Donor Conception
Do I Need Full Genetic Testing on My Sperm Donor?
Eloise Edington | 7 Feb 2022
Before using donor sperm in IVF, should you screen your donor for all genetic conditions?
When picking a sperm donor, how much information do you need to know? (Read FHH’s collection of Donor Conception and Surrogacy articles here.)
Prior to using donor sperm, fertility clinics screen the donor for key genetic conditions to help you make informed decisions about using donor sperm for IVF. But do you need a complete medical and genetic breakdown of your donor and do you need to undergo full genetic testing yourself before having fertility treatment?
Fertility clinics would answer “yes” but what if you can’t afford genetic testing or what if you feel genetic counselling is enough? Here’s my experience of how I chose a sperm donor.
Words by Holly Pigache
Before I share my experiences, please let me state: choosing a sperm donor is completely personal. Everyone’s situation and genetic make-up is unique and you should always speak with your fertility doctor when picking a sperm donor. Gathering as much medical and genetic information you can before choosing a sperm donor is important and fertility doctors understandably recommend making a decision from an informed position as possible.
Perhaps when I use the embryos I have in the freezer in years to come, I’ll wonder if I made the right decision. Or perhaps not. But here’s how I decided that the excellent genetic counselling I received through my fertility clinic was enough for me to pick my sperm donor.
How much information do you want to know?
Last summer I chose a sperm donor. Not because my partner has poor sperm health (I don’t have a partner), nor because I plan to be a solo-parent in the very near future, but because I’m concerned about my unexplained fertility and that I won’t find someone I want to have and raise children with.
My UK-based clinic recommended California Cryobank after I discovered the UK is seriously lacking in donor sperm… As the world’s largest sperm donor bank, California Cryobank (view their profile here) offered quite the selection of potential donors; I could filter donors by height, hair colour, eye colour, hair texture, whether they had adult photos (not for me, thanks), blood type, donor type, education, ethnicity, religion, ancestry – to name a lot but not all filters. It was a bit like being on a dating site, although with arguably longer-lasting consequences.
And this was just the beginning.
As I explored donors (did I want someone with black hair or does that not matter as I’m not dating the man?), I realised a lot more information was on offer than a dating site. I could find out the genetic make-up of these men, beyond physical appearance and personality. If one donor was a carrier for a genetic condition, would it matter if I was? Did I need genetic testing to choose a sperm donor?
After hours on the phone to my (poor) parents, I came to the decision that I didn’t want to know absolutely everything about my donor’s medical history. The genetic information available about my selected donor at the level of subscription I had with California Cryobank was very detailed and after speaking with a genetic counsellor, I felt I had enough information to proceed with this donor.
Some Science
Every person carries some abnormal genes for recessively-inherited disorders and it’s the nature of recessive disorders that the presence of a normal copy of the gene dominates the way that gene is expressed. (Cue secondary school biology lessons flooding back. Remember how two recessives make a dominant?)
If both the sperm donor and intended mother carry an abnormal gene, the child has a 25% chance of inheriting two copies of the abnormal gene and displaying the disorder.
If either the sperm donor or intended mother carry an abnormal copy of the gene (but the other biological parent has two normal copies of the gene) the child has a 50% chance of being a carrier of the genetic disorder but they won’t exhibit the disorder.
Recessive genetic mutations you’ll have heard of and probably learnt about at school:
- Cystic fibrosis
- Sickle cell anemia
By screening donors for recessive genetic disorders, we can learn the likelihood of offspring inheriting and displaying these disorders, make decisions for fertility treatment, family building and the health of our future children.
For Grace and her wife, having personal genetic tests was a “no-brainer”. Read their story here.
Watch: What is genetic counselling and do I need it for IVF? (When using a sperm donor, yes, you do.)
Donor Screening for IVF
In the UK, the HFEA requires all donors to be “medically screened and assessed before being accepted as a donor for treatment at a UK fertility clinic.” When choosing a sperm donor for fertility treatment, it’s reassuring to know the donor is screened for recessive genetic disorders because there are thousands. Whilst most are fairly harmless, some can be life-threatening.
If the donor’s genetic tests show they are a carrier of a recessive genetic disorder, your fertility clinic will inform you. You might then be offered genetic counselling to assess your likelihood of carrying the disorder. Genetic counselling tends to entail a lengthy phone call with a fertility specialist who explains how genetic disorders can be inherited, shares population statistics and discusses the chances of you carrying a recessive disorder, based on your medical notes and ethnicity.
Access FREE extended California Cryobank donor profile information with promo code FHH2022 for a Level 3 Subscription worth $250.
Some Options
As a hopeful mother using donor sperm for IVF, you could undergo genetic screening to assess which recessive genetic disorders you’re a carrier of and then select a donor who tested negative for those disorders.
Alternatively, you could find a donor you like, learn of their genetic profile and have genetic counselling. Following genetic counselling, you can choose to:
- change donors if you feel the risk of offspring having a genetic disorder is too high
- continue with your chosen sperm donor, equipped with information from genetic counselling and your sperm donor pack
- undergo genetic screening on your own genes to find out the exact chances of offspring carrying or displaying a genetic disorder if you choose to use this donor’s sperm.
Fertility specialists recommend having your own genetic tests but sadly this isn’t an option for everyone; genetic testing is expensive. With excellent genetic counselling you might decide you don’t want additional information about health and medical status – at least, this was my experience. As my IVF journey was entangled in dating as a single woman, I found this influenced how I felt about picking a donor. I reasoned that when you choose a partner, not all their genetic make-up is visible and you don’t fall in love with someone because they are or aren’t a carrier of a particular condition, nor do you always know if you’re a carrier. This was my personal viewpoint and others may well feel differently.
After spending a lot of money on IVF treatment, stretching funds to finance my own genetic testing was difficult and my close, open family gave me as much information about the health of my grandparents and great-grandparents as possible.
For me, speaking with my parents and the genetic counsellor meant I made a decision that felt right for me.
Picking a sperm donor isn’t something to take lightly, but of course you know that – you’re reading an article about sperm donation. The best you can do is make an informed decisions with the information you have. If you can’t afford full genetic testing, speak with your genetic counsellor; they’re there to help you work through the decision-making process of choosing a sperm donor.
