Age 40 is too Old an upper limit for Sperm Donors

New Guidelines For Screening Of Sperm, Egg And Embryo Donors In The UK
Main Category: Fertility
Article Date: 12 Jan 2009 - 3:00 PST

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New guidelines have been developed on the medical and laboratory screening procedures for sperm, egg and embryo donors. The guidelines, published in the journal Human Fertility, update those previously drawn up for sperm donors by the British Andrology Society in 1999 and for egg and embryo donors by the British Fertility Society in 2000 and combines the new recommendations into a single document.

In 2006 in the UK, 2106 women received treatment with donor sperm, 1622 women had treatment with donor eggs and 98 women with donor embryos. The guidelines aim to:

- Protect the recipients of donor sperm, egg and embryos from acquiring an infection from the donor.
- Protect any donor-conceived people from being born with an infection or acquiring a serious heritable disorder from the donor.

The guidelines recommend all donors should be assessed/screened for the following:

1. Diseases transmitted via bodily fluids. All prospective donors must screen negative for HIV, hepatitis B and C, and human T cell lymphotropic viruses (which have been implicated in causing some types of cancer). In the case of sperm and embryo donation, donors should be re-tested after a 180-day quarantine period. All prospective donors should also be tested for syphilis, gonorrhoea and chlamydia to minimise the risk of transmission to the recipient.

2. Genetically transmitted diseases. All donors should have a thorough medical history taken to ensure their family does not have a history of a disease with a major genetic component (e.g. congenital heart malformation, haemophilia, Huntington's disease). Any person with a significant inheritable condition that has a major adverse effect on lifestyle or life prognosis cannot be a donor. All potential donors should be screened for chromosomal disorders to ensure their cells contain the correct number of chromosomes. Potential donors should also screen negative for common genetic conditions related to their ethnic background (e.g. common mutations of the cystic fibrosis gene in those of Caucasian descent).

3. Prion-related diseases, e.g. Creutzfeldt-Jakob disease (CJD). Although there are currently no tests to detect people at risk of developing variant CJD, donors should not be accepted if either they or a close family member has been diagnosed with a prion-related disease, undergone invasive neurosurgery or received human pituitary-derived growth hormone or a tissue transplant from the human eye or nervous system.

4. Age limits. All potential donors should be over the age of 18. The recommended upper age limit for men is 40, and for women is 35 as the likelihood of successful pregnancy decreases with the age of the donor. The number of mutations in the DNA of sperm and eggs also increases with age, meaning there is a higher risk of the child being born with a genetic abnormality.

5. Fertility. Before donation, all men should have their semen quality tested to ensure their sperm are healthy and active. There is currently no test available to screen for fertility in women. Previous guidelines suggested that the ideal egg donor would already have proven fertility and have completed their own family. It is possible that ovarian reserve testing of potential egg donors may be a useful tool to predict whether a woman will be able to produce enough eggs for donation. However, this test has yet to be validated in the non-infertile population.

Dr Allan Pacey, Chair of the Working Party that developed the guidelines, said:
"The donation of sperm, eggs and embryos is a key aspect of assisted reproduction and many couples rely on donors to create a family. These guidelines aim to reinforce the safety of donation both for the recipient and for donor-conceived people. The UK professional bodies have worked together to revise these guidelines and promote good clinical practice, providing patients with safe and effective treatment and helping them have healthy children."

These guidelines were produced by a group comprising representatives from the Association of Biomedical Andrologists, Association of Clinical Embryologists, British Andrology Society, British Fertility Society and the Royal College of Obstetricians and Gynaecologists.

Notes

This report is published in Human Fertility 2008, 11(4), 201-210. DOI: 10.1080/14647270802563816. A full copy of the report is available here. Human Fertility is the official journal of the British Fertility Society.

The British Fertility Society is a national multidisciplinary organisation representing professionals practising in the field of reproductive medicine. For general information, see: http://www.fertility.org.uk/

The Association of Biomedical Andrologists was established in 2004 to provide support for laboratory scientists in the United Kingdom who undertake clinical andrology in their daily work. For general information see: http://www.aba.uk.net/

The Association of Clinical Embryologists was founded in 1993 to promote high standards of practice in clinical embryology and to support the professional interests of embryologists working in the UK. For general information see: http://www.embryologists.org.uk/

The British Andrology Society was formed as a special interest group in 1977 for scientists and clinicians working in the fields of human and mammalian reproduction with an interest in the male. For general information see: http://www.britishandrology.org.uk/

The Royal College of Obstetricians and Gynaecologists is a professional body for medical consultants which encourages the study and advancement of the science and practice of obstetrics and gynaecology. For general information see http://www.rcog.org.uk/

ABSTRACT

UK guidelines for the medical and laboratory screening of sperm, egg and embryo donors (2008)

Association of Biomedical Andrologists, Association of Clinical Embryologists, British Andrology Society, British Fertility Society, Royal College of Obstetricians and Gynaecologists

This article updates the 1999 British Andrology Society (BAS) guidelines for the screening of sperm donors and the 2000 British Fertility Society (BFS) guidelines for the screening of egg and embryo donors and combines the new recommendations into a single document. This was achieved by a multidisciplinary working group composed of representatives from the Association of Biomedical Andrologists, the Association of Clinical Embryologists, the BAS, the BFS and the Royal College of Obstetricians and Gynaecologists. The major changes to the guidelines include a requirement to consider a donor's risk of transmissible spongiform encephalopathies and the recommendation to screen for human T cell lymphotropic viruses 1 and 2. The role of nucleic amplification tests for the detection of blood borne viruses such as HIV is discussed, but it remains the recommendation that this be achieved by serological testing to detect antibody or antigen as appropriate with a quarantine period of 180 days.

Royal College of Obstetricians and Gynaecologists