Are UK Policies and Practices for Regulated Donor Insemination Forcing Women to Find Unregulated Sperm Donors Online? A Perspective on the Available Evidence

Abstract

In recent years, there has been an increase in women obtaining donor sperm via unregulated websites and social media. In this article, we bring together the disparate evidence in this emerging field to consider whether restrictive UK policies and practices for regulated clinical donor insemination (DI) are a potential explanation for the growing use of the currently unregulated, online route to donor insemination. To this end, we examine the nature of the National Institute for Health and Care Excellence (NICE) guidelines, recent data provided by the Human Fertilisation and Embryology Authority (HFEA), and prior research on who uses online sperm donation and their reasons for doing so. In addition, we highlight why this issue is important by outlining some of the benefits and drawbacks of the unregulated route. We argue that, whilst there are many factors driving the unregulated route to DI, restrictive UK policies and practices for regulated DI might be one of these. We conclude that turning our attention to structural barriers, such as regulated DI policies and practices, is necessary to produce more definitive evidence of this potential issue, and that adopting a Reproductive Justice framework could lead to more equitable provision of regulated DI services.

A SWOT analysis of unregulated sperm donation

“…Moreover, there is strong evidence of indirect discrimination of some groups through funding rules even when they are given legal access (Taylor et al, 2022).…”

“…Recipients indicated that the high cost of donor sperm in clinics and sperm banks is a prime motive for looking elsewhere (Jadva et al, 2018). When no reimbursement is offered, the costs of donor insemination may be very high, especially since the success rate per insemination is below 15 percent (Kupka et al, 2016;Taylor et al, 2022). As a consequence of the shortage of sperm donors in most countries (apart from Denmark), there are fewer donors to choose from (if recipients are allowed to do so) or to match.…”

“…As mentioned above, large groups such as single women and lesbian couples still have no or limited access to infertility treatment in many countries. It can be argued that restrictive policies and practices for formal donor insemination are forcing women to go online (Taylor et al, 2022). More and more European countries are allowing single women and lesbian couples to access fertility treatment.…”

“…Pride Angel had 27,650 members in 2017, among which approximately 17,000 registered as sperm recipients and slightly more than 5000 as sperm donors (Jadva et al, 2017). Taylor and colleagues estimated the number of potential recipients based on 60 English language websites and social media pages at 350,000 (Taylor et al, 2022). However, being registered does not mean that one is active or that connections are actually made in real life (Whyte et al, 2018).…”

The DIY IVF cycle—harnessing the power of deeptech to bring ART to the masses

“…Therefore, many couples have turned to inexpensive and less constrained alternatives such as seeking care abroad via “reproductive tourism” [ 5 ]. In the setting of donor insemination, women may turn to unscreened and unregulated sperm donors for financial reasons [ 6 ]. In addition to the cost, the global Coronavirus pandemic, restrictions, and invasive nature of ART, with frequent transvaginal ultrasounds and on-demand sperm production, have driven many couples seeking reproductive care to in-home alternatives that utilize health technology or “telehealth” [ 7 ].…”