Sperm donation banned? Diseases and unexpected exclusions around the world

What exclusion from sperm donation means

Very different decisions can lie behind a rejection. Keeping them separate helps explain the apparently contradictory responses of different sperm banks.

Exclusion from a donor programme

A finding or history does not meet that programme’s requirements. 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. Another assessment follows.

Additional investigation

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

Restricted use

A donation may only be used in particular circumstances, such as for a person known to the donor or following genetic assessment on the recipient’s side.

Facilities also have their own acceptance criteria. The American Society for Reproductive Medicine, ASRM, for example, includes good general health and suitable semen parameters among the foundations of donor selection. A sample may be unsuitable for a donation programme even when the man is fertile. ASRM: selecting egg and sperm donors

Common infection-related exclusions: the pathogens involved

Infection tests and medical history form part of the basic medical assessment. Particularly relevant are what a result actually shows and whether a previous infection was successfully treated.

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, the German TPG Tissue Ordinance requires negative results for HIV 1 and 2, hepatitis B and C, and syphilis. For chlamydia, a urine nucleic acid amplification test (NAT) is specified. It looks for the pathogen’s genetic material and must be negative. TPG-GewV, Annex 4, point 2

Treated infections

Gonorrhoea, sometimes known as the clap, is caused by Neisseria gonorrhoeae. Canada treats chlamydia or gonorrhoea diagnosed or treated in the previous two months as grounds for deferral. When the infection and treatment were longer ago, documented treatment success one month after completion is required. A cleared infection therefore does not automatically mean lifelong exclusion there. Health Canada: donor suitability

CMV: antibodies are not the same as an active infection

CMV means cytomegalovirus. It can pass through bodily fluids, including semen; infection during pregnancy can harm the child. CDC: CMV and transmission Nevertheless, under ASRM guidance, antibodies from previous exposure do not automatically mean exclusion. Important factors include ruling out an active infection, the recipient’s CMV status and the counselling required. ASRM: interpreting CMV findings

Inherited conditions: why healthy carriers may be assessed differently

No pathogen is involved here. The issue is genetic variants that can be passed to a child. Someone may be healthy but still carry such a variant. With many recessive conditions, a child’s risk of disease arises only when they inherit a corresponding disease-causing variant from both genetic parents. The results of the person whose egg is used may therefore also matter.

A study from the Chinese province of Hunan illustrates how selection differs: the sperm bank studied excluded applicants with indications of thalassaemia carrier status or G6PD deficiency. Thalassaemias affect the production of haemoglobin, 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 that facility’s practice from 2018 to 2021. It does not establish a nationwide Chinese ban. Study from Hunan, MedlinePlus: G6PD deficiency

At the Australian provider Sperm Donors Australia, testing for numerous inherited risks is included in the programme for clinic-recruited donors. A result does not, however, lead to the same decision everywhere: ASRM does not automatically regard healthy carriers of certain autosomal recessive conditions as unsuitable when there is no risk to their own health. The variant and the risk to the child conceived remain decisive. Sperm Donors Australia: donor programme, ASRM: genetic selection

Sometimes information is simply missing: people who were adopted may not know their biological parents’ or grandparents’ medical history. ASRM recommends an individual assessment in this situation. The issue is an incomplete risk assessment, not an established disease. ASRM: unknown family history

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

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

Asking about residence or origin can initially help determine which tests are needed. In Germany, additional HTLV-I antibody testing is specified if the donor lives in, or comes from, an area of higher prevalence. The origins of parents or sexual partners are also considered. Depending on the history, tests for malaria or Trypanosoma cruzi may be added. TPG-GewV: additional investigations

HTLV-1: a virus that can remain unnoticed for a long time

Human T-lymphotropic virus type 1 can be sexually transmitted. In some infected people it causes a particular blood cancer, adult T-cell leukaemia/lymphoma, or a spinal cord disorder. Many infected people have no symptoms. Their history can therefore justify a test even when an applicant appears healthy. WHO: HTLV-1 The WHO identifies parts of Japan, Australia and the Pacific islands among areas of 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 faeces of infected triatomine bugs; blood transfusions and transmission during pregnancy or birth are also possible. An infection that goes unnoticed for years 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. Transmission is mainly through infected Anopheles mosquitoes. Travel destination, possible exposure and previous illness explain the medical questions; nationality alone cannot answer them. WHO: malaria

These pathogens have very different routes of transmission. A regulation calling for an additional test does not itself prove transmission through donated semen. Individual assessment depends on the exact region, when travel took place and any illness. A country list alone cannot establish this.

Brazil: even dengue vaccination can mean a donation break

A step taken to protect your 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 in relation to dengue and chikungunya.

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

• After dengue or chikungunya, Anvisa specifies a 30-day deferral after full recovery.
• Following severe dengue, the stated period is six months after full recovery.
• A 30-day waiting period is specified after a dengue vaccination containing live attenuated viruses.
• Sexual contact with a person diagnosed with dengue or chikungunya within the previous 30 days is also considered: the waiting period is 30 days after the last contact.

These temporary precautionary rules also apply to overseas suppliers from affected regions wishing to send eggs or sperm to Brazil. Health conditions in the recipient country can therefore affect which donations a sperm bank may export. Anvisa: 2025 criteria, precise conditions

West Nile and Oropouche: how emerging risks are handled

West Nile virus (WNV) is mainly spread by mosquitoes. It can cause fever and, in severe cases, inflammation of the brain or its surrounding 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 time limit. CDC: West Nile disease, Health Canada: WNV criterion

Oropouche virus (OROV) illustrates how cautiously new findings need to be assessed. Following 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 advice to cell and tissue donation establishments in November 2024. Oropouche can cause fever, headache and joint pain, and occasionally nervous system disease. It is spread mainly by small blood-feeding insects, particularly biting midges.

The agency did not require a specific Oropouche testing programme 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 based on limited evidence, not proof of transmission through sperm donation. FDA: Oropouche and donor assessment

Zika: why an accurate country warning from the past may now be wrong

The pathogen is Zika virus, or ZIKV. It spreads mainly through Aedes mosquitoes but can also be sexually transmitted. Infection in adults often goes unnoticed or remains mild; during pregnancy it can cause severe birth defects. That made Zika especially relevant to reproductive medicine. CDC: Zika and pregnancy risks

Zika can be tested for. Molecular tests can detect the virus, and antibody tests exist too. A diagnostic investigation does not, however, reliably clear semen for use: a negative blood test can mean that the virus is no longer detectable in blood while it is still present in semen. Viral shedding in genital secretions can also fluctuate. The CDC therefore does not recommend such tests to rule out sexual transmission. CDC: Zika testing, CDC: limits of testing for sexual transmission

On 20 May 2024, the FDA withdrew its specific Zika guidance for human cell and tissue donation. The reason was the sharp fall in case numbers and the resulting change in relevance to potential donors. Establishments may therefore stop the special Zika risk screening. This change is based on the epidemiological situation, not on negative tests providing a guarantee. FDA: withdrawal and reasons

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

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 associated with eating products from cattle infected with BSE. BSE stands for bovine spongiform encephalopathy, commonly known as mad cow disease. The agents are prions, abnormally misfolded proteins, rather than viruses or bacteria. CDC: BSE and vCJD

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

The FDA’s 2007 guidance names two distinct geographical 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 since 1980 in the listed European countries. Germany and the Republic of Ireland are on the Europe list. For this guidance, Northern Ireland and even the Falkland Islands fall under the UK grouping. These are criteria about stays, not nationality. FDA: sections IV.E.23–25 and Appendix 5

ASRM also includes the European residence criterion in its 2024 donation guidance. The countries are therefore not merely an internet rumour. The specified periods and duration of residence remain crucial, however; a short holiday today is different. ASRM: US donor screening

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

Some questions about exclusion seem strange only because their medical history is unfamiliar. Canadian donor guidance, for instance, asks 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 reason here is iatrogenic Creutzfeldt-Jakob disease, meaning CJD transmitted by medical interventions. Historically, growth hormone preparations from the pituitary glands of deceased people or contaminated dura mater grafts could transmit prions. The concern is this particular treatment history, not all modern hormone treatment, nor automatically BSE-related vCJD. FDA: iatrogenic CJD and historical preparations

Tattoos, too, involve more than a yes or no. Canada lists, for example, tattoos and piercings performed in the previous six months without sterile procedures. The key issue is the potential infection risk of the procedure. Health Canada: medical history and exposures

Animal transplants: why even close contacts can matter

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

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

Living is the decisive word: the same guidance explicitly excludes medical products made from non-living animal material, such as certain pig heart valves, from these xenotransplantation products. Even when a question is very unusual, the exact treatment must be established.

When suitable tests replace country questions: HIV-1 group O

A particularly clear special case is HIV-1 group O, a variant of HIV-1. The FDA’s 2007 guidance specifies questions concerning certain African countries, including Cameroon, Gabon and Equatorial Guinea. The issue is a particular pathogen variant and how tests detect it.

The crucial qualification already appears in the same guidance: an establishment using an FDA-approved HIV antibody screening test whose intended use expressly includes detection of group O may omit these country questions. Repeating the country names alone leaves out precisely this exception. FDA: sections IV.E.27–28 and the subsequent note

What has changed: HIV, sexual behaviour and BSE precautions

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

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

Canada also revised its selection criteria in 2024: questions about particular 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; the assessment concerns a defined exposure. Health Canada: revised selection criteria, current criteria

In US BSE precautions, the FDA removed certain geographical deferrals for blood donation in 2022 following new risk assessments. Requirements for sperm donation did not change automatically as a result. Permission to donate blood again does not therefore necessarily mean meeting a sperm bank’s requirements. FDA: change for blood and blood components

Why one country accepts a donation that another does not

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

The status of the source matters as well. 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 force. Conversely, an older professional overview may still include criteria changed by a subsequent agency notice. FDA: status of the guidance

Following a rejection, it is therefore worth asking about the exact criterion. Only then can you establish whether the decision is permanent, a waiting period is still ongoing or donation might be possible in different circumstances.

How to check a possible restriction before you apply

You do not have to interpret the medical rules yourself. A short account of your history will, however, help the sperm bank assess your case.

• Record previous places of residence and longer stays, including the country, dates and approximate total duration.
• Add recent trips, vaccinations, special treatments and known conditions in your family.
• For treated infections, have findings, treatment dates and evidence of treatment success ready.
• If you are rejected, ask whether it means permanent exclusion, deferral until a certain date or an outstanding investigation.
• Check whether the decision applies to this programme, the country of treatment or a particular donation arrangement.

Keep your health information complete even when making 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 USA explore each country’s framework.

Conclusion

A dengue vaccination, a former place of residence or a genetic test may affect sperm donation for entirely different reasons. Knowing the disease, the specific condition and the rule’s current status helps make sense of even unusual questions on a donor form. A rejection initially concerns this donation within this programme; it is not a general statement about your health or fertility.