The report Rethinking Fertility Access has been a long time coming. As someone who took part in the Online Sperm Donation Project’s donor action research group, I’ve been involved in developing the report. The research project started in 2022 with interviews with a diverse range of people involved in online sperm donation, with varied backgrounds and directions. And then in 2025, the donor action research group formed, looked at the research findings, and thought about what needed to change. From this, we produced a set of recommendations for improving fertility access for all.
For me, this isn’t just another report based on research though. I am a “known sperm donor” who donates through online sperm donation, mainly for the LGBTQ+ community. I find their open and frank conversations to be quite refreshing. They have had some serious thinking before approaching this, with a good awareness of mental health and personal identity. This report is a reflection of the conversations I’ve had over recent years with people trying to build their families, and what I’ve learnt about some of the barriers they face. Listening to recipients’ experiences has been an education, and a privilege to have them share these with me.
People sometimes assume that all online sperm donors have the same motivations: number of donor-conceived children, money, or sex. Certainly, there are donors that attract attention for these reasons, and those stories often dominate the media. But that isn’t why I donate. When my wife and I wanted to start a family, we didn’t face any barriers. Why should others have to face these? I try to treat people as I would hope to be treated, if the shoe was on the other foot. How can we expect better, when there are no shining examples to follow? Be the example you wish to see, if you can’t already see one.
The report reflects the very real issues facing people that need a little help to reach their dream: a family.
I’ve spoken to many people about their journey to conception, and some – but not all – want to access clinic fertility treatment. However, the barriers to the clinics are many, and varied. Access to NHS-funded fertility treatment can vary significantly depending on where someone lives, producing a very unfair postcode lottery. Age limits, BMI thresholds, the limited number of funded treatment cycles, and lengthy waiting times all combine to create barriers to access. Some know that by the time they reach the top of the waiting list, they will already have exceeded the age limit. Others spend months in time and energy pursuing referrals without success. Still others find out they aren’t eligible for funding – or at least, not unless they pay themselves first. In my view, the current system is just not fit for purpose.
I’ve met recipient couples who have already tried the clinic route without success, or who simply cannot access it. Some are excluded because of BMI thresholds that fail to reflect individual circumstances. I’ve met strong, healthy women whose muscular physique places them above the BMI cut-off, as well as others whose bodies don’t fit a one-size-fits-all measure of health. Others simply cannot afford multiple cycles of intrauterine insemination (IUI) or IVF, or see these procedures as medically intrusive. Still others will be too old if they linger on an NHS waiting list.
Being a part of the Online Sperm Donation Project’s donor action research group has highlighted that I am not alone in observing these unfair constraints and it has been good to see these issues reflected in the report that we’ve produced. These barriers are not isolated experiences, and they prevent what should be a rite of passage: having a family.
In the report, we make five recommendations to improve fertility access:
- Reform NHS funding arrangements, including national standardisation of eligibility criteria and removal of non-clinical access restrictions;
- Look into the feasibility of a means-tested Financial Fertility Aid scheme;
- Review investment into NHS-funded fertility treatment, with a view to reversing declining NHS-funded treatment levels;
- Increase transparency in private fertility sector pricing;
- Introduce harm-reduction measures for online sperm donation.
Harm-reduction measures for online sperm donation could include free access to medical testing for donors and implications counselling for recipients and donors, a voluntary register to track the number of families donated to, further clarity on legal parenthood, and signposting to organisations that provide free, impartial resources, information and support – like Fertility Action.
There is the bigger picture still. Media stories frequently focus on the same handful of “mass donors”, but they don’t represent everyone involved in online sperm donation. And these stories certainly deter many responsible people from becoming donors. Few people – whether potential donors or recipients – want to risk being judged by colleagues, friends or family because of these negative stereotypes.
Sperm donation is a normal and necessary part of building many families. We need a more balanced conversation. That doesn’t mean ignoring the risks or avoiding difficult issues, but it does mean moving beyond the headlines and listening to wider and more diverse voices in online sperm donation. I firmly believe that we should start this one gentle conversation at a time, dragging this subject out of the shadows, and into the daylight, for all to see and be more broadly educated.
Dr Carole Gilling-Smith, Consultant Gynaecologist and a Founding Trustee at Fertility Action Charity commented;
“online sperm donation is controversial, but it is refreshing to read a well thought through piece that provides the perspective of those that are simply trying to help in a purely altruistic way an underserved community. Hopefully the discussions that Fertility Action will be involved with through our Fertility Access work will lead to more equitable funding of donor sperm treatment for all who need this to conceive and avoid the need for unregulated sperm donation”.
If you’d like to read more on this topic, the HFEA have FAQs related to unregulated sperm donation on their website, and support and resources are available at The Donor Conception Network and Paths To Parenthub.
Guest blog written by Jim, in collaboration with the Donor Action Research Group of the Online Sperm Donation Project. The Donor Action Research Group comprised two people who donate sperm via online websites or social networks (Andrew & Jim) and three researchers (Dr Aleks Krotoski, Dr Alice Lemkes and Dr Rhys Turner-Moore). The Group worked together over the course of a year to imagine, consider and take action towards ideal futures for online sperm donation. The Group was part of the final phase of the four-year multidisciplinary Online Sperm Donation Project, led by Led by Leeds Beckett University, it involved ten researchers from five organisations, ran from 2022-2026, and was supported by the Economic and Social Research Council.
