Tuesday, May 15, 2012

The Man Who Spermed a 1000 Babies

A long-dead Briton haunted the headlines a few weeks ago after it emerged that he might have fathered a thousand babies through donated sperms. And its not that Bertold Wiesner had a harem where he indulged in carnal pleasures with numerous females. He multiplied his seed through sperm donation.

The extraordinary tale of a thousand babies started at the end of World War II in a small reproductive clinic offering Artificial Insemination by Donor (AID) in the leafy suburbs of London pioneered by a Dr. Mary Barton, Bertold’s wife.
Most members of the “Berton’s Brood” are in their twilight years and several of them have embarked on a nostalgic quest connect with their hundreds of brothers and sisters scattered across the globe.

With Kenya boosting of several sperm banks in both private and public health institutions, the UK scenario is bound to trigger a lot of ethical, moral and medical questions not only among health practitioners but also ordinary citizens.
Although the chances of coincidental incest, called consanguinity, among the “Barton Brood” is next to none since they are scattered across six continents, the case would be the opposite if the same happened in a country the size of Kenya.

“Taking into consideration the parameters that we have put in place in our facility such an incidence borders on the impossible in Kenya or anywhere else in the world in this era,” explains Prof. Koigi Kamau, Chairman of the Obstetrics and Gynaecology Department in the University of Nairobi’s School of Medicine which together with Kenyatta National Hospital runs one of the oldest sperm banks in the country. “Besides careful profiling of donor samples to monitor usage the AID field is governed by social, cultural and religious principles”.

Prof. Kamau headed a task force setup by the government in 2004 to come with proposals on legislative policies to govern how the field was to operate, but the group of experts never completed its work due to what he calls “luck of support from relevant authorities”.

But besides the absence of a regulatory framework the moral and cultural issues surrounding sperm donor related conceptions remains a huge debate among many health practitioners not only in Kenya but also across the world.
According to Prof. Kamau, the Kenyatta National Hospital Sperm Bank exists principally for academic and medical reasons hence they only assist couples referred there by gynaecologists and other specialists. Unlike sperm banks in private clinics where AID is done for commercial purposes theirs is purely for research and treatment of couples struggling to have children.

“Although we don’t yet have a legal parameter to guide our operations we observe strict ethical and cultural and religious aspects since as an institution we exist to solve medical problems in a way that will make society stronger,” Prof. Kamau explains. “Assisting young single women with no medical problems is an act of encouraging and propagating the concept of single motherhood, which is against the traditional African definition of family which consists of father, mother and child”.

He says by helping married couples have babies the institutions is helping build stronger families since childlessness is one of the major causes of marital problems in the Kenyan society today.

“Although I fully believe children born of single ladies through natural should and must enjoy their rights just like any other citizens, single parenting is not an aspect that should be encouraged through science,” the scholar opines.
His sentiments are endorsed by Dr. John Ong’ech, Director of the Reproductive Health Services at the Kenyatta National Hospital, who says that he sometimes finds himself pushed in a professional quagmire when young and healthy women comes seeking AID.

“I have a moral issue when young women walks in and requests to have the service purely from emotional basis since they are frustrated by men and relationships,” he says. “I don’t encourage that hence I usually try to counsel them by explaining that AID is a treatment for medical and not social problems”.

But Dr. Solomon Wasike of Afya Royal Clinics and one of the founders of the sperm at Kenyatta Hospital differs sharply, insisting every Kenyan have a right to get a baby by whatever means.

“The most fundamental function of advanced medical science is to help humanity through situations and having a baby, whether single of married, is one of them,” he insists. “For single women to undergo the process of artificially induced conception they need to sign some legal papers formalizing their parenthood duties and responsibility to the baby and if it’s a couple the two parties have to do the same”.

Upon conception through a donated sperm or egg, the baby is legally bound to the recipient couple in terms of inheritance and all the other parenting privileges and responsibilities. Even if the identity of the donor was to be revealed to the child later in life, the latter has no legal claims to the former’s property.

The sperm bank at Kenyatta Hospital, the oldest in the country having been setup more than 25 years ago, gets a bulk of its donors from medical students from the university and other training institutions. However, anybody can be a donor as long as they are ready to undergo a series of rigorous medical tests including HIV\Aids besides revealing medical histories of their immediate histories.

Going by the popular myth that semen is commodity of high demand, one expects to find a line of young men lining up out the Kenyatta Hospital facility waiting to dispense their seed for fortune. But the reception is a very lonely place with only a few patients none of whom was ready to say what they were there for.

“We usually get an average of four samples a day and the most common method of extraction here is masturbation in a special testing room. We also do post-coital test (PCT) for those whose husbands don’t feel comfortable with their samples being brought to the lab,” explains George Munyao, the Kenyatta University Sperm Bank lab technician. “Before semen can be extracted from an individual, either as a donor or for fertility medical tests he has to avoid having sex for at least three days before the samples are taken”.

Laboratories in developed countries like the United States and the UK they have devised a variety sperm extraction methods that varies from onsite wanking in a special room called a “masturbatorium”, a specially made collecting condom used during intercourse at home or through electro-stimulation where the male organ is excited using electric signals.
Although this is not the case at Kenyatta, most of the specimen collection rooms in other countries contain pornographic videos and magazines to hasten production.

The frozen samples are labeled in such a way that the biometric details of the donating individual are listed for the purpose of identification. Tests are done before and three to six months after collection to cover for incubation of conditions like HIV.

“For storage the samples are frozen in liquid nitrogen at minus 196 degrees centigrade and kept in quarantine until the donors are declared safe after the series of tests,” explains Mr. Munyao who have worked as a “sperm washer” for the last two decades, making him one of the longest serving in the country. “To avoid rigours of testing new recruits every now and then many sperm banks prefer using a certain pool of donors for a period of time before recruiting a new team”.
Verified specimen ready for use is stored in vials or straws where one sample can be divided between one to twenty parts depending on the quantity of the specimen, called ejaculate, taken and whether the sperm cells are separated from the seminal fluid (washed) or not (unwashed).

Samples are labeled where the information provided includes tribe, race, weight, height, build, eye colour, hair type, hobbies and academic levels. To ensure a maximum degree of anonymity the donors are classified in numbers and letters and some clinics ensure that the collecting individual is different from the one dealing with recipients.

Men between the ages of 21 and 35 are the most preferred as donors and they are not paid any money besides a small token given to take care of out-of-pocket expenses like meals and transport. While a normal sperm count is where there is 20 to 150 million healthy cells per milliliter of fluid doctors say chances of conception using donated sperm samples are about 20-25 percent, almost the same with the natural methods.

“A man can be infertile due to low or abnormal sperm count, with the abnormal meaning the sperms might not have tails to help them swim through the birth canal or no heads to help penetrate the ovum,” Dr. Ong’ch says.
In such instances the couples are given the options of bringing along a donor of their choice or going to the bank to get sperm from an anonymous donor.

“The couples that I have assisted conceive this way more often than not come back to say thank while holding the baby,” the US-trained obstetrics and gynaecologist says. “But for obvious reasons all of them want to remain anonymous and as a doctor I am obliged to honour their wish”.

In discordant cases where the husband is HIV positive and the wife is negative the sperm extracted, washed of the virus-laden seminal fluids before artificially inseminating the wife with it.

“The semen, and not the sperm, is the carrier of the HIV virus hence what we do in the sanitization process we filter the sperm from the seminal fluid and put it in an artificial agent with the same qualities as the semen,” Dr. Ong’ech explains. “This way discordant couples are able to give birth without infecting each other or the unborn baby”.
If the wife is having blocked fallopian tubes the doctors recommend in-vitro fertilization (IVF) where the sperm from the husband or anonymous donor is used to fertilize the egg using a laboratory fluid medium and then transferred back to her uterus with the intent of establishing a successful pregnancy.

Dr. Joshua Noreh is one of the most celebrated IVF experts in East and Central Africa today having made history as the first doctor in Kenya to produce a “test tube baby” in 2007. After making improvements into the technology the success rate at his Nairobi IVF Clinic has improved to about 40 percent, among the best in the world.

Undergoing an IVF is not a cheap affair since a single procedure costs more than sh350 and one might have to undergo several before one lands a successful pregnancy.

The United State’s “ejaculatory industry” is the biggest in the world with country’s top four companies controlling 65 percent of the global market according to the current issue of TIME magazine. America is rumoured to generate a turnover in the excess of $100 million by exporting sperm to over 60 countries across the world, an aspect credited on liberal laws and intensive research.

The magazine goes to narrate the case of one sperm donor who was driven by curiosity to find out how his offspring looked like.

“But one day in 2005, Seisler grew curious about the results of his biological generosity,” the TIME story goes. “he plugged his donor number to the Donor Sibling Registry and was put in touch with….at least 20 families…he counts more than 70 offspring in the U.S and abroad”.


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