What I learned at the 2025 ASRM Scientific Congress and Expo

Last week, I attended the American Society for Reproductive Medicine (ASRM) 2025 Annual Scientific Congress & Expo in San Antonio, Texas. Here’s what I learned.

The Increasing Cost of Donor Sperm

A health services/economic study (Hobbs, 2025) examined the historical and contemporary costs of purchasing donor sperm in the United States by collecting publicly available online information from five of the largest U.S. sperm banks, analyzing costs by intended cycle type (IUI, ICI, IVF, ICSI) and donor anonymity status. The study found that the median cost of a donor sperm vial varied by cycle type and donor transparency: IUI vials cost $1,625 ($1,170-$2,195), ICI vials cost $1,495 ($1,195-$2,195), IVF vials cost $1,337 ($1,195-$2,195), and ICSI vials cost $1,195 ($820-$2,195), with higher costs consistently associated with ID-disclosure donors compared to “anonymous” donors. Historical data from one sperm bank revealed dramatic price increases over a two-year period (2023-2025): IUI vials increased from $995 to $1,495 (50% increase), ICI vials from $850 to $1,195 (41% increase), IVF vials from $995 to $1,495 (50% increase), and ICSI vials from $650 to $1,195 (84% increase), representing a 40-80% overall increase.

The dramatic price increases noted by Hobbs could be attributable to multiple factors, including increased operational costs due to ID release donation, private equity ownership of sperm banks with profit-maximization pressures, market consolidation and the pricing power of large sperm banks in a largely unregulated U.S. market, and premium pricing strategies. Some increased operational costs (genetic testing, screening, counseling) might represent baseline ethical requirements for gamete donation programs, rather than discretionary expenses. Comprehensive genetic carrier screening prevents transmission of serious hereditary conditions and enables informed reproductive decision-making. Similarly, the costs associated with open-identity donation (e.g., donor counseling about long-term implications, record-keeping systems, and health history updates) reflect recognition of both donor-conceived people’s informational autonomy and donors’ right to informed consent.

During the presentation, Hobbs suggested that U.S. donors are afraid to donate because they cannot be anonymous, implying that this fear contributes to reduced supply and higher costs. This claim is contradicted by recent U.S. data. Valido et al. (2024) found that the proportion of open-identity donors increased from 11.9% to 65% between 2006 and 2024, representing a voluntary shift toward identifiable donation in the unregulated U.S. market. The total donor pool remained stable during this time, ranging from 1,512 to 1,763 donors, while the number of sperm banks decreased by 52% (from 29 to 14). At the same time, the market for “known” sperm donation through paid matching services, apps, and online groups is expanding rapidly.

A 2025 global review by Mincheva et al. provides additional context for understanding market dynamics. The study found that 75% of U.S. sperm bank customers are now same-sex couples and single women, representing a significant shift in demand. On the supply side, one study of a major US sperm bank found that only 5.16% of sperm donor applicants ultimately become active donors, with 55% withdrawing during the screening process (Pacey et al., 2023). Furthermore, sperm banks’ screening practices often reflect biases and categorical exclusions of donors (e.g., FDA’s five-year deferral period for men who have sex with men or a bank’s policy of rejecting donors with neurodivergence), imposing supply constraints that reflect discrimination rather than evidence-based risk assessment. Additionally, the dramatic underrepresentation of Black donors (1.4% of donors vs. 12% of the U.S. population, according to Passarelli et al., 2024) reflects systematic barriers to recruitment, including medical mistrust rooted in historical exploitation of Black communities.

The stable donor pool during the voluntary shift to open-identity donation contradicts claims that anonymity concerns are constraining supply and driving costs. The evidence points to market consolidation and profit maximization as the primary cost drivers. Productive responses to increasing prices could focus on expanding the donor pool by eliminating discriminatory screening practices, addressing barriers faced by potential donors from marginalized groups, and removing categorical exclusions that lack scientific justification.

The Impact of Genetic Carrier Screening

Research presented at ASRM 2025 reveals significant gaps and inconsistencies in genetic screening practices across the donor conception industry, creating uncertainty for intended parents. Studies examining genetic screening protocols at major US sperm and egg banks found substantial variation in testing practices: among egg banks, only 4 out of 8 provided comprehensive information about genetic panels, with the number of genes tested ranging from 12 to 787 genes (Pattanaik, 2025a). Among sperm banks, 8 of the 13 most widely used banks employed extended carrier screening (ECS) panels for all donors, with testing ranging from 175 to 569 genes, while the remaining banks either did not offer ECS or only offered it for specific purposes (Pattanaik, 2025b). These inconsistencies have real-world consequences: one study found that in over 60% of 390 donor-recipient pairings, when one genetic parent (donor or recipient) was identified as a carrier for a genetic condition, the other genetic parent had not been tested for that same condition, creating uncertainty about the risk of passing that condition to offspring (Rooney, 2025). When recipients were offered additional testing to resolve these discrepancies, slightly over half declined, with recipients statistically more likely to decline when testing was discussed for a gamete donor rather than for themselves (Carroll, 2025).

The Search for Black Sperm Donors

Newman (2025) surveyed 109 recipients seeking Black sperm donors, including 31 who had prior search experience, 36 currently searching, and 42 planning future searches. Among current searchers, 41% had been looking for over a year, and 79% of past and current recipients rated finding a Black donor as very or extremely challenging. While 94% of past recipients obtained sperm from sperm banks, current and future recipients are increasingly turning to alternative methods like directed donation (12-15%) and online platforms (15-21%). Most striking, 40% of future recipients reported considering altering their reproductive plans—including potentially remaining childless—in response to challenges locating a Black sperm donor.

Egg Donation on TikTok

One study analyzed 100 TikTok videos about egg donation collected on March 30, 2025, and found that content is predominantly created by social media influencers (38%) and egg banking companies (34%), with only 3% produced by physicians and non-physician healthcare professionals. Motivations for donation cited in videos included financial compensation (26%), debt repayment/vacations/milestone luxuries (17%), helping women and families (19%), and altruism (17%), with videos frequently minimizing physical and emotional demands while emphasizing financial benefits. The majority of informational content originates from non-medical sources rather than healthcare providers, raising significant concerns about accuracy and reliability of health information. (Parkhi, 2025)

Frozen Sperm Disposition Decisions

I’ve seen so many studies about egg and embryo disposition, but this was the first I’ve seen about sperm. Chan (2025) examined records for 74 male patients at a single academic medical center who underwent ART with a female partner and made final disposition decisions about cryopreserved sperm between 2022 and 2024. The majority of patients (79.2%) chose to discard their cryopreserved sperm rather than donate to research, with no significant demographic or cryopreservation-related differences observed between those who discarded versus those who donated.

How Clinics Represent Dononation

A cross-sectional study analyzed 480 U.S. fertility clinic websites between March-April 2025 to evaluate the prevalence of donor anonymity language and assess how clinics communicate the realities of third-party reproduction in the genomic era. The study found that of the 480 clinics analyzed, 97 (20.21%) did not have any donor information available on their website, 99 (20.63%) did not specify donor type (anonymous/nonidentified or known/directed), 256 (55.21%) contained language suggesting donor anonymity, and only 19 (3.96%) contained language indicating that anonymity is not possible. Private clinics were significantly more likely than academic clinics to have language related to anonymity on their website (57.6% vs 45.9%; p = 0.0382). The study concludes that despite ASRM’s 2022 position on anonymity and the reality that true donor anonymity is no longer feasible due to readily available consumer genomics and DNA testing, more than half of fertility clinics continue to use language suggesting anonymous gamete donation on their websites, potentially misleading donors and intended parents about the possibility of true anonymity. (Martyn, 2025)

References

Carroll, J., Rooney, E., & Asher, J. (2025). “But wait, there’s more”: Recipient decision-making in light of discrepant genetic testing involving gamete donors.

Chan, Y., Huang, S., McClellan, E., & Goldman, R. (2025). Trends and factors associated with final disposition decisions of cryopreserved sperm.

Hobbs, C. L., & Martin, C. E. (2025). Cost of donor sperm in the United States: A historical and contemporary analysis.

Martyn, K. A., White, K., Ho, K., Rego, E., & Chemerinski, A. (2025). Donor anonymity in the age of DNA testing: A call for updated fertility clinic online resources.

Newman, A. (2025). In search of Black sperm donors: Recipient experiences.

Parkhi, S., & Walter, J. (2025). Scrolling for donors: A content analysis of egg donation discourse on TikTok.

Pattanaik, R., Zheng, J., Gupta, N., & Hershlag, A. (2025). Egg banks unregulated genetic screening: In search of an “SEC” (Securities and Exchange Commission).

Pattanik, R., Zheng, M., Gupta, M., Adeyeye, M., & Hershlag, A. (2025). Sperm banking unregulated genetic screening puts offspring at risk.

Rooney, E., Carroll, J., & Asher, J. (2025). Carrier screening results and selecting a gamete donor: So close and yet so far.