Sperm donation prohibited? Diseases and surprising exclusions worldwide

What exclusion from sperm donation means

Very different decisions can sit behind a rejection. Distinguishing them also makes apparently contradictory responses from different sperm banks easier to understand.

Exclusion from a donor program

A finding or history does not meet this program’s conditions. This may be a long-term decision without saying anything about your ability to father a child.

Temporary deferral

A waiting period is needed after an infection, exposure or particular treatment. Eligibility is then reviewed again.

Additional investigation

A question about countries or family initially leads to a targeted test or specialist assessment. Being asked the question is not itself an exclusion.

Restricted use

A donation may only be usable in a particular arrangement, such as for someone known to the donor or after genetic assessment on the recipient’s side.

Facilities also have their own acceptance criteria. The American Society for Reproductive Medicine, ASRM, for example, lists good general health and appropriate semen parameters as foundations of donor selection. A sample can be unsuitable for a donor program even though the man is fertile. ASRM: selecting gamete donors

Common infections: which pathogens are involved

The basic medical assessment includes infection testing and medical history. What a result really shows and whether a previous infection was successfully treated are particularly important.

HIV, hepatitis B, hepatitis C, syphilis and chlamydia

These involve HIV-1 and HIV-2, hepatitis B virus (HBV), hepatitis C virus (HCV), the syphilis bacterium Treponema pallidum and the bacterium Chlamydia trachomatis. Testing aims to prevent transmission through donation. FDA: pathogens and donor tests For sperm donation to other people, Germany’s TPG Tissue Ordinance requires negative results for HIV 1 and 2, hepatitis B and C, and syphilis. Chlamydia testing requires a urine nucleic acid amplification test (NAT), which looks for the pathogen’s genetic material and must be negative. TPG-GewV, Annex 4, item 2

Treated infections

Gonorrhea, also informally called the clap, is caused by Neisseria gonorrhoeae. Canada considers chlamydia or gonorrhea diagnosed or treated in the past two months grounds for deferral. If the infection and treatment occurred earlier, documented treatment success one month after completing therapy is required. A cured infection therefore does not automatically mean lifelong exclusion in Canada. Health Canada: donor suitability

CMV: antibodies are not the same as active infection

CMV stands for cytomegalovirus. It can pass through bodily fluids, including semen; infection during pregnancy can harm the child. CDC: CMV and transmission Under ASRM guidance, however, antibodies detected after previous exposure do not automatically mean exclusion. Relevant considerations include ruling out active infection, the recipient’s CMV status and the required counselling. ASRM: handling CMV findings

Inherited conditions: why a healthy carrier may receive different assessments

There is no infectious agent here. The issue is genetic variants that can be passed to a child. Someone may be healthy while carrying such a variant. With many recessive conditions, disease risk arises only when a child inherits a corresponding disease-causing variant from both genetic parents. That is why the test result of the person providing the egg may matter too.

A study from the Chinese province of Hunan illustrates how selection can differ: the sperm bank studied excluded applicants showing indications of thalassemia carrier status or G6PD deficiency. Thalassemias affect the production of hemoglobin, the red blood pigment. With G6PD deficiency, the enzyme glucose-6-phosphate dehydrogenase does not work adequately, so red blood cells may break down prematurely. Published in 2022, the study describes this facility’s practice from 2018 to 2021. It does not establish a nationwide Chinese ban. Hunan study, MedlinePlus: G6PD deficiency

At the Australian provider Sperm Donors Australia, testing for numerous inherited risks is part of the program for clinic-recruited donors. A finding does not produce the same decision everywhere, though: ASRM does not automatically consider healthy carriers of certain autosomal recessive conditions unsuitable when their own health is not at risk. The variant and the risk to a child conceived using that sperm and egg remain decisive. Sperm Donors Australia: donor program, ASRM: genetic selection

Sometimes the information is simply missing: people who were adopted may not know their biological parents’ and grandparents’ medical history. ASRM then recommends an individual assessment. The concern is an incomplete risk assessment, not a proven disease finding. ASRM: unknown family history

The article on carrier screening before sperm donation explains how both genetic parents’ carrier status relates to the risk to a child.

HTLV-1, Chagas disease and malaria: why origin and travel are assessed

A question about residence or origin may first help identify the right tests. Germany specifies additional HTLV-I antibody tests for donors who live in, or come from, areas of higher prevalence. Parents’ and sexual partners’ origins also count. Depending on the history, investigations for malaria or Trypanosoma cruzi may be added. TPG-GewV: additional investigations

HTLV-1: a virus that may remain unnoticed for years

Human T-lymphotropic virus type 1 can be sexually transmitted. In some infected people it causes a particular blood cancer, adult T-cell leukemia/lymphoma, or a spinal cord disease. Many infected people have no symptoms. Their history can therefore justify a test even when an applicant is healthy. WHO: HTLV-1 The WHO lists parts of Japan, Australia and the Pacific islands among areas with higher prevalence. These are regional concentrations, not blanket bans on those countries. WHO: regional distribution

Chagas disease: the parasite Trypanosoma cruzi

This single-celled parasite is found mainly in Latin America. Routes of transmission there include contact with the feces of infected triatomine bugs; blood transfusions and transmission during pregnancy or birth are also possible. An infection unnoticed for a long time may later damage the heart and digestive system. This explains why origin and previous stays can prompt an investigation. WHO: Chagas disease

Malaria: parasites of the genus Plasmodium

Malaria is caused by parasites of the genus Plasmodium, including P. falciparum and P. vivax. It is transmitted mainly by infected Anopheles mosquitoes. The destination, possible exposure and prior illness explain the medical questions; nationality alone cannot answer them. WHO: malaria

These pathogens have very different transmission routes. A regulation specifying an additional test is not in itself evidence of transmission through donor semen. Individual assessment depends on the particular region, timing of travel and any illness. A country list alone is insufficient.

Brazil: even dengue vaccination can mean a donation break

A measure taken to protect your own health can unexpectedly postpone your donation. In March 2025, Brazil’s health regulator Anvisa published updated criteria for egg and sperm donation and reproductive treatments relating to dengue and chikungunya.

The pathogens are dengue virus (DENV) and chikungunya virus (CHIKV). Both are transmitted by Aedes mosquitoes. Dengue can cause severe bleeding and circulatory problems, among other complications; chikungunya is particularly known for joint problems that sometimes persist. WHO: dengue, WHO: chikungunya

• After dengue or chikungunya, Anvisa specifies a 30-day deferral following complete recovery.
• After severe dengue, the stated period is six months following complete recovery.
• After a dengue vaccine containing live attenuated viruses, a 30-day waiting period is specified.
• Sexual contact with someone diagnosed with dengue or chikungunya in the preceding 30 days is also considered: the waiting period is 30 days after the last contact.

These time-limited precautions also apply to foreign suppliers from affected regions wishing to send eggs or sperm to Brazil. The health situation in the receiving country can therefore affect which donations a sperm bank may export. Anvisa: 2025 criteria, detailed conditions

West Nile and Oropouche: what happens when new risks appear

West Nile virus (WNV) is spread mainly by mosquitoes. It can cause fever and, in severe cases, inflammation of the brain or its membranes. Canada considers diagnosed or suspected WNV infection within 120 days of diagnosis or the onset of illness, whichever is later. This is a specific infection history with a defined period. CDC: West Nile disease, Health Canada: WNV criterion

Oropouche virus (OROV), by contrast, shows how carefully new findings must be interpreted. After outbreaks in parts of South and Central America and the Caribbean, and the detection of replication-competent virus in a traveller’s semen, the US Food and Drug Administration, FDA, issued a notice to cell and tissue donation establishments in November 2024. Oropouche can cause fever, headache, joint pain and occasionally nervous system disease. It is transmitted mainly by small blood-feeding insects, especially biting midges.

The agency did not require a special Oropouche testing program or a blanket restriction after every trip. It suggested considering possible illness and relevant symptoms in the previous six weeks when deciding eligibility. This is precautionary advice with limited evidence, not proof of transmission through sperm donation. FDA: Oropouche and donor assessment

Zika: why a once-accurate country warning can be wrong today

The pathogen is Zika virus, or ZIKV. It spreads primarily through Aedes mosquitoes but also sexually. In adults, infection often goes unnoticed or is mild; during pregnancy it can cause serious birth defects. This made Zika particularly relevant to reproductive medicine. CDC: Zika and pregnancy risks

Testing for Zika is possible. Molecular tests detect the virus, and antibody tests are available too. A diagnostic test does not reliably clear semen for use, however: a negative blood test may reflect the virus no longer being detectable in blood even while it remains in semen. Viral shedding in genital secretions may also fluctuate. The CDC therefore does not recommend these tests to rule out sexual transmission. CDC: Zika testing, CDC: test limitations for sexual transmission

On 20 May 2024, the FDA withdrew its specific Zika guidance for human cell and tissue donations. Its reason was the sharp decline in cases and the resulting change in relevance to potential donors. Establishments may therefore discontinue the special Zika risk screening. The change is based on the epidemiological situation, not a guarantee provided by negative tests. FDA: withdrawal and rationale

An old US travel restriction may therefore be outdated even though the pathogen remains medically relevant. Donation in another country requires a separate check of that country’s current requirements.

BSE and vCJD: why Germany, Ireland and the Falkland Islands appear

The historical reason for these unusual country questions is variant Creutzfeldt-Jakob disease (vCJD). It is linked to consuming products from BSE-infected cattle. BSE means bovine spongiform encephalopathy, commonly called mad cow disease. The agents are prions, abnormally misfolded proteins. They are neither viruses nor bacteria. CDC: BSE and vCJD

vCJD damages the brain, is fatal and may only become apparent years after exposure. This explains why questions reach so far into the past. No FDA-approved prion test is available for donor screening. Nevertheless, a residence criterion is a precaution, not a diagnosis. CDC: long incubation period, FDA: limits of prion donor screening

The FDA’s 2007 guidance gives two distinct geographic criteria: a total of at least three months in its defined UK area between 1980 and 1996, and a total of at least five years in the listed European countries since 1980. Germany and the Republic of Ireland appear on the Europe list. Northern Ireland and even the Falkland Islands fall under the UK grouping in this guidance. The issue is stays, not citizenship. FDA: sections IV.E.23–25 and Appendix 5

ASRM also lists the European residence criterion in its 2024 donation guidance. These countries are therefore not just an internet rumour. The stated periods and length of stay remain decisive, though; a short holiday today is a different matter. ASRM: US donor screening

Other special cases: older hormone treatments, dura mater grafts and tattoos

Some exclusion questions seem strange only because their medical history is unfamiliar. Canadian donor guidance asks, for example, about certain previous treatments with human growth hormone and grafts of the tough outer brain membrane, the dura mater. Health Canada: medical exclusion criteria

The background here is iatrogenic Creutzfeldt-Jakob disease, meaning CJD transmitted through medical interventions. Historically, growth hormone preparations made from deceased people’s pituitary glands or contaminated dura mater grafts could transmit prions. The criterion concerns this specific treatment history, not every modern hormone treatment, nor automatically BSE-related vCJD. FDA: iatrogenic CJD and historical preparations

Tattoos also involve more than a simple yes or no. Canada specifies, for example, tattoos and piercings performed in the preceding six months without sterile procedures. The decisive issue is the procedure’s possible infection risk. Health Canada: medical history and exposures

Animal transplants: why even close contacts may matter

A rare case is xenotransplantation: treatment with living animal cells, tissues or organs. The FDA considers possible transmission of known and as-yet unknown animal pathogens. This concerns a group of potential infection risks, not a single disease already diagnosed. FDA: background on xenotransplantation

The donor guidance also covers certain close contacts where an exchange of bodily fluids may have occurred. It gives sexual partners and sharing razors or toothbrushes as examples. Simply living together is not sufficient. The recommendation also includes product-specific exceptions. FDA: section IV.E.29

The key word is living: the same guidance explicitly excludes medical devices made from non-living animal material, such as certain pig heart valves, from these xenotransplantation products. Even a very unusual question needs clarification of the exact treatment.

When suitable tests replace a country question: HIV-1 group O

A particularly clear example is HIV-1 group O, a variant of HIV-1. The FDA’s 2007 guidance specifies questions concerning certain African countries, such as Cameroon, Gabon and Equatorial Guinea. This involves a particular pathogen variant and whether tests detect it.

The decisive qualification is already in the same guidance: a facility using an FDA-approved HIV antibody screening test whose intended use expressly includes group O detection may omit these country questions. Repeating only the countries’ names leaves out this very exception. FDA: sections IV.E.27–28 and the subsequent note

What has changed: HIV, sexual behaviour and BSE precautions

Some earlier exclusions have now been expressly reassessed. In the United Kingdom, the November 2024 legislative change allows people with HIV to donate to known recipients under certain conditions. The regulator HFEA specifies, among other requirements, at least six months of HIV medication and two prescribed blood tests confirming a sufficiently low viral level in the blood. Recipients must be informed and consent, and the clinic must be authorized to offer the procedure.

The exception applies to known recipients. It does not open general sperm bank donation to unknown people. This example shows why even saying that HIV always means an absolute donation ban would be too broad. HFEA: known donation with treated HIV

Canada also changed its selection criteria in 2024: questions about specific sexual behaviour replaced the previous blanket exclusion of men based on sexual contact with men. The current directive considers, for example, certain new or multiple sexual contacts involving anal intercourse. Sexual orientation is not a disease; a defined exposure is assessed. Health Canada: revised selection criteria, current criteria

For BSE precautions in the US, the FDA removed certain geographic blood donation deferrals in 2022 after new risk assessments. The requirements for sperm donation did not change automatically. Being allowed to give blood again does not necessarily mean meeting a sperm bank’s requirements. FDA: change for blood and blood components

Why the same donation is accepted in one country and not another

Several layers interact: local health conditions, the required investigations, the type of donation and the recipient country’s conditions. A Brazilian importer, for example, must take account of Anvisa’s local requirements. A British exception for known HIV-positive donors cannot simply be extended to use abroad. Anvisa: imported donations, HFEA: export limits

The status of a source also matters. As of 14 September 2026, the FDA still lists its new general donor eligibility guidance from January 2025 as a draft not for implementation. A draft is not a replacement already in effect. Conversely, an older professional overview may still contain criteria changed by a subsequent agency notice. FDA: guidance status

After rejection, it is therefore worth asking which exact criterion applies. Only then can you establish whether the decision is permanent, a waiting period is still running or donation might be possible under other conditions.

How to clarify a possible restriction before applying

You do not need to interpret the medical rules yourself. A short summary of your history helps the sperm bank assess your situation.

• Record previous residences and extended stays, including the country, dates and approximate total duration.
• Add recent travel, vaccinations, special treatments and known illnesses in your family.
• For treated infections, have findings, treatment dates and evidence of successful treatment ready.
• If rejected, ask: permanent exclusion, deferral until a particular date, or an investigation still missing?
• Clarify whether the decision applies to this program, the country of treatment or a particular donation arrangement.

Your health information should remain complete even on a second application. The article on health information for sperm donors explains what is useful. The guides to sperm donation in Germany and sperm donation in the US explore the respective frameworks.

Conclusion

A dengue vaccination, a former place of residence or a genetic test can affect sperm donation for entirely different reasons. Knowing the disease, the specific condition and the rule’s current status helps explain even unusual questions on donor forms. A rejection initially says something about this donation in this program, not about your health or fertility in general.