Most men who apply to donate sperm are rejected. Acceptance rates at major sperm banks hover around 1% to 5%, making it one of the most selective screening processes in medicine. Disqualifications fall into several categories: age, infectious disease, genetics, sperm quality, lifestyle, sexual history, physical traits, and even education level.
Age Limits
Sperm banks generally accept donors between the ages of 18 or 19 and 39. The American Association of Tissue Banks sets 39 as the upper limit. Sperm quality declines with age, and the risk of genetic mutations in sperm cells increases, which is why banks draw a hard line. Some banks narrow the window further, starting at 19 rather than 18.
Infectious Disease Testing
The FDA requires that every sperm donor be tested for a specific set of infectious diseases, and a reactive (positive) result on any of them makes you ineligible. The mandatory screening panel includes:
- HIV-1 and HIV-2
- Hepatitis B
- Hepatitis C
- Syphilis
- West Nile virus
- Zika virus
- HTLV-I and HTLV-II (viruses linked to certain leukemias)
- Chlamydia
- Gonorrhea
Syphilis testing is especially strict. If any screening test for syphilis comes back positive, you’re ineligible, even if a follow-up confirmatory test is negative. Donors are also tested for CMV (cytomegalovirus), though a positive result doesn’t automatically disqualify you. Instead, that information is shared with the recipient’s physician.
Genetic Carrier Screening
All sperm banks run genetic screening panels, and testing positive as a carrier of a recessive disease mutation typically results in disqualification. The two conditions every bank screens for are cystic fibrosis and spinal muscular atrophy (SMA), both of which are especially common among people of northern European descent.
Beyond those two, many banks now use expanded panels that test for dozens or even hundreds of conditions. Donors have been disqualified for carrying mutations associated with Gaucher disease, Bloom syndrome, alpha-thalassemia, and several rare metabolic disorders. One study found that expanded genetic testing flagged carriers who would have slipped through older, more limited panels. Because being a carrier means you show no symptoms yourself, this is often the first time applicants learn they carry these mutations.
A family history of serious hereditary conditions can also be disqualifying, even without a confirmed carrier result. Banks typically collect a three-generation medical family history and look for patterns of genetic disease, cancer syndromes, or congenital conditions.
Sperm Quality Thresholds
Your semen analysis is one of the earliest checkpoints, and it eliminates a large percentage of applicants. Sperm banks set their quality thresholds significantly higher than what a fertility clinic would consider “normal” for a man trying to conceive naturally. That’s because sperm must survive the freezing and thawing process, which kills off a portion of the sample.
Banks evaluate three main parameters: sperm count (how many sperm per milliliter), motility (the percentage that are swimming effectively), and morphology (the percentage with a normal shape). The exact cutoffs vary by bank, but they’re consistently well above the World Health Organization’s reference values for normal fertility. If your numbers fall below the bank’s threshold on repeated samples, you won’t be accepted.
Sexual History and MSM Deferrals
Current FDA regulations defer men who have had sex with men (MSM) within the past five years from anonymous sperm donation. This policy dates back to 2005 and was originally rooted in HIV risk data from the 1980s and 1990s. The American Medical Association has formally called for its elimination, arguing there is no clinical justification for the five-year deferral given modern infectious disease testing. As of now, though, the FDA rule remains in effect and is a disqualifying factor at banks that follow federal guidelines.
Other sexual history factors that trigger deferral include having had sex with someone known to be HIV-positive, having exchanged sex for money or drugs, or having had sexual contact with someone who injects drugs.
Neurological and Psychiatric Conditions
The FDA’s donor eligibility guidelines disqualify anyone diagnosed with dementia or any degenerative or demyelinating disease of the central nervous system. This includes conditions like ALS or multiple sclerosis, particularly when the cause is unknown. The concern extends to prion diseases: if you have a blood relative diagnosed with Creutzfeldt-Jakob disease (CJD), you’re considered at increased risk and are ineligible unless genetic testing confirms you don’t carry the associated mutation.
Past recipients of human pituitary-derived growth hormone or non-synthetic dura mater transplants are also flagged due to their association with CJD risk. These are uncommon scenarios today, but they remain on the screening checklist.
Most sperm banks also conduct psychological evaluations. A significant family history of serious mental illness, including schizophrenia and bipolar disorder, can lead to rejection at individual banks, even though these aren’t part of the FDA’s formal disqualification list.
Lifestyle and Substance Use
Smoking, heavy drinking, and drug use can all disqualify you, though the mechanism is sometimes indirect. Nicotine, alcohol, and marijuana reduce sperm count, motility, and morphology. If your semen analysis comes back below the bank’s thresholds and substance use is the reason, the result is the same: rejection. Some banks screen for drugs directly and have zero-tolerance policies for recreational drug use, while others focus on the semen analysis results regardless of cause.
Intravenous drug use, even once, is a permanent disqualifier under FDA guidelines because of the associated risk of bloodborne infections.
Travel-Related Deferrals
Recent travel to certain regions can temporarily disqualify you. Zika virus was a major concern starting in 2016, and donors who travel to areas with active Zika transmission face deferral periods. More recently, the CDC has advised sperm donors exposed to Oropouche virus, which circulates in parts of the Caribbean, Central America, and South America, to defer donation for at least six weeks after returning from travel, or six weeks after symptom onset if diagnosed. Travel to areas with malaria or other mosquito-borne diseases can trigger similar waiting periods.
Height, Education, and Physical Traits
Beyond medical screening, sperm banks apply their own selection criteria based on what recipients look for in a donor. California Cryobank, one of the largest banks in the U.S., requires donors to be at least 5’9″ tall, currently enrolled in or graduated from college, and between 19 and 39 years old. These aren’t medical disqualifications in the traditional sense, but they filter out a substantial number of applicants before any lab work begins.
Some banks also evaluate physical appearance, build, and personal characteristics as part of the selection process. Weight that falls significantly outside a healthy BMI range can be disqualifying at certain facilities, partly because obesity is associated with lower sperm quality and partly because of recipient preferences.