19 Mar 2020

Shopping for Sperm: More than just good looks

by | posted in: Intrauterine Insemination, Starting Out, The Clinic, Treatment | 0

Part 3: Should you care about the donor’s health?

Dear Eggsperts–So, I took your advice and talked to my girlfriend about becoming moms. Guess what? She’s totally on board and had been having the same feelings, but was afraid to ask. We are getting ready to see the doctor soon, but we know we are going to need a sperm donor. There are so many sperm banks and so many options!! How does someone choose a sperm donor? –Ticking in Tempe

Dear Ticking—In our last few posts, we gave some ideas to help you start thinking about when picking your sperm donor. And yes, we know that you have drawn up a “dream” list and may have already found a few who fit the bill? But, now, how do narrow it down even further? Who knew there were so many fish in the sea?

Shopping for the characteristics of the donor was the fun part, now for important medical stuff. This may help to filter out a few more potential donors.

Sperm donors fill out pretty extensive screening forms that give us some information about their personal health history.

How important is their health history and their family health history to you?

  • It may be as simple as:
    • Do they wear glasses?
    • Did they need braces?
    • Do they have food allergies?
    • Do they have hay fever?
  • It could be more complex like:
    • Did they have childhood illnesses?
    • Do they need medications for any illnesses?
    • Do they have family members with serious health issues?
    • Is there a history of mental health conditions in the family?

Fortunately, all sperm donors go through screening for communicable diseases and sperm is quarantined before it can be used. So, you don’t have to worry about things like HIV, Hepatitis, and Syphilis. But you may need to think about CMV.

  • Cytomegalovirus (CMV) is a common virus. Over half of adults over 40 have at one time been infected with CMV. You may not even know you had CMV. It may have been a mild illness with some fever and aches. 
  • Once you have had CMV, you are immune and have antibodies to CMV, so you aren’t at risk for getting it again. If you are exposed to CMV in pregnancy, your antibodies will protect your baby.
  • But, a baby born with CMV can have significant problems, so you want to make sure that if you haven’t had CMV, you don’t put yourself at higher risk for exposure in pregnancy. 
  • Sperm is washed and the risk of CMV infection from use of donor sperm is really low, even lower if doing IVF, but it isn’t absolutely zero.
  • Your clinic may test you for CMV antibodies.
    • If you have CMV antibodies, you may choose sperm from a donor regardless of their CMV antibody status.
    • If you do not have CMV antibodies, you should choose sperm from a donor that also does NOT have CMV antibodies. 
  • My first choice donors are CMV negative.

Some serious medical conditions have a genetic basis that require genes from both sperm and egg.

  • Some common examples are Cystic Fibrosis and Sickle Cell Anemia.
  • These are more, or less,common in certain ethnic groups.
  • It takes 2 gene mutations to cause a person to actually have the condition.
  • Some sperm banks will screen all, or some, sperm donors for gene mutations that can lead to medical conditions.
  • If a person has a single recessive gene mutation, they will not have
    the medical condition.
    • Half of the eggs or half of the sperm from a
      person with a single gene mutation will also have the mutation.

So, here’s where it gets tricky when choosing a sperm donor.

  • If the sperm donor has been screened for the common gene mutations, or a long list of gene mutations, and if the sperm is NEGATIVE, then even if you carry disease-causing mutation, your baby is very unlikely to have the disease. This is a simple decision.
    • My first choice donors have had screening and are negative for all conditions screened for.
  • If sperm donor has been screened for gene mutations and the donor is POSITIVE (i.e. carries a gene mutation), then you should be screened to see if you carry the same mutation.
    • You need to know that you do NOT have the same mutation.
    • If you do have the same mutation as the donor, there is a ¼ chance that your
      baby could have a serious medical condition.
    • You would NOT want to choose sperm from a donor that has the same mutation that you do.
  • Likewise, if you have previously been screened for gene mutations and DO NOT have any, then you can choose sperm that has screened negative or positive (or has not been screened) because the risk is low.
  • Similar, if you have been screened for gene mutations and DO carry a gene mutation, you should choose sperm from a donor that has been screened and does NOT carry the same mutation.
  • A tricky decision is sperm donors that have not been screened AND if you have also not had screening.
    • In this case, you and the donor have the same risk of carrying a gene mutation as the general population (i.e. no increased risk of a child with significant genetic medical condition)

NUTSHELL: Assuming you have NOT had genetic screening, choose sperm from donors who have

  • a) screened negative, or
  • b) unscreened

If you LOVE the donor profile of a donor with a positive screen, you should also be screened.

We told you this was heavy. We hope we made it less, not more, confusing. And we hope we are helping you to narrow your choices even further. At this point, you should be able to pick your “ideal” sperm source based on the characteristics and medical factors of the donor. I’m guessing by now, you have finished your cup of coffee (or is it wine now) as you are sorting through the catalog of choices. You may still have a bunch of great options, but the logistics of how much sperm and what sperm preparation to purchase is also a daunting task.

We hope we met your Eggspectations—An Eggspert

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Disclaimer: All of the comments on this page are for basic information only. They are based on the opinions and expertise of the authors and are not meant to provide a substitute for medical care or specific treatment recommendations. Each person is unique and requires individualized diagnosis and treatment plans. Any specific questions should be directed to your personal healthcare provider.