A feature in last week’s Sunday Star about single mothers, whichincluded a story of a woman who has a child through donor sperm,piqued the interest of readers as to how a sperm bank operates.ANTHONY LIM and JOSEPH LOH have the story.
IT'S safe to say that in the average Malaysian medical facility, you would expect to find a cold, sterile environment. However, on the second floor of Damansara Fertility Centre (DFC) in Petaling Jaya, this isn't quite the case.
Imagine a cosy, softly-lit room lined with mirrors, complete with a bed, TV set, DVD player, an en suite bathroom, a desktop calendar featuring scantily clad, sexy girls and a large picture of a Malaysian model on the wall.
Welcome to the semen collection room of the DFC. It is one of the many medical institutions in the country that provide fertility services, but one of the few with a sperm bank facility. Here, sperm is collected and stored in the premises from donors who use the comfortable confines of the room for the task.
The currency of a sperm bank is human semen, and how such a bank goes about its business is quite straightforward. Making a deposit is not as simple as it sounds, though.
According to Ryan Tan, the resident embryologist at DFC, “Only donors who meet our requirements are selected. Not all donations will be accepted. We have a requirement of semen quality that has to be fulfilled in order for us to accept the sample.
“Recruitment is based on family background, education (preferably graduates), history of illnesses or genetic diseases, physical attributes such as eye colour, skin colour, hair colour, body size, etc., history of fertility, blood test results and blood group.”
John MacPherson Keith, consultant clinical embryologist at DFC, explained further, “The donor has to pass a medical screening, which is quite rigorous, and even assesses his motives for becoming a donor. His sample is quarantined for six months, because the donor may not have exhibited any signs of disease at the time of donation. Only when the second screening is clear can the specimen be released for use.”
Once all requirements are satisfied, comes the time for collection, and of course a visit to the aforementioned room.
How is semen collected? When asked if there were any specialised tools involved in the semen collection process, Keith said: “Frankly, I think most men would be scared off if there were any tools involved.”
All that DFC provides is the cosy room. For obvious reasons, it does not stock any form of video or printed material, the calendar and poster of a sexy Malaysian model notwithstanding.
“Donors can bring their own material if it aids the process. However, there is a mysterious tendency for calendars in the room to go missing,” said Wendi-Anne Chong, DFC's group administrative director.
Chong recalled an incident that occurred during her early years at DFC.
“Back in our old premises, we did not have a conducive environment as we do now, and collection had to be done in the men's toilet. One individual, after spending a considerable amount of time, came out and asked, ‘Miss, can you help me?’ Being new, I was taken aback and said, ‘No, I can’t help you!’ and quickly referred him to the doctor. I found out later that he actually meant if we had any material to help him with the process.”
Keith provided another amusing anecdote.
“I remember a nurse who took a man up the stairs to the room and as she was descending he was already out of the room following her down the stairs, the job done. Pretty quick, I must say.”
The burning question on everyone's mind must be the volume of the average male ejaculation.
It is as little as 3-5ml, according to Tan, but his record sighting is nine millilitres, while Keith has seen volumes as much as 12ml.
Contrary to popular belief, large volume capability is not a symbol of manliness, but rather it indicates a pathological problem.
Said Keith: “It is not the testes that are produce extra sperm. Rather, it is the glands producing the liquid contained in the ejaculate that are working overtime. Therefore, high volume is not a good idea, and impractical even – two millilitres of concentrated sperm is far better.
“And yes, we know the story of the rock group 10cc, which apparently derived its name from what was assumed to be the average volume. Perhaps they meant all four group members together?”
Pass the liquid nitrogen
Semen is graded firstly by count concentration, which pertains to the sperm count in terms of parts per million; secondly by volume total, which is the amount of ejaculate produced; and finally by motility and morphology, which pertain to the vitality of the sperm cell and its shape respectively.
Once collected, semen is divided into small vials containing 0.5 to 1.8ml, pre-mixed with cryopectant (similar to anti-freeze solutions), frozen with liquid nitrogen and stored at -196°C.
As to how long it can be kept, Keith said, “Nobody has found a limit yet. Specimens have been stored for 40 to 50 years without any sign of deterioration. Although some sperm is damaged in the process, it can still be used. When dealing with a fresh collection, it is good practice to freeze and store it within an hour, as deterioration occurs soon after that time.”
This view is shared by Dr Paul Tay, associate professor at University Malaya Medical Centre's Reproductive Medicine Clinic, Obstetrics and Gynaecology department. “Freezing does damage the population, and it slows down its motility. This, however, varies from individual to individual. You can't look at someone and tell how the survival or thaw-out rate will be. When you thaw the sperm, you do expect a drop in the number because some sperm do die, not being able to withstand the process.”
No payment, just reimbursement Who makes up the donors? The largest number of donors are Chinese in their mid-20s, according to Tan.
“We believe most donate for altruistic reasons, but we seldom question the donor in this matter. Donors have to be above 21 years old to their mid-40s, which is the age limit.”
Do they do it for money, then?
“We do not actually pay donors. We reimburse them for transportation expenses and their time for the sum of RM200. We have been paying the same rate for years now, even though the price of petrol has increased,” clarified Chong.
Of course, the subject of sperm banks in Malaysia is a somewhat touchy subject.
While a common fixture in the West, a distinction arises in Malaysia, where its use is limited to married couples where the husband is suffering from a fertility problem.
“The use of sperm donation facilities is for non-Muslim couples only, and DFC also has a policy not to provide this service for single women to avoid any ethical entanglement,” said Chong.
Tay added, “In Malaysia, sperm storage for medical reasons is ethically and religiously acceptable. Hospital Universiti Kebangsaan Malaysia, the only government-based sperm bank in Malaysia, allows sperm storage solely from individuals for their future use. It does not have an open-door policy where anyone can just walk in and say they want to store their sperm.”
There are no regulations governing sperm banks in Malaysia, but the government does not view it favourably, because “it involves a third party outside of a marriage and anonymity of the donor in the process.
“There is no law that says you can or cannot do it, as long as there are no complaints or scandals,” said Tay, adding that it is a topic that is not broached or spoken about openly.
At the end of the day, the use of sperm banks for couples unable to conceive is a decision that is entirely their own.
Concluded Tay: “There are always choices – adoption, for example, a fulfilling childless marriage or even using donor sperm. It is a very personal thing.”