Sperm is a hot commodity in 21st-century Britain. Women will travel miles to find it and pay thousands to access it. Obtaining a donation from the European Sperm Bank – which is to say pursuing the standard, NHS-endorsed option of licensed donation – can cost upwards of £2,500. That's before diagnostic testing, treatment costs, and "pregnancy slot" bookings are taken into account. That's £2,500 for three, thumb-sized vials of frozen semen – and it might not be enough.
Treatment could be unsuccessful, at least the first time around. It might be a one-off, or it might a recurring problem. It might not even be possible to buy a donation. Demand for those frozen vials dwarfs availability, and the result is a system in which eligibility is strictly regulated.
Mark Jackson first learned of the sperm shortage six years ago. Sitting at his computer, reading news of the Boxing Day tsunami, he was made aware of his own mortality. “I realised that you could be wiped off the earth without having left any impact,” he reflects. “My eye was caught by a ticker running across the screen. It said that there was a shortage of gamete donations. I didn’t even know what that was, but I clicked on the link. I realised that maybe I could make a difference after all.”
Since then, his sperm has been used to “help” two families and Jackson has become a trustee of the National Gamete Donation Trust (NGDT). He is one of almost 500 registered donors in the UK, sharing his sperm via the 138 licensed clinics around the country. In 2005, when British law changed to allow donors’ offspring to learn, on turning 18, the identity of their father, that number was widely predicted to drop off. Suddenly, the prospect was raised of biological sons or daughters rocking up on donors’ doorsteps. It’s a scenario soon to be played out on the big screen, thanks to US comedy The Kids Are All Right, and it would be enough – sceptics reasoned – to turn many men off their trips to the fertility clinic.
In fact, the opposite has happened: thanks to several high-profile recruitment drives, numbers have increased: from 224 newly registered donors in 2004 to 396 in 2008. In theory, at least, this should be enough to satisfy demand, since each donor can “enable” up to 10 families. But it hasn’t done so.
The mismatch is so great that last week Laura Witjens, NGDT chairwoman, called for donors to be paid. At present, they are awarded a maximum of £250 in expenses and lost wages.
Spending by individual clinics on awareness raising, recruitment drives, and medical testing add to the cost of making sperm available for donation. All things considered, clinics, according to Infertility Network UK, fork out somewhere in the region of £5,000 per donor.
If, says Witjens, they were to add payment into the mix, clinics would be in a position to attract more donors, thus satisfying demand.
Yet it’s not obvious that a lack of donors is the problem, nor that financial incentives would provide a solution.
Earlier this year the Human Fertilisation and Embryology Authority (HFEA) discovered that the average donor was enabling just 1.5 families, far fewer than then legal limit of 10. Given that some 80 per cent of donors agree to the maximum amount, something is clearly amiss.
The answer lies with the clinics. Clinics recruit donors individually, and work through the process of donation – from preliminary tests to repayment of expenses – separately. Frequently, unused sperm isn’t shared with other clinics, and much of it goes to waste. “It’s something we are trying to address,” confirms a spokesman for the HFEA. “At the end of the day, we can’t force clinics to share their sperm.” Until the system is sorted out, the only option is to recruit more donors. Or, if you are a woman in search of sperm, to head, as it were, off-piste, and wade into the murky world of unlicensed private donation.
Ed Houben of the Netherlands has been donating sperm since 1999, and doing so privately since 2002. He is Europe’s most prolific sperm donor. Head to his website and you are directed towards an upbeat missive in which he explains his willingness to offer “a good sperm cell” to needy couples around the world. He has fathered some 70 children, several in his home country, and others as far flung as Australia, Canada and Israel. At present, he has another eight on the way.
Like Jackson, he was initially drawn to donation by the desire to make a difference, to leave his mark on the world. “I didn’t want to look back and not to have accomplished anything,” he says. “So I went to a clinic near my home and gave sperm.”
His move towards private donation was motivated, in part, by the restrictive policies incumbent in many a hospital. “Because of the donor shortage, clinics were less likely to help homosexual couples or single women. I was raised by a single mother and I’ve seen a lot of unhappy heterosexual couples. Maybe two mothers is better.”
Houben is the friendly face of private donation. Kindly and businesslike, he takes his role seriously, hosting annual get-togethers for his offspring. Women come to him secure in the knowledge that theirs will be a safe, reliable experience; of the dozens who have approached him, only a few have been turned down. “The most important thing to me is that the child has the best possible chance of a normal, happy life.” Of course, he isn’t alone in his integrity: many donors recruited privately are equally altruistic, going on to help couples in the most desperate of situations.
However, this so-called “grey market” of private donation can be a tricky place, because it is unwieldy and unregulated. Websites offering to introduce sperm and egg abound in listings classified as for the family-minded.
While most – such as feelingbroody.com and co-parentmatch.com – recommend that women insist on medical checks before accepting a donation, there is, ultimately, a limit to what they can do. “I have met people who donated without any checks,” Houben reflects with a sigh. “That’s playing Russian roulette.”
It’s not simply a matter of health. As the HFEA warns, without a clinic to mediate, “the details of parenthood can become problematic”. Indeed, private donors have no guarantee of their protection from parental duties. Three years ago, in the first case of its kind, Britain’s Child Support Agency forced a 37-year-old fireman who had provided sperm to a lesbian couple to contribute to the child’s maintenance. In that instance, the pregnancy was a result of artificial insemination. Natural insemination, when the mother conceives through sexual intercourse with the donor, only further muddies the waters.
Natural insemination, or NI, is more common than might be expected. “I would never have mentioned it,” says Houben. “But then people began asking. I was amazed at first, but there are people who find artificial insemination lacking in intimacy. For many, NI is the closest they get to being normal.”
Back in London, donors for licensed, artificial insemination are in high demand. “We advertise in the London papers,” explains Neeta Bala, donor bank coordinator at the London Fertility Centre. “We’re hoping to go into men’s magazines soon too, and we’ve done other papers and in college guides.” Their hit rate is around two donors per month – more than the average clinic, but far fewer than they would like. “It’s less than we need. We have peaks and troughs.”
Oddly, for such a prominent issue, the act of donation is rather opaque. What, one wonders, goes on within the hushed confines of the donation room?
For those in need of illumination – and it’s not simply a case of five minutes with some cut-price pornography – the process goes something like this. On calling the clinic, potential donors are talked through their decision by an embryologist. Then, if everyone is happy to proceed, a “semen assessment appointment”, is made. The donor’s sperm is sampled, frozen and cultivated to assess its longevity. Their blood, meanwhile, is tested for disease and genetic disorder. If both results come through clear, the man in question will be asked to return for between six and eight visits, producing samples every time.
Throughout the process, alcohol and sex will be strictly regulated and, afterwards, donors are asked to attend a counselling session. Six months after the final appointment, a second blood test is taken. Finally, the sperm is banked. The whole thing takes around eight months.
Happily, part of the enigma surrounding donation may be about to evaporate, thanks in part to a new book by Greg Wolfe. How to Make Love to a Plastic Cup: A Guy’s Guide to the World of Infertility explains in detail the comings and goings of gamete giving. From donation-room etiquette (chapter title: “Sperm-a-lot”) to the inevitable awkwardness of the clinic waiting room, it offers a wry, occasionally laugh-out-loud, briefing.
“Donation has become normal to me now,” says Jackson. “It’s part of my life.” As things stand, he knows nothing of the people his sperm has created. If they choose to look him up one day, he says, he’ll be happy to meet them: “I don’t have strong feelings. It would be up to them.”
For the time being, he has three children at home to take care of: a toddler, a five-month-old baby, and his girlfriend’s son from a previous marriage. Houben, meanwhile, continues to see those of his offspring who want to maintain contact. As for the future of his sperm, he remains uncertain. “Who knows how long I’ll continue? But whatever happens, I know I can look back on many happy families that I’ve helped create.”Reuse content