Choosing A Sperm Donor: Guidelines And Things To Consider
The miracle of ART or Assisted Reproductive Technology has created about 31 (thirty-one!) ways to have a family. Having access to ART can be a wonderful thing. Many people, who would not have been able to have a family in the past, are now able to. However, with so many choices, decisions can become overwhelming. Now that you have made the decision to use a sperm donor to conceive, here are some guidelines that may be helpful in choosing the actual donor.
Three Things To Consider When Choosing A Sperm Donor
In looking at those choices required to select a sperm donor, it may help to consider these three categories:
- genetic carrier screening
- psychological status
- identity categories
1. Genetic Carrier Screening Of Sperm Donors
Today’s technology can identify thousands of genes in a small sample of your blood or saliva. Genetic carrier screening is designed to pick up silent genes or mutations that could, when combined with the same mutation in a donor, create a higher risk for having a child with a serious genetic disease. Most children born with severe genetic diseases come from healthy parents who have no symptoms of disease and no family history of disease. We can prevent many of these diseases like Spinal Muscular Atrophy and Tay Sachs – caused by a child inheriting two disease carrying genes – one from each parent – if we know whether or not the parents carry the same matching mutations. Only 1% will have matching mutations. For women using donor sperm to conceive, we want to avoid you having any matching mutations with your sperm donor. So in preparation for you conceiving with sperm donation, we will perform a test known as Extended Carrier Screening or ECS. Once you know whether or not you carry a mutation, you can reduce your risk of having a child with a genetic disorder by only choosing a donor who does not carry a mutation that matches yours. Almost everyone carries a mutation or mutations. By themselves, this is normal.
Genetic carrier screening is evolving rapidly, with more and more tests available every day. The most extensive testing is not always available for all sperm donors. However, the genetic counselor at the sperm bank and the genetic counselors from the ECS company as well as your IRMS MD are available to guide you in choosing a donor that is a reasonable match for you from a genetic risk standpoint. No testing can reduce the risk of birth defects to zero, but genetic carrier screening can help guide you to lower risk choices, when you are using a sperm donor to conceive.
2. Mental Health Of Sperm Donors
The second issue to address is the psychological status of the sperm donor. Up until very recently, about two years ago, most sperm banks did not have a donor candidate sit with a psychologist or social worker to perform a mental health evaluation. They may have had what is identified as a “mental health history”. Mental health histories and a mental health evaluation are two very different things. A mental health history is just the prospective sperm donor filling out a form and a mental health evaluation is actually done by a trained mental health professional. Previously, most of the psychological history provided for the sperm donor candidate has been by self-report or done by intake, not by a more reliable mental health evaluation performed by a trained professional.
In the past two years, however, the industry has acknowledged the necessity for a sperm donor candidate to have an encounter with a trained mental health professional for either a clinical interview, psychological testing or both.
Since this is so new, many sperm donors have not had such evaluations. Since severe mental illness tends to show itself in later teens or early 20’s, Dr. Claudia Pascale, our reproductive psychologist, recommends selecting a donor who is 25 years or older.
She also recommends looking for patterns in the family history. For example, if someone reports having more than 2 first-degree relatives with a mental illness or reports their parent, grandparent and aunt or uncle suffer from the same condition, consider there may be a genetic link and a possible increased risk for mental illness.
3. Donor Identity Categories
The third category to consider in donor selection, may actually be the most important – the notion of identity. Basically, all donors, right now, are anonymous to anyone who chooses them. Just as the recipients or intended parents are to the donors. However, there are different categories that pertain to the identity of the donor to the offspring. You see, kids born of gamete donation are no different than anyone else. They’re curious about themselves. They just don’t have the information to answer the question “Where do I come from” right in front of them. So, it is very likely and natural for those conceived using a sperm donor to want to know more about their donor. Which brings us back to the question of those categories of donors. Basically, donors are either Anonymous, meaning the donor has decided they don’t want the offspring to know their identity; or either Open or Identity Release. These last two categories refer to the donor’s willingness to help offspring by being willing to share their identity once the child reaches the age of 18. Some children may actually request to meet their donor. There is some data that supports the ability for offspring to identify the donor is helpful.
There is a caveat to this issue of identity sharing. With today’s consumer-driven genetic testing, identifying a donor through commercial genetic companies like 23-and-me or Ancestry.com (regardless of what the donor’s preferences were at the time of their donation) is highly likely.