Egg and Sperm Donation

Egg and sperm donors are typically recruited through fertility clinics, specialized donor agencies, online platforms, and advertisements that often target college students and young adults. 

The clinics present donor profiles to prospective parents in curated databases that include photographs (sometimes childhood and adult), physical characteristics, ethnicity, educational background, test scores, personal interests, and medical histories. Compensation varies widely and may be influenced by perceived “desirable” traits, including race, height, academic achievement, or other characteristics.

Prospective donors undergo medical, psychological, and genetic screening. Screening protocols generally include testing for infectious diseases (such as HIV and hepatitis), carrier screening for certain heritable genetic conditions, and collection of detailed family medical histories. However, reporting requirements and the depth of screening can vary among clinics.

Sperm donation is, medically speaking, straightforward. A male donor provides semen samples at a clinic, oftentimes using pornographic material. The samples are analyzed for sperm count and motility, quarantined, and frozen (cryopreserved). After a quarantine period and repeat infectious disease testing, the sperm may be released for clinical use. 

Sperm is used either for intrauterine insemination (IUI) or IVF. In IVF, eggs retrieved from the intended mother or an egg donor are fertilized in a laboratory dish, and resulting embryos are transferred to the uterus.

There are no binding national limit on the number of offspring produced from a single sperm donor. Although some sperm banks impose voluntary caps—often based on the number of families rather than children—enforcement is inconsistent. Media reports and court cases in the United States and abroad have documented instances in which individual donors have fathered dozens or even hundreds of biological children, with some widely reported cases estimating fifty to 500 offspring. Large networks of genetic half-siblings raise concerns about accidental incest between children that don’t know they are related, as well as ongoing psychological and public health risks as children yearn to know their medical history and where they came from. 

Egg donation is substantially more invasive and medically complex. Women, typically between eighteen and thirty-four- years old, undergo ovarian stimulation with high doses of exogenous hormones over approximately ten to fourteen days. These medications stimulate the ovaries to produce multiple mature oocytes (eggs) in a single cycle rather than the single egg typically produced naturally.

When follicles reach maturity, the donor undergoes transvaginal oocyte retrieval under sedation. Using ultrasound guidance, a physician inserts a needle through the vaginal wall into the ovaries to aspirate the eggs. A single cycle may yield ten to thirty eggs.

The medical risks to egg donors are real and can include ovarian hyperstimulation syndrome (OHSS), a condition characterized by ovarian enlargement, fluid shifts, abdominal pain, blood clots, and in rare cases organ failure or death. Other risks include bleeding, infection, ovarian torsion, and potential injury to surrounding organs. Some studies have raised questions about possible long-term risks, including effects on future fertility or increased risk of certain cancers, though data remain limited due to the absence of long-term tracking systems. It is most accurate to say that researchers and doctors simply don’t know the risks of egg donation because it is not tracked systematically, but what we do know points to increased health risks for the women. 

Given this, many advocates have raised concerns about the lack of informed consent given the limited understanding of short-term and long-term health risks for egg donors. Notably, egg donors are not considered “patients” in the traditional sense because the procedures are not intended to treat their own health but to produce gametes for others. It raises an unavoidable question: Why are we facilitating large industries where medical procedures are being done on women who are not patients (whose health is not tracked and reported on) and are not in need of medical intervention?

Despite the term donation, gametes are routinely purchased. Egg donors may receive between $5 thousand and $15 thousand per cycle, with significantly higher payments reported for donors with particular educational credentials or physical traits. Sperm donors are paid per sample, often $100 to $1,000, and may donate repeatedly.

Agencies often use altruistic slogans, “Inside every hero there are a million more,” but the reality is that young adults, often students strapped for cash, are selling their fertility. And while adoption law treats a child’s identity and medical history as precious and protected, gamete donation often erases the biological parent contractually, turning the person’s genetic material into a product.

There is also an undeniable eugenic assumption in the egg and sperm donor market: Certain kinds of people are worth (financially speaking) more than others. Based on reviews of advertisements and websites selling egg or sperm, investigative journalists have found substantial variation in compensation by race, education, IQ, looks, and athletic talent. 

A central ethical and policy question concerns the interests of children conceived through donor gametes. This is unlike adoption, which involves judicial oversight focused on the “best interests of the child” and is only pursued when parents are unable—for whatever reason—to care for their child, gamete donation intentionally creates a situation in which a child is conceived with the knowledge that he or she will be permanently separated from one biological parent.

Thus, it is not uncommon for donor-conceived children to report a strong interest in knowing their biological origins. Research from Harvard Medical School’s Center for Bioethics and survey data from donor-conceived adults indicate that many donor-conceived children experience identity concerns, distress about donor anonymity, and frustration over the commercialization around their conception.

The 2010 study My Daddy’s Name Is Donor found that young adults conceived via sperm donation reported higher rates of depression, substance abuse, and delinquency compared to peers raised by their married biological parents. While interpretations of such findings are debated, they have contributed to ongoing policy discussions².

Medical risks also arise from incomplete or inaccurate genetic information. Donor-conceived individuals may lack access to full family medical histories or knowledge of hereditary conditions. In some high-profile cases, rare genetic mutations carried by a single sperm donor have been transmitted to multiple offspring, revealing weaknesses in oversight and reporting systems.

Furthermore, with the widespread availability of direct-to-consumer DNA testing, anonymity is increasingly difficult to guarantee. Many donor-conceived individuals have used genetic databases to identify biological parents and large networks of half-siblings, sometimes numbering in the dozens.