TV Review: Inside Out North East & Cumbria - 24.09.18 (BBC)

The demand for sperm donors is rapidly rising within the UK. This partly reflects the growing number of single women opting to start a family, as well as an increasing number of women in same-sex relationships who wish to conceive. However, more heterosexual couples are also opting to use donor sperm to become parents due to rising rates of male infertility.

So if you want to have a baby but are lacking a source of sperm, how do you go about finding a donor? The BBC documentary series 'Inside Out' has recently investigated how women in the north east of England are tackling this issue, and the results make for some pretty worrying viewing.

We are introduced to Sarah, who wishes to have a child on her own, and couple Kirsti and Danielle. Both parties have eschewed treatment through a fertility clinic and have instead opted to find a sperm donor online. The use of unregulated sperm donors is becoming more popular in the UK and this seems to be due to the financial costs associated with the fertility treatment offered by regulated clinics. While the monetary costs associated with unregulated sperm donation are often very low, with many donors providing sperm samples for free, the documentary rapidly demonstrates that this option is not exactly 'cost-free'.

The potential for sexual abuse to occur seems to be high. Anyone, and I mean, ANYONE, can join a sperm donation website claiming to be a genuine sperm donor. There is a complete absence of screening. Donors do not have to prove that they have altruistic intent, they may simply be there for their own sexual gratification.

In addition, there are no sperm quality assessments, donors aren't tested for transmissible diseases, nor are they screened for medical or mental health issues. Sarah highlighted the unpredictable nature of searching for a sperm donor online as she recalled: 'There have been a few idiots that you really wouldn't want to interact with, because they do harass you or start sending you images you really don't need to see.'

Donors typically either perform 'NI' (natural insemination), shorthand for penetrative sex, or 'AI' (artificial insemination), in which the sperm sample is produced into a container and the insemination procedure takes place using a syringe or catheter. From a medical standpoint, AI is a perfectly adequate method of assisted reproduction and there is absolutely no need for NI, yet I was shocked to find out (and clearly naive) that some online donors are propagating the myth that NI will result in a higher chance of success. Some donors simply refuse to donate sperm unless NI is performed.

Kirsti and Danielle ultimately took a break from looking for an online sperm donor because they found the men that they were interacting with to be quite 'threatening' and' intimidating' in their demand for NI. Sarah did find a donor online, however, her experience was not positive. 'Ultimately it turned out he was married and that he'd actually had a vasectomy, so was in no way viable at all,' she said.

While some of the stylistic choices of the programme seemed quite cheesy (notably, the men wearing masks walking through crowds of people), it was still possible to comprehend the gravity of situation and it raised a number of important issues. Predominantly, should more be done to prevent these self-declared sperm donors from taking advantage of vulnerable people?

This is a difficult question to answer. Fertility expert Dr Larisa Corda believes that unregulated sperm donation websites are dangerous. 'In the ideal world, I'd love to see them shut down because I think women's safety and welfare has to be paramount here,' said Dr Corda. However, if the costs of regulated fertility treatment are prohibitively high then parenthood has the potential to become something available to only the privileged few.

In the second part of the programme, the topic strays away from finding a sperm donor and instead focuses on the emotional and psychological impact of infertility in men. Consultant urologist, Mr Kevin McEleny, believes that male-factor infertility is one of the 'last taboos'.

'You find very few people willing to discuss it publicly,' said Mr McEleny. 'Research we've done shows that it really can, in some cases, challenge their identity of being a man.'

We meet Collin and Rhona Humphrey, a couple who were unable to conceive naturally due to a low sperm count. Collin recounted how difficult he found the diagnosis and how paralysed he was in his ability to confront his situation. 'If I could have run in the other direction I would have,' he said.

While the couple have ultimately been able to have a daughter with the help of a fertility clinic, it is clear that Collin's reaction to his fertility status has placed a lot of strain on their relationship.  Fertility specialists were unable to determine a cause of Collin's low sperm count and this was a source of great frustration for him.

The programme briefly touches upon some of the research being performed at Newcastle University, which aims to elucidate the role that genomics plays in influencing sperm quality. The results could ultimately help men such as Collin have a greater understanding of why they require help to conceive and this may enable them to seek support sooner.

Overall, the programme is a short but informative introduction to the world of sperm donation and male infertility. You don't need a science degree to be able to enjoy the programme and it would be of particular interest to those who may need to use a sperm donor in the future. In addition, the programme tries to pull the issue of male infertility out of the shadows and into the open. These attempts to normalise the relatively common issue of male infertility and encourage a wider conversation about the impact of a male-factor infertility diagnosis are very welcome.

This episode of 'Inside Out North East & Cumbria' is available on the BBC iPlayer until 23 October 2018.