Rejection from sperm donation can feel like a blow to identity
Coping with rejection as a sperm donor: A qualitative study of the personal impact of rejection and new health information. (Thirup, 2025)
Thirup, L., Skytte, A.-B., Kesmodel, U. S., Vogel, I., Pennings, G., Pacey, A., & Lou, S. (2025). Coping with rejection as a sperm donor: A qualitative study of the personal impact of rejection and new health information. PLoS One, 20(12), e0338513. https://doi.org/10.1371/journal.pone.0338513
Geographic Region: Denmark
Research Question: How do men experience being rejected as a sperm donor, how do they cope with the rejection and any new health or genetic information they receive, and how do they integrate that information into their lives over time?
Study Design: Semi-structured in-depth interviews conducted between April and September 2024, approximately 5 to 12 months after participants’ rejections. The interview topics included motivations for applying, the application process, the rejection experience and emotional reactions, coping strategies, and reflections in hindsight. Participants were encouraged to raise any topics they considered relevant.
Sample: 19 men rejected as sperm donors by Cryos International in Denmark. Of 3,031 applicants in the one-year recruitment window, 188 who met inclusion criteria were invited by email; 24 responded and agreed to participate; 5 could not be reached, yielding a final sample of 19. Inclusion criteria required applicants to have been rejected in Denmark within the prior year, to have consented to being contacted, and to have available contact information. The researchers intentionally sought variation by age, parental status, reason for rejection, and time since rejection. The sample had a mean age of 28 years. Ten participants had a partner. Four had children of their own. Twelve were students; six held a master’s degree. All 19 participants identified as Danish; no participants of other ethnicities were included. Reasons for rejection included reduced sperm quality (n=6), physical illness (n=5), genetic predisposition to disease (n=4), mental illness (n=2), and lack of information about family medical history (n=2). Mean time since rejection was 8 months (range: 5–12 months).
Key Findings
Most participants cited altruism as their primary motivation for applying, specifically the hope of helping others fulfill their dream of having a child. Many of these men had personal proximity to infertility through their own experiences, fertility treatment, being donor-conceived themselves, or seeing friends struggle to conceive.
Nine of the 19 men identified passing on their genes as a significant motivating factor. Some had resigned themselves to not having children of their own (due to age or lack of a partner) and saw sperm donation as a way to achieve a genetic legacy. Others simply expressed curiosity about the potential for future contact with any offspring. One participant expressed a sense of personal and social duty to preserve his red hair ‘minority genes.’
For 5 of the 19 men, the content of the rejection, specifically new medical or genetic information received during screening, caused significant concern. These concerns focused on their own health, their fertility, and the potential impact on their existing or future children. For these men, the health information overshadowed the rejection itself as a source of distress.
For the remaining 14 men, the rejection itself, rather than the reason for it, was what hit hardest. Many had already begun to see themselves as donors and described feeling that a part of their emerging identity had been taken from them. Ten men described strong disappointment; four expressed disbelief; six described the rejection as a sense of defeat and feeling ‘not good enough.’ For some, the rejection felt like a blow to their masculinity.
One participant expressed relief at being rejected, describing feeling depersonalized during the application process.
In general, participants reported being satisfied with the information they received during the application process and at the point of rejection.
For 14 of the 19 men, the emotional impact of rejection faded within days to weeks. By the time of the interview (5–12 months post-rejection), the experience was no longer playing a significant role in their lives.
For the 5 men who had received worrying health or genetic information, residual concerns still surfaced in certain situations (e.g., when discussing family plans with a partner), but had not become a persistent source of distress.
The researchers identified five coping strategies used by participants:
(1) Information seeking - two men (both fathers, both rejected for genetic predispositions) actively sought more detailed information about their conditions through medical contacts or online, which helped reduce anxiety once they learned the risks to their children were low;
(2) Actionable reasoning - three men attributed the cause of rejection to modifiable lifestyle factors (e.g., diet, smoking, alcohol), framing it as something within their control and therefore not a real problem;
(3) Positive reframing - eight men refocused attention on positive aspects of their lives or on other favorable information gained during screening (e.g., being told their sperm quality was good in other respects);
(4) Normalizing - seven men reduced feelings of failure by contextualizing the rejection as common (noting that only ~10% of applicants are accepted);
(5) Postponing - two younger men chose to mentally set aside concerns about fertility or health, treating the new information as relevant only to a future life stage.
Limitations: The study was conducted entirely within a single commercial sperm bank (Cryos International) in Denmark. Denmark has a distinctive, commercially developed relationship with sperm donation. The sample is ethnically homogeneous. This may reflect the demographics of Cryos's applicant pool rather than a sampling gap. Given Cryos's international recruitment and global distribution model, questions about who applies, who is accepted, and who is rejected along ethnic and racial lines are relevant but unaddressed by this study. The response rate was low: 24 of 188 eligible participants responded, yielding a final sample of 19. People still in acute distress months after rejection may have been less likely to participate, meaning the sample likely over-represents men who had already processed their experience. The finding that most participants resolved their distress within weeks should be interpreted with this selection effect in mind. Social desirability bias is a particular concern here given researcher positionality. Participants were speaking, in effect, with a researcher affiliated with the institution that had rejected them. Thematic saturation was not discussed.
Applications: Sperm banks and clinics could consider developing structured support pathways for rejected applicants, particularly those who receive unexpected health or genetic information to meaningfully reduce harm for this group.
Funding Source: Cryos International Sperm & Egg Bank
Lead Author: Lina Thirup is a researcher with a master’s degree in Public Health who was employed by Cryos International Sperm & Egg Bank; she is listed as a former Cryos employee in the paper’s competing interests statement. No personal connection to donor conception was disclosed.
Regulatory Context
Denmark permits both anonymous and identity-release (non-anonymous) sperm donation. Prior to 2007, only anonymous donation was permitted. Since 2007, donors may choose either status. Donor-conceived individuals using non-anonymous donors can access the donor’s identity at age 18.
Denmark is home to a large, commercially developed sperm banking industry, including Cryos International, which recruits donors internationally and distributes to over 100 countries.
Lesbian couples and single women gained access to fertility treatment in Denmark in 2006.
Denmark has no legally mandated cap on donor compensation, distinguishing it from countries like the UK, Australia, and Canada, where only altruistic donation is permitted. This makes Denmark an important international supplier of donor sperm.
Donors at Cryos may choose to be identity-release (ID Release) or non-identity-release, and donor-conceived individuals conceived using ID Release donors may access identifying donor information at age 18.
Related Posts
The emotional impact of sperm donor rejection (Pennings, 2024)
Identity-release donors more likely to be accepted than anonymous donors in international screening study (Pacey, 2023)
Two-thirds of withdrawn sperm donor candidates believe sperm banks could not have prevented their decision to quit (Pennings, 2025)