Here’s what we know – and don’t know – about using IVF sperm donors from overseas

Australia’s fertility sector has been rocked by yet more reports of serious errors, this time involving sperm donors from overseas.

On Monday, an ABC investigation revealed a Brisbane couple had signed a non-disclosure agreement after discovering that sperm from the wrong overseas donor had been used to conceive their child, who was born in 2014.

The same fertility clinic had keep secret an audit that found there was a “high risk” that sperm frozen before 2020 did not match the donor on the label. This included sperm from two overseas banks.

It’ well known that informal sperm donation, where people find a sperm donor online, is risky. But now formal sperm donation is in the spotlight. So how is it regulated and what do we know about donors? And how safe is it?

How does sperm donation work in Australia?

Formal fertility treatment, including sperm donation, is almost exclusively provided by private clinics. Medicare subsidises this treatment but patients still pay significant out-of-pocket costs.

Sperm donation is mainly used by single women and same-sex female couples. Couples who want to avoid passing on a known genetic condition, and some men who have had cancer treatment, may also choose to use a sperm donor.

Clinics provide those who need donor sperm with non-identifying details about several donors, and allow them to choose. Characteristics include the donors’ ethnicity, eye and hair colour, height and blood group, and whether they are a domestic or overseas donor.

Women with no known fertility problems may use a simple procedure called intrauterine insemination (IUI), where a small amount of the donor’s sperm is placed in the woman’s uterus when she is ovulating.

Women with fertility problems and those who have tried IUI without success need IVF to conceive. This involves fertilising eggs with donor sperm in the laboratory to form embryos, and then placing one in the woman’s uterus.

Who are the sperm donors?

Donors may be known – for example, a relative, friend or someone the recipient has connected with online.

De-identified donors, the most commonly used donors, are recruited by fertility clinics and aren’t known to the recipient.

Clinics have to record all donors’ identifying details so their offspring can access them when they reach adulthood.

International research shows most sperm donors are motivated by altruism and want to help people have children.

In Australia, donors can’t be paid for providing sperm. They must also agree to release their identity to any child born from their donation.

Potential donors undergo rigorous medical and psychological screening, which means only a small proportion of men who offer to donate sperm are accepted.

A study of more than 11,000 men who applied to become a sperm donor in Denmark and the United States found fewer than 5% were accepted and had samples frozen. Some men withdrew or didn’t respond; others had disqualifying health conditions or low sperm count.

As demand for donor sperm in Australia far outstrips supply, clinics import sperm from international sperm banks, mostly in the US or Denmark.

There are no national data on the proportions of sperm donation treatments that involve overseas or domestic donors. However, in 2024 clinics in Victoria stored sperm from 578 donors patients recruited, 1,001 donors clinics recruited, and only 46 donors recruited overseas.

Choosing a clinic and an overseas donor can be difficult. It also comes with added risks, such as the donor having donated to many clinics and people discovering their children have dozens or hundreds of half-siblings.

And, as demonstrated by the recent sperm mix-up report, the double witnessing procedures that are required in Australia may not have occurred for some imported sperm.

The rules for imported sperm vary slightly by state. But they are essentially the same as those for domestic donors.

What are the rules for donors?

Sperm donation is regulated through state and territory laws, the National Health and Medical Research Council Ethical Guidelines and the Reproductive Technology Accreditation Committee Code of Practice.

Although there are some differences between states, certain rules apply across all states and territories:

• a donor can’t receive any payment or inducement (apart from expenses incurred as a result of the donation, such as travel costs)

• potential donors and recipients must be counselled about the medical, special, psychological and legal implications of sperm donation

• potential donors must be screened for infectious and genetic diseases

• recipients are entitled to access information about the donor’s medical history, physical characteristics, and the number and sex of children born from that donor

• children born from sperm donation have the right to access information about the donor as adults. This includes identifying information such as their full name and date of birth

• clinics must maintain detailed records – including identifying and non-identifying information – of donors, recipients and offspring

• a donor has no legal responsibility for a child born from his donation

• a maximum number of families can be created with one donor’s sperm (five to ten, depending on state).

Clinics are required to report serious adverse events to the Reproductive Technology Accreditation Committee, but the committee doesn’t make this information public. So there is no way of knowing whether there has been other mixups, beyond what has been reported.

Is sperm donation safe?

In broad terms, fertility treatment – including sperm donation – is practised responsibly in Australia.

However, the reports of serious errors of the past few months, including reports of sperm and embryo mixups, as well as the use of non-disclosure agreements, raise questions about transparency within the industry.

As a result, in June, state and federal government ministers announced a rapid review of the fertility sector, and are currently awaiting its recommendations.

The review will consider whether the current patchwork of regulation should be replaced with national regulation, the merits of a national register of donors, recipients and offspring, and whether the current industry sponsored clinic accrediting body should be replaced by an independent body.

Based on the reported errors, it’s clear the sector needs an independent overseeing body to restore trust and confidence in the system.