Ep 191: Behind the Scenes at Fairfax Cryobank with Lisa Lightbourne and Andrea Darrington

Choosing a sperm donor can feel overwhelming, emotional, and deeply personal, especially when you’re not sure where to begin. In this episode of Fertility Forward, hosts Rena and Dara are joined by Lisa Lightbourne, Clinic Relations Manager, and Andrea Darrington, General Manager at Fairfax Cryobank, for a behind-the-scenes look at how donor sperm programs really work. Lisa and Andrea explain how intended parents navigate the donor selection process, what goes into screening and approving donors, and why only a small percentage of applicants are accepted. They also discuss donor identity release, how to approach narrowing down donor choices, and the emotional realities many patients face when considering donor conception. Along the way, the conversation explores the growing openness around donor conception, the importance of diversity and representation, and how more insurance coverage is helping improve access to care. Tune in for an insightful conversation about donor conception and modern family building! 

Transcript

SPEAKER_01 0:13

He everyone, we are Rena and Dara, and welcome to Fertility Ford. We are part of the wellness team at RMA of New York, a fertility clinic affiliated with Mount Sinai Hospital in New York City. Our Fertility Ford podcast brings together advice from medical professionals, mental health specialists, wellness experts, and patients because knowledge is power and you are your own best advocate. I am so excited to welcome to Fertility Ford today, Lisa and Andrea from Fairfax Cryobank, who are coming on to spill the tea about Fairfax and tell our listeners about what really happens behind the scenes and in front of the scenes at Fairfax. So welcome. Thank you so much for coming on. And we are so excited to have you and learn from you.

SPEAKER_03 1:03

Thank you, Rena. It's great to be here. Again, I'm Lisa. And yeah, great opportunity to raise awareness and talk a little bit about donor sperm and the place it has infertility.

SPEAKER_01 1:13

Yeah. So tell us first to any listeners that don't know what is Fairfax Cryobank? Who are you and what do you do?

SPEAKER_03 1:20

Yeah, we've actually been around for 40 years and really started helping patients needing donor sperm and came about through medical leadership. So really strong background as far as our medical director. A lot of the decisions get made are through that direction. So, but yeah, we've been in the fertility space for 40 years now.

SPEAKER_01 1:43

So tell us about the process. So say I go into a fertility clinic and whether by choice or not choice, I'm told I need to use donor sperm. Okay, then what happens? You know, my reproductive endocrinologist says you need to use donor. Do I then seek out Fairfax? Is that something that is already linked to my clinic? What are the next steps there?

SPEAKER_03 2:04

Yeah, so we find most physicians will refer to certain cryobanks. So ones that are reputable, responsible to refer to. We're naturally on the list for more, and we do have partnerships with a lot of clinics as well. And then we do, we refer patients to our website. We try to make it really user-friendly so that they can start diving into finding the match, right? Looking through all the different profiles, different ways you can sort by donors. We have a really diverse option for patients and get them comfortable in the donor space and hopefully finding a match, finding somebody they connect with to build their family.

SPEAKER_01 2:39

So, how does it work with Fairfax? How do you screen donors and decide that, okay, you're passing the process and okay, we'll list you and you can donate.

SPEAKER_00 2:49

Sure, definitely. On the donor screening side, it's a really robust process. So it's interesting, I think, because there's kind of sometimes a perception that it's similar to blood donation and it's fairly quick, but it's actually quite robust. So the donors have to go through about a three to four month screening process initially, and then they have ongoing screening. And so for every a thousand applicants we get, only about 1% will make it to our website and be available for patients to choose from. So we screen many different parameters, we screen the medical history of the donor to make sure they're not at increased risk for any conditions, and that includes their family history as well. They do a semen analysis. So we have to ensure that their specimen quality will be suitable for freezing and thawing and usage later. They do a physical exam, they do a psychological PAI assessment, they meet with a series of providers, including our healthcare providers that perform the physical exams, and then they do infectious disease testing and genetic testing. And even after they finish that robust three to four month process, our medical director will review their records. But then there's ongoing infectious disease testing, there's physical exams every six months. So it's a really in-depth screening process, and the percent of individuals that make it through are far and few between.

SPEAKER_01 4:10

Wow, that's really invasive. I frankly didn't know it was that intensive. I think there's sort of a misnomer out there that for men, they can just go in and donate and these men, because there have been documentaries or stories throughout the years, right? Of these men donating and then having so many children, which I think gives the impression that you can kind of just walk in off the street, give a sample, and then be good to go. But it it sounds like it's not like that at all. It's very intensive.

SPEAKER_00 4:38

Definitely. It's really intensive. It's a it's a time-intensive process. And in addition to Fairfax Cryobank and cryobanks eliminating donors who don't meet that criteria, to your point, Rena, sometimes donor applicants themselves will eliminate themselves out of the process early on because they realize, oh, this is actually a lot more than what I expected, which is good for all parties, but something that's not going to work for them, that's okay with us. So there's a large commitment required on the donor's end as well.

SPEAKER_01 5:06

Do you find that most donors come for any particular reason? You know, sort of when they stick it out through the process.

SPEAKER_00 5:14

Definitely. We find that a lot of our donors have had experience in their, you know, maybe with friends that have had different fertility journeys. So that's something that will come up sometimes in their essays where they know a family or friends, or you know, maybe somebody's parents who used IVF. There's genuinely the passion to help others. Nowadays, there's a big task economy out there with Uber and Lyft and different ways that people can make ad hoc compensation. So we find that donors that stay in our program that stick through this very long screening process and make it through, they tend to be individuals who want to help others. There's a lot of ways that individuals can make compensation. And this is a very arduous way to do so. So it's generally comes from a desire to help others with their family building dreams.

SPEAKER_01 6:01

And then to be a donor at Fairfax, are donors allowed to choose if they want it to be private or public in terms of the child knowing about them?

SPEAKER_00 6:12

Definitely. That's a great question. So in recent years, we've pivoted to a donor ID release program. So donors who do our program, they are basically required to consent to the donor. When the donor-conceived child reaches age 18, they're allowed to contact the cryobank and get identifying information for the donor. So all of our donors that have entered our program in recent years, they agree to this identification release process so that in the future, any children when they come of age 18 or older, they're able to connect with the donors. And on our website, when patients are undergoing the donor selection, there's some legacy non-ID donors, but then we have our ID disclosure donors and donors in recent years are all ID disclosure donors.

SPEAKER_01 6:58

Have you found that anyone has pivoted and not used Fairfax because of that? Meaning that as an intended parent, that they did not want to have that option. They wanted it totally closed and didn't want their child to have that.

SPEAKER_00 7:13

I think in recent years, it's more common that people want that than don't want that. I would say is the overwhelming majority. We have some of our legacy donors on the catalog that are non-ID. So I suppose there's the option for that individual if they want that. But I would say generally a lot of families prefer to have an ID release donor and then let their child in the future make that decision if they want to get the information or not.

SPEAKER_01 7:36

That aligns with in my field, which is psychology, is how we guide patients and that it should be open and revealed to the child from a young age. It's just part of their story. So that definitely aligns with that. Say I'm choosing a donor, I come to Fairfax, sort of what happens, you know, because I think, at least I see with my patients, there's a lot of fear or anxiety because they have no idea how everything unfolds. So they reach out to you, is it phone or email? And kind of then what are the next steps?

SPEAKER_03 8:08

Yeah, we really focus a lot of energy through our client service team to really guide patients through that. Because I agree for intended parents, right? It's a new journey for them and there's a lot to navigate. So our client service team really spent a lot of time with the patients, walking them through the process, even helping them select a donor. They're comfortable within the space and can kind of answer questions and guide them through. So, although a lot can be done on our website, and sometimes that's an initial way, right? To start looking around, check out some pictures, sort by all these different measures, whether it's ethnicity, you can sort by horoscope. Do you like cats or dogs, right? All these different ways to kind of get interested in donors, looking at their profile. But then ultimately our client service team is available to them to walk them through the process from beginning to end. So from purchase to arranging shipment. So often it goes into storage while they kind of wait for their treatment cycle. Most reproductive endocrinologists like them to start looking sooner than later, just so that they can go ahead and have that secure. And then once they're ready for their treatment cycle, then we arrange for shipment direct to the clinic. And what's the timeline on that? So they overnight ship vials. So it's based on how the clinics receive them. So we coordinate with the clinic, but yeah, it's usually shipped out overnight or second day once they're ready for their treatment cycle.

SPEAKER_01 9:28

And what about guarantees on a donor not being used more than once? Is that something that you're able to do or no?

SPEAKER_00 9:36

Sure. So we have different donor selections. So as part of the search criteria process on our website, we have different donors. So if somebody is interested, there's different programs too. So one program we have is the known donor program. So if let's say an individual has maybe a friend from college and they want to bring that donor to us and be screened exclusively for that individual, we can do that. That would be a directed donor screening. It would be similar to how we screen the donors that become available on our website, but that donor would be dedicated just for that individual who brought them to our facility. On our website, we have different types of donors. So we have, like I mentioned earlier, non-ID, ID donors. We also have donors with less total families. So we have donors that have 10 families that individuals can select from. So if they want a smaller family-sized donor, we have that option available for clients.

SPEAKER_01 10:33

Oh, wow. So there really is a lot of optionality and choice. Definitely. Yeah, definitely. I mean, even that, I think a lot of times I see my patients get overwhelmed with that. You know, they go in and they say, wow, I'm so overwhelmed. I don't even know how to choose. You know, there are so many options here. This feels super overwhelming.

SPEAKER_00 10:51

Definitely. Lisa, I don't know if you want to speak to what maybe some tips might be for narrowing down the group.

SPEAKER_03 10:57

Yeah, I think a lot of times just the filters are broad, right? And so they can start by, you know, maybe there's an ethnicity that they're looking for, certain physical characteristics. Most of the physicians we really do talk to, though, like for patients to even read the essays or look at the audio. So although we don't want to overwhelm them, we also want them to have a lot of selection and options. I think one of the nice things too is that we have photos available. So again, they can kind of select, find their donor, and start looking at pictures and seeing where they might connect with that particular match and that particular donor. But there's all these different filtering options within our database. So we encourage patients just to kind of get started looking and pick a few characteristics that resonate with them that'll narrow down the filter a little bit. And then they can start again digging into more details to see who they connect with.

SPEAKER_01 11:49

Do you have words of advice for someone that comes and they say, okay, note it. I hear everything you're saying, but I still have no idea where to start because I don't even know what matters to me. You know, do I look at religion? Do I look at ethnicity? Do I look at where they went to college? I'm not sure even where to start to narrow this down. Do you have advice for where to start for someone who may be feeling like that?

SPEAKER_03 12:11

Yeah, I think at that point you could probably look at some of the medical filters that you can sort through, right? So there's CMV status and kind of genetic carrier. So maybe there's certain genes that you need to be negative for. And so that way you can kind of narrow down, okay, these are the medical reasons, right? That I should filter out. And then that'll narrow down kind of the donor selection pool. And then at that point, I think a lot of times just sorting through pictures is a fun way to kind of try and connect with different donors. So we've got baby pictures on there, and then they can click. A lot of them do have adult or lifetime photos as well. So they can sort through that. And again, then they'll have all these other kind of filter options. But I agree, sometimes they can get overwhelming. So sorting out the things that are more necessary might be a good way to narrow down the gap and then go from there.

SPEAKER_01 12:58

What about if you come and you say, ideally, my family building plan is three children and I want them all from the same donor? Is that a possibility for somebody?

SPEAKER_03 13:08

Yeah, we often recommend purchasing more than one vial and we'll just hold them in storage. And it's for that reason. I mean, I will I'll talk to clinics and sometimes they found their donor and they've sold out, right? And that that can be hard. And I know our client service team will try to find, you know, are there options for that patient? But ultimately, if they can kind of secure what they need for their family building. So whether that's how many children they want, or sometimes the journey too is IUI before IVF cycle, right? We find a lot of insurances, for instance, will cover, you know, a certain number of IUIs before IVF. So that might factor in as well, kind of how many they want to purchase just so that they have enough for what their family building plans are. And then we can just store them at Fairfax and then ship out as needed. So we do provide storage as well through the cryo bank.

SPEAKER_01 13:56

Okay. Yeah, I guess how does it work? Because I've certainly had clients before that said, you know, it took them a very long time to settle on a donor, you know, it was a big endeavor. And then they get disappointed because it sells out overnight.

SPEAKER_03 14:10

Yeah, it's good to go ahead and secure what you need. The nice thing is, is if there were genetic reasons, let's say that they needed to switch the donor, they could do that. So let's say they secure who they need, go ahead and make the purchase, and then find out genetic reasons they need to switch. I mean, ideally, if they found somebody and resonated, we do, we recommend going ahead and purchasing at that point. And yeah, it is. It's a process for people. I mean, we've known of stories where they'll have almost a reveal party, right? Where everybody gets together and contributes to the conversations. For others, it's a more private decision that they make. But once they make that decision, yeah, it's a good idea to go ahead and kind of secure what you need. And then knowing that you have some flexibility, whether you can exchange donors with us, again, as long as they're stored with us, you have that flexibility. We also have a buyback at 50%. So we can also, let's say you had luck early on, you only want to keep maybe a vial for sibling use or two, and you've purchased more, we can buy back unused vials at 50%. So again, as long as vials are stored with us, we do have some flexibility for for parents.

SPEAKER_01 15:14

Oh, that's super interesting. So if you're someone who, let's just say you want one child and you're doing IUI, and so you know sort of the statistics there. And so you say, okay, I really want this donor. I'm gonna purchase three vials, but let's say the first IUI works, and then you can send them back. I or you could buy them back. That's so interesting.

SPEAKER_03 15:34

Yeah. So as long as they're stored with us at Fairfax, yeah. So we can buy them back. So again, it offers some flexibility and yet they feel like they can secure what they need, right? There's so many unknown variables when it comes to fertility. And so as as many things that we can support the patient through that. So we feel like we want to do that too.

SPEAKER_01 15:52

Mm-hmm. What about any common questions that you have from donors?

SPEAKER_00 15:59

Definitely. I think in terms of for donors, the kind of most common question is just similar to what we discussed before, educating them on the screening process, because sometimes they also walk in with the perception that this will be more like blood donation and a couple of visits and a more simpler process. So I would say the first series of questions we answer is just educating them on the screening process and the commitment that's required. And like I mentioned earlier, some applicants will self-select themselves out of the process because they realize, oh, this is a bigger commitment. I'm not ready for this. And that's okay, and that's good for us, and it's good for everybody. So we just work to educate the donors on the screening process, what it means to be releasing their identity in the future and walk them through that journey and make sure that it's a good program for them as well.

SPEAKER_01 16:47

I wish there was a larger conversation or more knowledge about this because I don't know if either of you feel the same way, but you know, I see with my patients and individuals in general, I really think there's this dialogue that's okay, you know, it's so easy for men to donate, right? They just kind of go in off the street, no problem. But to know that it's really this intensive process, you know, I think there's a general understanding about how difficult egg donation is, just the nature of doing it, right? It's very intensive to go through an egg retrieval. And so I think there's sort of this misnomer out there that sperm donation could be sort of anyone, but it really sounds like it's pretty parallel to egg donation in that it's a lot of time and effort and energy. And the individual that's going to donate, you know, I would imagine just as you said, from that, there's altruism there, you know, and really a genuine desire to help somebody.

SPEAKER_00 17:40

Yeah, definitely. I think there's a lot of parallels. Obviously, the procedure itself to obtain the sperm is nowhere near as invasive as egg donation, but the time, effort, the kind of length of commitment, and it's a lifetime commitment. The donor-conceived individuals, when they reach of age, they'll contact us, we'll work to try to facilitate that connection with the donor. So it's a lifetime commitment even beyond the initial screening process.

SPEAKER_01 18:04

What about any future implications? I mean, do you have any sort of idea where sort of the space is going, if anywhere different, or is it sort of working really well, staying the same?

SPEAKER_00 18:14

I think in general, as the IVF industry evolves, there's some evolution with regards to gamma donors. So as we were discussing earlier with the vials, now that more third-party companies are offering fertility benefits at different organizations, some people have the option to do IVF at the start or sooner. So they might need less vials than they might have needed initially if they were going to do IUIs. So I would say maybe on the client side, there's some evolution as more entities step into covering different parts of fertility care. On the donor screening side, we just continued to evolve with what the needs are. So as I mentioned earlier, the donors in recent years are willing to have their ID released in the future. So that's something that we've made a permanent requirement of the program. And we require it of all donors. So that isn't an FDA requirement necessarily. It's something that we've required and it's following the kind of more like society's openness about gamete donation and using gamete donors.

SPEAKER_01 19:15

That's super interesting. What about do you have any way to connect potential clients with those that have used donors? You know, a lot of I know a lot of times my patients that are considering donor, the concepts can seem very abstract to them. And so they're always looking to connect with someone that's been down the road before and already has a child. Do you have any sort of network where people are willing to connect or share experiences, or it's pretty private?

SPEAKER_00 19:43

Definitely. Well, we have our message boards. So on our website, we have message boards where prospective parents can exchange information. So that's one possible avenue. I think that also there's online forums outside of the cryobank, even where on different online websites, individuals might connect and maybe they're part of the same community, whether it's LGBTQ or Choice Moms, and then they connect in different online forums and chats and kind of discuss the experiences with each other. So I would say if somebody doesn't have somebody in their personal life and they're looking to like kind of have that connection, talk to some individuals, there's also that option too. There's a lot of online forums where people connect in in different groups.

SPEAKER_01 20:24

What about a patient that potentially is looking to cut costs? Right. And obviously Fairfax is super reputable. You've been around for years, amazing reputation, similar to fertility clinics, right? There's always levels. And so any advice for someone, maybe they're sort of trying to save money, they're looking at a bank that may not have the reputation as Fairfax. Is there anything that you would advise them to really pay attention to if they're going to go kind of down that road?

SPEAKER_03 20:55

Well, I think from Fairfax perspective, we try to include as many families as we can. So we have a program Fairfax Advantage, where vials are started at a lower price, and we rotate about 10% of the donors through that program. So we don't necessarily want right price to be the reason to not work with a reputable cryobank. So that I think the organization's really been good about trying to expand availability to all families. And then the other thing I think that's been a great improvement, as Andrea mentioned, is insurance coverage. So we're starting to see more and more include donor sperm in their coverage. So Maryland has a mandate. We're finding more states are mandating it, just again, recognizing that for some it's a fertility issue. For others, it's just access to sperm, right? And that we need to include them in the coverage. So there's some fertility benefit plans that have always included it, but we're finding more insurance coverage as well, again, available for donor sperm vials.

SPEAKER_01 21:53

Oh, good. And that's always so great to hear. We talk about so much in our space, right? How cost can be a barrier to care and There's been so much improvement over the years, but much still needs to be done. And so to know that this is trending in that direction as well for donor sperm is so positive to hear.

SPEAKER_03 22:13

Yeah, I think we're moving in the right direction. You suggest there's still more work to be done, but there's so much advocacy right now, and it feels like a good momentum. So we hope to continue to see the progress being made.

SPEAKER_01 22:26

I guess anything else either of you would want to share that someone should know about Fairfax or going down the road of sperm donation.

SPEAKER_03 22:34

Yeah, I think from a patient perspective, it's really getting comfortable within the space. So for a lot, it's new. And we recognize, you know, if it's facing infertility, sometimes they're already grieving a loss. For some, it's just access. And so it may seem unfair. So I think connecting within the community and seeing that this is an option for building your family and getting comfortable again with kind of what is the selection, who out there, it really does help even podcasts like this, just raising awareness so that people get more comfortable with the idea and that if this is the issue for you, right? And you have a dream for your family and what you want it to be, that this is maybe a good option and definitely to consider it.

SPEAKER_01 23:16

Because Andrea, anything you would want to add?

SPEAKER_00 23:19

Adding to kind of what Lisa had shared, I think it's a great option. And like we touched on earlier, it's great to look at all the social information available to the donors too, because sometimes you put in your first couple of characteristics, but then you might read an essay or an audio interview, and sometimes we'll get feedback from clients like, oh, I was gonna go with this donor, but then I listened to the audio interview, and this donor's favorite food is my favorite food, and I felt a connection. So I think as much as you can explore that material, you might find a unique connection with an individual, or there might be something that resonates with you, and I think that's great. And for any individuals who are considering becoming donors, it's a great endeavor. And I've met with donors who donated previously that are 20 years later in life, and they've shared that it's one of their proudest achievements. I think it's something that you can really do that really makes a true difference to individuals, and it's a great thing for people that are interested and willing and available to make that commitment. The ability to help grow families is something unique. And from speaking to donors who did the program in years past, it's one of what they consider their lifetime achievement, something that they feel really good about.

SPEAKER_01 24:32

Oh, that's amazing. That's so wonderful to hear. Yeah, I think for so many people it can feel like a very difficult option at first, you know, if it's not something that you anticipated, or you know, if there's grief or feelings involved about not family building with a partner, but it sounds like it's so a supportive play, a supportive environment, a lot of care, and it's really exciting. And I will say, you know, my patients that have used donors, getting started is usually the hardest part. And then once they start and start to go through the database, it becomes more real, it becomes more exciting, and they're able to really sort of see their dreams coming to life. So what an amazing service that you provide and that your donors provide.

SPEAKER_00 25:16

Definitely. No, it's it's an amazing experience. And we're lucky to be a small part of that journey. And I know our clients services team celebrates every time they get a call of somebody reporting a pregnancy or birth. It's really exciting. So we're honored to be just a small piece of that person's journey to building a family.

SPEAKER_01 25:34

Oh, that's so beautiful. So anything else that you might want to share? Sure.

SPEAKER_00 25:39

I'm thinking, Lisa, any additional thoughts on your end from a client perspective?

SPEAKER_03 25:45

I think a big topic is just diversity. And so just not to kind of push that aside, that it's important to us and recognizing all the different families and the diversity that come within the space and that we try to have a donor to meet everyone's needs. And you really can sort and hopefully find that connection. So it's important to us. We hear again in the field, it's important to others. And so we make efforts to make sure we're addressing that as well and the importance of diversity within the space. I think that's great to hear.

SPEAKER_01 26:19

Well, thank you both so much for coming on and sharing. I know this will be of interest to so many of our listeners who are very curious about what actually happens once you start the process of donor selection. So thank you both so much for coming on and sharing about Fairfax and your guidance and expertise. And the way we like to wrap our podcast is by sharing a gratitude. So it's something that you are grateful for.

SPEAKER_03 26:47

I'm definitely grateful for my family for sure. You know, I started having a family later in life and know how important it can feel. And so I'm super grateful for my family.

SPEAKER_01 26:59

Oh, I love that. What about you, Andrea?

SPEAKER_00 27:01

Yeah, similar to Lisa. So I'm a mom as well to one boy, and he's amazing, and he's definitely my biggest blessing. Definitely wears me out at times, but he is a sweet kid. And I'm so blessed in my personal life to have that and that relationship with him. And I'm blessed in my professional life to be able to help other people build their family. So I'm grateful for that as well.

SPEAKER_01 27:23

Oh, that's so beautiful. I guess I'll piggyback on that, and I'll say I'm very grateful for my daughter as well. And I guess so many of us in this space, you know, I got into it because of my own experience with trying to conceive. And it's so lovely to meet other people who really understand the journey and have gratitude for it and are also working to help others trying to get the same thing.

unknown 27:48

Definitely.

SPEAKER_01 27:49

Well, thank you both so much for coming on. Thank you. Thank you so much for having us, Rena.

SPEAKER_02 27:55

Thank you so much for listening today. And always remember, practice gratitude, give a little love to someone else and yourself, and remember you are not alone. Find us on Instagram at fertility underscore forward. And if you're looking for more support, visit us at www.rmany.com and tune in next week for more fertility forward.