What Do I Tell My Child About Sperm Donor 8282?

A recent NY Times article entitled “The Gift of Sperm Donor 8282” tells the story of three single women who, after acquiring sperm from an anonymous donor identified only as Donor 8282, each end up finding mates and getting pregnant – without ever having to use Donor 8282’s sperm. These women will never have to face the issue of what to tell their offspring about the fact of donation. But for many women and couples who do need to rely on donated sperm to get pregnant, the decision about whether, when and what to tell their child can be difficult.

As recently as 2005, a study in the UK revealed that 61% of parents who had conceived through the use of donor insemination did not intend to tell their children of their origins. Nevertheless, most experts in this field, including the Ethics Committee of the American Society of Reproductive Medicine, support disclosure about the fact of donation to children.

There are two reasons that are most often cited in support of disclosure to offspring. The first is the importance of open and honest communication between parents and children. Secrets can strain family relationships and cause harm if the child accidentally finds out about the fact of donation later in life. Closely tied to the issue of open communication is the recommendation that children be told as early in life as possible. Telling children early about the fact of donation avoids the betrayal children may feel if they find out when they are older.

The second commonly cited reason in support of disclosure is the child’s right to know their biological origins. Another study – this one conducted in the Netherlands -- concluded that “motives for choosing an identifiable donor were the same for heterosexual and lesbian couples” and the majority identified “the right of the child to know its genetic origins.” In an article entitled “Where did I come from? Answering kids’ questions about donor eggs or sperm” published by the NYU Child Study Center, an expert in child psychiatry states “every child has the right to know his/her genetic background, particularly since there have been many medical advances in identifying and curing genetically transmitted diseases.” Knowing one’s genetic heritage is important to the ability to make informed health care decisions.

For those who are opposed to disclosing the fact of sperm donation to offspring, concerns likewise focus on the well being of the child and the family. Reasons for non-disclosure cited by parents include:

• Concern the child may reject a non-genetic parent

• Concern the child may experience frustration or anger if he or she wants to learn more about the donor and cannot.

• A desire to keep the fact of infertility private.

The question of whether or not to disclose the fact of sperm donation to a child is a personal question that must be addressed by each parent. However, for those parents who do elect disclosure in the future, the current trend in sperm donation away from anonymous donors and towards more “open-identity” or “ID release” donors will make it easier for prospective children to contact their donors at the appropriate time. In addition to sperm banks like European Sperm Bank USA that specialize in Open-ID donors, several countries, especially in Europe and Australia, have laws facilitating disclosure of donor identities.

Who Pays For Infertility Treatment?

Using IVF, artificial insemination and other forms of assisted reproductive technology to conceive can be very expensive. Artificial insemination (ICI or IUI) with the use of donor sperm can cost anywhere from $500 - $1500/cyle or more. The average cost in the United States for IVF appears to be $13,000 - $15,000 per cycle, or more, depending on the type of treatment, testing, and medications needed. As such, it is important to become familiar with the costs of infertility treatment up front and determine whether these costs are covered by insurance or must be paid out of pocket.

Insurance policies dictate whether there is coverage related to infertility. Individuals attempting to get pregnant via artificial means are well advised to review their policy language closely to determine the scope of coverage, if any. To determine whether infertility care is covered and the scope of coverage, it is best to obtain a full copy of the insurance policy, rather than just a summary document that may be provided by the employer.

Fifteen states have adopted laws mandating some form of insurance coverage for infertility: Arkansas, California, Connecticut, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas, and West Virginia. While some of these laws provide significant detail on the type of procedures covered and the scope of coverage, other are much more vague. At one end of the spectrum are states like Connecticut and Illinois which require certain individual and group plans to provide coverage for a relatively broad range of infertility treatments, including artificial insemination, IVF, GIFT, ZIFT and low tubal ovum transfer. At the other end of the spectrum are states like Montana and West Virginia, which require HMOs to cover infertility services but do not define “infertility.”

A more detailed state-by-state summary of laws relating to coverage for infertility treatment can be found at www.resolve.org.

Research Indicates Soft Drinks May Damage Male Fertility

From the Copenhagen Post online:

A study has indicated that high consumption of soft drinks may be the cause of reduced sperm quality in men.

Young men who want to become fathers may want to cut their cola consumption, according to new Danish research results recently published in the American Journal of Epidemiology.

Doctors and scientists at Rigs hospital and at the University of Southern Denmark have found a probable correlation between high soft drink consumption and poor sperm quality.

The study was carried out to determine whether there was a correlation between caffeine intake and sperm quality.

But project leader Tina Kold Jensen, professor of environmental medicine, said that the results of the study – which examined 2,554 men at or around the age of 18 to determine their fitness for military service during the period of 2001–2005 – clearly showed that their fertility was inversely related to the amount of soft drinks they consumed.

National research has shown that the consumption of soft drinks has increased significantly over the past decade, as has the intake of fast food – mostly by the younger generation.

Jensen did say that because the consumption of soft drinks and fast food is invariably linked, the lower sperm quality may be down to the overall poor diets of the men rather than the soft drinks alone.

However, she pointed out that the sperm quality of those subjects who drank more than 14 half-litre bottles of cola per week was significantly worse than those who consumed less. Caffeine was probably not a factor, the study determined, because coffee consumption levels did not show the same variations in sperm quality.

Not surprisingly to the researchers, the study additionally showed a link between high soft drink consumption and too little exercise – a deficiency that also has been shown to have a detrimental effect on male fertility.

Accessing Scandinavian Donors

European Sperm Bank USA is the US affiliate of the Denmark-based European Sperm Bank.

I’d like to buy sperm from a Scandinavian donor. Where do I find that donor list?

European Sperm Bank, one of Europe’s leading sperm banks, sells donor sperm collected from Scandinavian donors. The donor list for European Sperm Bank can be found at www.europeanspermbank.com

Why is the FDA concerned about the sale of sperm from Scandinavian donors?

The FDA has established guidelines that prevent the importation of sperm from Scandinavian donors into the United States due to concerns about variant Creutzfeldt-Jakob Disease (vCJD), commonly referred to as “mad cow” disease. vCJD is referred to as “mad cow disease” because it is associated with the consumption of beef from cattle with a disease called bovine spongiform encephalopathy (BSE). The vast majority of BSE-contaminated beef were reported in the UK in the early 1990s. The CDC reports there have been a total of 217 cases of vCJD in humans, worldwide, since the disease was first identified in 1996. Most of these have occurred in the UK.

Does the FDA have any proof that vCJD or “mad cow” disease can be transmitted via sperm?

Although there is evidence that vCJD can be transmitted via blood products, there is no evidence that vCJD can be transmitted via sperm. The World Health Organization (WHO) lists semen and other reproductive tissues as having no detected infectivity for vCJD. Likewise, the USDA permits the importation of bull semen from BSE-affected countries, including the UK, into the US. Although the FDA acknowledged in a letter to European Sperm Bank that “there have not been any reports of transmission of vCJD by semen,” it contends that such transmission by semen is “theoretically possible.”

Well, surely, women in Europe are getting pregnant from men in Europe, aren’t they?

Yes.

Are they afraid that their partner’s sperm will give them “mad cow” disease?

It seems safe to say, no.

Is anything being done to change the FDA guidance?

In June 2008, European Sperm Bank filed a Citizen’s Petition with the FDA, asking that the guidelines be changed so that donor sperm from Danish and other European donors can be sold in the US. The FDA has not yet responded to the petition. A copy of the petition can be viewed at: http://www.regulations.gov/search/Regs/home.html#docketDetail?R=FDA-2008-P-0363

Where are you selling sperm from Scandinavia?

European Sperm Bank sells sperm from Scandinavian donors in many countries. In Canada, our distributor is Heather Brooks at Outreach Health Services (www.creatingcanadianfamilies.ca).

What about Europe? I have read about reproductive tourism. Can I go on a holiday to Denmark and get inseminated?

Yes, you can. We provide sperm to several clinics including Sellmer Kinik (www.sellmerklinik.dk) .

Why Doesn’t ESB-USA Offer A Ben Affleck Look-a-Like Donor?

There are numerous press releases and news reports regarding a competitor sperm bank’s 'Celebrity Look-a-Like' feature. It has been reported that the sperm bank’s #1 demand is for a donor who they claim is a Look-a-Like for the actor Ben Affleck.

Gary Olsem, Managing Director of the European Sperm Bank’s USA lab in Seattle, says “At ESB-USA, we do not claim to have any donors who are Look-a-Likes or clones of Ben Affleck or Keanu Reeves or even Jay Leno. Our donors are terrific men who have made a substantial commitment to help others have a family. They are not a fantasy to be packaged and sold in California as celebrity clones."

Olsem points out that his team can help clients find the right donor through their Photo Matching service or best of all, speaking with Kristina Jensen, the ESB-USA Donor Coordinator who knows the personalities and characters of the donors.

Gary Olsem says "We think that physical features are not the only important criteria to be considered in selecting a donor. Our team really gets to know a donor during the year that he is enrolled in our program. We can tell you which donor has a great sense of humor, or has a great work ethic, or has excelled in overcoming challenges to establish a career in academics or business. These are the kind of fine men with proven character who you want to choose to make such an important genetic contribution to your family. You should not choose a donor because a marketing person thinks he can be packaged and sold as a celebrity look-a-like!"

What is CMV?

Ctyomegalovirus, commonly known as CMV, is a virus that most American adults have been exposed to and have developed immunity to. CMV is a member of the herpes virus family which includes cold sores, chicken pox and infectious mononucleosis (mono). In healthy adults and children, CMV can cause mild cold or flu-like symptoms that may last 1-2 weeks. However, if a woman who has never had CMV becomes exposed during pregancy, there is a small risk the child may develop neurologic abnormalities.

How is CMV spread?

CMV is spread from person-to-person by exposure to saliva, urine, semen, blood and other body fluids. CMV is not associated with food, water or animals. Most individuals are infected in childhood and daycare centers are one of the more common exposure settings. Prevention consists primarily of avoiding exposure to infected body fluids and practicing good personal hygiene. There is no vaccine for CMV.

What happens to the virus after infection?

When a person is exposed to CMV, the body develops antibodies to fight the CMV infection. The virus is never completely eliminated from the body but remains dormant inside certain cells for the lifetime of the individual. Although this person will test positive for CMV antibodies, he or she is healthy, has no evidence of disease and will not ordinarily transmit the virus to another person. However, if there is a suppression of the immune system, the virus may reactivate, shed viral particles and cause disease.

Who is at risk of contracting a CMV infection?

Nearly all adults will be exposed to CMV in their lifetime. In the USA, it is estimated that 50-85% of adults will test positive for prior infection by 40 years of age. In developing countries, it is almost 100%.

What are the complications of a CMV infection?

In healthy adults and children, symptoms from CMV infection are usually mild and fully resolve in a couple of weeks. However, organ transplant recipients and people with AIDS who have compromised immune systems, may develop serious illness such as pneumonia. Pregnant women who are infected for the first time during pregnancy usually recover completely with few or no symptoms. Most babies will not be harmed by the virus, but a small percentage may develop neurological abnormalities. Congenital CMV infection is a leading cause of hearing loss.

How are donors screened for risk of CMV transmission?

At European Sperm Bank USA, CMV Total Antibody testing is performed on all donors prior to qualification and at approximate 90-day intervals thereafter. Negative results are consistent with no previous infection. If the Total Antibody test is positive, additional testing for CMV IgG Antibody and CMV IgM Antibody is performed to determine if the result represents a recent or old infection. A positive CMV IgM result is consistent with a current or recent CMV infection. A positive CMV IgG result in combination with a negative CMV IgM result indicates historic exposure to the CMV virus. These latter results are consistent with a normal immune response.

Which donors are excluded from donating?

If CMV testing indicates the donor has a current infection (positive CMV IgM), the donor is not eligible to participate in the program at that time. If, through periodic testing, it is determined that a donor has become infected, he will likewise be deferred and any retained vials since his last negative result will be discarded. If CMV testing indicates the donor only has an old infection (positive CMV IgG but negative CMV IgG), he will be accepted into the program and his donor profile will indicate CMV positive.

How reliable are the CMV antibody tests?

No laboratory test is 100% accurate. It has been estimated that 5-20% of people who test negative for CMV antibody will test as 'false-negative' because the antibody level is too low to detect. Because all vials remain in quarantine for at least 6 months, and the donor is tested multiple times prior to release of those vials, we are able to track any change in CMV test results that may occur.

What should I do if I am CMV negative?

Based on published literature, the risk of exposure from a donor who tests positive for CMV IgG antibodies but has had no current or recent infection is very low. It is believed that the risk is further reduced through semen processing methods that remove white blood cells and seminal fluid. However, if you are CMV negative – meaning you have never been exposed to CMV – we suggest you consult your physician prior to selecting a donor. Alternatively, you may want to restrict your selction to CMV negative donors.

Open Identity Donors

A new trend is gaining popularity throughout the U.S. and abroad when it comes to choosing a sperm donor for artificial insemination. Whereas most sperm donation used to be completely anonymous, many sperm banks now require some or all of their sperm donors to consent to the release of their identity to children who have reached the age of 18. In fact, in some countries, anonymous donation is no longer permitted. The use of an open identity (or ID release) donor is an option that appeals to many prospective parents

What is an open identity donor?

At European Sperm Bank USA, open identity donors have committed to at least one contact with the child, when the child reaches the age of 18. The contact must be initiated by the child; customer identities are confidential and are never released to sperm donors. There is no requirement that the donor commit to any sort of long-lasting relationship with the child, although the donor and the child may arrange to have further communication. All donors are required to go through a maturity evaluation by the sperm bank’s managing director and donor coordinator to ensure they understand the consequences of their decision to become an open identity donor.

Although prospective parents don’t get to meet a sperm donor before choosing to use his donated sperm, there is a lot to learn about donors through profile information. Often donors will list their reasons for donating along with detailed information about themselves. At European Sperm Bank USA, we have found that open identity donors are usually willing to provide more detailed information such as baby photos and extended profile information to the sperm bank.

Choosing a donor

Many potential parents find security in knowing their child will be able to have some contact with the donor who contributed to their genetic makeup. However, even if an open identity donor is selected, there is no guarantee that the donor will have the same exact wishes as the parent and child. To help select the right donor, European Sperm Bank USA offers extensive information on each donor, ranging from the results of each donor’s personality test to staff’s impressions of the donors.