Before technology gave us the option of doing IVF-ICSI, the only choice for couples with severe sperm problems was to use a sperm donor. Even today, there are times when donor sperm is used. These cases happen with couples who have absolutely zero sperm available (even with high-tech methods) or for whom IVF-ICSI is not feasible within the constraints of their budget. There are also women without any source of sperm who choose to get pregnant by donor sperm. One of the first questions facing patients who are ready to use donor sperm is "Where do we get the sperm?"

There are some who choose to go through a well-screened anonymous sperm bank and there are some who want to get sperm from someone they know. In general, my recommendations go more often towards the option of the anonymous sperm bank. There are three main reasons for this: Privacy. Medical safety. Legal safety.

PRIVACY: So after two years of unsuccessfully trying, you and your husband finally get around to having his sperm tested. Surprise! The results show that he has almost zero sperm. After eventually settling down from the devastating news, you start thinking about your options. You absolutely do not want to do In-Vitro Fertilization. What now? You two agree to get pregnant through donor sperm. He suggests his brother could donate, or maybe his uncle Ted. You two think about this for a minute and decide NO. By instead going with an anonymous donor, you can keep your privacy. At family gatherings, there will be no awkward situations related to running into any sperm donor relatives. What if you use sperm from a friend or family member and repeated cycles are unsuccessful? There is now the subconscious blaming of someone who was just trying to be nice and help out. Again, the privacy afforded by using totally a well-screened, but totally anonymous donor definitely warrants consideration.

MEDICAL SAFETY: Reputable sperm banks have a rigorous protocol for screening the donors. When you put your family member or friend on the spot and ask them if they will donate sperm, they may be less that honest on the screening questionnaires regarding any risky lifestyle habits they may have. This is a principle learned from the concept of directed BLOOD donors. If you put a family member on the spot and ask for a blood donation, the extreme pressure can lead them to be less than honest when replying to screening questions regarding intimate questions of sexual behavior or even drug use behavior. This results in even riskier conditions as compared to using standard banked sperm or blood. Professional sperm banks also practice quarantine, so that the sperm that you can get today has already been frozen for a year. The original donors have already been retested and found to be negative for infectious diseases. This prevents the scenario of a someone contracting HIV on Monday, testing negative on Tuesday and then donating sperm on Friday.

LEGAL SAFETY: People often advise other to avoid doing business with friends. Well, the principle applies even more strongly when it comes to having offspring. Friendships and relationships are always susceptible to change. There was a recent case this week of a woman who asked an ex-boyfriend to donate sperm for her. She promised him that of course he would not need to pay child support. He made the mistake of believing her. She changed her mind and successfully got the courts to put him on the hook for support. The decision was recently overturned. Fortunately, in the case of anonymous donation, this type of problem is not an issue.

Having said all this, there are still times when I have agreed to help patients get pregnant using sperm from known donors. When I do, I ALWAYS involve skilled family law attorneys who draw up contracts, stating as clearly as possible, the agreements of both parties. I also strongly encourage prolonged quarantee similar to that which is done by the sperm banks.

It’s a lot nicer for all involved, especially for the child, if things are not messy.