperm Bank

The alternative to using sperm from someone in your life is to procure sperm from a sperm bank. Here we’ll try and clarify how this process works as well as the tradeoffs in comparison to using a directed (or "known") donor.

How Sperm Banks Find Donors

There are 3–5 large sperm banks (200–500 donor’s sperm available at any one time) in the United States and a handful of smaller sperm banks.

Often, banks operate as a network, establishing recruitment centers near large, state universities where they screen candidates (medically and psychologically) before collecting their sperm.

If selected, donors waive their paternal rights, agree to testing, provide several samples, and create an online profile for customers of the bank to review.

The Costs of Using a Sperm Bank

The costs of using a sperm bank vary, and prices between the major banks range by 10%–15%. There are really two costs: the cost of information and the cost of sperm itself.

Information: You should assume you will pay for varying tiers of information on donors on the sperm bank’s portal, with top tier access running around $250 every three months.

Sperm: The costs to acquire a vial of sperm range from $1,000–$1,500, and rise if:

  • The donor is willing to have their identity known by the offspring when they turn 18 (this is known as an open identity (or “open”) donor)
  • The sample has been washed and treated before it is shipped out

For context, each IUI requires a vial of donor sperm. Since IUI works about 10 - 20% of the time, most people purchase 3 - 5 vials in total and the costs of sperm rise 4%–10% per year.

For IVF, which we address in more detail below, each round requires a vial of donor sperm and most clinics require a second vial in case something goes wrong when they attempt to unfreeze it.

The costs of a vial of sperm in many countries have shot up to $1,000 to $1,500 per vial post-COVID and have remained at those prices.

If you purchase more than one vial of sperm, the additional vials are often held at the sperm bank until they’re needed. In cases where a patient decides they don't need or want sperm still held at the bank, the bank is often prepared to buy it back at 50% of what people paid for it.

Ultimately, since treatment is inefficient (sperm gets used up quickly) and most parents want more than one child, customers find they need more sperm than they expected. These customers often regret not buying more sperm (from a donor they like) earlier, because donors eventually stop providing samples and other customers may have stepped in and bought all that was left.

Positives of Using a Sperm Bank

First, compared with trying to select a directed (or "known") donor, sperm banks provide a broad selection (though many customers complain they find it hard to find what they’re looking for.) What’s more, you can get access to the sperm almost immediately.

Second, sperm banks handle much of the logistical hassle that falls to those using a directed (or "known") donor: physical, psychological, and medical screening has been handled. The donor has waived all rights and claims to the child.

Third, most sperm banks are highly LGBTQ+ friendly, as lesbian women comprise nearly half of their business.

When purchasing sperm some experts suggest that the partner who will be using the sperm (or using it first) makes the purchase. The reason is that once it is shipped to the clinic, the clinic’s record system will have an easier time matching it to the recipient if it is in their name.

Negatives of Using a Sperm Bank

First, the experience of finding a sperm donor through a bank can be painful. While banks claim to reject 90% of applicants to donate, many customers find the volume of donors to be overwhelming and the quality to be underwhelming.

Second, sperm banks make little information available to customers. Customers want to see adult photos while banks usually just supply younger photos of the donor. Personal essays are penned by 18 and 19 year olds, and leave customers to wonder what this person will be like as a fully-formed adult. Specific schools attended are purposely made vague because they are seldom viewed as “elite” institutions.

Third, many worry that banks often know less about their donors than customers are led to believe. While banks are meant to follow FDA and ASRM screening guidelines, standards vary between banks, and sometimes even within the same bank, depending on the recruitment center.

The headline below profiles a case where a sperm donor was advertised as having a 160 IQ and a PhD but was later revealed to have neither—instead, he had been convicted of burglary and diagnosed with schizophrenia before donating. His samples were used to father 23 offspring and were obtained from a large bank that’s generally considered reputable.

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Fourth, sperm banks provide frozen sperm. Frozen sperm carries lower rates of success than fresh sperm. Fresh sperm can only be provided by a directed (or "known") donor. When one uses frozen sperm, it’s always wise to have at least two vials available for any given cycle in case the first vial does not thaw successfully.

Finally, some clinics may prefer that the sperm they are provided from a sperm bank is prepared in a certain way (depending upon how it will be used), and it’s important the bank is made aware before it is shipped.

Open Identity (or "Open") Donors from Sperm Banks

If you choose to get sperm from a bank, the next major decision is often whether you’d prefer to buy sperm from an open identity (or "open") donor or from a nonidentified (or "anonymous") donor (which will cover in the next chapter).

An open identity (or "open") donor is a donor typically selected from a sperm bank, who has agreed to make his identity available to future children when they turn 18 years old. Alternatively, a nonidentified (or "anonymous") donor has instructed the sperm bank never to release his identity to the offspring.

In making this decision, women will want to think through their feelings about their future children (as adults) having the option to reach out to the sperm donor.

A sperm bank recently made data available on what percentage of adult offspring actually follow up and request access to their sperm donor’s identity.

As you can see, children of lesbian couples requested their donor’s identity 37% of the time. While that’s less than the percentage of children of solo or single mothers, it still reflects the very real possibility if you elect for an open identity (or "open") donor, your child will take advantage of the information available to them.

Of those who requested information, the primary motivation was to get “more information with reference to self,” namely what traits do they share in common. Most eventually planned to make to make contact with the donor and over 90% of donors said they’d be open to reciprocating contact. Nearly 90% of the adult offspring harbored “no or low” expectations for what might arise from such interactions.

Nonidentified (or "Anonymous") Donors from Sperm Banks

Similarly to an open identity (or "open") donor, a nonidentified (or "anonymous") donor provides sperm to a sperm bank.

However, they do not consent to the adult offspring learning of their identity (much less reaching out). Roughly 60%–70% of donors to sperm banks today are listed as nonidentified.

However, there is a very real question as to whether preserving the donor’s “anonymity” is realistic with the advent of consumer genetic testing.

There’s an ever increasing chance that in the future, if your child really wants to find out about their paternal genetic heritage, they’ll be able to use services like 23andMe or Ancestry, and ultimately learn the identity of their biological father. Within minutes, thanks to social media, they may be in touch—allowing little time for a planned, lucid weighing of the positives and negatives.

Given this donor elected to remain anonymous, there’s a real possibility such an interaction might not go well.