Why do we need it and how does it work?
An increasing number of people are turning to sperm donors to help make their dreams of a baby a reality. Sperm donors (both privately and through fertility clinics) provide a valuable service, giving perhaps the greatest gift of all to families in need – the gift of life. But with an increase in sperm donation comes difficult questions around the genetic health of samples. Parents and fertility doctors want to ensure that the children they are helping to bring into the world are going to live long and healthy lives. Genetic testing helps to ensure that a foetus not only has the best chance of thriving in the womb but that the child it will go on to become is unlikely to develop a genetic condition. We take a closer look at genetic testing and sperm donation, below.
Why do our genes matter?
Genes are packed into bundles called chromosomes. We are all born with 23 pairs of chromosomes, half that we inherit from our biological father and half that we inherit from our biological mother. It is the interaction of these chromosomes that forms the blueprint for who we will become. Our genes determine physical features like eye colour, hair colour, and potential height but can also determine whether we will go on to develop certain medical conditions. By reviewing the genetic profile of a sperm donor before conception occurs, fertility experts can determine whether a child is likely to inherit a genetic condition.
Genetics play a role in a huge number of conditions and diseases. These inclu de, Downs Syndrome, cystic fibrosis, and Huntingdon’s disease. Potential parents undergoing fertility treatment understandably want to reduce the risk of their children being born with a genetic disease to the lowest possible level.
What is genetic testing?
Genetic testing is when experts take a sample of biological tissue to review the genetic profile of a subject. This sample could come from blood, hair, saliva, or in the case of donor testing, sperm. Genetic experts examine the DNA chain within the sample for mutations to indicate the likelihood of a future child developing a genetic condition. Genetic testing is a highly specialised process that is carried out on a lab.
Why do we need to carry out genetic testing on sperm donors?
Parents and fertility doctors want to ensure that the donor they have chosen has the best possible chance of producing healthy children. Genetic testing offers a safeguard against future genetic disease providing both doctors and prospective parents with peace of mind. It’s important to remember though, that no test, genetic or otherwise can fully guarantee the future health of a child.
Are all sperm donations genetically tested?
No. Sperm donations collected by a licensed fertility clinic are usually genetically tested as a standard part of the selection process, but many private donors are unlikely to be tested. Prospective parents who choose to use a private donor will usually ask for a detailed medical history and STI tests in place of genetic testing.
Will sperm donors undergo other health checks?
If the sperm donor is donating through a licensed fertility clinic they will face a rigorous round of medical tests including blood and urine checks, STI tests, an HIV test and a detailed physical. Fertility clinics want to ensure the sperm donors they accept into their programme are as healthy as possible.
Can I pay for genetic testing of a private sperm donor?
There are companies that offer genetic testing to private individuals, but this needs to be something that your sperm donor is comfortable with and may attract a significant cost. You may also lack the expertise to fully interpret the results of genetic testing without the support of a fertility doctor or genetics expert.
Are there any genetic disorders that tests won’t pick up?
Yes. Unfortunately, the number of genetic mutations and markers for disease is enormous and there are some mutations that genetic scientists still do not fully understand. While fertility clinics test for many of the most common genetic mutations this is not enough to anticipate every potential condition. A clinic may also identify specific genetic tests they wish to carry out based on a donor’s family history in addition to their usual testing process. Furthermore, some genetic mutations occur spontaneously and cannot be anticipated by reviewing the DNA of a child’s biological parents. Some of the most common genetic mutations tested for include those that lead to cystic fibrosis, sickle cell disease, and spinal muscular atrophy.
Do sperm donors go on to have healthier children?
Children born via sperm donor experience birth defects at 1/5 of the rate seen in the general population. These results indicate that the rigorous vetting of sperm donors including genetic testing does work. It’s uncertain as to whether a rise in private sperm donations could affect this figure.
Will genetic testing ensure my child is born without any health problems?
No. Unfortunately, no doctor or test can ever guarantee that your child will be born without health problems. A small percentage of children are born with some form of birth defect regardless of how they are conceived. This is a risk and a fear that all parents face. What genetic testing can do is to help you feel confident that the risks of your child being born with a genetic disorder are reduced as much as possible.
Are there any disadvantages to genetic testing?
As above, genetic tests may not reliably pick up on every genetic disorder your child may suffer. And as some mutations occur spontaneously when an embryo is conceived, it is impossible to ever fully screen out genetic abnormalities.
There is also the issue that some genetic disorders (which may cause a donor to be rejected) may not be life threatening or debilitating. Some conditions are unlikely to become apparent until a person is in their 50s or 60s and even then, can be managed comfortably. This creates an ethical question around genetic screening and whether it could be preventing children from being born who would have lived largely full and healthy lives. Some experts worry that increasingly rigorous testing will eventually lead to a shortage of donors. At present only around five to seven percent of donors who apply are accepted.
Where can I find out more about genetic testing of sperm donors?
You should speak to your fertility clinic to find out more about their genetic testing process and other health checks that they complete on potential sperm donors. This will usually include a full medical, STI checks and obtaining a detailed family history. Some clinics also offer genetic matching services which compare the DNA of the mother and potential sperm donors to find the best genetic match.
Genetic testing is a useful tool and can help to ensure the healthiest and most suitable donors make it through the donation process. However, it’s important to remember that not all uncertainty can be eliminated from the conception process and that every part of parenthood carries both risk and reward. By learning about and minimising the risks they face, potential parents can move through the fertility process with a greater sense of understanding.