Sperm Donor Screening: What People Test For
Sperm donor screening has four parts: a health and family history, a physical examination, laboratory tests for infections, and genetic carrier screening. Sperm banks add a quarantine period, freezing each sample for six months and testing the donor again before release. A single negative test on the day of donation does not replace that waiting period.
Those four parts are the same in Ohio and in Yorkshire, which is why this guide covers them once for everyone. The regulators differ and the panel differs slightly, while the reason behind each test does not. What changes by country is the law around parenthood and what treatment costs, and those belong on the country pages for the United States and the United Kingdom.
What does sperm donor screening actually cover?
Four things, and they answer four different questions. The medical and family history asks what runs in the donor’s family. The physical examination and the risk questionnaire ask whether there are signs or behaviors that make an infection more likely. The laboratory panel tests for specific infections. Carrier screening tests for specific inherited conditions.
The American Society for Reproductive Medicine’s 2024 guidance on gamete and embryo donation organizes donor eligibility around exactly this triad of history, examination and laboratory testing, with genetic and psychological screening layered on top. The same document is blunt about what the whole apparatus achieves: “There is no method to completely ensure that infectious agents will not be transmitted by DI,” meaning donor insemination, and it presents the guidance as something that “should significantly reduce these risks” rather than remove them. The people who design the screening say directly that it makes an unlikely outcome much less likely without producing a guarantee.
Which infectious diseases are donors tested for?
At minimum, HIV types 1 and 2, hepatitis B, hepatitis C, syphilis, chlamydia and gonorrhea. In the United States, 21 CFR 1271.85 requires testing every tissue donor for HIV-1, HIV-2, hepatitis B virus, hepatitis C virus and Treponema pallidum, the organism that causes syphilis. Donors of reproductive cells are additionally tested for Chlamydia trachomatis and Neisseria gonorrhoeae, the two agents the regulation names as communicable diseases of the genitourinary tract.
Sperm donors fall into a further category. Because semen contains viable, leukocyte-rich cells, the same regulation adds human T-lymphotropic virus types I and II, and cytomegalovirus. That is why HTLV and CMV appear on a sperm donor’s panel and not on many other testing panels people are familiar with.
ASRM’s 2024 table of laboratory tests required for gamete donors expands this into individual assays, several of them per agent, and adds West Nile virus nucleic acid testing, either year-round or seasonally for samples collected between June 1 and October 31.
UK practice covers the same ground under different governance. The HFEA, which licenses fertility clinics in the United Kingdom, states that clinics are “required by law to ensure that donors, patients and any future children are protected by carrying out rigorous health tests and offering everyone involved counselling.” The tests that follow from that requirement include HIV, hepatitis B and C, syphilis, HTLV, chlamydia and gonorrhea, alongside a family history assessment.
Why does a negative test have an expiry date?
Because every test has a window period, meaning a stretch of time after infection during which the test still reads negative. The Centers for Disease Control and Prevention sets out the window periods for HIV tests by test type: a nucleic acid test can usually detect HIV 10 to 33 days after exposure, an antigen/antibody lab test 18 to 45 days, a rapid antigen/antibody test 18 to 90 days, and an antibody test 23 to 90 days.
The practical meaning is that a result describes the past rather than the present. A test taken today speaks only to exposures old enough to be detectable, and says little about the weeks immediately before the sample was taken. CDC’s instruction after a possible exposure is to test again once the window period for that test type has passed, and every other screening timeline follows from the same fact.
Why do sperm banks freeze samples for six months?
To close the blind spot at the near end of a test result. Under 21 CFR 1271.85(d), for anonymous semen donors in the United States, a new specimen must be collected at least six months after the date of donation and tested again for the same agents. The sample stays frozen in the meantime, which is what makes the delay possible, and it can wait for the donor’s second test in a way that a fresh sample cannot.
ASRM records the same requirement for nondirected sperm donors as a “6-mo quarantine with repeat infectious-disease testing,” and gives the reasoning in its discussion of fresh semen: “It is possible for HIV and other infectious organisms to be transmitted by fresh donor semen before the donor has become seropositive. Consequently, the potential for transmission of infections by fresh semen cannot be eliminated.” Its stated position is that “the use of fresh semen can be justified only for sexually intimate partners.”
Six months sits well beyond the longest window periods on the panel. It is the biggest single difference between a bank sample and a fresh one, and it is also the reason bank sperm takes months to become available.
What happens when the sample is fresh?
Quarantine becomes impossible, so the timing of the test is the only lever left. ASRM notes that under current FDA guidance, directed donor specimens, meaning specimens from a donor the recipient has chosen and knows, “are exempt from quarantine,” with testing required within seven days of donation.
ASRM does not treat that exemption as sufficient and recommends something in between. Its guidance states that “quarantine of directed donor specimens for 35 days followed by retesting for infectious diseases is recommended,” citing evidence that the chance of an undetected infection after a negative nucleic acid test falls below one in a million after 14 days for HIV, 35 days for hepatitis B, and 7 days for hepatitis C, counted from the time of potential exposure. The 35 day figure is simply the longest of the three.
That is the number worth knowing for anyone arranging donation outside a clinic, because it converts an abstract worry into a plan: a negative test, then 35 days with no new exposure, then a repeat test. Whether that is achievable in a particular arrangement depends entirely on the people involved.
What does genetic carrier screening look for?
Conditions the donor could pass on without having them. ASRM’s 2024 guidance states that “screening for cystic fibrosis, spinal muscular atrophy, and thalassemia/hemoglobinopathy carrier status should be performed on all oocyte and sperm donors.” Those three are the baseline, and most banks run a considerably wider panel than that.
On wider panels, ASRM recommends “pan-ethnic expanded carrier screening” over ethnicity-based panels, citing the limitations of self-reported ethnicity and the fact that rare recessive conditions occur in any group despite lower carrier frequencies. It also asks that the sperm source and the egg source ideally be screened for the same conditions, which matters because carrier screening only produces a risk figure when both sides are known.
Being a carrier is not by itself disqualifying. ASRM states that “donors who are heterozygous carriers of autosomal recessive conditions, with no health risks to carriers, need not be excluded,” since a recessive condition requires a variant from both genetic parents. What the result changes is which recipients can safely use that donor.
Karyotyping, which examines chromosome structure rather than single genes, is handled differently. ASRM says donors “should not have a known karyotype abnormality, such as a translocation, inversion, or sex chromosome disorder,” while treating routine karyotyping as optional and recommending it where the family history suggests a chromosome rearrangement.
What can a family history tell you, and what can it miss?
It can flag patterns that no laboratory test on the panel would catch, and it depends entirely on what the donor knows and reports. ASRM asks that “all donors should provide a detailed three-generation family history, to the extent possible,” reviewed by a certified genetic counselor or a professional boarded by the relevant genetics boards.
The limits are stated in the same document, and they are unusually candid. ASRM writes that the effectiveness of the criteria “is dependent on the accurate reporting of family history and genetic testing by the donor,” that assessment “may be limited by factors such as small family size,” and that “many health conditions, birth defects, and genetic diseases are not predictable by family history assessment, and stringent adherence to these criteria does not guarantee that there will be no genetic risks.”
Two structural gaps follow. A donor from a small family has less signal available, and a donor who was adopted or was himself donor conceived may have almost none. ASRM also asks that donors be told of “their duty to update the clinic or agency with relevant family history changes over time,” since a family history is a snapshot of what was known on one day and conditions appear in families after that day.
What does a semen analysis measure?
Volume, sperm concentration, total number, motility, morphology and vitality. The reference values in general use come from the World Health Organization laboratory manual for the examination and processing of human semen, sixth edition, published in 2021. Its lower reference limits include a sperm concentration of 16 million per milliliter, total motility of 42 percent, progressive motility of 30 percent, and 4 percent normal forms.
Those numbers are frequently misread. They are the 5th centile of a reference population of fertile men, meaning 5 percent of men who had recently fathered a child fell below each limit. A result below a limit describes a position in a distribution rather than a diagnosis, and a result above every limit guarantees nothing either.
For donors specifically, ASRM sets no numeric threshold. Its 2024 guidance says the main qualities to seek are “an assurance of good health and normal semen analysis,” adds that “there are no uniformly accepted standards,” and refers to WHO’s minimum criteria. It also notes that proven fertility in a donor is desirable without being required. Banks additionally assess how a sample survives freezing and thawing, since that process kills a proportion of sperm.
Why is cytomegalovirus on every sperm donor panel?
Because it is extremely common and it matters mainly to people who have never had it. CMV is a herpes family virus that most adults carry without ever noticing. It appears on the panel under 21 CFR 1271.85(b)(2), which requires CMV testing for donors of viable, leukocyte-rich cells and a written procedure governing the release of any sample from a donor whose specimen tests reactive.
ASRM excludes donors with an active infection, defined by a positive urine or throat culture or by paired serum samples showing a fourfold rise in IgG with IgM at least 30 percent of the IgG level. Past infection is treated differently: “Because CMV is so common, insemination with semen from a CMV-seropositive man (without active infection) is permissible when the female partner is also CMV-seropositive or after informed consent from a seronegative woman.”
ASRM puts the associated risk of newborn CMV infection at approximately 1 percent in that situation, notes those infants “appear to have no significant illness or other abnormality,” and adds that the practice carries some risk because multiple strains exist. This is why CMV status appears on donor profiles at sperm banks and why recipients are commonly tested for CMV IgG.
What do the questionnaire and physical examination add?
They catch risk that a laboratory test taken in the window period would miss. ASRM describes the purpose plainly: “A complete personal and sexual history should be obtained to exclude, as donors, individuals who might be at high risk for HIV, STIs, or other infections that might be transmissible via gamete donation.”
The FDA questionnaire ASRM reproduces includes time-bound deferrals: non-sterile tattooing or piercing within the previous 12 months, incarceration for more than 72 consecutive hours within the previous 12 months, treatment for syphilis, gonorrhea or chlamydia within the previous 12 months, and a diagnosis of Zika virus in the past six months. Some criteria in that list have been contested and revised over time, and the underlying logic is that behavior and exposure history carry information a single blood draw does not.
The physical examination works the same way. Its decline criteria in the ASRM document include genital ulcerative lesions or urethral discharge, physical evidence of syphilis, needle tracks including those under tattoos, unexplained jaundice, and unexplained oral thrush, each a visible sign of something the panel might not yet show. ASRM asks that active donors have a complete physical examination before acceptance and every six months thereafter, which makes screening a repeating process rather than a one-time clearance.
Is a donor’s mental health screened as well?
At clinics and banks, usually yes. ASRM states that “psychological evaluation and counseling by a qualified mental health professional is strongly recommended for all sperm donors,” and describes an evaluation combining a clinical interview with a standardized, validated instrument for assessing mental and behavioral disorders. It covers motivation to donate, current stressors, psychiatric and substance use history in the donor and the family, relationship stability, and whether the donor understands enough to give informed consent.
Two topics on that list are worth naming because they surprise people. ASRM asks that the evaluation address the donor’s understanding of the “risk of losing anonymity,” including “the likelihood and implications of contact through direct-to-consumer deoxyribonucleic acid (DNA) websites,” and the implications of multiple families receiving their gametes. Recipients get a parallel consultation, and the topics it should cover include, explicitly, the “limitations of donor screening.”
How does screening work in a private arrangement?
It becomes something the two people organize themselves, and it usually looks like a shortened version of the clinic sequence. What people commonly describe doing is a full sexual health screen for both parties from a doctor or a sexual health service, sharing the actual results rather than a verbal assurance, agreeing a period with no new exposure, and testing again before the first attempt.
Three things make the difference between that being meaningful and being decorative. The date on a result matters as much as the result, since every test has a window period during which a recent infection is still invisible. The repeat test matters, since the first test cannot see the recent past. And a result that has been seen is different from a result that has been described, which is the most common gap people report in private arrangements.
Carrier screening is available privately as well and is worth requesting alongside the infection panel. Because a recessive condition requires a variant from both genetic parents, screening one side produces a much weaker answer than screening both.
The HFEA advises having treatment at a licensed clinic rather than inseminating at home with a donor found online, and states that it “is concerned that apps, websites, or social media sites helping exploitative or serial sperm donors expose people to serious medical, legal, and emotional risks that could have lifelong impacts.” Read as a description of what a regulated pathway provides, that position is a fair checklist of what the private route has to reproduce on its own.
Since this comes up in a guide published by a platform, it is worth saying plainly what we are. We are a matching platform. People create profiles, search, and message each other, and that is the entire product. We do not handle, store, test or ship anything biological, we are not a clinic or a sperm bank and are not affiliated with one, we do not verify identities, run background checks or screen anyone’s health, and we do not give medical or legal advice. Any test result seen on a profile or in a message is a document one person is showing another. The checks, and the decisions, stay with you.
One further point belongs here as a safety issue. Some people offering donation propose so-called natural insemination, meaning sex. This is a pattern people report encountering rather than a method, it removes every protection described in this guide, and it is a reason to end a conversation rather than to negotiate terms.
What does screening not cover?
Several things, and knowing which is more useful than assuming the panel is exhaustive. Screening does not test for every genetic condition, since panels cover specific variants of specific conditions and residual risk remains after a negative result. It does not predict conditions with complex or multifactorial causes. It does not cover infections outside the required panel, and the ASRM document sets no requirement to test for HPV, herpes simplex, trichomonas, mycoplasma or tuberculosis, and no drug or toxicology screening.
It also does not track how many families a donor’s samples reach, which is governed separately. ASRM’s guidance still cites the long-standing suggestion that “in a population of 800,000, limiting a single donor to no more than 25 births would avoid any significant increased risk of inadvertent consanguineous conception,” while noting this “may require modification when the specimens are distributed over a wide geographic area.” Outside a clinic there is no register, and the number depends on what a donor chooses to tell people.
Screening also settles nothing legal. Who counts as a parent after a donor conception is decided by statute and case law, and in the United States it differs between states. The country pages handle that in the right register, with common questions answered for the US and for the UK.
Frequently asked questions
How recent does a donor's test result need to be?
Recent enough that no exposure has occurred since it was taken, which is a question about the person rather than the paper. FDA rules for directed donors require testing within seven days of donation, and ASRM recommends a further 35 days of quarantine plus a repeat test, based on evidence that the chance of an undetected infection after a negative nucleic acid test falls below one in a million after 14 days for HIV, 35 days for hepatitis B, and 7 days for hepatitis C.
Is a home STI test kit enough?
It depends on which infections the kit covers and when it was taken relative to any exposure. CDC gives window periods for HIV of 10 to 33 days for a nucleic acid test and 23 to 90 days for an antibody test, and most home kits are antibody based. Clinic panels for donors also cover HTLV, CMV and West Nile virus, which consumer kits generally do not include. A doctor or sexual health service can advise on what is appropriate in an individual case.
Does genetic screening mean the child will be healthy?
No, and ASRM states this directly. Its 2024 guidance says that many health conditions, birth defects and genetic diseases are not predictable from family history, and that stringent adherence to donor screening criteria "does not guarantee that there will be no genetic risks." Carrier panels cover specific conditions and specific variants, and a residual risk remains after a negative result.
What does a CMV-positive donor profile mean?
Usually that the donor has had cytomegalovirus at some point, which is true of most adults. ASRM excludes donors with active infection and describes use of semen from a seropositive donor without active infection as permissible when the recipient is also seropositive, or after informed consent from a seronegative recipient, putting the associated risk of newborn CMV infection at approximately 1 percent.
Do donors get screened again if they keep donating?
Yes at clinics and banks. ASRM asks that active donors have a complete physical examination before acceptance and every six months, that laboratory testing accompany each donation within the seven-day window, and that a new full psychological evaluation be done when more than 24 months have passed since the previous one.
The short version
Sperm donor screening is a history, an examination, an infection panel and a genetic carrier panel, and the part that does the most work is the timing rather than the list. Every test has a window period, which is why banks freeze samples for six months and test the donor again, and why ASRM recommends 35 days of quarantine plus a repeat test where freezing is not an option. Carrier screening covers cystic fibrosis, spinal muscular atrophy and hemoglobinopathies as a minimum, usually on a wider panel, and produces a risk figure rather than a clearance.
For anyone arranging this privately, the useful version is short. See the actual results rather than a description of them, check the date against the window period, agree a stretch of time with no new exposure, and test again before the first attempt. The mechanics of the attempt are covered in the guide on how home insemination works, and the timing of the cycle in the guide on finding your fertile window.
The rest of the guides cover the parts that are the same wherever you live, and the legal and cost picture sits on the country pages for the United States and the United Kingdom. You can create a profile at your own pace, read more about who we are, or get in touch if something here needs correcting.
Sources: 21 CFR 1271.85, Donor testing requirements, eCFR · ASRM Practice Committee, Gamete and embryo donation guidance, Fertility and Sterility 2024;122:799–813 · CDC, Getting Tested for HIV · WHO laboratory manual for the examination and processing of human semen, sixth edition, 2021 · HFEA, Home insemination with donor sperm. Checked August 2026.