Interview with Sherron Mills, Reproductive Pioneer, Part I

Sherron Mills, founder and CEO of Pacific Reproductive Services (PRS) in California, is a trailblazer in helping lesbian couples and single mothers create their families. She’s been doing so for nearly a quarter century. Mills took a break from running PRS to speak with me about the past, present, and future of her work, and to offer advice for those considering parenthood themselves. I’m splitting the interview into two parts, because Mills was generous with her time. Stay tuned for Part II tomorrow.

In 1979, Sherron Mills was one of the founders of the noted women’s health clinic in San Francisco, the Lyon-Martin Clinic. She explains how this led to her involvement in reproductive services: “Several of us involved in getting that clinic going had always wanted children. We wanted to have a donor insemination program at Lyon-Martin, but our board of directors back then was a little wary of it and we never got it started there. I left there in 1983 and started working in a private practice and doing it on my own in that practice. I met a woman who agreed to be a donor recruiter for me. She recruited donors from San Francisco State University and that was how we got going.”

They used fresh sperm back then, with less rigorous donor screening, but AIDS was on the horizon. In 1985, the AIDS antibody test became available. The American Association of Tissue Banks (AATB), which helps set industry standards, came out with guidelines calling for sperm to be frozen, quarantined, and tested for infections diseases both initially and after three months. (Now it is six months.) This meant that Mills had to start banking sperm, a skill she set about learning from colleagues.

Business started slowly, but has blossomed. “It was word of mouth initially around the Bay Area,” Mills recalls. “People would find out that ‘Hey, there’s someone that does insemination of lesbians.’ Then in 1990 we got a call from a woman in New York and she said ‘Hey, you inseminated my cousin, could you ship sperm out to NY?’ And we thought ‘Sure,’ and we started shipping sperm. That part of the business has grown over the years. I would say almost half our sperm gets shipped out of the Bay Area now. We opened a second office in Pasadena in 1996 because we needed to be in a bigger town with a more diverse population to recruit more donors. Now we’re shipping sperm all over the United States. We have shipped all over the world but we don’t generally ship [internationally] unless we have specific requests. We also do inseminations in both of our sites in San Francisco and Pasadena and we’re opening a new insemination site in New York this fall.”

PRS does not do more complex procedures, such as in vitro fertilization (IVF) and egg donation, nor do they bill themselves as infertility experts. “Those are physicians that have gone through board-certified training,” Mills explains. “Because we’re run by nurse practitioners, we do the early part of infertility evaluations. Then if we can’t get a patient pregnant or if they’re older—40 or older—we recommend they go directly to our associates to get infertility evaluations. They might need more high-tech things than we can do. We can give lower-dose fertility drugs, the ones you can take by mouth. We can do ultrasounds to detect ovulations, and we also do intrauterine inseminations on our site. If anyone needs anything that’s more of a specialty than that, we refer them to our associates. If they’re not local, we help them try to find someone in their area.”

Mills tries to make sure these referrals are to doctors with good reputations, high success rates, and known support for lesbians and single parents. In San Francisco and Pasadena, she knows many of them personally. Elsewhere, the doctors are often those whom prospective parents have chosen even before contacting PRS. “Basically what we do is find out what their experience was like with this group and the results. If they had a good experience and the people were supportive, then we’ll put them on our list of someone people can go to in that area.”

Despite the increasing number of clinics willing to work with lesbians and single mothers, Mills still feels there is a need for a clinic like PRS, which is focused almost exclusively on this clientele. “While a lot of basically heterosexual-run clinics will help lesbians and they’re nice to them, I think we give extra support to these couples and their relationships. We want to be sure that people [staff] are not doing this grudgingly because they’re making some money, but that they can really support the lesbian couples just like heterosexual couples, which involves talking to them if things aren’t working out right, if they’re not getting pregnant.”

“We’ve also had a few transgender clients come to us,” Mills notes. “We try to get to them before they get their treatment and if the transition is male-to-female, we can bank sperm before they take treatment. If the transition is female-to-male they’re more limited in what they can do, but they could go through something like in vitro where they get some fertility drugs, we use some donor sperm, and they go and have the first part of IVF which is egg retrieval, expose the sperm to the egg, and get some embryos. Then they can freeze the embryos and then later, after they go through their procedure, if they want they can have these embryos implanted in their partner.” (Eggs don’t freeze very well, Mills notes, while embryos do.)

Mills says PRS also stands out in the attention it gives to its patients during the whole course of the insemination process. “The other thing we do, that no other sperm bank in the United States will do, we’re right there with patients the whole time while they’re inseminating. Even if we’re shipping it to them, we’re available to talk to them about their cycles. Early on, before they even get started, we have an introductory visit with them. We teach them, if they don’t know how, to coordinate their cycle and detect ovulation, and make sure they get their timing right. We give them advice. We say, ‘If you don’t get pregnant in about three cycles, call us back.’ If they’re in their late 30’s we might recommend that they go see a fertility specialist or have a fertility evaluation. If they’re local we do it for them, but we try to follow them and give them support and advice all the way through until they get pregnant. Of course, some people can’t get pregnant and it’s just a matter of giving them some empathy. I think that’s what holds us out separately from other sperm banks.”

PRS’ other main distinction is that it is the clinic with the most willing-to-be-known donors, those who agree to meet with the children once the children turn 18. Mills feels this is an important service. “When a lesbian couple or a single woman is raising a child without a father there, we believe children will have a curiosity about their paternal roots that helps them complete a sense of who they are, makes them feel whole. We think that they have a right to this information, and we encourage people to be open—even heterosexual couples—to be open about the fact that they’ve used donor sperm, if they have, because secrets are bad. If people find out, the children feel betrayed, especially if they find out when they’re older and you haven’t told them. So we feel like it’s important for donors to be willing to be known. Our clients really want that themselves.”

PRS is careful about how children and donors contact each other, however, and won’t release donor information until the child is legally an adult. Both the child and his/her legal parents then sign an agreement stating they will not share the donor’s identity outside their family. Mills explains, “Our original reason is that we didn’t want there to be any chance of litigation between the donor and the recipient about the child. For instance, we didn’t want the donor being able to claim paternity and we wouldn’t want the recipient to be able to ask him to help support the child.” Now, technology adds a new reason. “Because of the Internet, it’s possible for one child to learn about their donor and to go on the Internet and tell everyone else who that donor is and therefore he would have no more privacy. Children might contact him more than he would want to be contacted, he might be barraged with phone calls or e-mails or things like that. We tried to balance between protecting the donor’s privacy and also making sure that if this donor has promised to meet the child, that that occurs.”

Mills says she wants the situation to be a win-win for everyone. “Usually what we do is contact the donor first and let them know there’s a child who wants to meet them. Most of them that have met so far have had e-mail contact first, then a phone call, and then they arrange their own meeting. That’s really worked out nicely because everybody’s both excited and apprehensive about it. It’s been really really nice though. The ones that have met so far, it’s really been a good experience.” She affirms, “They’re nice guys usually, the guys who are willing to be known.”

Since she founded PRS, Mills has seen many changes in the reproductive services industry. “The biggest good change is that it’s now regulated,” she says. “It has made my life much harder, but it is a good thing because it makes sure that banks are being very careful about their donor screening, that they’re doing it right, and they’re doing it by labs that are doing it accurately. It makes sperm banks follow up on adverse outcomes because all of us carry five or six recessive genes for lethal conditions. Where you’re exposing a father’s sperm to one person, you’re less likely to have two people have the same recessive gene which would likely express in an awful condition. When you’re spreading sperm out to numerous women, then it just mathematically increases the likelihood that one of them will carry the recessive gene also, and you’re going to have a child born with some kind of medical condition which might not manifest until years later.”

Mills wants the FDA to move beyond its existing regulations for infections diseases, however, and require more extensive genetic screening. “We have never had an infectious disease pass from a donor to a recipient. If a donor ever tests positive for an infectious disease, it is rare because we do good screening of the guys before we even test them, and donors are tested multiple times during the time that they’re donating,” she explains. “For genetic diseases, we follow the AATB guidelines for genetic testing of donors, but you can’t possibly pretest for every possible genetic disease. There are thousands and thousands of them, there aren’t tests for all of them, and some of the ones that do have tests, the tests cost thousands of dollars—so it’s not feasible for sperm banks to test for everything. You can’t. But I do think the FDA should set up some regulations for genetic screenings and follow up of adverse outcomes because every sperm bank is going to have adverse outcomes.”

Tomorrow, I’ll conclude the interview with Mills’ advice for those considering parenthood themselves, as well as her own reflections on being a mother.

As always, Mombian does not provide medical advice. Visitors are reminded that only they themselves can decide if such advice is right for them. Any medical information offered on this site should be discussed and verified with one’s own medical professionals.