Understand the Sperm Donation Process: Screening, Consent, and Clinic Steps

Understand the Sperm Donation Process: Screening, Consent, and Clinic Steps

I actually went through the donor screening process myself.

Spoiler: it’s way more medical, more emotional, and honestly more meaningful than the jokes make it sound.

I’m not a doctor, but I’ve now been on both sides: as a potential donor who went through screening and as a health writer who’s spent way too many late nights digging into the research, guidelines, and fine print. If you’re considering donating, using donor sperm, or you’re just sperm-curious, here’s what really happens.

Why People Actually Donate (and Use) Sperm

When I first walked into the clinic, the waiting room was a weird mix of nervous 20‑somethings and couples holding hands. I ended up chatting with a guy next to me who said, very casually, “My sister is doing IVF and it made me realise this is actually kind of a big deal.”

That hit me. This isn’t just biology; it’s family-building.

People use donor sperm for a bunch of reasons:

• Heterosexual couples dealing with male-factor infertility
• Single women who want to become parents
• LGBTQ+ couples, especially lesbian couples and trans people
• People who carry serious genetic conditions they don’t want to pass on

On the donor side, yes, some people do it for the compensation, but that’s rarely the only reason. In my experience, once you’re sitting in front of a counselor answering questions like, “How do you feel about potential donor-conceived adults contacting you in 20 years?” you realise this is a long-term decision.

Step 1: Pre-Screening – Who Even Qualifies?

The first surprise for me: most guys get rejected.

Many clinics accept fewer than 5–10% of applicants. They’re not trying to be harsh; they’re trying to keep the medical and genetic risks as low as possible.

• Age usually 18–39 (some banks cap at 35)
• No major inherited diseases in your family (at least 2–3 generations reviewed)
• Non-smoker or willing to quit
• No heavy drug use or recent high-risk sexual exposure

I filled out a questionnaire that felt like a mashup of a dating profile, a family tree, and my entire medical history. They wanted:

• Detailed family health info (cancers, heart disease, mental health, genetic conditions)
• Education and occupation
• Ethnic background (useful for matching and for specific genetic screening)

When I answered “migraine with aura” on a family member and the coordinator instantly flagged it to ask about stroke history, I realised: they are not messing around.

Step 2: Semen Analysis – The First Real Test

Then comes the part everyone jokes about: the actual sample.

When I tested this the first time, I was weirdly nervous. You’re shown to a private room, handed a sterile container, and told not to use lube (it can affect the sample). Most clinics ask you to abstain from ejaculation for 2–5 days beforehand.

The lab then looks at:

• Volume – how much semen
• Concentration – sperm per milliliter (WHO’s lower reference is 15 million/mL, but donor standards are often higher)
• Motility – how many are moving and how well
• Morphology – how many have normal shape

My first analysis came back with a comment I’ll never forget: “Excellent donor-quality motility.” I took a picture of the report and immediately texted a friend, “Finally, I have a measurable talent.”

But here’s the honest bit: I’ve seen guys crushed when their results came back low. It can hit your confidence hard. The clinic I went to had a policy of offering referrals to urologists instead of just saying “no thanks” and sending people away.

Step 3: Medical, Genetic, and STI Screening

Once my semen analysis passed the bar, the real scrutiny started.

Infectious disease testing

Most reputable clinics follow guidelines similar to those of the FDA (in the US) or HFEA (in the UK). That includes screening for:

• HIV-1 and HIV-2
• Hepatitis B and C
• Syphilis
• Chlamydia and gonorrhea
• HTLV (in some regions)

In my case, they also screened for CMV (cytomegalovirus) status, since that matters for matching with recipients.

Genetic carrier screening

This was the part that felt the most intense. I sat with a genetic counselor who walked me through panels for conditions like:

• Cystic fibrosis
• Spinal muscular atrophy (SMA)
• Fragile X (depending on country/clinic)
• Hemoglobin disorders (like sickle cell disease or thalassemia)

I remember her saying, “Almost everyone is a carrier for something. The question is: are you a carrier for something serious and common enough that we shouldn’t put this into the donor pool?”

She was right. A 2016 study in JAMA found that expanded carrier screening panels pick up carrier status in a majority of people tested. That doesn’t mean you’re unhealthy; it just means your genes have stories.

I came back as a carrier for a rare recessive condition I’d never heard of. The clinic still accepted me because they could safely match recipients who’d tested negative for that condition. That was a big reminder: this is all about risk management, not perfection.

Step 4: Psychological and Legal Consent

This is the part nobody puts in the movie scenes, but it’s absolutely crucial.

I sat in a small office with a counselor who asked things like:

• “How would you feel if, 18 years from now, someone knocked on your digital door and said, ‘I’m your donor-conceived offspring’?”
• “Have you discussed this with your partner/family?”
• “What are your expectations around anonymity?”

Different countries and banks have different rules:

• Some allow anonymous donors (though DNA testing sites are making anonymity shaky at best).
• Many now prefer or require identity-release donors, meaning donor-conceived adults can request your identity at 18.

When I signed the consent forms, I had to agree to things like:

• No parental rights or responsibilities
• No financial claims
• Limits on how many families or births my samples could be used for

I really had to sit with this: I might have genetic children out there who’ll never call me “Dad,” and that has to be okay.

Step 5: The Clinic Workflow – From Donation to Storage

Once you’re an approved donor, you enter the slightly surreal routine part.

Donations

I was asked to donate on a regular schedule, usually once or twice a week. Each visit looked roughly like this:

1. Check-in and quick health screening (any new partners? illnesses? medications?).
2. Provide sample in the collection room.
3. Lab staff processes the sample, usually within an hour.

Processing and freezing

The lab team then:

• Assesses the sample again
• Mixes sperm with a cryoprotectant (a special solution that helps them survive freezing)
• Divides it into vials or straws
• Freezes them in liquid nitrogen tanks at around −196°C

Not all sperm survive freezing and thawing. That’s why banks care so much about initial quality; they need good post-thaw counts for IUI or IVF.

Quarantine and retesting

Here’s something I didn’t fully appreciate until I read the FDA guidance: sperm is usually quarantined for months.

My early donations were frozen and held while I was re-tested for infectious diseases months later (the window period for some infections). Only if those tests were clean did the older samples get released for clinical use.

That delay is frustrating if you’re impatient, but it makes a lot of sense for recipient safety.

Recipient Side: How Clinics Actually Use Donor Sperm

I later interviewed a fertility specialist who walked me through what happens on the other side.

Depending on the situation, donor sperm is usually used in:

• IUI (intrauterine insemination) – washed sperm placed directly into the uterus
• IVF (in vitro fertilization) – eggs collected, fertilized in the lab, then embryos transferred
• ICSI (intracytoplasmic sperm injection) – a single sperm injected into an egg, often used with IVF

Clinics match recipients with donors based on:

• Medical compatibility (blood type, CMV status, carrier status)
• Physical characteristics (height, eye color, hair color)
• Personal traits and interests (education, hobbies, even voice recordings in some banks)

One doctor told me, “People think they’re picking a ‘perfect’ donor, but we coach them to think in terms of reducing risk and choosing someone they feel comfortable with, not building a designer baby.”

Pros, Cons, and Things No One Tells You

Upsides of being a donor

From my experience and from talking to other donors, the positives look like:

• You genuinely help people build families who might otherwise never have children.
• You get a very thorough health and genetic workup (often worth a lot if done privately).
• There’s compensation (varies by country and clinic).

Downsides and hard truths

• It’s a commitment: repeated visits, screenings, restrictions during the donation period.
• Emotional weight: knowing genetic offspring may exist out there.
• Anonymity is increasingly fragile in the age of consumer DNA tests.
• You may discover unexpected genetic or health information about yourself.

On the recipient side, families face their own mix of joy and complexity:

• Joy: a real, tangible path to parenthood.
• Complexity: questions about disclosure to the child, identity-release donors, and cultural or family reactions.

One donor-conceived adult I spoke with said, “I’m grateful I exist and also wish my parents had more info about my donor’s medical history.” That’s a good reminder that more transparency usually ages better than secrecy.

How to Vet a Good Sperm Bank or Clinic

If I were starting again, here’s what I’d personally check before signing anything (as donor or recipient):

• Are they regulated by a recognised authority (FDA, HFEA, ESHRE, or a national equivalent)?
• Do they clearly explain screening, quarantine, and limits on births per donor?
• Do they offer identity-release options and proper counseling?
• Do they provide up-to-date, detailed donor medical profiles, including genetic screening?

I’ve seen slick websites with terrible transparency, and quiet, unflashy clinics doing world-class work. The branding doesn’t tell you the whole story; the policies do.

Final Thoughts: What I Wish I’d Known Before

When I first walked into that clinic, I thought sperm donation was mostly about embarrassment, money, and paperwork.

What I discovered was:

• It’s heavily medical and surprisingly ethical.
• It involves long-term thinking about genetics, identity, and future adults.
• The screening process can teach you things about your own body and family history that you’ll carry for life.

If you’re considering donating, ask yourself: Am I okay with future contact? With no legal parent role? With my genetic legacy being out there in a controlled but real way?

If you’re considering using donor sperm, push for transparency: on screening standards, on donor identity-release policies, and on how your clinic handles long-term follow-up.

When done properly, with solid science and honest conversations, sperm donation isn’t just a medical transaction. It’s a careful collaboration between strangers to help create a family.

Sources

• U.S. Food & Drug Administration – Donor Eligibility: Reproductive Tissue - Official FDA guidance on screening and eligibility for reproductive tissue donors
• Human Fertilisation and Embryology Authority (HFEA) – Sperm donation - UK regulator explaining donor rules, screening, and identity-release
• Mayo Clinic – Donor sperm insemination - Overview of how donor sperm is used clinically
• American Society for Reproductive Medicine (ASRM) – Gamete and embryo donation: a committee opinion - Professional guidelines on donor screening and use
• JAMA – Carrier Screening for Genetic Conditions in Healthy Adults - Research article on expanded carrier screening and how often people are carriers