"Hey, why don't you just ask Andreas to donate some sperm for you? He's nice, quite clever and not entirely ugly," my wife, Sam, recently told our friend, Rachel*, a 30-something single woman with no long-term male partner. On the same day, when discussing this article with journalist Deborah Herd, I blurted out, "You know what, I'll go and donate some sperm myself, just to see what's involved."
The idea of sperm donation seems to have become so commonplace that neither Sam nor I really thought about the implications of our comments. As soon as we’d thought them through, both Sam and I changed our minds.
“I love Rachel but your sperm is kind of mine, too, and I actually feel quite uncomfortable sharing it,” said Sam. "We might still decide to have another child and, if Rachel has one with your sperm, that would be a bit like a part of our family moving into her house. It’s all a bit too weird."
Personally, I don’t have an issue with the practicalities of donating sperm but I can’t get my head around the possibility that it might result in a child – or children – of mine living in my home town, but whom I wouldn’t know from a bar of soap.
Environmentalists argue that, considering the world’s already massive population, the concept of donating sperm should be done away with. In a country like South Africa with a huge orphan population, adoption is clearly the better choice rationally.
Yet, for many women, there is an overwhelming and understandable desire to carry and give birth to their own biological child. "I can see my grandmother in my niece’s eyes and face," explains Rachel, "and I just know that there is a place for people like that in this world."
Literally a lifeline
For most of us, the idea of a sperm bank has been tainted by testosterone-driven American comedies involving horny teenagers and well-thumbed girlie magazines. The reality is more sombre and more medical.
Matthew Wray, a 30-year-old orthopaedic sales rep from Cape Town, donated sperm during a spell on a kibbutz in Israel. “It was common practice there. The Israelis have a relatively small gene pool and kibbutz volunteers are encouraged to donate sperm,” he says.
“It was all very unglamorous and involved a simple questionnaire, a brown paper bag, a plastic vial and a public toilet cubicle in a hospital. Since it was entirely anonymous, Ididn’t really think about the implications a lot. It paid about R400 a ‘shot’ and I have friends who financed substantial holiday trips that way.”
Although the financial reward is probably the main motivation for most sperm donors, according to Dr A. D. Esterhuizen, laboratory director at the Medfem Clinic in Bryanston, some of the donors are aware that they are assisting couples to “reach a dream”. “Some of them think of it as an adventure they are embarking on,” he says.
“It was initially purely for the money and nothing else,” concedes Donald van der Merwe*, a banker, who donated sperm in Johannesburg when he was 23.
“As a gay male, I felt that it was not going to be harming anyone and I thought that I could put myself to good use and if I got some really good cash out of it then why not? As time went by and I walked past the pictures of the children who would not have been born without my participation, I began to develop a sense of self-worth in the process.”
For many people who want a child of their own, sperm banks are literally a lifeline. In the United States, some 30 000 babies are born from donor sperm annually and, according to Dr Klaus Wiswedel, of the Cape Fertility Clinic in Newlands, anywhere between 100 and 200 donor sperm pregnancies are achieved every year at his clinic alone.
Five years ago, Riaan*, a 36-year-old East Londoner, thought he had completed his family; he was married with two children and decided to have a vasectomy. Subsequently, he divorced and remarried. Now he and his second wife, Maria*, 26, want a child. Surgery to reverse the vasectomy failed and the quality of Riaan’s sperm proved to be poor. They failed to conceive following 3 cycles of artificial insemination, as well as in-vitro fertilisation.
“We were devastated,” admits Maria. “We took out a loan to pay for the initial procedures and have very little money left to pay for any more. Now we have decided to try artificial insemination with donor sperm. It was a very difficult decision and, at first, Riaan was not keen on the idea but we found a perfectly matched donor and are going ahead. We have spent over R80 000 on this journey and hope that with the aid of the donor sperm we’ll be able to have the child we both want so much.”
Sperm donation in SA
Should potential recipients be worried about the genetic range of the donor sperm available in South Africa? Should they do their sperm shopping overseas? Doctors Wiswedel and Esterhuizen are adamant that local sperm banks are up to international standards. The Medfem Clinic currently has 27 active donors and the Cape Fertility Clinic has between 40 and 50. The variety and the depth of character profiling is as good here as anywhere else, says Dr Esterhuizen, and using South African donor sperm is, of course, much less expensive than importing sperm from overseas.
In South Africa, all sperm donations are anonymous. Overseas, it is possible to get an identity-release sperm donation, which allows a child to make contact with his or her father when they are older.
The Medfem Clinic has operated a sperm donor bank since 2005. There are also other sperm banks in Cape Town and Pretoria. “Potential donors are interviewed and we conduct a series of blood tests, including HIV and hepatitis B, as well as a full semen analysis. Infection tests are done on a regular basis and donors need to repeat an HIV test every 3 months,” says Dr Esterhuizen.
Dr Wiswedel of the Cape Fertility Clinic emphasises that sperm quality is at a premium. “We don’t just want good sperm, we want superb sperm!” he says. Sperm quality is determined by:
Donor profiles and donor rights
Once a donor has been accepted on medical grounds, he is required to complete a detailed donor profile, listing everything from physical characteristics like eye colour and weight to level of education, occupation, hobbies and personal interests. In South Africa, sperm donation is always anonymous and, by law, donors have neither legal rights nor responsibilities with regards to their biological offspring.
A donor has the right to specify to whom he would like to donate his sperm in terms of the recipient’s marital status, religion, sexual preference and ethnicity. Most donors are university students who typically produce a sample once or twice a week.
As commercial trade in human tissue and body parts is against the law in South Africa, donors are not paid for their semen samples, but they receive an honorarium to cover their expenses, usually about R150 per donation.
Once the sperm from an individual donor has resulted in 5 successful pregnancies, the donor is “retired” and all of his remaining stored samples are destroyed.
How to receive donor sperm
South African sperm banks
South African sperm banks, which have to be registered with the Department of Health, only give donor sperm to individuals and couples who are in treatment with gynaecologists.
International sperm banks
Although some international sperm banks, including the Sperm Bank of California, ship frozen semen samples to your doorstep anywhere in the world and provide information on DIY insemination at home, it is illegal to import sperm without a permit and only medical practitioners registered with the Department of Health are officially sanctioned to administer donor sperm to recipients.
Choosing a donor
Dr Esterhuizen points out that recipients “have access to the donor’s physical appearance (eye colour, hair colour, height, weight, hair type, complexion), hobbies, degrees, qualifications and blood group. Donors also complete an extensive family history questionnaire, and this can also be made available to patients.”
Different procedures using donor sperm
artificial insemination with donor sperm (AID), in which a semen sample is directly injected into the recipient’s uterine cavity
in-vitro fertilisation (IVF), in which eggs are fertilised in the laboratory and viable embryos are then placed into the recipients uterine cavity
intra-cytoplasmic sperm injection (ICSI), a type of IVF in which a single donor sperm cell is directly injected into an egg in the laboratory to improve chances of fertilisation.
Who uses donor sperm?
"We have a variety of people making use of our donor sperm," says Dr Esterhuizen of Medfem Clinic, "including many single ladies and same sex couples."
At the Cape Fertility Clinic, Dr Wiswedel estimates that 80% of donor sperm recipients are infertile couples and the remainder are single women and lesbian couples. In South Africa, married couples making use of donor sperm typically sign a consent form that provides for legally shared parental responsibilities and rights for both partners.