Sharing the good fortune of fertility

Dear Dr. G,

I read with interest the recent article on the preservation of sperm based on the question posed by a man facing the challenges of testicular cancer.

I am glad I don’t have major health setbacks, having been blessed with good health and fertility. Indeed, I am in my early thirties, married for five years and am already blessed with four beautiful children.

My wife wonders why she gets pregnant so easily and reckons my good sperm count must be a contributing factor to this.

In the spirit of Chinese New Year, I am putting Dr. G on the spot to find out more about being a sperm donor purely for the benefit of the less fortunate. Is sperm donation even legal in a country like Malaysia and if so, is there an age limit to being a donor? In other words, am I too old to be a sperm donor?

Also, what tests do I need to do before donation and how do I go about doing it? What sort of details do I have to provide to the clinic and will they be confidential. Additionally, will I ever find out about the fortunate (or unfortunate) recipient of my sperm?

Lastly, I often hear of people getting paid to donate sperm. Is there such a thing?

Regards,
Fortunate Frederick

In general, infertility is defined as the inability for couples to conceive after one year or more of an active sex life without contraception. Although there are no exact statistics of the prevalence of infertility, the World Health Organization estimates 60 to 80 million couples are affected, and this number is constantly rising.

Contrary to the common belief that infertility is predominantly a female problem, male infertility can account for up to 40% of all cases. Male infertility applies to a sexually mature man having difficulty to impregnate a healthy fertile female, and this affects up to 7% of the general male population.

The realization of male-factor infertility has also become more apparent, and therefore the utilization of donor sperm has become more prevalent.

Sperm donation is the provision of sperm by a man with the intention to beused in artificial insemination of a woman who is not his sexual partner in order to be impregnated by him. Mary Barton, a gynecologist published an article in the British Medical Journal in 1945 on sperm donation. She helped conceive 1,500 babies, of which her husband probably fathered nearly half of them.

Clearly, such a practice has questionable ethics and indeed, places like Japan and Iowa in the United States only started regulating the practice in 1964 and ultimately more than one million babies have been produced over the last five decades through sperm donation.

On that note, a sperm bank is a facility or enterprise collecting and storing human sperm for childless couples, single women or even lesbian couples.

From a medical perspective, pregnancy derived from such artificial insemination is no different from sexual intercourse. In most countries, regulators such as the HFEA (Human Fertilization and Embryology Authority) impose strict rules on the establishment to ensure the safety of the public.

Sperm banks typically recruit potential donors through colleges and advertisements and a donor must be healthy, normally aged 18 to 40, and willing to undergo frequent and vigorous testing. Although there is no real upper age limit for sperm donors, most centers will recruit young candidates below the age of 40. Most men who donate their semen do so with the passion and intention to help childless individuals, without the legal responsibility of caring for the child.

On payment, although an allowance is paid to donors in many countries, the financial incentive is hardly the drive for donation. One recent study amongst 7 countries where donors are paid, it is revealed the financial incentive merely ranges from USD10 to 70 Euro. In countries like the UK, the compensation is only for the traveling expenses incurred for the donation.

Stringent screening for sexually transmitted infections, genetic disorders and chromosomal abnormalities may be also a deterrent. I guess to some individuals, such an assessment may be perceived as incentives, but I am sure there are easier ways of getting medical check-ups than shedding your seed.

During this screening, the basic features of the donors, such as race, height, weight, eye color are recorded for the selection. However the identities of the donors are kept as strictly confidential information in most jurisdictions.

When it comes to taboos and regulatory guidelines, this may be associated with a significant drop in the number of donors noted between 1995 to 2015.

Also, there is no real physical risk of repeated sperm donation, as there is no real difference in the recurrent acts of “wasting” of the semen in the comfort of your bedroom or “saving” the samples in the masturbatorium. In certain jurisdictions, there is a limitation placed on the number of inseminations permissible from one single donor.

Pindar, the ancient Greek Lyric Poet from Thebes once said: “Every gift which is given, even though it be small, is in reality great, if it is given with affection!” During the warmth of the festivity of Chinese New Year, we often get to witness the act of kindness in mankind. It may be a taboo in considering giving one’s good fortune in fertility as a form of gift to the less fortunate, but in reality this is also an act of kindness!

Therefore, when Dr. G is put on the spot for his views on the risks and benefits of donating sperm, his advice is simply that “every fortune is God’s gift, it be as small as sperm, but it can be destined for greatness!”