A donor's perspective on rethinking fertility access and the future of family‑building

When I joined the Donor Action Research Group on the Online Sperm Donation Project, I didn't join simply to take part in research. I joined because, as an online sperm donor, I have seen first-hand how many people struggle to build a family, and I wanted to help bring about meaningful change. My hope was that by sharing and hearing real people's experiences, we could identify practical ways to improve access to sperm donation, reduce unnecessary barriers and make the fertility system fairer for everyone.

Working alongside people with different experiences was one of the most rewarding parts of the project for me. The action research moved beyond misconceptions, assumptions and individual stories to reflect on common themes in the project's research findings and think about practical solutions.

The report, Rethinking Fertility Access, is the result of our discussions and workshops. It brings together the issues we discussed in the group, including inequalities in access to clinic fertility treatment, the reasons why some people need online sperm donation and our practical recommendations. Our recommendations include reforming NHS funding arrangements and eligibility criteria, exploring a means-tested Financial Fertility Aid scheme, reviewing investment in NHS-funded fertility treatment, increasing transparency in private fertility sector pricing and introducing harm-reduction measures for online sperm donation.

For me, it was important that the report captured the reality of what donors and recipients experience. I have supported many of the people affected by the issues covered in the report. I see the barriers not as theoretical problems but as daily realities. The individuals who contact me are often exhausted before they even begin. Many have spent years navigating inconsistent NHS rules that shift depending on where they live, long waiting lists and financial barriers.

Currently, the number of fully funded IVF cycles varies across the four UK nations and provision varies considerably regionally across England, resulting in a postcode lottery where identical patients may receive full funding in one area and none in another (see BioNews 1343 and 1344). It's clear that there needs to be national standardisation to create a fairer fertility system for all.

The idea of a Financial Fertility Aid scheme was something that I particularly advocated for when producing the report. This could offer means-tested financial support for individuals and couples who have not conceived following NHS-funded treatment and need to pursue further fertility treatment. By helping to cover the costs of donor sperm, IUI/IVF cycles or essential clinic fees, such a scheme could make parenthood a realistic possibility for many who would otherwise be unable to afford it.

As someone who has donated sperm to help others create families, it is important to me that people get the support they need at a cost they can afford to have a genuine opportunity to grow their families. Directing available public funds in this way could open up possibilities for many people, offering more choice to those who currently face significant financial barriers.

Crucially, the report also highlights that many people are not medically infertile but socially infertile. Social infertility refers to individuals and couples who cannot conceive without assistance due to social or relational circumstances.

Solo women and same-sex couples cannot conceive without donated sperm, and yet, currently, they are required to self-fund between six and 12 cycles of donor insemination before becoming eligible for NHS funding (see BioNews 1121 and 1344).

Many recipients whom I meet echo the participant quoted in the report: 'I started looking into IVF on the NHS, but unfortunately, I can't, I'm not eligible […] so I thought my next most logical step is to look for an online donor.' This quote captures the crossroads where so many recipients find themselves – and where donors like me become part of their story.

Another critical part of the report for me is the acknowledgement that online sperm donation is now an established part of the fertility landscape. People choose this route to conception for different reasons. Some people want to get to know their donor. Some want their donor involved in the donor-conceived person's life. And some just value a more flexible and non-medical approach. Others, however, like the recipient in the quote above, turn to online donation because they cannot access or afford treatment through regulated services.

Rather than ignoring online sperm donation, I believe we should make it safer. As we outline in the report, a harm-reduction approach could include better information and free implications counselling for recipients and donors, free medical screening for donors, a voluntary register to track the number of families donated to, further clarity on legal parenthood, and signposting to organisations that provide free, impartial advice and support. These are practical changes that recognise and support the reality of modern family-building.

My hope is that the report becomes the starting point for meaningful change. The future of fertility policy must be shaped not only by policymakers and clinicians but by the people who live with the consequences of these decisions every day. We need a fertility system that is fair, nationally consistent and reflects modern families. I hope that, one day, sperm donation – inside and outside of the clinics – will become accepted and supported in much the same way as blood and organ donation are today.

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Written by Andrew, in collaboration with the Donor Action Research Group on the Online Sperm Donation Project. The Donor Action Research Group comprised two people who donate sperm via online websites or social networks (Andrew and Jim) and three researchers (Dr Aleks Krotoski, Dr Alice Lemkes and Dr Rhys Turner-Moore). The Group worked together over the course of a year to imagine, consider and take action towards ideal futures for online sperm donation. The Group was part of the final phase of the four-year multidisciplinary Online Sperm Donation Project. Led by Leeds Beckett University, it involved ten researchers from five organisations, ran from 2022-2026, and was supported by the Economic and Social Research Council.