Banking Crisis: What should be done about the sperm donor shortage?

Report on a debate organised by the Progress Educational Trust and the Royal Society of Medicine on 25 June. 

This debate, supported by the British Fertility Society Educational Charity Limited, brought together a panel of clinicians, academics and advocates to discuss the causes of, and possible solutions to, the acute shortage of donor sperm in the UK. 

The shortage is widely attributed to the removal, in 2005, of entitlement to donor anonymity. A small rise in the total number of donors since then this has been countervailed by a decreasing willingness to donate sperm to banks for use by multiple families. This, it has been argued, is diminishing the capacity of the UK’s public and private health sectors to treat infertility, resulting in growing concern and lengthening waiting lists at clinics.

A useful commentary by Alan Thornhill, scientific director of the London Bridge Fertility, Gynaecology and Genetics Centre, published on BioNews, sets out the framework in which some perceive this problem:

‘Long before the current commercial banking crisis, the UK suffered another banking crisis - that of donor sperm shortages. The difference is that the sperm bank crisis is not global. Instead it is quintessentially British - full of principle and good intention but sadly resulting from compromise and inconsistency. Only the areas of inconsistency are consistent: the removal of anonymity, donor expenses, screening and selection guidelines and the limitations on use of individual donors. Taken separately, each of these areas is not without merit and the intentions behind legislative changes and professional guidelines are honourable. Taken together, they create more problems for patients and their children than they could ever solve.’

Proposed solutions to the shortage that were discussed by panelists at the Banking Crisis debate include increasing the number of families that an individual is permitted to donate to (above the current UK limit of 10); improving donor recruitment and public awareness campaigns; increasing ‘loss of earnings’ compensation to donors and explicitly remunerating donors and commodifying donation (rather than adhering to an altruistic model); deregulating the licensed import of donor sperm from overseas; and reintroducing donor anonymity.

Speaking on the panel, Mark Hamilton, Consultant Obstetrician and Gynaecologist at the University of Aberdeen, focused on the issue of the unmet demand for donor sperm, and the problem of ‘fertility tourism’ arising from couples’ inability to obtain treatment through donor sperm in the UK, which then might put them at risk. Allan Pacey, Senior Lecturer in Andrology at the University of Sheffield, addressed the issues involved in running a sperm bank, and stressed that the UK donor recruitment system needs to change.

Laurence Shaw, Deputy Medical Director of the London Bridge Fertility, Gynaecology and Genetics Centre, proposed a number of potential solutions to the donor crisis, including looking at innovative ways in which donors could have some incentive to donate. Laura Witjens, Chair of the National Gamete Donation Trust, argued that greater respect should be given to sperm donors, based on recognition of the importance of the act of donating.

Professor Susan Golombok, Director of the University of Cambridge Centre for Family Research, focused on the psychological issues involved in sperm donation, as opposed to medical questions such as sperm quality and donors’ ages. While recognising that it is difficult to see how children conceived as a result of sperm donation under the current rules will react, as adults, to finding out that they have up to nine half siblings, she cautioned that a precautionary approach should nonetheless be taken in terms of limiting the number of families that can benefit from donor sperm.

The disussion was chaired by Professor Emily Jackson, Deputy Chair of the Human Fertilisation and Embryology Authority (HFEA). The panelists’ opening remarks were followed by a lively debate from the floor.

The following articles, published on the Guardian‘s Comment Is Free site, give a flavour of the debate:

Killing sperm donation. Ending sperm donor anonymity has created an acute shortage for the sake of a few people who want to trace their origins. By Laurence Shaw. guardian.co.uk, 24 June 2009.

Give sperm donors some respect. Rather than bring back anonymity, as Laurence Shaw suggests, we should focus on the way donors are treated at clinics. By Laura Witjens. guardian.co.uk, 25 June 2009.