Image: Archi Banal

OPINIONSocietyJune 6, 2023

The case for privatising sperm donation

Amber Older

Guest writer

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Image: Archi Banal

Overly tight regulation is hurting hundreds of New Zealanders who want a baby but can’t have one the old-fashioned way, argues Amber Older.

Deafening silence. Awfully good. Bittersweet. Who doesn’t love an oxymoron? Here’s another one: sperm shortage. Come again? Come again, indeed. And again, and again, while you’re at it.

According to the website of Fertility Associates, New Zealand’s largest clinic, the wait time to receive donor sperm is two-and-a-half to three years for in vitro fertilisation (IVF treatment) and intrauterine insemination (IUI). The timeline varies depending on the restrictions that some donors place on who can access their sperm (more on that shortly) and on individual preferences – for example, around ethnicity. The uncertainty of this time frame is compounded by the proviso that Fertility Associates “also cannot predict the demand or availability of donors into the future”.

The 2004 Human Assisted Reproductive Act (HART) makes it illegal for Kiwi sperm donors to be paid or given “valuable consideration” for their services. There is scant publicity or advertising to raise awareness of the desperate need for donations. It’s little wonder, then, that some people are turning to the internet to bypass the clinic waiting list. Last year, the online platform The Gift Of Family was launched. The “registered entity” aims to “connect Sperm Donors, Egg Donors, Embryo Donors and Surrogates with Recipients hoping to fulfil their dreams of parenthood”.

Comedian Tom Sainsbury has spoken about donating sperm to a lesbian couple who wanted to start a family (Photo: Supplied)

I recently listened to comedian Tom Sainsbury share his donor story on a parenting podcast. When asked why he agreed to father two kids to a lesbian couple he (at the time) hardly knew, his answer brought back all the fears and frustration of my own journey to motherhood. Fifteen years ago, I was single, fast approaching 40, and watching from the shore, empty wine glass and broken strappy sandal dangling in hand, as the ship of motherhood set sail without me.

Driven by the primal ache of maternal yearning (how does that ache suddenly become so…urgent?) I set out to explore my options – specifically, my fertility levels. Good news: they were that of a 28, not 38-year-old. I had time on my side! Bad news: the waiting list for the sperm bank was two years minimum and 40-year-olds were too old to make a “withdrawal”. What, then, were my options? Dear reader – this is where things get interesting.

Despite my favourable fertility levels, the specialist advised that the only sperm I could access was the handful (four) of donations flagged by their kindhearted donors for lesbian couples and singletons. To access that sperm, I would need to voluntarily undergo the same hormonal treatment used by women with compromised fertility. The process involved downing a slew of drugs and injecting myself in the stomach every morning to stimulate my egg supply. When the time was right, my eggs would be harvested, mixed with the donor sperm, and an embryo would be transferred back to my womb.

Price tag? North of $15k. Chance of conception? South of 20%.

New Zealand is experiencing a chronic jizz shortage

That was just the physical side. The process would also require two sessions with a counsellor to assess whether I was mentally and emotionally ready to become a mother through the aforementioned process. Once I had passed these tests, the specialist explained, I would be able to “meet” the donors via their paper applications. No photos – but there was a section where each donor shared in his own words why he was making his sperm available. Based on their two-page profiles, I could choose a donor and start the baby ball rolling.

Even though I hated taking medicine and the thought of self-injections made me nauseous, I couldn’t wait to start. Three weeks later, I had sailed through the counselling sessions and was ready to meet my donors. I felt nervous and excited. How will I choose him? What if I like more than one donor? Does it matter that I can’t see what he looks like? I decided to approach the selection session like I would a dinner party with strangers. If there was someone I enjoyed chatting with and who made me laugh, he would father my child.

One donor wanted full involvement with the child’s life, from religious upbringing to school zones. Donor two hadn’t told his partner he was making the donation, automatically rendering him more sneaky than saintly. Donor three was 50 years old when he’d made the donation five years earlier. Thanks, but no thanks.

Donor four seemed… good enough: he was in a long-term, committed relationship, his partner fully supported the decision to donate, he didn’t expect to meet the child (but was open to it if a meeting was initiated when they turned 18), and he knew the difference between a comma and semicolon. I even chuckled a couple times as I read his profile. Glory days! Sort of.

I left the clinic with a signed agreement that, within six months, I would begin hormone treatment and use the sperm of donor four. I felt comfortable with that time frame and the understanding that, if I changed my mind or didn’t start the process within that period, the sperm would be made available to someone else.

At about that time, out of the blue, an American friend phoned me to share her news: “I just paid US$1500 to knock myself up!” She met her donor through Cryobank California, one of the two biggest sperm banks in the world. Its donors are fully vetted and screened and are paid up to US$1500 a month for their services – plus gift vouchers and movie tickets. My friend felt she knew her donor intimately: she’d seen his baby pictures, examined his genetic test results, pored over his academic record at Harvard Business School, and could recite by heart his multi-branched Italian/Croatian family tree.

I was envious. How could she know so much about the father of her baby while I was stuck with a few measly paragraphs? A long-planned three-week visit to see my family in California was fast approaching and suddenly I knew how I was going to spend my holiday. The first time I logged on to my Cryobank account, I cried. I was overwhelmed by the quantity and quality of options. There were youthful, virile men of all sizes, shapes, colours, political leanings, religious bents and education levels. When I stumbled across a 28-year-old Jewish filmmaker who worked for the Boston chapter of the American Civil Liberties Union, my heart soared.

My heart sank, however, when I learned that I’d face arrest if caught entering NZ with a canister of foreign spunk. I briefly considered asking for three months’ leave from work to return to the US, crash out on the floor of my parents’ tiny one-bedroom apartment and try to knock myself up. But I knew the stress would wreak havoc on my ovulation cycle, which notoriously went out of whack whenever I travelled internationally. It was voluntary IVF with my 200-word donor or nothing.

Sometimes, fate intervenes. Not long after I returned from the US, I got lucky, found love, got pregnant the old-fashioned way, and became a mum six weeks before I turned 40. But not everyone gets in-the-nick-of-time lucky. In his podcast interview, Tom Sainsbury referenced the “seven” donors whose sperm was available for lesbian couples (and probably for “others” like me). When I heard that number I despaired. From four to seven donations in 15 years? Was my earlier donor option still on offer?

I know it’s a complex issue. There are myriad ethical, health, safety, social and legal issues to consider and protect. But the impact of having sperm so tightly regulated means a world of stress, anxiety and potential pain for the hundreds of Kiwis who want a baby but need someone else’s swimmers to conceive.

Surely, it’s a classic example of supply and demand. Here, the demand so far outstrips the supply, it undermines what the World Health Organisation deems a basic human right – to have a child. There aren’t many times I say “Let’s follow America’s lead” but, when it comes to sperm donation, I do. Hey, New Zealand – it’s time to break the deafening silence, make an awfully good decision, and come together to turn the Kiwi sperm shortage into a bittersweet vestige of the past.

Illustrations by Ned Wenlock.

SocietyJune 4, 2023

The Sunday Essay: Fragile tissue

Amelia Jacobson

Guest writer

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Illustrations by Ned Wenlock.

If I moved through the world with pulsing red lines across my body, would that allow others to see the reality of my pain?

The Sunday Essay is made possible thanks to the support of Creative New Zealand.

Original illustrations by Ned Wenlock.

I sit on a grey plastic chair, my sense of time obscured by the blaring fluorescent lights. The emergency department bustles around me in a blur. People cough and splatter, hold bleeding wounds and soothe crying children. I sit, I wait. The seats either side of me filling and emptying. All I want is relief, to lie down, but I shuffle in this hard chair. I sit, I wait. A voice cuts through; it takes me a beat to realise my name has finally been called. Shakily, I follow the doctor into a room.

The clicking of a keyboard. Muffled voices. Heartbeat monitors beeping. Repeating in a rhythm, the volume increases in increments. “We may need to operate, so we’ll have to keep you nil by mouth,” the doctor informs me, his eyes focused on the screen in front. My stomach tightens – I’ve forgotten how hungry I am. I realise how many hours must have passed. I ask about pain relief, telling him a nurse said four hours ago they’d get me something. He flicks his gaze to me briefly “We’ve got a shortage of beds.” I’m just so tired, I want to be at home. I would rather be in the comfort of my own bed if they can’t help me.

He asks me about my pain and I relay my lengthy medical history and the declined referrals. He pushes a pain chart toward me, an outline of a body, and asks me to mark the pain. My heartbeat rings in my ears as I scratch the pen across paper, drawing lines across the legs, arms, ribs, shoulders and along the back of the figure.

He keeps speaking, but it’s drowned out. I cannot make sense of it. Somehow, I am back sitting on the hard grey chair. It is quieter now. Someone is vacuuming. I sit, I wait.

From the womb my body floated, signalled unsafe, my hip detached from the socket even before I entered this world. As an infant, instead of crawling I would bum-shuffle across the floor. I’d sit with my legs splayed into a W shape, grasping at any sense of stability my body could find. I was a playful and imaginative child, throwing myself into various creative pursuits with zest and enthusiasm. But my childhood was also punctuated by constant injuries with no obvious trauma or trigger. I remember sprained ankles, strained wrists, and spending my afternoons perched in front of the TV as I immersed my feet in buckets of ice.

I couldn’t yet understand why group sports or wide games induced a tightening in my stomach, a sense of dread. I desired inclusion, involvement, but my body would signal to tighten, to protect. I always felt different, clumsy, sensitive. So I became an observer, sitting on the periphery.

I became skilled at bandaging my ankles, I accumulated various joint braces, and x-rays became a normal part of life. Hours were spent at physio and chiropractic appointments, diligently doing each new set of rehab exercises after every injury. I made my way around the primary school playground with crutches because my hips were constantly dislocated, and my left foot couldn’t touch the ground. The pain was still distressing, though I came to expect it, prepare for it. Still, no one could connect the dots.

I continued like this, proactively responding and bounding back into the fullness of life after each recovery. But I was unaware of how this pattern was shaping my development and suppressing my emotionality. At 14 I got glandular fever; peers and medical professionals alike made constant jokes about the “kissing disease”. I downplayed how sick I was, not fully resting, pushing myself and unwilling to miss out. A month later I was still sick. Two months later, still sick.

Sick. Sick. Sick.

I was so fatigued I could barely leave the couch. Every time I sat up I was struck by dizziness. It felt as if my body was betraying, turning against me. Sharp pain fired through every bone. Six months of my teenage life, on maximum doses of tramadol and codeine, watching every episode of House and Grey’s Anatomy in a blurred hope of an episode about someone like me. Doctors’ appointments ending in shrugged shoulders and unanswered questions. Blood tests coming back all clear. Referrals declined.

In 2019, in the midst of the chaos of my second year at film school, I was diagnosed with Ehlers-Danlos syndrome, hypermobility type. At 22, mine was considered an early diagnosis. The Ehlers-Danlos syndromes are a collection of connective tissue disorders. EDS is considered a rare condition; hypermobile EDS is not as scarce, but it is still rarely diagnosed. It is exhausting to recount all the times my symptoms have been downplayed because I come across as young and healthy. Connective tissue is all throughout the body, so the symptoms of EDS can seem vast and disconnected, and many of them are not visually obvious.

My pain is visceral, but it is invisible. This leaves room for doubt, for questioning. When the only framework for communicating pain is a clinical 1 to 10 scale, it limits the expression of how EDS impacts me and my quality of life. If I moved through the world with pulsing red lines across my body, threading around my tissue, marking it tangibly, would that allow others to see my reality? For empathy not to fail in the gaps of certainty? Susan Sontag, Elaine Scarry and Virginia Woolf have all written about the way physical pain causes a severing from language and expression – to be cut off and isolated by its invisibility, its unprovability. This sense of doubt hangs over the experience of living with EDS and leads to the burden of self-management. I fall through the cracks of the public health system, of ACC and MSD; I self-fund most of my care.

I spent years seeking answers, trying to understand what was wrong with me. As a young woman going into medical settings, I cultivated a sense of stoicism, a detachment, fearful of being labelled a “hysterical woman”. Expressing my experience only in practical and pragmatic terms, constantly self-advocating but leaving emotions out of it. I am only now unlearning and unravelling this default response, to hold space for the humanness of my experience. When I sat in the specialist’s office, heard my sprawling medical history read out, I finally had all the dots connected. This was real – there was an explanation the whole time. I no longer had to fight to be well, to conform to an able-bodied standard. I was able to retreat from the war against my body.

As I step over the threshold of inhabiting this body, my focus shifts to the external. I now understand I have been taught by our world to think this way. I am forced to reconcile the systems that present the true limitation. I embrace my fragile tissue, my softness, as I navigate new ways of being.

If you would like to know more about the Ehlers-Danlos syndromes visit ehlers-danlos.org.nz. For wellbeing support for EDS or other chronic illnesses, see shiloh.org.nz