Among donors, a  systematic review  of 29 studies from nine countries concluded that 20–50% of donors would still be willing to donate even if anonymity could not be guaranteed. [ 11 ]  Between 40 and 97% of donors agree to release non-identifying information such as physical characteristics and level of education. [ 11 ]  The proportion of actual donors wishing for contact with their offspring varies between 10 and 88%. [ 11 ]  One study reported that most donors are not open to contact with offspring, although more open attitudes are observed among single and homosexual donors; conversely another anonymous study of American donors noted that 88% were open to contact with offspring. [ 11 ]  About half of donors feel that degree of involvement should be decided by the intended parents. [ 11 ]  Some of the donors prefer contact with offspring in a non-visible way, such as where the child can ask questions but the donor will not reveal his identity. [ 11 ]  One study recruited donors through the  Donor Sibling Registry  who wanted contact with offspring or who had already made contact with offspring. It resulted that none of the donors said that there was "no relationship", a third of donors felt it was a special relationship, almost like a very good friend, and a quarter felt it was merely a genetic bond and nothing more. Fifteen percent of actual donors considered offspring to be "their own children". [ 11 ]   On the whole, donors feel that the first step towards contact should come from offspring rather than parents or the donor himself. [ 11 ]  Some even say that it is the moral responsibility of the donor not to seek contact with offspring. [ 11 ]


The same review indicated that up to 37% of donors reported changes in their attitude towards anonymity before and after donation, with one in four being prepared to be more open about themselves after the donation than before (as a "potential donor"). [ 11 ]  Among potential donors, 30–46% of potential donors would still be willing to donate even if anonymity could not be guaranteed. [ 11 ]  Still, more than 75% of these potential donors felt positive towards releasing non-identifying information to offspring, such as physical characteristics and level of education. [ 11 ]  Single or homosexual men are significantly more inclined to release their identity than married, heterosexual men. [ 11 ]  Potential donors with children are less inclined to want to meet offspring than potential donors without children (9 versus 30% in the review). [ 11 ]  Potential donors in a relationship are less inclined to consider contact with offspring than single potential donors (7 versus 28% in the review). [ 11 ]  From US data, 20% would actively want to know and meet offspring and 40% would not object if the child wished to meet but would not solicit a meeting themselves. [ 11 ]  From Swedish data, where only non-anonymous donation is permitted in clinics, 87% of potential donors had a positive attitude towards future contact with offspring, although 80% of these potential donors did not feel that the donor had any moral responsibilities for the child later in life. [ 11 ]  Also from UK data, 80% of potential donors did not feel responsible for whatever happened with their sperm after the donation. [ 11 ]  With variation between different studies, between 33% and 94% of potential donors want to know at least whether or not the donation resulted in offspring. [ 11 ]  Some of these potential donors merely wanted to know if a pregnancy had been achieved but did not want to know any specific information about the offspring (e.g. sex, date of birth). [ 11 ]  Other potential donors felt that knowing the outcome of the donation made the experience more meaningful. [ 11 ]  In comparison, a German study came to the result that 11% of donors actually asked about the outcome in the clinic where they donated. [ 11 ]


An Australian study concluded that potential donors who would still be willing to donate without a guarantee of anonymity were not automatically more open to extended or intimate contact with offspring. [ 11 ]


Even when donors choose to be anonymous, offspring may still find ways to learn more about their biological origins. Registries and DNA databases have been developed for this purpose. Registries that help donor-conceived offspring identify half-siblings from other mothers also help avoid  accidental incest  in adulthood. [ 56 ] [ 57 ]


Offspring of anonymous donors may often have the ability to obtain their biological father's donor number from the fertility clinic or sperm bank used for their birth. They may then share their number on a registry. By finding shared donor numbers, offspring may find their genetic half-siblings. The donor may also find his number on a registry and choose to make contact with his offspring or otherwise reveal his identity. [ 56 ]


Different factors motivate individuals to seek sperm from outside their home state. For example, some jurisdictions do not allow unmarried women to receive donor sperm. Jurisdictional regulatory choices as well as cultural factors that discourage sperm donation have also led to international  fertility tourism  and sperm markets.


When Sweden banned anonymous sperm donation in 1980, the number of active sperm donors dropped from approximately 200 to 30. [ 58 ]  Sweden now has an 18-month waiting list for donor sperm. [ 49 ]  At least 250 [ 49 ]  Swedish sperm recipients travel to Denmark annually for insemination. Some of this is also due to the fact that Denmark also allows single women to be inseminated. [ 59 ]


After the United Kingdom ended anonymous sperm donation in 2005, the numbers of sperm donors went up, reversing a three-year decline. [ 60 ]  However, there is still a shortage, [ 61 ] [ 60 ]  and some doctors have suggested raising the limit of children per donor. [ 62 ]  Some UK clinics import sperm from  Scandinavia .


Despite the shortage, sperm exports from the UK are legal and donors may remain anonymous in this context. However, the HFEA does impose safeguards on the export of sperm, such as that it must be exported to fertility clinics only and that the result of any treatment must be traceable. The number of pregnancies obtained from an individual donor in each country where his sperm is exported will be subject to any local or national rules which apply. In addition, UK sperm banks may apply their own global maximum for the number of pregnancies obtained in respect of each donor.


Since 2009, the import of sperm via registered clinics for use in the UK has been authorised by the HFEA. The sperm must have been processed, stored and quarantined in compliance with UK regulations. The donors have agreed to be identified when the children produced with their sperm reach the age of eighteen. The number of children produced from such donors in the UK will, of course, be subject to HFEA rules (i.e. currently a limit of ten families,) but the donors' sperm may be used worldwide in accordance with the clinic's own limit, subject to national or local limits which apply.  By 2014 the UK was importing nearly 40% of its sperm requirements, up from 10% in 2005. [ 63 ]  In 2018 it was reported that almost half of the imported sperm into Britain came from Denmark (3,000 units). [ 64 ]


Korean  Bioethics Law prohibits selling and buying of sperm between clinics, and each donor may only help giving rise to a child to one single couple. [ 65 ]  It suffers from a shortage.


Canada prohibits payment for gamete donation beyond the reimbursement of expenses. [ 66 ]  Many Canadians import purchased sperm from the United States. [ 67 ]


The United States, which permits monetary compensation for sperm donors, has had an increase in sperm donors during the  late 2000s recession . [ 68 ]


The use of sperm donation is most common among single women and lesbians. [ 1 ]  Some sperm banks and fertility clinics, particularly in the US, Denmark and the UK, have a predominance of women being treated with donor sperm who come within these groups with some recording over 85% of recipients from these backgrounds. Many sperm banks and fertility clinics direct their main advertising towards these groups. Many, but not all, of the single women or trans-gender people who choose sperm donation may be LGBT+. This produces many ethical issues around the ideals of conventional parenting and has wider issues for society as a whole, including the issues of the role of men as parents, family support for children, and financial support for women with children. [ 69 ]


The growth of sperm banks and fertility clinics, the use of sperm agencies and the availability of anonymous donor sperm have served to make sperm donation a more respectable, and therefore a more socially acceptable, procedure. [ 70 ]  The intervention of doctors and others may be seen as making the whole process a respectable and merely a medical procedure which raises no moral issues, where donor inseminations may be referred to as "treatments" and donor children as "resulting from the use of a donor's sperm", or "born following donation" and subsequent children may be described as "born using the same donor" rather than as biological children of the same male.


A 2009 study has indicated that both men and women view the use of donor sperm with more skepticism compared with the use of donor eggs, suggesting a unique underlying perception regarding the use of male donor gametes. [ 71 ]


Some donor children grow up wishing to find out who their fathers were, but others may be wary of embarking on such a search since they fear they may find scores of half-siblings who have been produced from the same sperm donor. Even though local laws or rules may restrict the numbers of offspring from a single donor, there are no worldwide limitations or controls and most sperm banks will  onsell  and export all their remaining stocks of vials of sperm when local maxima have been attained (see 'onselling' above).


One item of research has suggested that donor children have a greater likelihood of  substance abuse ,  mental illness  and  criminal  behavior when grown. [ 72 ]  However, its motivation and credibility have been questioned. [ 73 ]


Coming forward publicly with problems is difficult for donor-conceived people as these issues are very personal and a public statement may attract criticism. Additionally, it may upset their parents if they speak out. A website called Anonymous Us [ 74 ]  has been set up where they can post details of their experiences anonymously, on which there are many accounts of problems.


There are a wide range of religious responses to sperm donation, with some religious thinkers entirely in support of the use of donor sperm for pregnancy, some who support its use under certain conditions, and some entirely against.


Catholicism  officially opposes both the donation of sperm and the use of donor sperm on the basis that it compromises the sexual unity of the marital relationship and the idea "that the procreation of a human person be brought about as the fruit of the conjugal act specific to the love between spouses." [ 75 ]


The  Eastern (Greek) Orthodox Church  allows for IUI using the husband's sperm, but does not accept IVF and other assisted reproductive techniques. [ 76 ]


The  Southern Baptist Convention  holds that sperm donation from a third party violates the marital bond. [ 77 ]   The  United Methodist Church  supports a variety of reproductive strategies including sperm donation. [ 78 ]


The Church of Jesus Christ of Latter-day Saints , the largest sect  within the movement , allows for artificial insemination.  However, doing so with sperm from someone other than a wife's husband is officially discouraged, but not forbidden;  leaving the matter up to individual judgement. [ 79 ] [ 80 ] [ 81 ]


Sperm donation, like egg and embryo donation, is a relatively new medical method that has raised many religious and moral questions. Gamete donation is still a controversial issue in Islam.


As stated earlier, scholars of Sunni and Shia have different fatwas about sperm donation. While Sunni scholars have forbidden the use of any third party in infertility treatment, Some Shia scholars have announced that it is halal under the mentioned prerequisites. [1]


Jewish thinkers hold a broad range of positions on sperm donation. Some Jewish communities are totally against sperm donation from donors that are not the husbands of the recipient, while others have approved the use of donor insemination in some form, while  liberal communities  accept it entirely. [ 82 ] [ 83 ] [ 84 ]


In 1884, Professor William Pancoast of Philadelphia's  Jefferson Medical College  performed an insemination on the wife of a sterile Quaker merchant, which may be the first insemination procedure that resulted in the birth of a child. Instead of taking the sperm from the husband, the professor  chloroformed  the woman, then let his medical students vote which one of among them was "best looking", with that elected one providing the sperm that was then syringed into her  cervix . [ 85 ] [ 86 ]  At the husband's request, his wife was never told how she became pregnant. As a result of this experiment, the merchant's wife gave birth to a son, who became the first known child by donor insemination. The case was not revealed until 1909, when a letter by Addison Davis Hard appeared in the American journal  Medical World , highlighting the procedure. [ 87 ]


Since then, a few doctors began to perform private donor insemination. Such procedures were regarded as intensely private, if not secret, by the parties involved. Records were usually not maintained so that donors could not be identified for paternity proceedings. Technology permitted the use of fresh sperm only, and it is thought that sperm largely came from the doctors and their male staff, although occasionally they would engage private donors who were able to donate on short notice on a regular basis. [ 88 ]


In 1945,  Mary Barton  and others published an article in the  British Medical Journal  on sperm donation. [ 89 ]   Barton, a gynecologist, founded a clinic in London which offered  artificial insemination  using donor sperm for women whose husbands were infertile. This clinic helped conceive 1,500 babies of which Mary Barton's husband,  Bertold Weisner , probably fathered about 600. [ 90 ]


The first successful human pregnancy using frozen sperm was in 1953. [ 91 ] [ 92 ]


"Donor insemination remained virtually unknown to the public until 1954". [ 93 ]  In that year the first comprehensive account of the process was published in  The British Medical Journal . [ 94 ]


Donor insemination provoked heated public debate. In the United Kingdom, the  Archbishop of Canterbury  established the first in a long procession of commissions that, over the years, inquired into the practice. It was at first condemned by the  Lambeth Conference , which recommended that it be made a criminal offence. A Parliamentary Commission agreed. In Italy, the Pope declared donor insemination a sin, and proposed that anyone using the procedure be sent to prison. [ 94 ]


Sperm donation gained popularity in the 1980s and 1990s. [ 95 ]


In many western countries, sperm donation is now a largely accepted procedure. In the US and elsewhere, there are a large number of  sperm banks . A sperm bank in the US pioneered the use of on-line search catalogues for donor sperm, and these facilities are now widely available on the websites of sperm banks and fertility clinics. [ 69 ]


Recent years have also seen sperm donation become relatively less popular among heterosexual couples, who now have access to more sophisticated fertility treatments, and more popular among single women and lesbian couples [ 1 ]  — whose access to the procedure is relatively new and still prohibited in some jurisdictions. [ 96 ]


In 1954, the Superior Court of  Cook County, Illinois  granted a husband a divorce because, regardless of the husband's consent, the woman's donor insemination constituted adultery, and that donor insemination was "contrary to public policy and good morals, and considered adultery on the mother's part." The ruling went on to say that, "A child so conceived, was born out of wedlock and therefore illegitimate. As such, it is the child of the mother, and the father has no rights or interest in said child." [ 97 ]


However, the following year, Georgia became the first state to pass a statute legitimizing children conceived by donor insemination, on the condition that both the husband and wife consented in advance in writing to the procedure. [ 98 ]


In 1973, the Commissioners on Uniform State Laws, and a year later, the  American Bar Association , approved the  Uniform Parentage Act . This act provides that if a wife is artificially inseminated with donor semen under a physician's supervision, and with her husband's consent, the husband is legally considered the natural father of the donor inseminated child. That law was followed by similar legislation in many states. [ 99 ]


In the United Kingdom, the Warnock Committee was formed in July 1982 to consider issues of sperm donation and assisted reproduction techniques. [ 100 ]  Donor insemination was already available in the UK through unregulated clinics such as  BPAS . Many of these clinics had started to offer sperm donation before the widespread use of freezing techniques. "Fresh sperm" was donated to order by donors at the fertile times of patients requiring treatments. Commonly, infertility of a male partner or sterilisation was a reason for treatment. Donations were anonymous and unregulated.


The Warnock Committee's report was published on July 18, 1984. [ 100 ]  and led to the passing of the  Human Fertilisation and Embryology Act 1990 . That act provided for a system of licensing for fertility clinics and procedures. It also provided that, where a male donates sperm at a licensed clinic in the UK and his sperm is used at a UK clinic to impregnate a female, the male is not legally responsible for the resulting child.


The 1990 Act also established a UK central register of donors and donor births to be maintained by the  Human Fertilisation and Embryology Authority  (the 'HFEA'), a supervisory body established by the Act. Following the Act, for any act of sperm donation through a licensed UK clinic that results in a living child, information on the child and the donor must be recorded on the register. This measure was intended to reduce the risk of  consanguinity  as well as to enforce the limit on the number of births permitted by each donor. The natural child of any donor has access to non-identifying information about their donor, starting at the child's eighteenth birthday.


The emphasis of the 1990 Act was on protecting the unborn child. However, a general shortage of donor sperm at the end of the 20th century, exacerbated by the announcement of the removal of anonymity in the UK, led to concerns about the excessive use of the sperm of some donors. These concerns centered on the export and exchange of donor sperm with overseas clinics, and also the interpretation of the term "sibling use" to include donated embryos produced from one sperm donor. Successive births by surrogates using eggs from different women but sperm from the same sperm donor were also counted as donations to a single recipient. Donors were informed that up to ten births could be produced from their sperm, but the words "other than in exceptional circumstances" in the consent form could potentially lead to many more pregnancies. These concerns led to the SEED Report [ 101 ]  commissioned by the HFEA, which was in turn followed by new legislation and rules meant to protect the interests of donors. Subsequent changes to legislation are designed to protect donors and recipients so that where a man donates his sperm through a UK clinic, that sperm is not permitted to give rise to more than ten families in the UK, but the donor may give express consent for more families to be created worldwide. However, the export of donor sperm is subject to the European Tissues Directive or the application of the effects of the Directive where exports are outside the EU which relate to traceability and record-keeping.


On the global market, Denmark has a well-developed system of sperm export. This success mainly comes from the reputation of Danish sperm donors for being of high  quality [ 102 ]  and, in contrast with the law in the other Nordic countries, gives donors the choice of being either anonymous or non-anonymous to the receiving couple. [ 102 ]  Furthermore, Nordic sperm donors tend to be tall, with rarer features like blond hair or different color eyes and a light complexion, and highly educated [ 103 ]  and have altruistic motives for their donations, [ 103 ]  partly due to the relatively low monetary compensation in Nordic countries. More than 50 countries worldwide are importers of Danish sperm, including  Paraguay , Canada,  Kenya , and  Hong Kong . [ 102 ]  Several UK clinics also export donor sperm. The use of the sperm outside the UK will also be subject to local rules. Within the EU there are now regulations governing the transfer of human tissue including sperm between member states to ensure that these take place between registered sperm banks. However, the  Food and Drug Administration  (FDA) of the US has banned import of any sperm, motivated by a risk of  mad cow disease , although such a risk is insignificant, since artificial insemination is very different from  the route of transmission of mad cow disease . [ 104 ]  The  prevalence of mad cow disease  is one in a million, probably less for donors. If prevalence was the case, the infectious proteins would then have to cross the  blood-testis barrier  to make transmission possible. [ 104 ]  Transmission of the disease by an insemination is approximately equal to the risk of getting killed by lightning. [ 105 ]


Movie plots involving artificial insemination by donor are seen in  Made in America ,  Road Trip ,  The Back-Up Plan ,  The Kids Are All Right ,  Starbuck , and  Baby Mama , the latter also involving  surrogacy . [ 106 ]  In the journal  Contexts , sociologist Margaret Nelson noted that big Hollywood movies represent sperm donation as a means of recreating the  nuclear family  rather than exploring increasingly complex family arrangements. [ 107 ]


Films and other fiction depicting emotional struggles of  assisted reproductive technology  have had an upswing first in the latter part of the 2000s (decade), although the techniques have been available for decades. [ 106 ]  Yet, the number of people that can relate to it by personal experience in one way or another is ever growing, and the variety of trials and struggles is huge. [ 106 ]


A 2012  Bollywood  comedy movie,  Vicky Donor , was based on sperm donation. The film release saw an effect; the number of men donating sperm increased in India. [ 108 ]


A 2017  Kollywood  movie  Kutram 23  is also a movie based on sperm donation.


In the 2018 life simulator video game  Bitlife , the player can donate sperm; however, they will never meet the child who is born as a result. [ 109 ]


Accidental incest  is  sexual activity  or  marriage  between persons who were unaware of a family relationship between them which would be considered  incestuous .


The laws of many jurisdictions [ which? ]   void incestuous marriages , even if entered into without awareness of the kinship. If an incestuous relationship is suspected,  DNA testing  may be used. Some jurisdictions [ which? ]  permit offspring of IVF donations access to donation records or to adoption records. [ citation needed ]


People may be unaware of a  kinship  relationship between them in a number of circumstances. For example,  artificial insemination  with an anonymous  donated sperm  may result in offspring being unaware of any biological relations, such as paternity or half siblings. To reduce the likelihood of accidental incest, fertility clinics usually limit the number of times that a donor's sperm may be used. [ 1 ] [ 2 ]  Some countries have laws limiting the number of children a donor can father, [ 3 ]  while others limit sperm donations based on family numbers to enable one family to have true siblings.


Taiwan  allows those conceived by artificial means to find out if they are related to a person they are considering marrying. [ 4 ]


Accidental incest may also arise in the following situations:


Genetic sexual attraction  is a pseudoscientific explanation offered for cases of sexual attraction and relations between adults who were not aware of their  close blood relations . [ 6 ]


Bernard Norman Barwin  is a Canadian physician and medical professor. He was appointed to the  Order of Canada  in 1997, but resigned the award in 2013 after admitting to  professional misconduct . [ 1 ]


Barwin was born in  South Africa  to parents of  Russian  and  Lithuanian  background. [ 2 ]  He is also of  Ashkenazi Jewish  descent. [ 3 ]  Barwin and his wife left South Africa after he completed his first degree in 1962, in opposition to the  Sharpeville massacre . [ 2 ]  He completed his medical training in  Belfast ,  Northern Ireland . [ 2 ]


Barwin was director of the High Risk Pregnancy Clinic and co-director of the  Ottawa General Hospital 's fertility clinic. He left in 1984 because he was not a certified  gynaecologist  in Canada. He would then establish his own clinic, though still licensed as a general physician. [ 4 ]


He was the Associate Professor of Obstetrics and Gynaecology at the  University of Ottawa . He was also one of the founding members of  Fertility Self-Help Group  (ISSG), which later became the  Infertility Awareness Association of Canada . He also founded  Canadians for Choice  and has been President since 2004. In addition, he was the President of the Canadian Fertility Society, the  Planned Parenthood  Federation of Canada and Planned Parenthood Ottawa. [ 5 ]


In 1997, Barwin was appointed to the  Order of Canada  for having a "profound impact on both the biological and psycho-social aspects of  women's reproductive health ." [ 6 ]  In 2009, he was awarded the  Honorary degree  of  Doctor of Laws  from  Carleton University . [ 7 ]


In 1995, Loree-Ann Huard and Wanda Cowton sued Barwin for allegedly using the wrong  sperm donor . [ 8 ]  The couple and Barwin settled out of court in 1998. [ 8 ]  In 2010, two former patients of Barwin brought lawsuits against him alleging that he had inseminated them with the wrong sperm. [ 8 ]


In January 2013, Barwin admitted to professional misconduct in regards to four women who were  artificially inseminated  with the wrong sperm. [ 9 ] [ 10 ] [ 11 ]  A panel of the  College of Physicians and Surgeons of Ontario  found Barwin guilty of one of three counts of professional misconduct. They issued an official reprimand, revoked his license practice for two months, and ordered him to cover the $3,650 cost of the disciplinary proceedings. [ 4 ]  A review of the incidents could find no "evident" reasons for the error. [ 4 ]  He resigned from his appointment to the  Order of Canada  and it was formally removed later that year. [ 6 ] [ 12 ]


On 1 November 2016, former patients of Barwin brought a  class action  against Barwin on behalf of his former patients and the children that Barwin helped conceive at his clinic, the Broadview Fertility Clinic. [ 13 ]  The statement of claim alleged that Barwin used his own sperm when inseminating his patients. [ 13 ]


His medical licence was revoked by the  College of Physicians and Surgeons of Ontario  in 2019. [ 14 ]


On 1 November 2021, a judge approved a $13 million dollar settlement against Barwin. [ 15 ]


Donald Lee Cline  (born December 10, 1938) is a former American medical doctor of  obstetrics and gynecology  and convicted felon. [ 1 ] [ 2 ]  Between 1974 [ clarification needed ]  and 1987, Cline sired over 90 children without disclosing himself as the  sperm donor  to his patients. [ 3 ]  As of May 11, 2022, Cline has been confirmed as the biological father of 94 doctor-conceived offspring. [ 4 ]


Cline received his undergraduate degree from  Indiana University  and his M.D. from  Indiana University School of Medicine . After interning at  Indiana University Health Methodist Hospital , he served two years in the Air Force and 12 years as inactive reserve. In 1979, Cline opened his clinic on 2020 West 86th Street in Indianapolis and specialized in  reproductive endocrinology & infertility . [ 2 ]  He practiced there until retiring in 2009. Following his felony conviction in 2018, Cline surrendered his  medical license . He is prohibited from reinstatement by the  Medical Licensing Board of Indiana . [ 5 ]


In 2014 when Jacoba Ballard, a daughter of a former patient of Cline, reviewed the results of her at-home  DNA test , she discovered a biological connection to eight previously unknown half-siblings. [ a ]  Her  genetic genealogy  research ultimately revealed Cline, her mother's fertility doctor, as her biological father. [ 7 ] [ 8 ]  Cline is now known to have covertly fathered at least 94 offspring. [ 9 ]


Ballard filed a complaint with the  Attorney General of Indiana  who initiated an investigation in 2015. [ 10 ]  Then Indiana attorney general Tim DeLaney declined to prosecute because "there was no law forbidding Cline’s conduct." [ 11 ]  Ballard then pursued media coverage.  Fox59  anchor Angela Ganote investigated her story. [ 10 ]  During her investigation, Ganote learned that Cline had lied to the attorney general's office in their investigation. [ 12 ]  Documents show that he had told investigators, "I can emphatically say that at no time did I ever use my own sample for insemination nor was I a donor." [ 13 ]


After a story aired on Fox59, Cline left a voicemail for Ballard contradicting what he had told investigators. "Uh, this is Dr. Cline, You know, I thought I was doing the right thing. I only donated my own sample nine or 10 times," he said. He had placed the call to ask Ballard for help with damage control. "Um, my wife and I, uh, after 57 years of marriage, um, we have had a great deal of problems over this. She considers this adultery. I donated my sample. Gonna lose my wife. Our marriage will be over. Can you help?" [ 13 ]


Ganote told DeLaney that Cline was lying to them. [ 10 ]  Ballard played the audio of the voice mail. The attorney general then conducted an independent DNA test. The results confirmed a 99.9997% probability of paternity. [ 13 ]  Charges were filed against Cline. In  State of Indiana v. Donald Cline , Cline pleaded guilty to two Level 6 felony counts of obstruction of justice and received a one-year suspended sentence. [ 14 ]


On November 30, 2016, Elizabeth White and son Matthew White filed a proposed complaint for damages and demand for jury trial with the State of Indiana Department of Insurance. The proposed complaint cites negligence, constructive fraud, battery, breach of contract, breach of express warranty, and negligent hiring or retention as to defendant and reproductive endocrinology associates. [ 15 ]  They then filed a multi-count complaint in Marion Superior Court. Cline's motion to dismiss was denied. In an interlocutory appeal, a panel of Indiana Court of Appeals affirmed the lower court's decision, finding that "Matthew sufficiently stated breach of contract and tort claims for which relief can be granted." [ 16 ]


As of May 2022, Cline had paid out more than $1.35 million to settle three civil lawsuits filed by donor children and families. Three more are pending. [ 9 ]


The Cline fertility fraud and similar doctor-donated sperm cases exposed a lack of legislation specific to infertility patients' and their children's rights. [ b ] [ 19 ]  Ballard lobbied the state of Indiana for change. [ 20 ]  On May 17, 2019, Indiana became the first state to designate fertility fraud as a Level 6 felony. [ 21 ]   S.E.A. 174, P.L. 215  became effective July 1, 2019. It reads:


Establishes a cause of action for civil fertility fraud and provides that a prevailing plaintiff may be awarded: (1) compensatory and punitive damages; or (2) liquidated damages of $10,000. Specifies the statute of limitations for civil fertility fraud. Increases the penalty for deception involving the identity of a person or the identity or quantity of property to a Level 6 felony if the offense involves a misrepresentation relating to: (1) a medical procedure, device, or drug; and (2) human reproductive material. Urges the legislative council to assign the topic of fertility laws, including gestational surrogacy, to an appropriate study committee. [ 22 ]


States which have enacted legislation:  Arizona ,  Arkansas ,  California , [ 23 ]   Colorado , [ 23 ]   Florida , [ 23 ]   Indiana ,  Iowa , [ 24 ]   Texas , [ 23 ]   Utah


States proposing legislation:  Michigan ,  Nebraska , [ 23 ]   New York , [ 23 ]   Ohio , [ 25 ]   Kentucky ,  Oregon ,  Pennsylvania ,  Washington


There is no Federal legislation specifically applicable to fertility fraud.


There is a high presence of  auto-immune disorders  among Cline's donor-fathered children. Cline's own auto-immune condition,  rheumatoid arthritis , would have excluded him as an eligible sperm donor at his own clinic. [ 26 ]


Many of the donor-children live within a 25-mile (40 km) radius of each other. Their concern with  consanguinity  and its potential genetic disorders increases as their own children grow up and develop intimate relationships. [ 27 ] [ 28 ]  In an extended profile piece in  The Atlantic , reporter Sarah Zhang wrote:


The donor children have begun cataloging the ways their own paths have crossed, too. White went to Purdue at the same time as one of his half brothers. One sibling sold another a wagon at a garage sale. Two of them lived on the same street. Two had kids on the same softball team. They’re worried that their children are getting old enough to date soon. 'Did you not consider we all live in a relatively close area?' one sister said she has wondered about Cline. 'Did you really think … that we wouldn’t meet? That we wouldn’t maybe date? That we wouldn’t have kids who might date? Did you never consider that?' Cline now looms over their kids’ every innocent crush, their every prom date. [ 29 ]


Donald Cline's fertility fraud is the subject of a  Netflix  documentary titled  Our Father  which premiered in May 2022. [ 27 ] [ 32 ]


Cline has four children with his wife, Audrey, in addition to the 94 other children conceived by  artificially inseminating  women with his own sperm without their knowledge or consent. [ 2 ]


A  donor offspring , or  donor conceived person , is conceived via the donation of  sperm  ( sperm donation ) or  ova  ( egg donation ), or both (either from two separate donors or from a couple).


For donor conceived people, the  biological parent (s) who donated sperm or eggs are not legally recognized as parents and do not appear on their birth certificate. In many countries it is common for donor conceived people to be given no identifying information about their donor, however in some countries anonymous sperm and/or egg donation has been made illegal due to concerns for the medical and emotional needs of donor conceived people. [ 1 ]  Even in cases with anonymous donors, donor conceived people are sometimes able to connect with biological parent(s) and/or half siblings conceived from the same donor using  DNA testing  or through online registries for donor conceived people.


With the significant increase in the numbers of donor-conceived individuals (38,910 live babies were born in 2005 as a result of 134,260  ART  cycles performed at reporting U.S. clinics in 2005, compared with 20,659 babies born as a result of 64,036 ART cycles in 1996), many have questioned the ethics surrounding the technologies and human decisions surrounding donor conception, and there has been plenty of controversy.  For example, the term " Snowflake baby " was coined in reference to unused frozen embryos (left over from other couples' attempts to conceive through in vitro fertilization) that have been "adopted" by families. Abortion opponents tend to support such adoptions.


"ART Cycles" are not accurate as many people (<40%) who use IVF (egg donation) do not report their births, [ 2 ]  and that there is no tracking or record keeping required for children born from sperm donation.  Estimates of 30,000-60,000 often used are from estimates made with incomplete records from the mid-1980s. [ 3 ]


The psychological and social impacts of assisted reproductive technologies (ART) on donor-conceived children and their families has gained a great deal of interest in recent years as this population has continued to grow. An increasing number of family-support organizations strongly encourage parents to openly discuss their children's origins, whether through donor insemination or following treatment with donated gametes, because research suggest that donor conceived people who learn the nature of their conception at a young age do not suffer psychologically but that those who learn about their conception at a later age may feel lied to or betrayed. [ 4 ]


For most sperm or egg recipients, the choice between  anonymous sperm or egg donor  and a non-anonymous one is generally not of major importance. [ 5 ]  For some donor conceived children, on the other hand, it may be psychologically burdensome not having the possibility of contacting or knowing almost nothing about the donor. [ 6 ]  Thus far, studies have found that a significant number of donor conceived children want information about their donor  [ 5 ] [ 7 ]


There are donor sibling registries matching genetic siblings and donors. However, with modern information technology, there are other ways of getting information.


One study estimated that approximately 67% of donor conceived children in  adolescence  with an identity-release donor plan on contacting him when they are eighteen years old. [ 8 ] [ clarification needed ]


Donor registration facilitates donor conceived people,  sperm donors , and  egg donors  establishing contact with genetic relatives. They are mostly used by donor conceived people to find genetic half-siblings from the same egg or sperm donor.


Some donors are non-anonymous, but most are anonymous, i.e. most donor conceived people don't know the identity of their donors. Still, they may be able to obtain unique donor numbers or known donor characteristics, e.g. hair, eye, and skin colors, from fertility clinics to find matched genetic half-siblings.


The largest donor registry is the  Donor Sibling Registry (DSR)  however there are also many other registries and sometimes registries for siblings set up by the clinic themselves.


Clinics and sperm banks facilitate the transaction that allows for prospective parents to become pregnant with donated gametes. They recruit and screen donors and advertise their product to prospective parents. Their position as a middleman is what makes anonymous sperm donation possible, though many clinics and sperm banks also offer non-anonymous donors, where donor conceived people may get the identity of their donors. The most common type of non-anonymous donor is an identity-release donor, which allows offspring to receive identifying information (such as name, phone number, and/or email address) upon their 18th birthday but there are also donors who share identifying information from the beginning. Identity release donors can have some issues, as the donor's contact information may change between the donation and the child's 18th birthday or the donor may pass away.


Many people fear that if anonymous donation is made illegal, the number of donors will decrease and there will not be enough supply however, an Australian study concluded that potential donors who would still be willing to donate without a guarantee of anonymity were not automatically more open to contact with offspring. [ 9 ]  Most potential donors would be willing to meet offspring in a single contact. [ 9 ]  In addition after anonymous donation was banned in the UK, donations actually increased. [ 10 ]


Due to the advent of  genetic genealogy  and  DNA databases , even sperm donors who have not initiated contact through a registry are now increasingly being traced by their offspring. In the current era there can be no such thing as guaranteed anonymity as it is now possible for "anonymous" sperm donors to be identified by their offspring. [ 11 ]  Possibly the first such case was in 2005, when it was revealed in New Scientist magazine that a fifteen-year-old had used information from a DNA test and the Internet to identify and contact his sperm donor. [ 12 ]


In 2018, it was reported that DNA testing has led to a significant increase in donor-conceived people finding their siblings and sperm donors. [ 13 ]


Within groups of donor conceived people there is controversy regarding the practice of donor conception and anonymity. Some donor conceived people feel frustrated with the circumstances of their conception, particularly if they were conceived anonymously, because they wish to learn more about their biological family but they find themselves without the means to do so. They may feel that their parents, who often chose donor conception over adoption because of desire for a biological connection, are hypocritical in choosing an anonymous donor and preventing them from connecting to biological relatives. [ 14 ] [ 15 ]  On the other hand, some primarily feel grateful that donor conception allowed for their existence and are less interested in the biological family. And yet others don't consider it much or feel neutral. Overall however, most donor conceived people are at least somewhat interested in their biological family and believe that the fertility industry needs greater regulation. [ 16 ]


Donor registration  facilitates  donor conceived people ,  sperm donors  and  egg donors  to establish contact with genetic kindred. Registries are mostly used by donor conceived people to find out their genetic heritage and to find half-siblings from the same egg or sperm donor. In some jurisdictions donor registration is compulsory, while in others it is voluntary; but most jurisdictions do not have any registration system.


There are registries of the fertility clinics etc. as well as independent registries.


Fertility clinics etc. keep registries of donors and receivers. The donor number is generally available to the donor as well as the receivers. On the other hand, a donor doesn't generally know which receivers that are linked to his/her donor number, and the receivers don't generally know the true identity behind the donor number.


In the case of non-anonymous donors, the donor conceived people may know the true identity of the donor behind the donor number.


Since clinic registries are often very limited, independent registries may be more efficient in finding genetic kindred.


Some donors are non-anonymous, but most are anonymous, i.e. the donor conceived person doesn't know the true identity of the donor. Still, he/she may get the donor number from the fertility clinic. If that donor had donated before, then other donor conceived people with the same donor number are thus genetic half-siblings. In short, donor registries matches people who type in the same donor number.


Alternatively, if the donor number isn't available, then known donor characteristics, e.g. hair, eye and skin color may be used in matching siblings.


Donors may also register, and therefore, donor registries may also match donors with their genetic children.


Sperm banks keep their own records of sperm donors and recipients, although there may not be any obligation to save them unless there is non-anonymous sperm donation, let alone any obligation to reveal them for donor conceived people who want to know about their genetic history.


In the US there is increased pressure on sperm banks to make donor information available to donor conceived people, for example by creating a collaborative private registry between sperm banks. [ 1 ]  Without such initiative, it may lead to a government driven registry that sperm banks and clinics must report to. [ 1 ]


Some countries have established laws concerning the registration of donors, others permit states to regulate this or have no regulation.


In  Australia , health issues are the responsibility of the states and territories. In  Victoria , donor registers are maintained by the  Victorian Assisted Reproductive Treatment Authority  (VARTA) (until 2010 called the  Infertility Treatment Authority). [ 2 ] [ 3 ]
Donor registration is compulsory and donors agree to release identifying information to the donor child when they reach 18 years of age. Some other states, such as Western Australia, have a voluntary register on which donors and recipients may register their details.


In  New Zealand  the  Human Assisted Reproductive Technology Act 2004  established compulsory registration of donors  and their offspring born from donations made after 22 August 2005. Fertility clinics must inform the Registrar of Births Deaths and Marriages that a donor offspring has been born, and give the Registrar identifying details about the donor, offspring and clinic. Non-identifying details about the donor must be retained by the fertility clinic for 50 years or until the clinic closes, when they are transferred to the Registrar.


Information from clinics and the Registrar may be released to donors, donor offspring and their parents, and medical professionals. However, there are restrictions on releasing identifying details about donor offspring until they turn 18 years old (16 years old with permission of the Family Court).


The Registrar of Births Deaths and Marriages  maintains a second voluntary register detailing donor and donor offspring arising from donations prior to 22 August 2015.


As in Austria, donor registration is a task for each region, in Sweden:  county . Thus, any official fertility clinic cannot know if a donor has donated in other places within the country as well.


The Personal Data Act  [ 4 ]  regulates donor/sibling registries in Sweden. For instance, personal data may mostly not be handed out unless there is consent from that person, and this might include donor codes, although only the clinic itself can link it directly with that donor. However, they may still indirectly link to the donor, and therefore, it is not certain that clinics are willing to deliver donor codes. Furthermore, even if the organization is availed the data, then, by the same law, such an organization has huge responsibilities. For instance:


In the  United Kingdom , the  Human Fertilisation and Embryology Authority  (HFEA) has a central register of people conceived using gamete donation after 1 August 1991. People conceived using donations made after 1 April 2005 will have the right to know who their donor was when they turn 18. [ 5 ]
 UK Donorlink  was a Department of Health Funded voluntary register for people conceived before 1 August 1991 and for their donors. [ 6 ]


The  Donor Sibling Registry  is a website and  non-profit  US organization serving  donor offspring ,  sperm donors ,  egg donors  and other  donor conceived people . [ 1 ]  It was founded in September 2000 by a mother-and-son team, Wendy Kramer and Ryan Kramer of  Nederland, Colorado . [ 2 ]


The Donor Sibling Registry (DSR) was founded in 2000 to assist individuals conceived as a result of sperm, egg or embryo donation who are seeking to make mutually desired contact with others with whom they share genetic ties. The DSR has pioneered an international discussion about the donor conception industry and the families, with its research, media appearances, speaking engagements, and interviews. The DSR advocates for the right to honesty and transparency for donor-conceived people, for social acceptance and legal rights, and values the diversity of all families. [ citation needed ]


The DSR began as a  Yahoo!  group, which was created in September 2000. [ 3 ]  It was started by Wendy Kramer and her then 10-year-old son Ryan Kramer as a means of communicating with other offspring of  artificial insemination . [ 2 ]  After the first year, the group was home to only 37 members. In October 2002, Wendy created a press release which was sent to local news agencies. The story was picked up by Denver's  NBC  affiliate,  KUSA-TV . [ 4 ]  Shortly after, a small article about the DSR was written for  The Denver Post . This article led to national and international media coverage, giving the DSR enough exposure to grow its member base into the thousands. In 2003 the DSR became a 501(c)3 charity organization and moved from a Yahoo group to its own database website. [ citation needed ]


The DSR has conducted and published dozens of papers in peer-reviewed academic and legal journals.


When a donor-conceived person, a parent of a donor-conceived person or a sperm or egg donor signs up to the Donor Sibling Registry, they are automatically filed under their respective facility/clinic/cryobank by their donor number.  Matches and messages from potential matches can only be viewed for an annual membership fee. If only one person of a donor number is listed, the posting is white.  When two or more people sign up under the same donor number, they are filed together as a "match".  Matches can occur between half siblings (light yellow), sperm donors and their offspring (dark yellow), or egg donors and their offspring (also dark yellow).


Due to changes in technology and the introduction of the commercially available home DNA tests, the ability of Donor Sibling Registry to be an effective use of resources may be outdated. [ citation needed ]


Ferguson v. McKiernan  was a 2007  Pennsylvania Supreme Court  case in which, in a 3–2 decision, the court reversed a lower court ruling requiring  sperm donor  Joel McKiernan to pay  child support . [ 1 ] [ 2 ]


Joel McKiernan met Ivonne Ferguson in May 1991, with their relationship becoming intimate several months later. In 1993, Ferguson expressed a desire to have another child. However, after finding out that her  tubal ligation  was irreversible, Ferguson submitted to  in vitro fertilization  (IVF) in order to conceive another child. During this process, she asked McKiernan to deliver his sperm so that she could use it for the IVF procedure. While he was initially hesitant to do so, she convinced him by promising that she would not track him down for any child support afterwards. [ 3 ]


Ferguson gave birth to male twins (Travis and Tyler) [ 4 ]  on August 25, 1994. Afterwards, McKiernan mostly maintained his anonymity until Ferguson found his phone number and filed for child support in May 1999. [ 3 ]


While both a trial and a Superior Court ruled in favor of Ferguson, [ 3 ] [ 5 ]  their ruling was overturned by the  Pennsylvania Supreme Court  in a 3–2 vote on December 27, 2007. [ 1 ]  In the  majority opinion  (joined by Justices  Ralph Cappy  and  Ronald Castille ), Justice  Max Baer  upheld the validity of the verbal contract between Joel McKiernan and Ivonne Ferguson and thus held that McKiernan had no obligation to pay child support. [ 1 ] [ 4 ]


In his opinion, Justice Baer cited the  Uniform Parentage Act  and wrote that holding sperm donors responsible for paying child support would make them less likely to donate their sperm, which in turn would limit the reproductive prerogatives of would-be mothers. Justice Baer also noted the spread of unconventional methods of sperm donation in Pennsylvania in recent years. Finally, Baer rejected the  causation  argument in favor of forcing McKiernan to pay child support and pointed out that, were it not for McKiernan's actions, she would not have had any additional children unless another, anonymous donor had given sperm, and she thus would not have been entitled to any child support. [ 1 ]  (In response to this,  UCLA   law professor  Russell Korobkin pointed out that, if this  logic  was taken to the extreme, then it would mean that no children would ever be entitled to any financial support from their parents without their parents' consent since existence for these children is better than non-existence and thus these children weren't actually harmed by being brought into existence. [ 6 ] )


In their dissents, Justices  Thomas Saylor  and  J. Michael Eakin  argued that there is no basis in Pennsylvania public policy for the court's ruling. [ 3 ]  In his dissent, Justice Saylor argued on  separation-of-powers  grounds that any new Pennsylvania state government policy in regards to sperm donors and child support, however desirable, should come from the  Pennsylvania Legislature  rather than from the Pennsylvania judiciary, with the implication that for the Pennsylvania Supreme Court to do otherwise in regards to this would be for it to overstep its designated authority. [ 3 ]  Meanwhile, in his dissent, Justice Eakin pointed out that  relying on the 2002 Uniform Parentage Act is misplaced since this act was not adopted by the Pennsylvania General Assembly (Pennsylvania Legislature). [ 3 ]


Cecil Byran Jacobson  (October 2, 1936 – March 5, 2021 [ 1 ] ) was an American former  fertility  doctor who used his own  sperm  to impregnate his patients without informing them.


Jacobson was born in  Salt Lake City ,  Utah . A graduate of  Brown University , he became a researcher at  George Washington University , but had no specialist training in infertility medicine. [ 2 ]


In the 1960s, Jacobson, who was Chief of the Reproductive Genetics Unit at George Washington University Medical School, claimed that he had  impregnated  a male  baboon ; he had supposedly implanted his sperm into a female baboon’s abdominal cavity. He claimed that he had terminated the pregnancy after four months, but never published his results in scientific publications. [ 3 ] [ 4 ]


In the 1980s, Jacobson operated a reproductive genetics center in  Fairfax County, Virginia . He specialized in treating women who had difficulty getting pregnant, or problems carrying a pregnancy to term. One form of treatment was to inject patients, before and after conception, with the hormone  hCG  (commonly used as a  parenteral   fertility medication  and a  hormone  normally released during pregnancy), and patients who had been unable to conceive with other treatments reported success under Jacobson's care.


The pregnancies progressed normally through the early stages: standard pregnancy tests were positive and patients' bodies began to undergo changes associated with pregnancy. Jacobson performed  ultrasounds , identifying a fetus in the grainy image. Around the third month, Jacobson would report that the fetus had died. In fact, these patients were never pregnant, and the bodily changes were a reaction to the hCG. The pregnancy tests were inevitably  false positives  because the tests determined pregnancy by the presence of hCG. During Jacobson's criminal trial, experts examined the ultrasound photographs, and reported that the purported "fetuses" were actually nearby organs or fecal matter.


Nevertheless, other patients were successful in becoming pregnant and having children. While some patients were uncomfortable with Jacobson's manner, and began to distrust him, other patients gave him credit for successful treatment.  [ citation needed ]


In 1989, suspicious former patients tipped off a local television station, which investigated and reported on the false pregnancies. Jacobson was sued by numerous patients. Federal prosecutors charged Jacobson with perjury (for false testimony during the civil proceedings) and mail and wire fraud (for the use of the letters and the telephone system as part of his fraudulent practice).


During the course of the criminal investigation, another type of fraud came to light. For a variety of reasons, some patients had arranged to be  artificially inseminated  with sperm provided by screened, anonymous donors arranged by Jacobson. In order to preserve the anonymity of the donors, Jacobson explained, he identified them in records using code numbers; only Jacobson was to know their true identities. Investigators found no evidence that any donor program actually existed. Some of Jacobson's patients who had conceived through donor insemination agreed to  genetic testing . At least seven instances were identified in which Jacobson was the biological father of the patients' children, including one patient who was supposed to have been inseminated with sperm provided by her husband. DNA tests linked Jacobson to at least 15 such children, and it has been suspected that he fathered as many as 75 children by impregnating patients with his own sperm. [ 5 ]


Jacobson vigorously denied wrongdoing. He offered these explanations: With regard to the "false pregnancy" cases, he had believed that the women had actually been pregnant, and continued to maintain that some of them really were pregnant. He was well aware that injected hCG could trigger a false positive on a pregnancy test, but thought that the dosages he administered were too low to have that effect. If he misread the ultrasound results, that was an honest error. As for the donor insemination, Jacobson maintained that he had in fact relied on anonymous donors as claimed. He acknowledged using his own sperm on some occasions, when donors failed to show up when needed, and a patient was about to miss a window of opportunity to become pregnant. He could not account for the incident in which his own sperm was used in place of the patient's husband's, other than to suggest cross-contamination in the laboratory.


In 1992, Jacobson was convicted of 52 counts of  mail fraud ,  wire fraud , and  perjury . He was sentenced to five years in prison and had his medical license revoked. Jacobson appealed his convictions and sentence, but they were upheld by the court of appeals. [ 6 ] [ 7 ]   He later moved to  Provo, Utah , where he was involved in  agricultural research .


He was awarded the  Ig Nobel Prize  for  Biology  in 1992, which cited him as "Dr. Cecil Jacobson, relentlessly generous sperm donor, and prolific patriarch of sperm banking, for devising a simple, single-handed method of quality control." [ 8 ]


Jacobson died on March 5th, 2021 in  Springville , Utah at the age of 84. His cause of death was reported as compilations due to health issues he had been dealing with prior. [ 9 ]


Thomas Ray Lippert  (1950–1999) was a convict and former  business law professor  at  Southwest State College  in Marshall, Minnesota. Lippert worked at a  fertility clinic  named Reproductive Medical Technologies Inc. in Utah from 1988 to the mid 1990s where he reportedly replaced customers'  semen  with his own. [ 1 ]  In 1974–1975 he was arrested and later convicted for  kidnapping . [ 2 ] [ 3 ] [ 4 ] [ 5 ]


This  crime -related article is a  stub . You can help Wikipedia by  expanding it .


This biographical article about an American legal academic is a  stub . You can help Wikipedia by  expanding it .


Naruda Donoruda  is a 2016 Indian  Telugu -language  romantic comedy  film, directed by Mallik Ram and produced by Supriya Yarlagadda and John Sudheer Pudhota. The film is a remake of the 2012  Hindi  film  Vicky Donor . [ 1 ]  It stars  Sumanth  and  Pallavi Subhash  in lead roles, while  Tanikella Bharani  plays a pivotal role. The music was composed by  Sricharan Pakala  and released on  Aditya Music . The film was released on 4 November 2016. [ 2 ]


Vicky (Sumanth), an unemployed man, with seemingly no  purpose in life, lives with his grandmother and widowed mother (Rajya Lakshmi). Their family survives on a beauty parlour business. Dr Aanjaneyulu (Tanikella Bharani) runs an infertility clinic, and is in search of a good sperm donor. He comes across Vicky, and is enamored by him and his forefathers. After some convincing, Vicky eventually starts selling his sperm to Aanjaneyulu, filling the lives of many childless couples with joy. It's a win-win for Vicky and Aanjaneyulu as both grow rich.


Meanwhile, Vicky falls in love with a divorced bank employee, Aashima Roy (Pallavi Subhash). Never revealing that he's a sperm donor, Vicky marries her. But problems arise when Aashima gets to know the truth. Vicky eventually reconciles with his wife, after Aanjaneyulu helps her understand the true benefits of sperm donation.


Music composed by Sricharan Pakala. [ 3 ]  Music released on  Aditya Music .


Deccan Chronicle  gave 2 out of 5 stars stating "Naruda Donaruda is a fresh subject which could have been made much better. Except for Thanikella Bharani’s performance in a few scenes, the movie has nothing interesting. And it’s not a good comeback for Sumanth". [ 4 ]
 The Indian Express  stated "Watch it for Tanikella Bharani’s performance. But don’t expect it to be a joyride right through. Entertainment is on offer only in parts, the rest is boring". [ 5 ]


This article about a Telugu-language film of the 2010s is a  stub . You can help Wikipedia by  expanding it .


Posthumous sperm retrieval  ( PSR ) is a procedure in which  spermatozoa are collected  from the  testes  of a human corpse after  brain death . There has been significant debate over the ethics and legality of the procedure, and on the  legal rights  of the child and surviving parent if the  gametes  are used for  impregnation . [ 1 ]


Cases of post-mortem conception have occurred ever since human  artificial insemination  techniques were devised, via sperm donation to a  sperm bank  after the death of the donor. While religious objections have been made even under these circumstances, far more censure has arisen regarding  invasive  retrieval from fresh  cadavers  or patients either on  life support  or in a  persistent vegetative state , particularly when the procedure is carried out without explicit consent from the donor.


The first successful retrieval of sperm from a cadaver was reported in 1980, in a case involving a 30-year-old man who became brain dead following a motor vehicle accident and whose family requested sperm preservation. [ 2 ]  The first successful conception using sperm retrieved post-mortem was reported in 1998, leading to a successful birth the following year. [ 3 ]  Since 1980, a number of requests for the procedure have been made, with around one third approved and performed. [ 1 ]  Gametes have been extracted through a variety of means, including removal of the  epididymis ,  irrigation  or  aspiration  of the  vas deferens , and rectal probe  electroejaculation . [ 3 ]  Since the procedure is rarely performed, studies on the efficacy of the various methods have been fairly limited in scope.


While  medical literature  recommends that extraction take place no later than 24 hours after death,  motile  sperm has been successfully obtained as late as 36 hours after death, generally regardless of the  cause of death  or method of extraction. Up to this limit, the procedure has a high success rate, with sperm retrieved in nearly 100% of cases, and motile sperm in 80–90%. [ 4 ]  There is currently little precedent for successful insemination using sperm harvested after 36 hours. New technologies are being researched that could make this a routine reality, in turn creating new ethical dilemmas. [ 5 ]


If the sperm is viable, fertilisation is generally achieved through  intracytoplasmic sperm injection , a form of  in vitro  fertilisation . The success rate of  in vitro  fertilisation remains unchanged regardless of whether the sperm was retrieved from a living or dead donor. [ 4 ]


The legality of posthumous sperm extraction varies from jurisdiction to jurisdiction. Generally, legislation falls into one of three camps: a full ban, a requirement of written consent from the donor, or implied consent obtained from the family.


Following the 1984  Parpalaix case  in  France , in which the widow of deceased  cancer  patient Alain Parpalaix obtained permission from the courts to be inseminated with her husband's spermatozoa after his death, the  Centre d’Etude et de Conservation du Sperme Humain  (Center for the Study and Preservation of Human Sperm) petitioned the courts successfully for a full ban on posthumous insemination, [ 6 ]  in line with the country's ban on  in vitro  fertilisation for post- menopausal  women. [ 7 ]


Similar legislation exists in  Germany ,  Sweden ,  Taiwan  and the  Australian  states of  Victoria  and  Western Australia . [ 6 ]


Guidelines outlining the legal use of posthumously extracted  gametes  in the  United Kingdom  were laid out in the  Human Fertilisation and Embryology Act 1990 . The Act dictates that explicit written consent by the donor must be provided to the  Human Fertilisation and Embryology Authority  in order for extraction and fertilisation to take place. [ 8 ]   Following the 1997 case of  Regina v. Human Fertilisation and Embryology Authority , the terms of the Act were extended to  comatose  patients, and so theoretically  assault  charges could be (but in this case were not) brought against doctors for overseeing or performing the procedure. [ 6 ]


There are few other jurisdictions that fall into this category.  New York senator   Roy M. Goodman  proposed a  bill  in 1997 requiring written consent by the donor in 1998, but it was never passed into law. [ 9 ]


Also in Spain it is necessary to have a signed consent from the death person and the wife can only use the sample in a period of 12 months.


In 2003,  Israeli   Attorney General   Elyakim Rubinstein  published several guidelines outlining the legal situation of  posthumous sperm retrieval for the purpose of later insemination by a surviving female partner. The guidelines specified firstly that only requests by a partner (married or otherwise) of the deceased would be honoured – requests by other members of the donor's family would be denied. While extraction of the sperm was guaranteed following a request by the partner, permission to use the sperm was to be determined case by case, a court of law deciding on the basis of the effect on the presumed wishes of the donor, and the effect of the procedure on the donor's dignity. If it could be demonstrated that the deceased took definite steps towards parenthood (implied consent), use of extracted sperm by the female partner would generally be permitted. [ 10 ]


Many other countries, including  Belgium  and the  United States , [ 6 ]  have no specific legislation regarding the rights of people on gamete donation following their death, leaving the decision in the hands of individual  clinics  and  hospitals . As such, many medical institutions in such countries institute in-house policies regarding circumstances in which the procedure would be performed. [ 11 ]


Several ethical issues surround the extraction and use of gametes from cadavers or patients in a  persistent vegetative state . The ones most often debated concern religion, consent, and the rights of the surviving partner and child if the procedure results in a birth.


Some major religions prohibit posthumous sperm retrieval, including  Roman Catholicism [ 12 ]  and  Judaism . [ 13 ]  Roman Catholicism proscribes the procedure on much the same grounds as  in vitro  fertilisation, namely the rights of the unborn. Judaic strictures are based on the  halakhic  prohibition on deriving personal benefit from a corpse, and in the case of those in a persistent vegetative state, their categorisation as  gosses  (dying person) prohibits anyone from touching or moving them for anything that does not relate to their immediate care. [ 13 ]


Consent of the donor is a further ethical barrier. Even in jurisdictions where explicit or implicit consent is not required, there are occasions in which clinicians have refused to perform the procedure on these grounds. [ 11 ]  If no proof of consent by the donor can be produced, implied consent, often in the form of prior actions, must be evident for clinicians to proceed with the extraction. Sperm retrieval is rarely carried out if there is evidence that the deceased clearly objected to the procedure prior to his death.


Finally, if the procedure is performed and results in a birth, there are several issues involving the legal rights of the child and its mother. Because posthumous insemination can take place months or even years after the father's death, it can in some cases be difficult to prove the paternity of the child. As such,  inheritance  and even the legal rights of the child to marry (due to the possibility of  consanguinity  between partners) can be affected. For this reason, several countries, including  Israel  and the  United Kingdom , impose a maximum term for the use of extracted sperm, after which the father will not be legally recognised on the child's  birth certificate . [ 6 ] [ 10 ]


The  Repository for Germinal Choice  (originally named the  Hermann J. Muller Repository for Germinal Choice , after  Nobel laureate   Hermann Joseph Muller ) was a  sperm bank  that operated in  Escondido, California  from 1980 to 1999. The repository is commonly believed to have accepted only donations from recipients of the  Nobel Prize , although in fact it accepted donations from non-Nobelists, also. [ 1 ]  The first baby conceived from the project was a girl born on April 19, 1982. Founded by  Robert Klark Graham , the repository was dubbed the "Nobel prize sperm bank" by media reports at the time. [ 2 ]   The only contributor who became known publicly was  William Shockley , Nobel laureate in physics.


Robert Graham managed the bank until his death in February 1997 and the responsibilities were passed to Floyd Kimble, a businessman from  Ohio  who had shown interest in the bank. At the time of Graham's death, the bank claimed to have produced 217 children, none of whom from sperm donated from Graham's initial focus, Nobel Prize winners. [ 3 ] [ 4 ]  When Kimble died in 1998 the combined relatives of both men decided to close down the bank. All sperm samples were destroyed; it remains unclear what happened to the Repository's records. [ 1 ]


Although most news articles of the time made much of the Repository's "Nobel sperm" standards, in fact the Repository is only known to have stocked the sperm of one Nobelist, William Shockley. Other donors were recruited from among the ranks of scientists and academics Graham and his assistant, Paul Smith, considered to be "the future Nobel laureates". [ 1 ]


Graham's initial attempts to recruit Nobel laureates who lived near the Repository yielded only three volunteers, Shockley among them; however, when the news media began reporting on the existence and intentions of the Repository, two of the laureates broke off their ties to Graham and did not donate. Only Shockley remained, and even he donated only once. Paul Smith was charged with recruiting new donors, and he traveled throughout California, focusing mainly on college campuses, in search of volunteers. Smith later estimated his "hit rate" of donors signed up compared to men he invited to be "six or eight, maybe ten" out of one hundred. The search was expanded to country-wide, and eventually more donors were recruited, although none of them were – then or currently – Nobel laureates. At the time of his death, Graham had expanded his requirements to allow athletes, artists, and businessmen as donors. [ 1 ]


One donor named Jason Kaiser, known as Orange Red at the repository, was featured in the 2003 documentary along with Paul Kisak. The documentary was entitled  Genius Sperm Bank , which the  Discovery Channel  broadcast in 2004. The documentary briefly touched upon Kaiser's viewpoints at the time, and reunited him with three of the nine children that reputedly had resulted from his donations. Although not a Nobel laureate, Kaiser did achieve a  Master of Science  degree in  cytogenetics  and Kisak was in  Mensa ,  Intertel ,  the CIA  and had an  MBA  and multiple  Engineering  degrees.


As with the repository's criteria to accept sperm donors, its criteria for women to receive sperm from the bank were not as high as initially reported. Rumors that women were required to be members of  Mensa  were false; in fact, women did not need to meet any particular intellectual requirement. Essentially, any woman who was married, in good health, and not homosexual was accepted; the only women reported to have been refused sperm were "one [woman] who took  lithium , [and] another who was obese and diabetic." [ 1 ]


Graham's original intention was to monitor the outcomes of children produced through the bank's sperm, and he asked families using the bank's sperm to agree to periodic surveys; however, most recipients showed no interest in sharing information on their children once the procedure was over, and when he sent out a survey to recipient families in the early 1990s, few families responded. Two women who claimed to have been the recipients of repository sperm and to have raised children born of that sperm responded anonymously to a series of articles in  Slate  in 2001. Both stated that their children were extremely intelligent and healthy. [ 3 ]


A later segment of the same  Slate  article reported on the highlights of the lives of fifteen of the resultant children. Of the fifteen, six reportedly had 4.0  GPAs  and two were reported to be "artistically precocious". One child was reported by his parents as a "math-science genius" and another as a "musical whiz". All the children contacted by  Slate  were in good health, except one, who had what his mother described as a "developmental disability". [ 5 ]


Journalist  David Plotz  wrote several articles on the repository for the online magazine,  Slate . Plotz would later write a book about his experiences investigating the repository in the book  The Genius Factory: The Curious History of the Nobel Prize Sperm Bank  (2005). Moreover, a documentary, which aired on  BBC Horizon  in 2006, went over the history of the Repository and various statements made by Graham. The program also featured discussion from another donor, University of Central Oklahoma biology professor  James Bidlack . [ 6 ]


The Big Bang Theory ' s  pilot episode  satirizes the repository when  Leonard  and  Sheldon  visit the "high-IQ sperm bank," intending to donate specimens, only to leave after Sheldon suffers a moral crisis over committing "genetic fraud" by donating sperm that may not produce the promised genius offspring. [ 7 ]


Episode 5 of  This is Life with Lisa Ling  focused on the sperm bank, interviewing people who donated, people who went to the sperm bank seeking donated sperm, and people who were born as a result. [ 8 ]


The German novel  Fast genial  ("Almost Genius") by  Benedict Wells  tells the story of a fictitious child produced by the sperm bank, who searches for his biological father.


9. Singareddy, Nikita "The Nobel Prize Sperm


Bank" [ 1 ]


24 June 2020


In  sperm banks ,  screening  of potential  sperm donors  typically includes screening for  genetic diseases ,  chromosomal abnormalities  and  sexually transmitted infections  (STDs) that may be transmitted through the donor's sperm. The screening process generally also includes a quarantine period, during which samples are frozen and stored for at least six months after which the donor will be re-tested for  STIs . This is to ensure no new infections have been acquired or have developed during since the donation. If the result is negative, the sperm samples can be released from quarantine and used in treatments.


The screening process and requirements vary significantly between jurisdictions. In the United States, the screening procedures are regulated by the FDA, the  ASRM , the American Association of Tissue Banks, and the  CDC . [ 1 ]  The screening regulations are more stringent today than they have been in the past.
In Europe, the screening procedures are regulated by the  EU Tissue Directive .


The CDC standards for sperm donor screening require: [ 1 ]


Screening for  cytomegalovirus  is not mandatory in all jurisdictions, and positive donors may still donate at sperm banks. [ 3 ]


Donor screening for  cytomegalovirus  (CMV) is carried out by testing for  IgG antibodies  against CMV that are produced if the donor ever has contracted CMV, which is the case in between 50% and 80% of adults. [ 4 ]  Such antibody-positive individuals may potentially shed virus that remain latent in the body in the semen, infecting the mother and, in turn, the embryo/fetus. Most babies will not be harmed by the virus, but a small percentage may develop neurological abnormalities. [ 5 ]  However, the risk of acquiring CMV infection from an antibody-positive sperm donor is believed to be extremely low, at least where sperm banks perform follow-up tests on antibody-positive donors for type  IgM antibodies  that indicate current or recent CMV infection, and where sperm preparations are performed that decrease the amount of  white blood cells  in the samples, e.g. in samples prepared for  IUI . [ 5 ]


Washing techniques are developing that purify sperm from viral load of HIV and hepatitis C, [ 6 ]  but nevertheless clinics do not offer sperm from carriers of significant STIs.


Children conceived through sperm donation  have a birth defect rate of almost a fifth compared with the general population. [ 7 ] [ unreliable medical source? ]  This may be explained by the fact that sperm banks only accept donors who have good  semen quality , and because of the rigorous screening procedures which they adopt, including a typical age limitation on sperm donors, often limiting sperm donors to the ages of 21–39 (see  paternal age effect ), and genetic and health screening of donors. In addition, sperm banks may try to ensure that the sperm used in a particular recipient woman comes from a donor whose blood group and genetic profile is compatible with those of the woman.


Sperm donation is also used in cases of  rhesus incompatibility . This particularly occurs where a woman has a  blood type  which is rhesus negative, and where her partner is rhesus positive. The woman's body may reject a fetus if it has rhesus positive blood.  Anti D  injections have been developed and may be used to attempt to avoid this, and these are usually automatically given to rhesus negative women immediately after they give birth to their first child. However, in the past this was either not possible or was not always routinely undertaken where a woman gave birth or had an abortion and she may have trouble carrying a child later in life. Furthermore, for some women, the anti D injection does not provide the entire solution, particularly where there is a medical history of complications during pregnancy which risk the woman's blood and that of the fetus becoming mixed. In such cases, sperm from a rhesus negative donor can provide the solution and a woman may be able to conceive and carry a pregnancy to full term when otherwise this would not be possible. For this reason, sperm from rhesus negative sperm donors is often in great demand, particularly those with the O negative blood group who are universal donors.


A  sperm bank ,  semen bank,  or  cryobank  is a facility or enterprise which purchases, stores and sells human  semen . The semen is produced and sold by men who are known as  sperm donors . [ 1 ]  The sperm is purchased by or for other persons for the purpose of achieving a  pregnancy  or pregnancies other than by a sexual partner. Sperm sold by a sperm donor is known as  donor sperm .


A sperm bank may be a separate entity supplying donor sperm to individuals or to fertility centers or clinics, or it may be a facility which is run by a clinic or other medical establishment mainly or exclusively for their patients or customers.


A  pregnancy  may be achieved using donor sperm for insemination with similar outcomes to  sexual intercourse . [ 2 ]  By using sperm from a donor rather than from the sperm recipient's partner, the process is a form of  third party reproduction . In the 21st century  artificial insemination  with donor sperm from a sperm bank is most commonly used for individuals with no male partner, i.e. single women and coupled lesbians. [ 3 ]


A sperm donor must generally meet specific requirements regarding age and screening for  medical history . [ 4 ]  In the United States, sperm banks are regulated as Human Cell and Tissue or Cell and Tissue Bank Product (HCT/Ps) [ 5 ]  establishments by the  Food and Drug Administration . [ 6 ]  Many states also have regulations in addition to those imposed by the FDA. [ 7 ]  In the  European Union  a sperm bank must have a license according to the  EU Tissue Directive . In the United Kingdom, sperm banks are regulated by the  Human Fertilisation and Embryology Authority .


The first sperm banks began as early as 1964 in Iowa, USA and Tokyo, Japan and were established for a medical therapeutic approach to support individuals who were infertile. As a result, over 1 million babies were born within 40 years. [ 4 ]


Sperm banks provide the opportunity for individuals to have a child who otherwise would not be able to conceive naturally. This includes, but is not limited to, single women, same-sexed couples, and couples where one partner is infertile. [ 3 ]


Where a sperm bank provides fertility services directly to a recipient woman, it may employ different methods of  fertilization  using donor sperm in order to optimize the chances of a pregnancy. Sperm banks do not provide a cure for  infertility  in individuals who produce non-viable sperm. Nevertheless, the increasing range of services available through sperm banks enables people to have choices over challenges with reproduction.


Individuals may choose an anonymous donor who will not be a part of family life, or they may choose known donors who may be contacted later in life by the donor children. People may choose to use a  surrogate  to bear their children, using  eggs  provided by the person and sperm from a donor. Sperm banks often provide services which enable an individual to have subsequent pregnancies by the same donor, but equally, people may choose to have children by a number of different donors. Sperm banks sometimes enable an individual to choose the sex of their child, enabling even greater control over the way families are planned. Sperm banks increasingly adopt a less formal approach to the provision of their services thereby enabling people to take a relaxed approach to their own individual requirements.


Men who donate semen through a  sperm  bank provide an opportunity for others who cannot have children on their own.  Sperm donors  may or may not have legal obligations or responsibilities to the child conceived through this route. Whether a donor is anonymous or not, this factor is important in allowing sperm banks to recruit sperm donors and to use their sperm to produce whatever number of pregnancies from each donor as are permitted where they operate, or alternatively, whatever number they decide.


In many parts of the world sperm banks are not allowed to be established or to operate. Where sperm  banks  are allowed to operate they are often controlled by local legislation which is primarily intended to protect the unborn child, but which may also provide a compromise between the conflicting views which surround their operation. A particular example of this is the control which is often placed on the number of children which a single donor may father and which may be designed to protect against  consanguinity . However, such legislation usually cannot prevent a sperm bank from supplying donor sperm outside the jurisdiction in which it operates, and neither can it prevent sperm donors from donating elsewhere during their lives. [ 8 ]  There is an acute shortage of sperm donors in many parts of the world and there is obvious pressure from many quarters for donor sperm from those willing and able to provide it to be made available as safely and as freely as possible. [ 9 ]


The finding of a potential sperm donor and motivating them to donate sperm is typically called recruitment. A sperm bank can recruit donors by advertising, often in colleges, in local newspapers, and also on the internet. [ 10 ]


A donor must be a fit and healthy  male , normally between 18 and 45 years of age, and willing to undergo frequent and rigorous testing. The donor must also be willing to donate their sperm so that it can be used to impregnate people who are unrelated to and unknown by them. Some sperm banks require two screenings and a laboratory screening before a donor is eligible. [ 11 ]  The donor must agree to relinquish all legal rights to all children which result from their donations. The donor must produce their sperm at the sperm bank thus enabling the identity of the donor, once proven, always to be ascertained, and also enabling fresh samples of sperm to be produced for immediate processing. Some sperm banks have been accused of  heightism  due to minimum height requirements. [ 12 ]


A sperm bank will aim to provide donor sperm which is safe by checking and screening donors and of their semen. A sperm donor must generally meet specific requirements regarding age and medical history. Requirements for sperm donors are strictly enforced, as in a study of 24,040 potential sperm donors, only 5620, or 23.38% were eligible to donate their sperm. [ 13 ]


Sperm banks typically screen potential donors for a range of diseases and disorders, including  genetic diseases ,  chromosomal abnormalities  and  sexually transmitted infections  that may be transmitted through sperm. The screening procedure generally also includes a quarantine period, in which the samples are frozen and stored for at least six months after which the donor will be re-tested for the STIs. This is to ensure no new infections have been acquired or have developed during the period of donation. Providing the result is negative, the sperm samples can be released from quarantine and used in treatments. Common reasons for sperm rejection include suboptimal semen quality and STDs. [ 13 ]  Chromosomal abnormalities are also a cause for semen rejection, but are less common. [ 13 ]   Children conceived through sperm donation  have a birth defect rate of almost a fifth compared with the general population. [ 14 ]


A sperm bank takes a number of steps to ensure the health and quality of the sperm which it supplies and it will inform customers of the checks which it undertakes, providing relevant information about individual donors. A sperm bank will usually guarantee the quality and number of  motile  sperm available in a sample after thawing. They will try to select men as donors who are particularly fertile and whose sperm will survive the freezing and thawing process. Samples are often sold as containing a particular number of motile sperm per milliliter, and different types of samples may be sold by a sperm bank for differing types of use, e.g.  ICI  or  IUI .


The sperm will be checked to ensure its fecundity and also to ensure that motile sperm will survive the freezing process. If a man is accepted onto the sperm bank's program as a sperm donor, his sperm will be constantly monitored, the donor will be regularly checked for infectious diseases, and samples of his blood will be taken at regular intervals. A sperm bank may provide a donor with dietary supplements containing herbal or mineral substances such as  maca ,  zinc ,  vitamin E  and  arginine  which are designed to improve the quality and quantity of the donor's semen, [ 15 ]  as well as reducing the refractory time [ 16 ]  (i.e. the time between viable ejaculations). All sperm is frozen in straws or vials and stored for as long as the sperm donor may and can maintain it.


Donors are subject to tests for infectious diseases such as human immunoviruses  HIV  (HIV-1 and HIV-2),  human T-cell lymphotropic viruses  (HTLV-1 and HTLV-2),  syphilis ,  chlamydia ,  gonorrhea ,  hepatitis B virus ,  hepatitis C virus ,  cytomegalovirus  (CMV),  Trypanosoma cruzi  and  malaria  as well as hereditary diseases such as  cystic fibrosis ,  sickle cell anemia ,  familial Mediterranean fever ,  Gaucher's disease ,  thalassaemia ,  Tay–Sachs disease ,  Canavan's disease ,  familial dysautonomia ,  congenital adrenal hyperplasia ,  carnitine transporter deficiency . Some sperm banks may also use  karyotyping  to ensure donors are 46XY.


A sperm donor may also be required to produce their medical records and those of their family, often for several generations. A sperm sample is usually tested micro-biologically at the sperm bank before it is prepared for freezing and subsequent use. A sperm donor's blood group may also be registered to ensure compatibility with the recipient.


Some sperm banks may disallow sexually active gay men from donating sperm due to the population's increased risk of  HIV  and  hepatitis B . Modern sperm banks have also been known to screen out potential donors based on genetic conditions and family medical history. [ 17 ]


The majority of sperm donors who donate their sperm through a sperm bank receive some kind of payment, although this is rarely a significant amount. A review including 29 studies from nine countries came to the result that the amount of money actual donors received for their donation varied from $10 to €70 per donation or sample. [ 18 ]  The payments vary from the situation in the United Kingdom where donors are only entitled to their expenses in connection with the donation, to the situation with some US sperm banks where a donor receives a set fee for each donation plus an additional amount for each vial stored. At one prominent California sperm bank for example,  TSBC , donors receive roughly $50 for each donation (ejaculation) which has acceptable motility/survival rates both at donation and at a test-thaw a couple of days later. Because of the requirement for the two-day celibacy period before donation, and geographical factors which usually require the donor to travel, it is not a viable way to earn a significant income—and is far less lucrative than selling human eggs. Some private donors may seek remuneration although others donate for altruistic reasons. According to the  EU Tissue Directive  donors in EU may only receive compensation, which is strictly limited to making good the expenses and inconveniences related to the donation.


A sperm donor will usually be required to enter into a contract with a sperm bank to supply their semen, typically for a period of six to twenty-four months depending on the number of pregnancies which the sperm bank intends to produce from the donor. If a sperm bank has access to world markets e.g. by direct sales, or sales to clinics outside their own jurisdiction, a man may donate for a longer period than two years, as the risk of  consanguinity  is reduced (although local laws vary widely). Some sperm banks with access to world markets impose their own rules on the number of pregnancies which can be achieved in a given regional area or a state or country, and these sperm banks may permit donors to donate for four or five years, or even longer.


The contract may also specify the place and hours for donation, a requirement to notify the sperm bank in the case of acquiring a sexual infection, and the requirement not to have intercourse or to masturbate for a period of usually 2–3 days before making a donation. [ 19 ]


The contract may also describe the types of treatment for which the donated sperm may be used, such as  artificial insemination  and IVF, and whether the donor's sperm may be used in surrogacy arrangements. It may also stipulate whether the sperm may be used for research or training purposes. In certain cases, a sperm donor may specify the maximum number of offspring or families which may be produced from the donor's sperm. 'Family' may be defined as a couple who may each bear children from the same donor. The contract may also require consent if the donor's samples are to be exported. In the United Kingdom, for example, the maximum number of families for which a donor is permitted to bear children is ten, but a sperm bank or fertility center in the UK may export sperm to other fertility centers so that this may be used to produce more pregnancies abroad. Where this happens, consent must be provided by the donor. Faced with a growing demand for donor sperm, sperm banks may try to maximize the use of a donor whilst still reducing the risk of consanguinity. In legislations with a national register of sperm donors or a national regulatory body, a sperm donor may be required to fill in a separate form of consent which will be registered with the regulatory authority. In the United Kingdom this body is the HFEA.


A sperm donor generally produces and collects sperm at a sperm bank or clinic by  masturbation  in a private room or cabin, known as a 'men's production room' (UK), 'donor cabin' (DK) or a masturbatorium (US). Many of these facilities contain pornography such as videos/DVD, magazines, and/or photographs which may assist the donor in becoming aroused in order to facilitate production of the ejaculate, also known as the "semen sample" but the increasing usage of porn in the U.S. has dulled many men to its effects. [ 20 ]  Often, using any type of personal lubricant, saliva, oil or anything else to lubricate and stimulate the genitals is prohibited as it can contaminate the semen sample and have negative impacts on the quality and health of sperm. [ 21 ]   In some circumstances, it may also be possible for semen from donors to be collected during sexual intercourse with the use of a  collection condom  which results in higher sperm counts. [ 22 ]


After collection, sperm must be processed for storage. According to the Sperm Bank of California, sperm banks and clinics can use the 'unwashed' or 'wash' method to process sperm samples. The 'wash' method includes removing unwanted particles and adding buffer solutions to preserve viable sperm. However, this approach can contribute to further stress on the sperm cells and decrease the survival of sperm after freezing. The 'unwashed' approach allows for more flexibility to freeze the semen sample and increases the number of sperm survival. [ 23 ]  One sample can produce 1–20 vials or straws, depending on the quantity of the  ejaculate  and whether the sample is 'washed' or 'unwashed'. 'Unwashed' samples are used for  intracervical insemination  (ICI) treatments, and 'washed' samples are used in  intrauterine insemination  (IUI) and for  in-vitro fertilization  (IVF) or assisted reproduction technologies (ART) procedures.


A  cryoprotectant   semen extender  is conducted if the semen sample is placed in the freezer for storage. Semen extenders play a key factor in protecting sperm sample from 'freeze and osmotic shock, oxidative stress, and cell injury' due to the formation of ice crystal during frozen storage. The collection of semen is preserved by stabilizing the properties of the sperm cells such as the membrane, motility, and 'DNA integrity' in order to create a sustainable viable environment. [ 24 ]  There are two common forms of medium for sperm cyropreservation, one containing of egg yolk from hens and glycerol, and the other containing just glycerol. [ 25 ]  One study compared media supplemented with egg yolk and media supplemented with soy lecithin, finding that there was no significance between sperm motility, morphology, chromatin decondensation, or binding between the two, indicating that soy lecithin may be a viable alternative to egg yolk. [ 25 ]


After the sample has been processed for cryoprotection, the sperm is stored in small vials or straws holding between 0.4 and 1.0 ml of sperm and then  cryogenically preserved  in  liquid nitrogen  tanks. Two approaches for sperm cryoperservation include conventional freezing and vitrification. The conventional technique consists of a slow freezing process that is most commonly used for assisted reproduction technologies (ART). Whereas the vitrification method is a faster approach for sperm cryopreservation in converting liquid to solid state. The disadvantage of this latter process is increase in contamination from the liquid nitrogen and smaller sperm sample size to improve the speed for 'high cooling rate'. [ 26 ]


It has been proposed that there should be an upper limit on how long frozen sperm can be stored; however, a baby has been conceived in the United Kingdom using sperm frozen for 21 years [ 27 ]  and andrology experts believe sperm can be frozen indefinitely. [ 28 ]  The UK government places an upper limit for storage of 55 years. [ 29 ]


Following the necessary quarantine period, which is usually six months, a sample will be thawed. To thaw a sperm sample, the vial or straw is left at room temperature for approximately 30 minutes, and then brought to body temperature by holding it in the hands of the person performing the insemination. [ 30 ]  Once a sperm sample is thawed, it cannot be frozen again, and should be used to artificially inseminate a recipient or used for another assisted reproduction technologies (ART) treatment immediately. [ 30 ]


Freeze-drying is another promising alternative for storing semen for its accessibility with regular refrigerator. This method has been successfully replicated in animal species. However, DNA can be damaged in this process, therefore further research is warranted to determine factors that can effect the efficacy of this method. [ 31 ]


One study conducted by investigators at the University of North Carolina Chapel Hill looked into donated sperm utilization within the United States from 1995 to 2017. Cross-sectional studies recorded that an estimated 170,701 individuals during 1995 used donated sperm, while the 2011 to 2013 cohort had a decreased amount of donated sperm use of 37,385. Most recently, in the 2015 to 2017 cohort, 440,986 individuals were reported to use donated sperm. [ 32 ]  When looking at 200,197 individuals across 2011–2017, 76% had a 4-year college degree or further while 24% had high school or 2-year college degree. In terms of household percent of poverty, 71% of the sperm bank users were at or above 400% of the household poverty level while only 11% were between 200 and 399% of the household poverty levels. Although the household income levels were not explicit, there seems to be an obvious trend that higher education level attainment (such as finishing college or higher) and being at much higher income level above the household poverty levels were the common tendencies in the sperm bank users. [ 32 ]