Is the UK sperm donor shortage a myth?

For the first time, a British sperm bank - the London Sperm Bank (LSB)- has sufficient stocks and donors to begin supplying clinics registered with the Human Fertilisation and Embryology Authority (HFEA). The move marks a shift in the dynamics of UK sperm donation, which so far has been served by a sparse domestic supply and imports from Scandinavia or the USA.

In 2008, the British Fertility Society (BFS) described the shortage of sperm donors in the UK as 'critical' and last year Professor Allan Pacey, then chair of the BFS, warned that the situation was leading to reduced patient choice, increased waiting times and could result in patients seeking out risky procedures.

But for us at the LSB that problem has moved on as we now begin the supply of sperm to clinics registered in the UK. Indeed, the growing volume and variety of our sperm stock would suggest that the perception that there is a shortage of donor sperm in Britain is no longer correct. Over the past five years we have had almost 25,000 enquiries from would-be donors, and we are now able to provide patients with a choice of more than 100 donors at any given time.

Nevertheless, such a turnaround in donor recruitment should not mask the detailed programme of assessment, counselling and screening needed to convert an enquiry into a recruited donor. The rate of attrition is high - only 4 percent of applicants are successful in becoming donors. The most frequent reasons for rejecting applicants are poor semen parameters and anomalies discovered at the genetic screening stage.

Despite this, we now operate the UK's largest independent sperm bank, with more than 25,000 vials of good quality sperm now in frozen storage. All the samples meet the UK's regulatory requirements of registration, screening and traceability. We have performed more than 5,000 treatments with donor sperm using this evolving technology, and we are confident that our systems work. That's one reason why we can now operate on a wider scale.

Behind this surge in domestic donors lies an alternative and innovative approach to donor recruitment, with amplified modern communication tools and personalised customer care to reach and encourage a wider pool of responders (1).

Demographically, the outcome is a far wider range of donors - from all walks of life - than ever seen before. And, far from being intimidated by the HFEA's 2005 decision to provide donor-identifying information to children when they reach the age of 18, our donors have proved overwhelmingly in support. Indeed, men can be motivated and relationships can be built in gamete donation, with donors keen to provide additional information to support future families created with their assistance.

A healthy supply of donor sperm at the LSB means that patients throughout Britain and overseas can now access sperm from anonymous donors from a regulated sperm bank in the UK, rather than having to depend on unlicensed private donations or on clinics abroad.

Internet technology has played an important part in developing the whole programme, with patients now able to select their sperm from a wide variety of donors presented in an online catalogue. This provides details of the donors' different backgrounds, education, occupation and life experiences, and is a significant move forward from the days when British sperm banks provided just basic characteristics.

Now, each donor profile on our website comes complete with staff impressions, family background (including a family tree), donor self-summaries and information that enables recipients to learn much more about their chosen donors' personality - a feature that women say is important when looking for that right donor to help start their family.

But the programme owes much to the men who really make all this possible, men from all backgrounds who present as genuinely motivated to help others. It requires dedication in repeated visits and screening tests which might take a year. Their commitment confirms an altruistic element to their personality and a creativity that enables them to understand the implications of their decisions - and underlines the adage that 'boring men don't become sperm donors'.

This upswing in donor recruitment has also run in parallel with a shift in patient behaviour in the whole matter of gamete donation; a swelling of public demand for treatments which are patient-centred and not merely at the behest of professionals.

Why should domestic patients needing egg donation travel abroad for donor eggs - or rely on Denmark or the USA for sperm supplies? I addressed these questions in a recent RBM Online commentary (2), suggesting that changes in patient behaviour now mark the beginning of a more level playing field in reproductive medicine. Just as in Italy, where the dismantling of draconian legal restrictions around gamete donation was driven by patients, it is now consumers in the UK - whether donors or patients - who lie behind this remarkable turnaround in sperm donation.