IFLG-Why-Is-There-a-Shortage-of-Black-Egg-Donors-and-Black-Sperm-Donors-Rich-Vaughn

Why Is There a Shortage of Black Egg Donors and Black Sperm Donors?

All too often, Black women who seek treatment for infertility and Black intended parents who seek to create families via assisted reproductive technology (ART) encounter an unexpected barrier to access: A shortage of Black egg donors and sperm donors.

After struggling with infertility, Rhonda Spencer, a producer at West Michigan ABC affiliate WZZM13, and husband Jamal were saddened to learn that, in order for Rhonda to have a child, they would need an egg donor. They were further crushed to discover there were no Black egg donors available to them. “As a Black woman, I want to have a Black child,” Spencer said in a WZZM13 report. “It was a hurdle that I hadn’t even thought about.”

Robin Strouse, RN, donor coordinator at Fertility Center in Grand Rapids, Michigan, told WZZM13 that of 1,000 egg donor applicants over a three-year period—only a portion of whom make it through the application process—just 15 percent were Black and only 5 percent Hispanic; 80 percent were white non-Hispanic. At the time of a 2018 report by Rewire News Group, California Cryobank—one of the nation’s largest sperm banks with labs in Los Angeles; Los Altos, California; Manhattan and Cambridge, Massachusetts—offered only 17 sperm donors identified as Black or African American.

In a series originally published in 2019, The New York Times followed the saga of a West Hollywood lesbian couple, B.A. and Nikki Williams, both Black, who wanted to become parents using a sperm donor and IVF. As Nikki recounted, the couple researched numerous sperm banks, searching for organizations that were both LGBTQ-friendly and offered racially diverse donors,  before finally settling on the one that had the largest number of Black donors—23 out of 450 total listed.

Then they ran up against another hurdle: Nikki, whose egg would be used in conceiving their baby, tested negative for both sickle cell anemia and CMV, a viral infection that can result in birth defects. To avoid the chance of passing along those diseases to their child, they needed to find a donor who also tested negative. Their choices dropped instantly from 23 to four.

The shortage of Black egg and sperm donors is echoed in other countries: In 2017, of some 1,900 egg donors in the UK, 15 were identified as “Black Caribbean,” 20 as “Black African,” and 1,608 were identified as white, according to a BBC report.

Racial disparities in healthcare access and outcomes, including in reproductive healthcare, are nothing new. According to infertility advocacy website The Broken Brown Egg, Black women experience infertility at much higher rates than white women, yet are much less likely to seek treatment. And when they do access treatment, outcomes for Black women and other women of color are less successful than for non-Hispanic white women: According to a long-term study by the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SARTCORS), in 2014 and 2105, ART cycles in Black women “were 64 and 67%, respectively, as likely as white women to result in a live birth following primary transfer.”

Why Aren’t There More Black Egg Donors, Black Sperm Donors?

Many of the same cultural and socio-economic factors that historically have discouraged Black intended parents from seeking, or impeded access to, ART treatment also have contributed to the shortage of Black egg donors and sperm donors. In a November 2020 statement, the ASRM Diversity, Equity and Inclusion Task Force “concluded that the lack of people of color in key positions in our profession, high price of treatment, inaccessibility of medical care, differences in success rates, lack of accessible patient education, and implicit biases and discrimination by some offices pose immense burdens to infertile individuals of diverse backgrounds, in same sex relationships or who are without a partner.”

Stigma of Infertility

Fertility often is a taboo subject in the Black community, the Rev. Dr. Stacey Edwards-Dunn, founder of non-profit advocacy group Fertility for Colored Girls, told WZZM13. Older African-Caribbean women, reluctant to seek fertility treatment, will say, “You don’t talk your business to people,” UK counselling psychotherapist Helen George told the BBC.

Other ART professionals believe cultural or religious taboos discourage some would-be donors. “There are some challenges culturally when it comes to recruiting non-Caucasian donors, whether it be religious or secular cultural reasons where people are not necessarily supportive of sperm or egg donation,” Michelle Ottey, director of operations at the Virginia-based Fairfax Cryobank told Rewire.

Distrust of Medical Profession

Both egg and sperm donation require extensive medical screening and multiple visits to the lab or clinic; egg donation also involves the administration of medications on a strict schedule and one or more invasive medical procedures. Black people in America and in some other parts of the world have experienced generations of discrimination, systemic racism and denial of access within the medical profession. “There is fear of the medical system,”…fear of “going into the doctor’s and not being cared for rightly.” Edwards-Dunn told WZZM13.   

“You can never exclude [the knowledge of that history] as a possibility,” said Scott Brown, vice president of communications for California Cryobank, in the Rewire report. “I don’t know how aware most 23-year-old men are about their ethnic history, but the potential for [decreased] interaction with the medical community in general [is there]. Probably some of the same challenges we face in every career or walk of life.”

For some potential donors, such historical mistreatment creates an understandable foundation of distrust that translates to a reluctance to become an egg or sperm donor.

Lack of Information for Black Egg Donors, Sperm Donors

Edwards-Dunn, who struggled with infertility before founding Fertility for Colored Girls, attributes the shortage of black egg donors, in part, to lack of education. “A lot of young black women don’t even realize it’s an option,” she told WMMZ13.

Natasha, a UK woman of Afro-Caribbean heritage, said she doesn’t believe women realize there is a shortage of egg donors. “There’s no awareness; no one’s printed any leaflets,” she said. “It’s not sitting in the waiting rooms of any hospitals.”

UK counseling psychotherapist George told the BBC she faults the country’s Human Fertilisation and Embryology Authority, which, while aware of the shortage of racially diverse egg donors, claims that informing the public, and publicizing the one-time £750 donor payment,  is not its job.

Difficulty of Donating

Neither egg donation nor sperm donation are quick and easy. Reputable agencies require extensive donor screening for genetic or contagious disease and mental health. Brown of California Cryobank says for every hundred applicants, only one makes it through the process to become a sperm donor; Ottey at Fairfax Cryobank estimates only one in every 200 applicants becomes a donor. Once accepted, a sperm donor must return once or twice a month for six months, making geography and proximity potential obstacles as well.

“You can’t just walk in off the street, donate, and get $50,” Ottey said. “[Donating] is a real commitment, and you’re contributing to a family. We do lose applicants who come in and don’t take it very seriously.”

In addition to extensive screening, which can take three months or more, egg donors must self-inject hormones and medications on a strict schedule over a period of weeks, in addition to the egg harvesting procedures. For some women, the time, inconvenience and discomfort make it difficult or impossible to meet work or study responsibilities while undergoing the donation process.

Lack of Diverse Representation in ART Profession

Contributing to the fear and distrust some Black people feel about egg or sperm donation is their underrepresentation among donor agency and sperm bank staff and professionals.

LGBTQ activist Jaime Grant, who has two children with her Black ex-partner conceived using donor sperm, told Rewire her experience was “white doctors serving white people.”

Brown of California Cryobank says a lack of diverse leadership in the profession contributes to the shortage of diverse donors. “They say to themselves, ‘I wonder why?’ when they don’t have a doctor of color among them.”

Marketing to White Customer Base

Because there is little regulation of sperm banks and donor agencies in the U.S., facilities are guided by market factors, and the shortage of racially diverse donors at sperm banks and donor agencies reflects the perceived economics of the industry. “Sperm banks are private companies so they don’t have to provide data,” Yale sociologist Rene Almeling, author of Sex Cells: The Medical Market for Eggs and Sperm told Rewire. “Is it [that] sperm banks don’t have donors of color, or customers of color because they don’t have donors?”

Solutions to Black Egg Donor, Black Sperm Donor Shortage

The COVID-19 crisis has shone a spotlight on healthcare disparities that disproportionately impact Black and other communities of color; Black Lives Matter and other current social justice movements have raised awareness of the need for equal access to all forms of medical services. This increased awareness has informed and inspired all sectors of the assisted reproductive technology profession to make needed changes.

Advocacy organizations such as ASRM, which has for years studied racial inequalities both in access to ART and outcomes, have begun to formulate solutions. “Understanding the racial disparities in outcomes of different IVF treatments is a critical first step in assuring access to care for all patients,” said Michael Thomas, MD, ASRM Secretary and Chair of the ASRM Diversity, Equity and Inclusion task force. “Due to lower implementation rates and higher clinical loss rates, Black women are experiencing disproportionate barriers in pregnancy through IVF.” Among the ASRM recommendations are increasing the representation of Black people and other people of color “in the profession and leadership of reproductive medicine” through enhanced recruitment and educational efforts.

We must take a serious look at these issues in the ART legal community as well. As a growing number of states require insurers to offer coverage for infertility treatment, the financial burden of ART, which has historically disproportionately impacted people of color, is slowly lessening for many intended parents. We have a duty to increase the number of states with fertility insurance mandates and to promote the removal of all insurance barriers to family formation through assisted reproduction.

We also must strongly consider racial balancing within the leadership ranks of assisted reproductive lawyers. In my role with the American Bar Association’s Family Law Section and ART committee, I am working with colleagues to develop a continuing education course on diversity, inclusion and cultural competency for fertility lawyers. This just a small but important start; there is so much more we could be and should be doing.

All of these efforts, taken together, will make a difference. In its 2015 report in Fertility and Sterility, the ASRM Ethics Committee concludes:

Reproduction is a fundamental interest and human right, and the access, treatment, and outcome disparities that are associated with ART are a form of stratified reproduction that warrants correction. Moreover, supporting increased access to ART appropriately recognizes infertility as a disease, in keeping with pronouncements by the WHO and worldwide trends…. The status of fertility treatment as available mainly to non-Hispanic whites and the “economic elite” perpetuates the dismissal of fertility treatment as a “lifestyle choice” or as a luxury comparable to elective cosmetic surgery.

As the report states, “It is the responsibility of all assisted reproductive technology (ART) stakeholders, including physicians, policy makers, and insurance providers, to address and lessen existing barriers to infertility care.” We at IFLG proudly accept the responsibility.

 

 

Richard Vaughn
rich@iflg.net

Attorney Rich Vaughn is founder and principal of International Fertility Law Group, one of the world’s largest and best-known law firms focused exclusively on assisted reproductive technology, or ART, including in vitro fertilization (IVF), surrogacy, sperm donation or egg donation. Rich is co-author of the book “Developing A Successful Assisted Reproduction Technology Law Practice,” American Bar Association Publishing, 2017.

Peiya Wang
PEIYA WANG(王培娅)
Paralegal (律师助理)

Peiya Wang joined IFLG as a paralegal in 2015, where she manages surrogacy, egg donation and parental establishment cases and provides translation services for many of IFLG’s international clients. Peiya moved to the United States in 2012 to attend Northeastern University in Boston, Massachusetts, receiving a Master of Science degree in Global Studies and International Affairs in 2014. Peiya moved to Los Angeles in 2015, received her paralegal certification from UCLA Extension, and obtained her second Master of Science degree in Legal Studies from Loyola Law School. Peiya relocated back to her hometown, Beijing, China in 2019 and works from IFLG’s Beijing office. When away from the office, Peiya is a dragon boat paddler and a ballroom dancer, where she favors Rumbas and Cha-chas. She is fluent in Mandarin and English.

Katie Deaquino
KATIE DEAQUINO
Senior Paralegal

Katie is a Senior Paralegal with IFLG and has dedicated over sixteen years to the areas of surrogacy and reproductive law. She received her Paralegal Certificate from Coastline Community College and has worked with some of the top law firms in the assisted reproduction community. Katie is also a commissioned Notary Public. With IFLG, Katie manages Surrogacy, Egg Donation, and Parental Establishment cases and provides support to other IFLG team members. Katie truly enjoys helping others build their families through assisted reproduction and is thankful she has had the rewarding experience of assisting IFLG clients. Katie often spends her free time with her Husband, four young children and her bulldog “Bella”.

Luis Sosa
LUIS SOSA
Paralegal

Luis R. Sosa joined IFLG as a paralegal in 2016, where he enjoys pursuing his passion for family and reproductive law. While working toward his bachelor’s degree at Florida International University which he received in 2013, Luis worked as a paralegal and legal assistant for family law litigation firms in Miami and Washington, D.C. As a paralegal and case manager for IFLG, Luis, who is bilingual in English and Spanish, manages surrogacy, egg donation and other reproductive law cases. Luis has worked for IFLG in both Los Angeles as well as San Francisco, and is currently based in Dallas, Texas. In addition to spending time with husband Randy and dog Marty, Luis enjoys being outdoors and appreciating the arts.

Alexander Espinoza
ALEXANDER ESPINOZA
Legal Assistant

Alexander joined IFLG as a legal assistant in 2019, where he manages surrogacy, egg donation and parental establishment cases. Alex is bilingual in English and Spanish and has been in the legal field for 23 years. Alex is excited to join the IFLG team and pursuing his will to help others in the reproductive law process. In his spare time he loves spending time with his family and friends, being outdoors, road trips, loves music and dancing.

Toni Hughes
TONI BOONE
Paralegal

After receiving her B.S. in Business Management, Toni joined IFLG to pursue her dream of working in the legal field. As a Paralegal with over 10 years of experience in the assisted reproduction technology field, Toni is our Managing Paralegal, responsible for training and managing our paralegal staff. From drafting legal documents to assisting our clients with post-birth matters, Toni embraces the challenge of learning something new in this field each day. Besides spending time with her son, Jordan, Toni enjoys exploring new things, cooking, spending time with family and friends, and serving as a Youth Advisor for “Next Generation.”

Miesha Cowart
MIESHA COWART
Financial Coordinator

Miesha Cowart joined IFLG as a financial specialist in 2014 following a successful career in development and business finance. Miesha previously worked for 10 years in the construction industry as a controller and for 13 years as Development Coordinator for the non-profit U.S. Fund for UNICEF. In her free time, Miesha works with “Next Generation” at her church. “They are my heartbeats!” she says of the youth in her community.

KIM DEVEREAUX
Paralegal

Kim has over 30 years of experience in the legal field and has worked exclusively in surrogacy and assisted reproduction law since 1999. Kim is a senior case manager responsible for managing parental establishment cases and interacting with IFLG’s Of Counsel attorneys across the country. With three children of her own, Kim understands the importance of family and finds working in this area of law a rewarding experience.

Rich Vaughn
RICHARD B. VAUGHN
Founder

Attorney Rich Vaughn combined his personal passion as a father of twin boys born via assisted reproductive technology (ART) with more than 20 years of experience in business and technology law to build International Fertility Law Group. Today IFLG is one of the most successful and best-known law firms in the world focused exclusively on fertility law, helping thousands of intended parents through empathetic listening, compassionate guidance, and unmatched legal expertise. As an advocate for reproductive freedom, Rich also contributes his knowledge and time to improving the understanding and practice of ART law, most recently as a founder of and speaker at the first Cambridge University International Surrogacy Symposium held in June 2019, as immediate past chair of the American Bar Association ART Committee, and as a popular presenter to law schools, faculty and advocacy organizations all over the world.

Elizabeth Tamayo
ELIZABETH TAMAYO
Paralegal

Elizabeth received her Bachelors of Science degree in Criminal Justice from California State University of Los Angeles. Shortly after graduating, she continued her education at the University of California, Los Angeles where she obtained her Paralegal certificate. Elizabeth is fluent in Spanish and has been in the legal field since 2009. She is excited to be a part of the IFLG Team helping families realize their dreams.

Sunny Chien
SUNNY CHIEN
Paralegal

Sunny joined IFLG as a paralegal in 2017, where she manages surrogacy, egg donation and parental establishment cases for many of IFLG’s international clients. She holds a Bachelor of Arts degree in Philosophy from California State University of Los Angeles, where she graduated cum laude. Sunny is bilingual in English and Mandarin and has extensive experience as a legal assistant and paralegal at Los Angeles-area law firms. She is excited to be part of the IFLG team. In her spare time, Sunny enjoys spending time with her family and their dog, going to the beach, cooking, and being outdoors.

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Molly O'Brien
MOLLY O'BRIEN
Partner

Fertility law attorney Molly O’Brien began working in the field of assisted reproduction technology (ART) in 2005, at an egg donation agency and a surrogacy agency where she became familiar with all aspects of in-vitro fertilization, egg donation and the financial aspects of surrogacy. Since becoming an attorney in 2011, Molly has drafted and negotiated surrogacy, egg donation, sperm donation embryo donation agreements for hundreds of her clients all over the world.

Phoebe Sadler
PHOEBE S. SADLER
Associate

Fertility law attorney Phoebe Sadler has a background in family law and has been practicing exclusively in the area of assisted reproduction technology (ART) law since 2018.

Rubina Aslanyan
RUBINA ASLANYAN
Paralegal

Rubina has an extensive background in the legal field as a paralegal in Family Law and has worked in surrogacy and assisted reproduction law since 2012. Her area of focus is in managing and assisting clients with surrogacy, egg donation, and parental establishment cases for many of IFLG’s domestic and international clients. During her spare time, Rubina enjoys spending time with her family and dog Bella, traveling and cooking.

Cara Stecker
CARA STECKER
Senior Paralegal

After receiving her paralegal certificate in 2005, Cara began working in assisted reproductive law. During the fifteen years Cara has worked in this field, she has gained a wide range of experience and knowledge that she uses to help better assist clients and those involved in the assisted reproductive journey. Cara’s primary roles involve managing parental establishment matters and coordination with IFLG’s Of Counsel attorney network, drafting contracts and parental establishment court documents and providing support to other team members. Cara finds great joy in being a small part of a team of caring people who help others achieve their dream of having a family. In her spare time, Cara enjoys spending time with her husband and three children, watching her children play the sports they love, and she enjoys, running, cycling and exploring the outdoors in the sun.

Stephanie Kimble
STEPHANIE KIMBLE
Paralegal

Stephanie received her BS in History and Political Thought from Concordia University Irvine in 2015 and her Paralegal Certificate from University of San Diego later that same year. She has been working as a Paralegal since 2016 in Family and Reproductive Law. She is excited to be part of International Fertility Law Group working on managing Surrogacy, Egg donation and Parental Establishment Cases.

Trish Pittman
TRISH PITTMAN
Assistant Financial Coordinator

With more than 20 years of experience in the field of accounting, Trish joined the IFLG team in 2019 as Assistant Financial Coordinator. Her client-facing focus at IFLG is to assist with all client trust accounting. Trish is the mother of two daughters and enjoys spending time teaching and learning new things from them. In her free time, she loves long walks in the park and reading suspense and mystery novels.

Elsa Jimenez
ELSA JIMENEZ
Legal Assistant

Elsa joined IFLG as a Legal Assistant in 2019, bringing more than 35 years of experience working in the legal profession (concentrating in tort and litigation matters). At IFLG she assists surrogates with their surrogacy and parental matters. The oldest of five siblings, born and raised in East Los Angeles to Mexican immigrant parents, Elsa loves “seeing the beauty of families forming” through assisted reproductive technology. She and her husband Carlos have four children and one grandson. Elsa enjoys jazz and ’80s music, being outdoors in nature, collecting teacups and tea pots, and spending time with her close-knit family.