The Kjeld sperm donor case reveals a massive failure in the fertility industry
The industry needs to exercise more care and diligence for the sake of the children it's helping to conceive.
Some sperm donors seem to take seriously Elon Musk’s advice to do their part (over) populating the planet. Take, for instance, Pavel Durov, the Russian billionaire founder of the Telegram messaging application. Durov has outlined an unconventional approach to fatherhood: he offers to fund in vitro fertilization (IVF) for women under age 38 who wish to conceive using his donated sperm. Durov has already fathered over 100 children around the world, and he is planning on fathering even more. In a recent interview with the Wall Street Journal, Durov said his offspring will receive an equal share of his fortune.
For women who are not applying for the benefits of conceiving one of Durov’s descendants, imagine that you—with or without a partner—decide to use the services of a sperm bank. You believe that sperm donors undergo a strict medical examination and genetic screening; you think they run every genetic test in the book to certify the good health and genetic quality of the donor. You are convinced that you are buying a quality product that will contribute to giving birth to a healthy child—right? A recent case in Denmark, known as the ‘Kjeld case,’ has shown that you may be wrong.
The Kjeld case
In Denmark, a country that dominates the global sperm donation market, a man known as ‘Donor 7069,’ or simply given the alias Kjeld, was active from 2005 to 2023—a total of 17 years.
This man unknowingly carried a rare genetic mutation in the TP53 gene, which plays a role in suppressing tumor formation. It activates repair proteins if it detects DNA damage that can be fixed, and triggers apoptosis (programmed cell suicide) if the damage is too severe. Scientists refer to this gene as the “guardian of the genome” because of its crucial role in weeding out cancer-causing mutations.
Mutations in the TP53 gene are associated with Li-Fraumeni syndrome, a rare disorder that significantly increases lifetime risk for a broad spectrum of aggressive cancers. These cancers have a poor prognosis, especially in children and young adults.
Types of cancer that can result from TP53 mutations include breast cancer, bone and soft tissue sarcomas, brain tumors, acute leukemia, adrenocortical cancer, kidney, thyroid, colon, pancreas, ovarian, testicular, prostate cancers, melanoma, and lung adenocarcinoma. Individuals often develop an early onset of more than one primary cancer in their lifetime before age 40, and have up to a 90% chance by age 60, according to the Li-Fraumeni Syndrome Association.
Use of this donor’s sperm resulted in nearly 200 children being born across 14 EU countries who carried the TP53 mutation. Some of those children are known to have developed cancer and tragically died. The case has highlighted the dangers in the fertility industry’s current practices and exposed significant regulatory gaps.
First of all, the Kjeld case exposed the inadequacy and insufficiency of current genetic screening. Standard genetic screening methods used by sperm banks, including the Copenhagen-based European Sperm Bank (ESB), failed to detect the TP53 mutation in the donor’s blood cells—because it wasn't present there. It was a “mosaic” mutation that was only found in some cells of his body, including sperm.
Mosaicism explained
According to the Li-Fraumeni Syndrome Association, “in mosaicism, the specific alteration of TP53 may not be discovered during genetic screening if the white blood cells aren’t affected and don’t carry the mutation. Additional testing of other tissues may be required and/or algorithms of genetic allele frequency of tumors may be employed to help determine if the alteration in the tumor is sporadic or germline.”
Unfortunately, the Kjeld donor didn’t undergo additional screening or testing that would have pinpointed the mosaic mutation present in some cells.
Interestingly, the ESB prides itself on offering premium donors whose sperm “undergo a thorough screening process and are approved individually by our Medical Team, who are clinical geneticists,” as is stated on its website. This demonstrates the limitations in accuracy of current screening and testing protocols.
A lack of tracking
Furthermore, the Kjeld case exposed the lack of strong international rules limiting the number of children that a single donor can father. This allowed Kjeld’s sperm to be used for nearly 200 conceptions across Europe, far exceeding individual countries’ limits (for example, Belgium has a limit of six families per donor), thus magnifying the potential impact of an undetected health risk. The movement of the donor’s sperm across 14 different EU member states made it extremely difficult to track health outcomes and enforce a consistent standard of care or limits.
There was also a lack of transparency and oversight. Reportedly, the sperm bank resumed sales of the donor’s sperm after an initial inconclusive test in 2020, only permanently banning him in 2023 after being informed of multiple cancer diagnoses in donor-conceived children. This points to a significant failure in internal monitoring and transparency.
Another study reported that the Kjeld case was not an isolated incident; there have been 263 Rapid Alerts regarding Danish donors. Despite these alerts, the follow-through is slow and disorganized. In the case of the Kjeld donor, one French mother only received notification about the genetic risk one and a half years after the discovery.
Despite this case happening in Europe, it should be remembered globally as an example of the dangers and uncertainties behind the fertility industry. This industry, after all, responds primarily to revenue; its goal is to sell services to people seeking help to satisfy their dreams of becoming parents. It's all too easy for ethics to take a back seat in the pursuit of profit.
The European Sperm Bank, despite its authoritative-sounding name, isn't a public or governmental institution. It's a business that has been owned by the private equity investment firm Perwyn since 2022. Because of its failure to detect one dangerous mutation, nearly two hundred children were born under a potential sentence of an early death by cancer. None of us should consider that okay or acceptable.
