As sterility increases, sperm donorship becomes big business
DEMAND for immaculate conception is on the rise. And "quality sperm donors" are at a premium. Stress and pollution, especially in the metros, are taking their toll onthe Indian male's ability to reproduce. Corroborating this, a recent WHO report says that of the 15 per cent Indian couples in the child-bearing age-group who are infertile, nearly half are men. And many men, who may not be altogether sterile, are increasingly suffering from low sperm count.
As the incidence of low fertility among the urban Indian male increases, it's boom time for the artificial insemination industry. For those hesitant to adopt and yet unreconciled to remaining childless, a new breed of doctors is quick to recommend donor insemination. Couples desperate to have their own progeny and prove they are not "infertile" are easily persuaded to opt for this technique. Clandestine fertility clinics are mushrooming in Indian metros, for it's good business—with doctors charging anything between Rs 10,000 and Rs 25,000 for an insertion that should not cost more than Rs 2,500.
Warns a leading gynaecologist in the capital: "Donor insemination has been made into a backyard industry by many malprac-tising doctors. Volunteers are hardly scruti-nised and no tests done to check out HIV and genealogical disorders that may be passed on to recipients." A large number of clinics use fresh sperm from impromptu donors, whereas the scientific option is to take several semen samples, clean and cry-opreserve them by freezing them at a temperature of minus 197 degrees centigrade.
While fresh sperm insemination was in wide use till recently, it has been almost totally discontinued in the developed countries. It is now recognised that one-timescreening of the donors is inadequate to guard against infectious elements in the semen and accurate diagnostic methods of testing fresh semen are yet to be evolved. Both, the Cen-tre for Disease Control and the American Fertility Society now recommend the exclusive use of frozen semen that has been "quarantined" forsix months and released after re-testing the donor. HIV and Hepatitis B viruses show up anywhere between three and six months after the semen sample is taken, so the donors are tested repeatedly over this period.
"Now that medical science has provided childless couples with this option, the donor sperm has become a commodity and like any other commodity in the marketplace, one has to ensure its high quality," says Dr Bhashini Rao, managing director of Cryo Genie, the capital's only frozen sperm bank, asserting that they reject up to 60 per cent of those volunteering to donate.
Statistics confirm that donor insemination is a burgeoning trend. Rao's organi-sation alone sells over 100 donor semen samples at Rs 600 each every month. Reproductive biologists estimate that 500 to 600 cases of Artificial Insemination by Donors (AID) are taking place monthly in Delhi's private clinics. The Bombay-based Malpani Infertility clinic, the first in India to start a sperm bank, has reported 300 successful pregnancies over the past five years.
To cater to the growing demand for donor sperm in the south, Cryo Genie is setting up a branch at Bangalore in January. Says Rao: "We have been supplying over 20 sperm samples to various Kerala clinics every month. Requests are pouring in from other states, too. So, we thought why not make things simpler there and start a nodal point in Bangalore."
The demand for donor sperm not only cuts across regions, but classes too. Gynaecologist Tanu Kapur points out that the trend is no longer confined to the elite. "Despite the relatively high costs of this procedure, I am surprised by the number of lower middle class women who approach me with queries on donor insemination. Determined to disprove the stigma of being banjh (barren), women, irrespective of class,are coming forward seeking insemination by relatives and friends," she says. Disapproving of this tendency, Kapur insists she advises women against bearing the child of somebody familiar, as it can lead to emotional trauma later.
However, sometimes the extended family gets involved in the decision to go in for donor insem-ination. Such is the fear of property being inherited by a child "in whose veins family blood doesn't run" that some couples insist on an immediate relative from the husband's side being selected. "In one bizarre instance, I was eventually persuaded to impregnate a woman with her father-in-law's semen," admits a Delhi gynaecologist on condition of anonymity.
But for couples who don't want to involve others and intend not to reveal taking recourse to donor insemination, educational qualifications and a degree of physical resemblance to the husband are primary considerations. "Most such couples prefer medical students and bankers because they have high IQ levels," says Dr Sanjay Patil of the Delhi IVF Infertility clinic, at least 10 per cent of whose patients opt for donor insemination. Apart from these professional groups, university students are among the "high grade" donors.
The "working conditions" for volunteers are not exactly high grade, regrets Dr Rao. Individual donors are confined to small cabins and handed pornographic journals like Playboy and Penthouse . "In the West, a lot of attention is paid to creating the right environment. Titillating films are screened so that the donors don't feel like guinea-pigs."
It is, however, not the bland environment but the fear of disclosure that keeps away prospective donors. Sailesh Prasad, a 22-year-old student at a university in the capital, says that many of his friends are keen to donate sperm, but are constrained by the fear that their parents might find out. A sperm donor for over a year, Prasad sheepishly attributes altruistic motives to his donorship: "What are the Rs 200 I get for each donation? It doesn't even cover the taxi fare to the clinic. I do it because I want to bring happiness to issueless couples.
Concern over the possibility of even accidental revelation of identity dogs most donors. "The thought that some kid might walk up to me and claim I am his father makes me break into cold sweat at times," confesses Srikant Reddy, a lanky, bespecta-cled medical student. He admits, though, that the money is good, and probably the main motive: "Who would mind earning some extra bucks for masturbating?"
Recognising the burgeoning trend, the administration has finally swung into action to prevent donor insemination from becoming an outright commercial activity. Earlier this year, the Delhi government enacted a pioneering law to legalise the storage, sale, donation and supply of semen to protect childless couples from exploitation, commercialisation and exposure to health hazards by unscrupulous doctors.
The Delhi Insemination (Human) Act 1995 makes the registration of sperm banks mandatory and provides for strict semen testing for HIV infection. It also prohibits the segregation of the XX or XY chromosomes to avoid pre-conception sex selection. While the act ensures that strict secrecy is maintained regarding identities, clinics are required to retain a "complete record of bio-data, including the donor's mark of identification and the recipient of the semen or ovum".
Interestingly, the possibility of future contact by genetic offspring had a negative impact on the availability of donors in Sweden. There was a dramatic drop in the number of volunteers when, in 1985, it enacted legislation giving donor-inseminated children the option of knowing their biological fathers' identities on turning 18. However, subsequent research shows that over the last 10 years there has been an upswing in the number of donors. Several developed nations have since introduced similar laws.
"You can keep framing laws that look very good on paper, but who will implement them?" asks Dr J.J. Sood, a sub-fertility specialist and president of the National Association of Sexology India. The important thing, he feels, is to ensure that couples who ask for donor insemination "deserve" to be parents. "And, I ensure that the concerned husbands have the necessary maturity to accept surrogate fatherhood." For, unlike the donor, they have to live with the sperm.
(Names of the sperm donors have been changed.)