The United States is one of the largest exporters of sperm in the world because unlike many other countries, the sperm “donation” industry remains largely unregulated.

For example, in the United States, there are no binding regulations on the number of children that can be born from a donor’s sperm. This lack of regulation has resulted in sibling groups that number in the high double and even triple digits. But in countries such as Germany, the United Kingdom, New Zealand, and Sweden, either a limited number of families may use the sperm from a donor or there is a maximum number of offspring that can be born from a donor. In the United States, however, the American Society for Reproductive Medicine (ASRM) has a non-binding guideline that suggests limiting a single donor to no more than 25 births in a population of  800,000 would avoid any significant increased risk of inadvertent consanguineous conception.

Under the ASRM’s non-binding guideline, it is acceptable to produce 10,000 offspring per donor within the United States alone

According to the U.S. Census Bureau, in 2020 the United States had a population of 331,449,281. Dividing this by ASRM’s recommended population number of 800,000, we get 414.3116. Then, multiplying that number by 25, ASRM’s recommended number of siblings per population of 800,000, we get 10,357.79. Thus, under the ASRM’s non-binding guideline, it is acceptable to produce 10,000 offspring per donor within the United States alone. Expanded to encompass the estimated world population of 7,577,130,400 in 2019, in theory a sperm donor from the United States could produce 236,785.325 offspring worldwide under ASRM’s guideline. These numbers render the so-called guideline meaningless.

In addition to the possibility of large sibling groups, the reality is that most donor conceived people will never know how many siblings they have throughout the world because the United States does not track this information. There is no official registry by which donor siblings can identify each other and make contact. The only available options are (1) posting the donor’s clinic-provided identification number on private registries (some with membership fees) or (2) taking multiple commercial DNA tests in hopes that a sibling will someday appear.

In a related issue, while other countries (e.g., Germany, the United Kingdom, New Zealand) have banned anonymous donations or at least made donor identities available to their genetic children at 18 years old, the United States continues to operate with no such requirements. Sperm banks across the country continue to accept anonymous donations despite the prevalence of commercial DNA testing and increasing calls from donor conceived people to consider the harm that results from anonymity. Indeed, even when a donor is identified through commercial DNA testing, there is no guarantee they will welcome contact given their prior (now largely unrealistic) assurance of anonymity.

Likewise, the expectation of anonymity and lack of regulations have allowed donors to sometimes completely fabricate their credentials and health history because sperm banks and clinics have not been legally required to verify this information. Without a system of checks and balances to verify the information provided by donors, intended parents are not guaranteed to receive accurate medical history for their future child, which can lead to long term complications and even death. But this could change as more high profile instances of such tragedies are brought to attention.

So far at the federal level in the United States, the Food & Drug Administration (FDA) requires screening donors for specific communicable diseases and allows the FDA to inspect medical facilities. And clinics that perform ART procedures must provide annual data to the Centers for Disease Control & Prevention (CDC) so that the CDC can publish success rates. But again, this is the extent of federal regulation in the United States. Sperm banks are not required to conduct genetic testing on donors, resulting in varied testing policies across the country. Individual states, however, are beginning to enact legislation related to gamete donation.

Top Image by Shari Sirotnak via Unsplash