15 Mar 2022 Egg Donors, Sperm Donors Are Unsung Heroes of Assisted Reproduction

Even as reproductive professionals report a shortage of egg and sperm donors, thanks to the lengthy donation process, less anonymity, and lingering impact of the coronavirus pandemic, many people still choose to make the sacrifice of time and privacy in order to help parents in need of fertility services. In many cases, it is the donors who make the whole process of assisted reproduction possible.

We often see media reports of couples struggling with infertility who are finally able to fulfill their dreams of having a child using assisted reproduction. Or, as in my case, LGBTQ individuals finally able to become parents using assisted reproductive technologies such as IVF and surrogacy. Typically, these good-news stories feature pictures of the new family units and first-person accounts of the struggle and how it was all worth it, to bring a baby into the world.  But these stories, understandably, focus on the outcome—the beautiful baby or babies created—and not about how the whole process started. In many cases, the path to parenthood starts with an egg donor or a sperm donor… but somewhere along the line, their story gets lost in the mix.

Of course, we use the words “egg donor” and “sperm donor” as scientific terms, but I think we sometimes forget that donors are mothers and fathers, sisters and brothers. They are college students, and professionals, family members and friends, next door neighbors and even strangers.  They are the people who make miracles of reproductive technology possible, and their decision to become an egg or sperm donor impacts not only the lives of the intended parents and their future family, it impacts their own lives, too. So, how does donating eggs or sperm affect the donors’ lives, now and in the future? 

Being a genetic donor is not a new concept. Sperm donation has been around since the 1300s, when Arabs began using artificial insemination on mares according to a historical timeline by Huffington Post. In the late 1800s, the first recorded artificial insemination with sperm donation in a medical institution was recorded and resulted in the birth of a baby boy nine months later. Over time and with more success, sperm donation gained popularity as a solution to infertility, with an explosion of commercial sperm banks in the 1970s.

In 1983, doctors at UCLA successfully implanted a donor egg into another woman’s uterus, resulting in a successful birth nine months later. Today, with vastly improved technology and access, the demand for sperm and egg donors continues to grow, as more different types of family units turn to assisted reproduction. According to US News & World Report, sperm donation recipients used to be primarily heterosexual males who were struggling with infertility with their wives, but today 70 percent of sperm donor recipients are single moms or lesbian couples. Similarly, egg donors now frequently help gay fathers and older women who are struggling with infertility. 

Sperm Donation, Egg Donation Processes Are Complex

Although it once may have been easier for men to donate sperm with a quick run to the sperm bank for some extra cash, modern times have brought modern complications. “It’s not easy, and I think there’s a public perception that, ‘I need quick money for my rent at the end of this month,’” Susan Kellogg-Spadt, director of female sexual medicine at the Center for Pelvic Medicine in Delaware County, told US News. “That level may have been yesteryear, but it’s certainly not now.” Today the screening process for sperm donors is time-consuming, requiring the applicants to provide an extensive medical history, undergo STD testing and genetic testing, and provide a sample for sperm quality and quantity.  

The sperm donation process is also very selective. California Cryobank and Fairfax Cryobank, two of the largest sperm banks in the United States, only take in 1 out of 100 donor applicants, as reported in The New York Times. If they qualify, donors must then commit to going to the clinic once or twice a week for up to a year, and to refrain from sexual intercourse 24 to 48 hours before the donation in order to contribute enough sperm. Donors need to provide an ample sperm count, as it sometimes takes multiple tries for recipients to become pregnant and/or the recipient may wish to purchase enough sperm to have more than one child from the same donor in the future.

The donation process can be even more daunting for egg donors, albeit in a smaller time frame.

According to Very Well Family, egg donors also undergo a full medical history screening, STD and genetic testing like sperm donation, as well as pelvic exams and ultrasounds. If the donor passes all the preliminary testing, and the eggs are deemed viable, the donor then must inject herself with fertility drugs daily during the donation cycle.  Following the medication regimen, the eggs are collected during a surgical procedure. Although the egg retrieval procedure typically takes less than 30 minutes, many women report cramping and bloating in the days following the procedure. Most egg donors are able to return to regular activities the next day. Although egg donation is physically more invasive than sperm donation, a donation cycle takes a little over a month to complete, whereas sperm donation is typically a lengthier commitment.

Loss of Donor Anonymity

The option to remain an anonymous donor may also be a thing of the past. Early sperm donors typically were assured anonymity, but new technology and an evolving understanding of the impact of anonymity on offspring have changed that. The advent of home DNA kits such as My Heritage and 23AndMe, genealogy sites such as ancestory.com, and new state laws that establish the rights of donor-created children to access donor information once they turn 18 have given modern donors a new consideration: There may come a time in the future when the donor child wants to reach out to his/her donor, adding to the weight of the original decision to become a donor.  

This new loss of anonymity has changed the demographic slightly for sperm donors. “Instead of 18 year old medical students, donors now tend to be slightly older men who are happy to be contacted,” Nina Barnsley, director of the Donor Conception Network, told DailyMailOnline.

Jayden, a sperm donor in Australia, who has five biological children as a result of  his donations according to news.com.au, knows at some point that he may be contacted in the future and looks forward to it. He likes knowing that he has helped create families. “Men should donate so long as they are comfortable knowing they may be contacted 18 years after the donation and be able to talk about what they did with their current or future partners…most importantly, {recognize and accept that} any children they may have themselves as their own children will have half-siblings, a much wider family outside of their own brothers or sisters,” he said.

The impact of loss of anonymity on egg donors is less clear, as we reported earlier. While compensation for sperm donation is relatively low, an egg donor may be paid thousands of dollars per cycle—potentially making her more willing to give up anonymity. For both sperm and egg donors, “known,” or identified donors willing to be contacted by offspring in the future, are paid more for donating.

How Does it Feel to Become an Egg Donor or Sperm Donor?

While donors are compensated monetarily for their time and physical inconvenience, most donors report they don’t do it for the money, but to help someone. As IFLG attorney Molly Malone wrote in the article “What Is It Like to Be An Egg Donor? 5 Things You May Not Know,” most egg donors express compassion toward another person who is unable to have a child.

“Most donors, at the end of the day, have a sincere desire to help others; the fact they can make money and help someone else in the process is a double bonus," Malone writes. "Many do not want to have children of their own but understand that their ability to procreate can help someone else realize the dream of parenthood. A remarkable number also express a desire to help members of the LGBTQ community specifically to have equal opportunities to become parents. Regardless of the motivation, donating eggs so that another person can have a child is a beautiful gift that will change someone’s life.”

Even with the time-consuming and detailed process of donating, donors who complete the process and are selected tend to feel a connection to their donor-conceived child and a sense of accomplishment. Jayden, the sperm donor from Australia, goes on to say of his experience in news.com.au, “They explained the entire process in detail about how my donations would impact me and the families who take my donations. This left zero doubt in my mind that I was doing a good thing.” Many donors have found that their families are supportive of their decision and believe it is important to tell their own children so that they know they have a genetic half sibling. 

Potential donors are now told of the probability for future contact, so those who make it through the screening process and continue are aware that they may receive an email or phone call at some point in the future from the donor-conceived child. With the new laws governing more transparency of sperm and egg donations, donors can make a more informed decision whether to go through with the donation or opt out. 

As founder of a legal practice specializing in assisted reproductive technology law, I feel privileged to be able to witness the happiness of donor-receiving intended parents whose dreams of having a child are coming true. It also makes me very aware that my husband and I would not have our twin sons had it not been for our egg donor.

In many ways, donors are the unheralded heroes whose generosity has given such fulfillment to so many families. The donor shortage, resulting in part from the lengthy donation process and the loss of anonymity for donors in recent years, has created another challenge for would-be parents. We are hopeful that improved technology will make donation less time-consuming and easier, particularly for egg donors, and that laws and public policy will evolve to provide more encouragement and support for these critically important participants in the assisted reproduction process. We are grateful for all the generous, compassionate people willing to donate, because the reality is, even with all the technology in the world, for many infertile couples, same-sex couples and singles, parenthood would not be possible without the donors.