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An Investigation of Racial and Ethnic Disparities in Donor Sperm Availability in the United States.

OBJECTIVE: To determine whether the racial and ethnic distribution of sperm donors contributing to United States (US) sperm banks differ from the demographics of the US population and those of US donor sperm recipients undergoing treatment with in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI).

DESIGN: Cross-sectional study.

SETTING: United States donor sperm banks, US census, and fertility clinics reporting to Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS).

SUBJECTS: Sperm donors from 18 banks, men aged 18-39 years based on the 2021 Census Current Population Survey (CPS), and recipients of donor sperm for IVF/ICSI in clinics reporting to SART CORS from January 1, 2018 to December 31, 2020.

EXPOSURE: Race/Ethnicity MAIN OUTCOME MEASURE: Proportions of sperm donors and donor sperm recipients undergoing IVF/ICSI identifying as each racial and ethnic group.

RESULTS: Eighteen donor sperm banks were identified, encompassing 1,503 donors. Of these donors, 60.9% identified as White compared with 55.1% of the US male population, p<0.001 and 67.7% of donor sperm recipients, p<0.001. Proportions of donors identifying as Asian or two or more races were larger than those of US men and donor sperm recipients (Asian: 18.6% vs. 6.5%, p<0.001 and 18.6% vs. 10.2%, p<0.001; two or more races: 11.6% vs. 2.2%, p<0.001 and 11.6% vs. 1.7%, p<0.001). In contrast, Black donors were underrepresented when compared to the US population of men and donor sperm recipients (2.8% vs. 12.9%, p<0.001 and 2.8% vs. 13.0%, p<0.001). Hispanic donors were underrepresented when compared to the US population of men (6.0% vs. 22.2%, p<0.001). Percentages of Hispanic sperm donors and donor sperm recipients were similar (6.0% vs. 7.0%, p=0.17).

CONCLUSION: The racial and ethnic distribution of sperm donors differs significantly from the demographics of the US male population and US donor sperm recipients undergoing IVF/ICSI. These findings suggest a need for targeted recruitment efforts of Black sperm donors.

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