Research seeks reasons behind shortage of Black sperm donors

Sperm banks provide a solution for people who wish to become parents and would not have a chance otherwise. Couples with fertility issues, single women and some members of the LGBTQ community would likely not have the fundamentally human and life-changing opportunity to conceive a child were it not for donated sperm.

But that opportunity is seriously limited for people who want to conceive using sperm from African American or Black donors. As of May 2023, just 4.4% of sperm in the four largest sperm banks in the United States were from Black or African American donors, while nearly 14% of the U.S. population is Black or African American, exacerbating inequities in access to reproduction and fertility care for this population.

This shortage is a problem that Courtney Marsh, M.D., MPH, associate professor of obstetrics and gynecology at the University of Kansas Medical Center, has witnessed first-hand as a fertility doctor treating patients who are African American or Black at The University of Kansas Health System.

“One of the top priorities for patients using donor sperm typically is that it be from someone who looks like them. Race and ethnicity are something that patients want to select for, and donors identifying as Black are really underrepresented,” said Marsh, who also directs the Division of Reproductive Endocrinology and Infertility at The University of Kansas Health System. “And then patients also look beyond race for medical things such as blood type or infectious disease status, so it can be really difficult for them to find a match.”

Marsh knew that to solve this problem, researchers would need to find out why the shortage exists in the first place. Last year, she was awarded an Access to Care Grant by the American Society for Reproductive Medicine to study attitudes toward sperm donation in the Black community — the first study to do so.  

The research team for the project includes two KU reproductive urologists, Richard Fantus, M.D., and Ajay Nangia, M.D., who have conducted research in access to care inequities in sperm-related reproductive health, and Sharla Smith, Ph.D., MPH, a health systems and health services researcher at KU who specializes in maternal and infant health disparities and founded the Kansas Birth Equity Network.

The researchers have assembled focus groups of Black and African American cisgender males aged 18 and older in Kansas City, Topeka and Wichita. The focus groups meet for two hours, during which two Black male medical students lead the group through a structured interview designed to ascertain the attitudes of the attendees and the attitudes of their communities toward sperm donation, as well as what they think would help increase the number of Black donors. The researchers are also surveying sperm banks about their perceptions of the shortage and about how they recruit people of color for donations.

The researchers will begin to analyze the data they are collecting later this summer. Marsh said there is a wide range of problems that she expects to be identified in the focus groups, including a lack of awareness about donating sperm, issues with meeting screening criteria to donate, and concerns about having a third-party handle genetic material and about [perceived] attitudes in the community about donating.

Marsh plans to use what they learn in the study to work to design an intervention to increase the availability of donor sperm from Black and African American men. The intervention could be an educational tool, or it could involve working with the sperm banks to improve their marketing and recruitment techniques, or it could be designing a social media campaign designed to increase awareness or change perceptions of sperm donation in the community.

“It’s a really complex problem, with issues at every level of the donation process, so there won’t be one easy answer,” said Marsh. “Right now, we are just trying to understand the problem.”