Analysis of the screening results of 24040 potential sperm donors in a human sperm bank in Henan Province, China: a 14-year retrospective cohort study

Abstract

STUDY QUESTION Is there a relation between the characteristics of potential sperm donors and the acceptance rate of these potential donors? SUMMARY ANSWER A relatively higher acceptance rate was observed for potential sperm donors who were aged ≤ 35 years, were married, had children, and who had received higher education, and acceptance rates were also higher during spring and winter than summer and autumn. WHAT IS KNOWN ALREADY Recruiting donors to a sperm bank program is difficult and slow owing to the high rates of rejection and dropout. STUDY DESIGN, SIZE, DURATION A total of 24040 potential sperm donors were screened by the Henan Human Sperm Bank from 2006 to 2019. PARTICIPANTS/MATERIALS, SETTING, METHODS Potential sperm donors were recruited using the following baseline requirement: height of 168 cm or taller; age 22-45 years; currently attending or had graduated from high school or above. Men who met the criteria for age, height, and education level were invited for semen quality screening. The acceptable criteria for semen samples included liquefaction time < 60min, volume ≥ 2mL, sperm concentration ≥ 60 × 106/mL, progressive motility ≥ 60%, post-thaw motility ≥ 40%, pre-freezing total motile sperm per vial > 30 × 106/mL, post-thaw total motile sperm per vial > 12 × 106/mL, and freeze-thaw survival rate ≥ 60%. Any potential sperm donors meeting the minimum criteria for acceptable semen quality on two consecutive semen samples were scheduled for clinical assessment, physical examination, and laboratory tests. The reasons for sperm donor rejection were analyzed. The characteristics of accepted and rejected donors were compared using the chi-square test, and multivariate logistic regression analyses were conducted to identify factors associated with the acceptance rate of potential sperm donors and the positive rate of sexually transmitted diseases (STDs). MAIN RESULTS AND THE ROLE OF CHANCE Only 23.38% (5620/24040) of potential sperm donors were accepted. The top four reasons for rejection were suboptimal semen quality (90.27%), STDs (6.26%), dropped out (2.65%), and chromosomal abnormalities (0.35%). The most common reason for the rejection of donors with an STD was a positive test for mycoplasmas (49.05%), followed by hepatitis B virus (27.56%), Chlamydia trachomatis (4.68%), and Escherichia coli (3.03%). n this study, the acceptance rate for men aged ≤ 35 years was significantly higher than that for men aged >35 years (P < 0.05). The acceptance rates were also significantly higher for men with a higher education than for men with lower education, married men than unmarried men, and men with children than men without children (P < 0.05). Moreover, acceptance rates were significantly higher during spring and winter than during summer (P <0.05) but were not significantly higher during autumn than during summer (P >0.05). LIMITATIONS, REASONS FOR CAUTION This study was not performed to analyze the effect of lifestyle habits, such as alcohol consumption and cigarette smoking, on the acceptance rate of potential sperm donors. WIDER IMPLICATIONS OF THE FINDINGS Only a small proportion of potential sperm donors were accepted in this anonymous sperm donor program. New strategies for sperm donor recruitment may be required to improve the acceptance rate. In the future, we may have to target potential sperm donors who are aged ≤ 35 years and who received higher education in order to improve the acceptance rate. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the Joint Construction Project of Henan Medical Science and Technology Research Plan under grant number LHGJ20190389. The authors report no conflict of interest. TRIAL REGISTRATION NUMBER N/A

An analysis of the outcome of 11 712 men applying to be sperm donors in Denmark and the USA

“…This analysis shows that, during 2018 and 2019, only a small fraction of initial applicants at Cryos in Denmark and the USA were finally accepted as sperm donors and passed all the screening tests such that their frozen samples were certified as being suitable and safe to be released for use. This figure (3.79%) is very similar to that reported by Paul et al (2006) in the Northeast of England (3.63%), but significantly lower that recently reported by Liu et al (2021) in China (23.38%). However, in their numerator, Liu et al (2021) only reported applicants who had previously met the basic requirements, and this probably corresponds closer to the 5996 applicants in our study who passed the initial screening questionnaire ( Fig.…”

“…This figure (3.79%) is very similar to that reported by Paul et al (2006) in the Northeast of England (3.63%), but significantly lower that recently reported by Liu et al (2021) in China (23.38%). However, in their numerator, Liu et al (2021) only reported applicants who had previously met the basic requirements, and this probably corresponds closer to the 5996 applicants in our study who passed the initial screening questionnaire ( Fig. 1 ) and who then attended for semen analysis.…”

“…The recruitment rates for other countries include: 14.8% in Nigeria ( Akinrinola et al , 2003 ), 32% in the USA ( Schroeder-Jenkins and Rothmann 1989 ), and 33.2% in China ( Ping et al , 2011 ). Liu et al (2021) suggested that these country differences in the final acceptance rate may be caused by different recruitment criteria in operation at each location. However, in this study, we have been able to show that there were genuine country differences between Denmark and the USA in the overall acceptance rate, given that Cryos uses the same policies, procedures, and protocols in both countries.…”

“…They found that only 3.63% of the initial applicants had samples that were frozen and subsequently released for use, with the most common reason for rejection being suboptimal semen quality (85.07%). More recently, Liu et al (2021) reported on the screening results of 24 040 candidate sperm donors over a 14-year period at a single centre in China and found that 23.38% of candidate donors were accepted. Moreover, they found that acceptance rates were significantly higher for men who were married, with children of their own and who had higher levels of education.…”

Cryopreservation of Sperm: A Review

“…In the 21st century, artificial insemination using a donated sperm sample from a place used to store sperm or the sperm bank has been most widely utilized by persons without a male partner, i.e., single women and women in same-sex partnerships [ 2 ]. Generally speaking, there are age and health background checks that a sperm donor must pass [ 3 ]. In the United States, sperm banks are under the observation of the Food and Drug Administration's Human Cell and Tissue or Cell and Tissue Bank Product regulations.…”