The price for a single vial of sperm in the fertility market goes for anything between $370 to $890 dollars. That cost only covers the sperm itself, whereas the browsing, freezing, storing, reheating, inserting, and inseminating all have their own steep costs. While some elements of the process are covered by insurance, the cost of actual sperm always comes out of pocket.
"There are charges for every step but people are completely invested, so they're willing to pay for whatever they have to do," says Carly, a mother of two who conceived using a sperm donor.
Sperm, you might assume, is a low-demand and high supply market, but it's actually the inverse. With women wanting the highest quality sperm possible — college educated sperm that is free of disease and physical abnormalities — the amount of labor that's involved in obtaining this pristine goo drives sperm prices sky high.
"We screen thousands and thousands of men at our five locations," says Dr. Michelle Ottey, the Laboratory Director at Fairfax Cryobank in Virginia. "And only about one percent of them actually make it through.Statistically, it's harder to get into the sperm donor program at Fairfax than it is to get admitted to an Ivy League school." It's not just the quality control of the sperm that drives up costs, Ottey adds, the packaging of who the sperm belongs to is also folded into the price point.
"We create profiles, take professional photos, we try to put the audio tapes together and the medical and personal profiles and everything."
The Sperm Bank of California charges clients extra for "extended profiles" of their donors. For $40 extra dollars, the Bank will send you three baby photos of the donor along with more detailed information about him. Some websites, such as California Cryobank, offer a 90 day subscription ranging from the mid $100s to the mid $200s. But neither option guarantees that women will find the right donor for them within a sperm bank's catalogue.
Adding to these costs is the fact that plenty of women don't get pregnant on the first try or even the second attempt. Carly, for instance, was able to conceive on her first attempt, but with her second child she wasn't able conceive until her fourth attempt. To add anxiety to cost, there's always a chance another recipient could swoop in and buy out a bank's remaining stock of a particular donor's vials you've chosen. This threat is even more real for women who desire to have multiple children with the same donor.
After a man donates--donations typically pay out to between $35 - $55--the vials are typically stored at the sperm bank because the sperm can't survive in a kitchen's freezer. So women must pay for storage fees as well. Fees are typically $50 dollars a month. Some banks, such as Sperm Bank of Seattle, will throw you a bone and give you a month of storage for free, but this is rare. Prospective parents then have to rush ship the vials (or shipped directly to their doctor's office) each time a woman is about to ovulate. The shipping can run over $200—possibly even more if you happen to ovulate on the weekends—and comes with a nitrogen tank, which of course has a rental fee with quotes between $25 a day and $50 a day.
Raw Versus Unwashed Sperm
Now, let's say you've selected your college educated, disease-free sperm of mixed European descent and you've paid for the baby photos, the vials, and the shipping. And now you're ovulating. What are your options for insemination? Many women choose intrauterine insemination (ICI), wherein a medical professional inserts a catheter past the cervix so the sperm is introduced directly into the uterus. The success rate is often quoted at about 12.5 percent, but the procedure can run out-of-pocket up to $375 per insemination attempt, or $435 if you're ovulating on a weekend or holiday. Part of that costs comes from having to "wash" the sperm, which is a process of separating the good swimmers from the bad or dead ones, thereby improving a woman's chances of conception.
Carly and her partner chose to use (ICI) for both pregnancies. "I'm not infertile. I just needed a doctor's assistance to get the sperm inside of me, and because that was the case, nothing was covered by insurance," Carly says. Some insurance policies cover insemination for couples who may be suffering from male or female infertility, but for those who suffer from "social infertility," like lesbians and single women, they have to pay.
A woman's best bet for pregnancy by artificial insemination is through in-vitro fertilization (IVF), wherein a fertilized egg is surgically implanted into the womb which is also hugely expensive. According to Forbes, a typical IVF cycle costs $12,000, before medications, which adds another $3,000 to $5,000 dollars.
A less expensive but also the least effective form of insemination is intracervical insemination (ICI) with "raw" sperm. Raw sperm just means, "unwashed" old-fashioned spunk. It can be self-administered at home using a syringe or catheter. After getting the sperm as close to the cervix as possible, the woman lays down with her hips tilted up, and hopes that it swims upstream. ICI can be performed at home. The pregnancy rate is rather low, with some estimates as low as six percent per attempt.
The High Cost of Social Infertility
Insurance providers and state laws haven't caught up to the changes in the fertility industry.
"When [Fairfax] Cryobank first started in the '80s," explained Dr. Ottey, "'it was almost exclusively, if not exclusively, for heterosexual couples dealing with male infertility. At this point, we still obviously serve that population, but overall the majority of people that are using our donor sperm are either single women or lesbians who need the sperm to build their family."
Only 15 states require that insurance providers either cover or offer coverage for infertility, and even within these states, those who cannot physically produce sperm aren't guaranteed help paying for services despite that heterosexual couples now only make up a fraction of those seeking donor sperm and fertility treatments.
While some insurance companies may provide single women or lesbian couples help in the form of co-pays for office visits, ultrasounds, or a portion of the IUI itself (coverage that varies wildly), the sperm itself is the prospective parent's responsibility exclusively for those who are medically or socially infertile. And while single women and lesbian couples seem to have a harder time getting help paying for this process, heterosexual couples can be excluded as well in states with draconian rules that couples have to be married such as in Arkansas (according to Resolve).
Unfortunately, the process is getting more expensive. At Fairfax, for example, from 2015 to 2016, prices across the board for donor sperm jumped $55 per vial. "As you can imagine, as the technology is improving and they're adding additional test requirements, the cost does vary and go up over time, just like everything," Dr. Ottey says. Fairfax also has recently implemented new programs, such as their sibling tracking program as well as their donor alumni tracking program, that also increase the value of Fairfax's vials.
"It would be fantastic if insurance could cover more of these costs," Ottey says, "but I don't know how likely that is."