10.6092/issn.2038-3460/17395
In this article, we compare the meaning and assessment of semen quality across three different contexts: male infertility, sperm donation, and in-vitro sperm. We ask how semen quality is determined in these three contexts and what kind of practices and normative choices these evaluative processes involve. While the notion of good semen quality is often reduced to biomedical evidence, our analysis shows that it also draws on beliefs about what is desirable and what is not, producing biomedical evidence in light of specifically desired outcomes. Unpacking semen quality, by looking at the specificities of how it is done across three different contexts, in this article we thus move beyond comprehending quality standards as purely technical matters and reposition biomedical assessments of male reproductive potential in their political and normative contexts.
application/pdf
2038-3460
17395
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Sebastian Mohr
https://creativecommons.org/licenses/by-nc-sa/2.5/
Tecnoscienza – Italian Journal of Science & Technology Studies
reproductive biomedicine
The Good Sperm Cell. Ethnographic Explorations of Semen Quality
Text.Serial.Journal
https://tecnoscienza.unibo.it/
9
Essays
2018-08-06
2023-06-25
2018-08-06
2023-08-28
9-28
TS
Sebastian Mohr
2018/08/06
10.6092/issn.2038-3460/17395
9
Centre for Gender Studies, Karlstad University
2038-3460
1
reproductive biomedicine
en
28
The Good Sperm Cell. Ethnographic Explorations of Semen Quality
https://tecnoscienza.unibo.it/article/download/17395/16253
9
                                                                                          Essay
                                                                                              9




The Good Sperm Cell
Ethnographic Explorations of Semen Quality

            Sebastian Mohr                                   Klaus Hoeyer
            Centre for Gender Studies,                     Department of Public Health,
               Karlstad University                          University of Copenhagen




     Abstract: In this article, we compare the meaning and assessment of se-
     men quality across three different contexts: male infertility, sperm dona-
     tion, and in-vitro sperm. We ask how semen quality is determined in these
     three contexts and what kind of practices and normative choices these
     evaluative processes involve. While the notion of good semen quality is of-
     ten reduced to biomedical evidence, our analysis shows that it also draws
     on beliefs about what is desirable and what is not, producing biomedical ev-
     idence in light of specifically desired outcomes. Unpacking semen quality, by
     looking at the specificities of how it is done across three different contexts,
     in this article we thus move beyond comprehending quality standards as
     purely technical matters and reposition biomedical assessments of male re-
     productive potential in their political and normative contexts.

     Keywords: artificial sperm cells; gender; infertility; masculinity; reproduc-
     tive biomedicine.

     Corresponding author: Sebastian Mohr, Centre for Gender Studies,
     Karlstad University, 65188 Karlstad, Sweden – Email: sebastian.mohr@
     kau.se




1. Introduction

    Julia and I are alone in the laboratory. It is Thursday afternoon, and even
though it has not been a slow day at the sperm bank, it is a lot quieter now than it
was before lunch, quiet enough for Julia to find the time to calibrate the counting
chambers which are used to count sperm cells. She is telling me stories about
some of the sperm bank’s clients she has to deal with, when Aaliyah walks in.
Aaliyah is the donor coordinator at the bank and responsible for scheduling do-
nors for their interviews and check-ups. As she tells Julia and me, the donor can-
didate waiting at the front desk had shown up too late for his appointment: “Why
do they do that”, she says frustrated. It would be hard enough to schedule all the


TECNOSCIENZA
Italian Journal of Science and Technology Studies
9 (2) pp. 9-28 - ISSN 2038-3460
www.tecnoscienza.net                                2018
10                                                                   Tecnoscienza – 9 (1)

interviews in the first place. “But, he is very cute”, she adds right away and Julia
and I tilt our heads in order to get a glimpse of him through the laboratory win-
dow. Julia and I agree: he is very cute. Aaliyah doesn’t know what to do with the
donor though, since his first sperm count had turned out to be too low, “only 76”.
Normally, donor candidates need to have a count of 200 in order to be consid-
ered. “Well, you know, the quality of samples varies a lot”, says Julia to Aaliyah.
She had a donor once who just needed to wait longer in between ejaculations in
order for his quality to improve. To start with, his samples were not good quality,
even at an interval of 70 hours in between ejaculates: “But then I had him wait for
100 hours and what do you know, the quality was perfect.” Maybe this candidate
has a chance after all. Aaliyah agrees: “Okay, I will let him donate today and if it is
good enough I reschedule him for an interview.” (Excerpt from fieldnotes)

    Quality assessments of semen are, in part, a technical matter. Semen
samples are weighed, their pH-value measured, their viscosity catego-
rized, and the number of sperm cells counted. As such, semen analysis
has become a science. However, this scientific expertise is plagued by un-
certainties: how many sperm cells need to be positively evaluated in order
for a man to be classified as fertile? How much semen fluid needs to be
tested in order to give a valid answer? How motile is motile enough for
‘normal’ reproduction? Does a crooked tail or a ‘pretty’ head say any-
thing about a sperm cell’s ability to merge with an egg cell? In principle,
just one viable sperm and egg cell are enough to produce a child. Yet
while technology can be used to assess a man’s and his semen’s reproduc-
tive potential, the determination of a threshold will always rely on an in-
terpretation of that assessment. Furthermore, as the introductory field-
note from fieldwork at an American subsidiary of a Danish sperm bank il-
lustrates, quality assessments of semen include non-technical matters as
well. Values such as attractiveness or the ‘cuteness-factor’ of donor can-
didates as well as their reliability to show up for appointments on time
can become part of ‘semen quality’ and thus influence decisions about
whether men’s semen will be accepted by a sperm bank.
    Evaluations of quality as part of reproductive medicine include nor-
mative claims and understanding these claims is important since they, as
Ayo Wahlberg puts it, enable assessments of which life is worth living
(Wahlberg 2008; 2010). This article explores the concept of “semen qual-
ity” in the context of reproductive biomedicine. In particular, we are
concerned with how assessments of semen quality become imbued with
certain values and how these assessments are used to make decisions
about reproductive futures. Our analysis concerns three different con-
texts: assessments of semen quality at a male fertility clinic, the concept of
good semen quality at sperm banks, and definitions of good quality at a
research lab for artificial sperm cells, so called in-vitro sperm. The entan-
glement of quality measurements with social values and reproductive vi-
sions in these three distinct settings shows how semen quality is far from
being inherent to semen itself. Rather, semen quality represents a particu-
lar techno-scientific configuration of semen depending on the context in
Mohr and Hoeyer                                                         11
which semen is assessed. Comparing the assessment of semen quality
across three contexts we thus show how biomedical judgements about
good semen quality are highly normative decisions rather than simply
matters of technical precision.
    We begin with a short discussion of perspectives on semen from with-
in the social sciences which provide the background for our own analyti-
cal approach. Thereafter we attend to how semen quality is construed as a
political and medical problem in public debates in Denmark and in an-
drological literature. This provides a backdrop for the subsequent analy-
sis and comparison of concrete practices of semen quality assessments at a
male fertility clinic in Denmark where subreproductive semen is analyzed,
the selection of sperm donors based on semen quality at Danish sperm
banks, as well as quality assessments in experiments with in-vitro sperm
cells in Germany. In conclusion, we will offer remarks on what good
quality semen means in these different situations and how that relates to
norms of reproduction.
    The fieldwork that provides the empirical context of our analysis was
carried out between 2011 and 2014 and is part of Sebastian Mohr’s doc-
toral research on sperm donation and sperm donors in Denmark (Mohr
2014; 2015; 2016a; 2016b; 2018). Fieldwork included participant obser-
vation at a large clinical research and medical treatment centre for repro-
duction and fertility in Denmark as well as at Danish sperm banks and
their American subsidiaries and semi-structured interviews with two re-
searchers developing new modes of producing male germ cells in-vitro,
that is, outside the male body, at a German institute for human genetics.
What connects these different contexts, beyond their interest in semen
quality, is their international orientation in regard to concrete working
practices and ways of knowing and valuing under the umbrella term
(male) reproductive biomedicine. Thus while each empirical site repre-
sents an individual organizational unit, they are nonetheless connected by
a shared investment into what Marica Inhorn has termed “reproscape”,
that is, a global biomedical “meta-scape […] traversed by global flows of
reproductive actors, technologies, body parts, money, and reproductive
imaginaries.” (Inhorn 2011, 90). Passages from interviews and field jour-
nals were translated to English from their original German or Danish. All
informants appear under pseudonyms.


2. Studying Semen: From Discourse to Materiality

   Semen has fascinated human kind for a quite a while. At least since
Antonie van Leeuwenhoek examined sperm cells under a microscope in
the middle of the 17th century, semen has been interrogated again and
again. Preceding the relatively recent social science interest in semen as
part of reproductive technologies (Martin 1991; Daniels 2006; Moore
2008; Adrian 2010; Almeling 2011; Émon 2012; Mohr 2016a), social sci-
12                                                           Tecnoscienza – 9 (1)

entists though have primarily focused on semen’s cultural role (Herdt
1987; Allen 1998). Inspired by a symbolic reading of the body (Douglas
2010), this research understands semen to be part of a symbolic system
with which people orient themselves in the world pointing to the central
role of ideas about semen in gender and kinship norms.
    As Antje Kampf points out, the need to understand the physiological
characteristics of semen grew tremendously after World War Two
(Kampf 2013), with infertility gaining attention as a recognized pathology
in need of therapy. The subsequent success of reproductive biomedicine
after the introduction of IVF sparked an interest in the social sciences for
the social dynamics of reproductive biomedicine (Franklin and McNeil
1988). This coincided with the so called materialist turn in the social sci-
ences as a result of which social scientists turned their attention to the
production of biological facts and materialities. In particular feminists
such as Emily Martin (1991) or Donna Haraway (1991) for example en-
gaged with so called biological facts, revealing ways in which these facts
are embedded in the performative realm of gendered social life.
    The assessment of cell’s characteristics in particular can be under-
stood as not only technologically and culturally mediated understandings
of what ‘cells’ are and do, rather they also reflect the human quest to gain
control over reproduction (Clarke 1998; Svendsen and Koch 2008). In
their work on the selection and assessment of embryos at a Danish fertili-
ty clinic, Mette Nordahl Svendsen and Lene Koch show that work at the
biomedical lab is embedded in moral landscapes understood as terrains
of agency which are “continually recreated in relation to organizational
relations, research protocols, techno-scientific objects, clinical classifica-
tions and notions of professional responsibility.” (Svendsen and Koch
2008, 106). Likewise, when semen quality is assessed, scientists and lab
technicians are not only “doing” cells. They are also re-enacting norms
which revolve around what it means to be human and not least what rela-
tions certain gendered individuals should have with one another. Thus
while the claim to scientific objectivity engrained into biomedical sciences
certainly has a particular history (Daston and Galison 2007), the under-
standing of semen as a pure male liquid that gives new life its form so im-
portant for reproductive biomedicine, also has a longer genealogy as Mu-
rat Aydemir shows (Aydemir 2007). This understanding leads back to an-
cient Greece and Aristotle’s conceptualization of the role of men in the
creation of life which holds that men pass on certain social characteristics
with their semen. This notion is still relevant today when for example
sperm donors are selected not only according to their sperm count but al-
so because of certain characteristics thought of as transferable to the child
(Daniels and Golden 2004; Mohr 2016a). This potency of semen also
plays into religious imaginaries of human-deity relationships as Amy
DeRogatis (2009) shows (DeRogatis 2009). Here semen either becomes
God’s tool to punish sins with sexually transmitted diseases or takes on a
Mohr and Hoeyer                                                            13
metaphorical meaning in the form of the word of God entering the body
as healing sperm.
    These examples from a larger body of scholarly work on the meanings
of semen (Tober 2001; Blaagaard 2006; Kilshaw 2007; Shand 2007;
Kroløkke 2009; Lie et al. 2011) draw attention to the ways in which the
meaning and actions of semen are dependent on networks in which it cir-
culates. Semen is never alone, even as a single cell under a microscope.
However, most of this literature has focused on the ways in which semen
is represented, and on the social implications of networks that enable the
exchange of semen. The clinical tests and procedures themselves howev-
er, which determine whether a semen sample is used or discarded, and
whether a man can become a sperm donor or is likely to become a father,
have not received a lot of attention. This article addresses this gap, focus-
ing on the production of quality in the assessment of semen.
    Since in the clinical domain, the potentials ascribed to semen and the
ways in which samples are used and patients treated are often determined
via a measurement of semen quality, we use quality as our analytical ob-
ject in order to understand the norms and values that are incorporated in
clinical and laboratory practice. By understanding how quality is deter-
mined, one can better comprehend the characteristics of those norms
which are entrenched in biomedical rationalities, yet which are rarely
acknowledged as particular ethical, social, and political choices.


3. Semen Quality as a Sociopolitical and Medical Problem

    Throughout the past decade, Danish men’s semen quality has been
monitored and debated regularly, with falling numbers of semen quality
giving rise to a notion of a fertility crisis (Andersen et al. 2000; Jørgensen
et al. 2006; Aggerholm et al. 2008; Jørgensen et al. 2011). In May 2011,
the Danish Health Authority Sundhedsstyrelsen published a minute that
concluded that Danish men’s semen quality was actually not as low as
previously believed (Bredsdorff 2011). The researchers responsible for
the data behind this minute were not consulted prior to its release and,
subsequently, Danish and international researchers reacted with much
anger because they had interpreted the data differently than the Danish
Health Authority. Whilst there is a shared understanding between these
two parties that measurements of semen quality are necessary and im-
portant, there seems to be no agreement upon how to conduct and inter-
pret such measurements. Some researchers are even convinced that the
data used to determine whether semen quality has fallen or risen during
the past 15 years is too heterogeneous (methodically, ethnically, and geo-
graphically) to conclude anything at all (Merzenich et al. 2010).
    From a broader social science perspective, the interest in semen quali-
ty and attempts to measure and compare it on a national and even inter-
national level, seems to reflect a social fear that Danish men are losing
14                                                           Tecnoscienza – 9 (1)

their fertility, threatening a bright reproductive future. As Lisa Jean
Moore has argued echoing much of the work outlined above, any discus-
sion about semen quality should be situated within a much wider dis-
course about the crisis of masculinity within western societies (Moore
2008). That is to say that the term ‘semen quality’ and the ways it is un-
derstood, measured, and mobilized are not only connected to specific ma-
terial qualities of sperm cells, but also to our understanding of the role of
men, both within reproduction and more generally as part of a heter-
onormative society. In this context having bad semen quality is potentially
connected to being seen – and understanding oneself – as a man of lesser
quality (Birenbaum-Carmeli and Inhorn 2009; Goldberg 2010).
    Public discussions about semen quality are characterized by a very
vague understanding of what semen quality actually is and what it refers
to. Even in andrological textbooks the term’s meaning is most of the time
assumed rather than explicated. Semen quality can be understood as a
measurement of the ability of sperm cells to fertilize an egg cell. Arising
out of the andrological literature on semen quality, this definition reifies
gender stereotypes by assigning the role of the passive and awaiting part
to the egg cell (Martin 1991). Alternatively, semen quality could be de-
fined as a measurement of the ability of sperm cells to merge/fuse with an
egg cell. More importantly, however, both these definitions point to the
end result of a process, rather than a measurable parameter inherent to
sperm cells itself. Indeed, a clear definition of which semen parameters
‘quality’ actually refers to is almost always missing from chapters in an-
drological reference books. Instead, these books define semen quality im-
plicitly through the evaluation of a set of characteristics acting as proxies
for desired end results (Kvist and Björndahl 2002; Björndahl 2010;
Cooper 2010)1.
    A number of different parameters have been identified as being im-
portant for a sperm cell’s capacity to reach an egg cell and fuse with it in-
to a zygote: semen’s smell, texture, and volume; the number of sperm
cells, their vitality, and tendency to stick to one another; the individual
sperm cell’s appearance and morphology; and the concentration of sperm
cells within the ejaculate. Semen analysis is the process by which these pa-
rameters are identified, an established and relatively low-tech laboratory
practice. Semen quality is used to argue for or against a certain medical
intervention in men’s bodies and lifestyles when they undergo so called
fertility treatment2, but also as a point of reference for public health
guidelines with regard to national and international reproductive trends.
Yet, as British andrologist Allen Pacey (2009) puts it, the assessment of
semen quality is not an exact science. After the World Health Organiza-
tion (WHO) had published a new manual for examining and processing
semen in 2010, it was discussed very critically within andrological circles
(Handelsman and Cooper 2010; Jequier 2010), especially in relation to
the WHO’s much-contested definition of normal fertility (Joffe 2010).
Mohr and Hoeyer                                                          15
    Adding to the difficulties with defining and conducting precise meas-
urements of semen quality, most andrologists believe that quality is not
stable over time, or across contexts. Sexual arousal (Pound et al. 2002),
environmental pollution (Jurewicz et al. 2009), work environments and
lifestyle (Collodel et al. 2008; Sharpe 2010), and situations of deep crisis
such as war (Abu-Musa et al. 2011), all seem to affect semen quality. Yet
even with the awareness that semen analysis has intrinsic limitations, the
search for more accurate and objective ways of measuring semen quality
continues. The introduction of computer based semen analysis (CASA) in
the 1980s and its continued development (Vested et al. 2011) as well as
the growing influence of DNA based methods of analysis (Lewis and
Agbaje 2008) are examples of this. The attempt to find a more objective
way of measuring semen quality can never fully do away with the fact that
measurements embody norms, and that the semen samples which are
measured are influenced by subjective circumstances such as sexual
arousal. In other words, the longing for objectivity does not do away with
subjectivity. The evaluation and assessment of semen is embedded in a
dynamic field of scientific requirements and claims, cultural systems of
meaning, and individual fate. This also means that quality is an ambigu-
ous concept whose actual meaning is played out in practice, and it is to
this practice that we now turn, beginning in a clinic for male infertility.


4. Male Infertility: Semen Quality as Minimum Goal

    In the clinic, efforts revolve around a simple goal: conception. When
men are treated for infertility as a consequence of subreproductive semen,
semen thus does not need to be excellent in order to qualify as ‘good
enough’. Rather, good quality sperm cells are cells which have the poten-
tial to reach an egg cell despite particular deficiencies. This premise
frames what standards for assessing semen quality in this context looks
like: the goal is to find a basis from which to decide whether a man, and
implicitly a couple, should receive treatment in order to become (a) par-
ent(s). In other words, the quality assessments of subreproductive semen
have a treatment objective. At the same time, measuring semen quality in
this setting involves a number of different approximations and choices of
what to measure as a proxy for that which one actually wants to look at
but cannot examine directly: the capacity of sperm cells to move in a par-
ticular woman’s body and fuse with that woman’s egg cell.
    The treatment centre for male infertility where fieldwork was under-
taken is situated in a large hospital in Denmark and combines clinical
treatment with a research centre. Analyzing semen samples of men with
fertility problems is therefore only one of many different procedures car-
ried out by the staff and researchers. Semen analysis takes place in a spe-
cial laboratory separated from other parts of the treatment centre and
combines many different tests and procedures: weighing semen samples;
16                                                           Tecnoscienza – 9 (1)

evaluation of their texture and pH-value; measuring motility (capacity to
move) and concentration of sperm cells in the samples; testing sperm
cells’ penetration strength and their reaction to anti-bodies and assess-
ments of sperm cells’ morphology (cells’ physical appearance). A lab
manual describes the procedures for conducting each test. These guide-
lines broadly follow the manual for semen analysis published by the
WHO (Cooper 2010) but also differ in certain details. For example, the
WHO manual recommends counting 200 spermatozoa twice when as-
sessing a semen sample’s motility, whereas the lab manual specifies count-
ing only 100 sperm cells twice. Standards for semen analysis are not fixed
but continuously adapt to local practices. Counting only 100 spermatozoa
instead of 200 as recommended by WHO does not make the Danish lab’s
test results less reliable since counting 200 sperm cells is just as imprecise
as counting 100. In both instances, only a tiny part of the semen sample is
being tested (0,00003 %) with a single semen sample potentially having
between 40 and 600 million sperm cells.
    The laboratory staff is aware that their work encompasses these ap-
proximations. One of the bio-analysts talked about how, at the beginning
of her professional training, she tried to count every single sperm cell eve-
ry time she looked through the microscope. She thought counting every
cell would be more correct than just counting 100. But that was, as she
phrased it, “an illusion”: certainty about a man’s fertility cannot be
reached even when all cells are counted. In line with the bio-analyst’s re-
flection, manuals for semen analysis point out that semen analysis is not a
definitive answer to the question of whether a man can father children or
not. Rather, semen analysis is an approximation that supports a decision
for or against a treatment plan. Or in other words, measurement practices
develop performative effects: they not only describe a certain version of
reality but create one in the sense of determining what treatment will look
like and how people will perceive of themselves (Am I man enough? Can
we become parents?).
    One of the ways in which semen quality is assessed at the treatment
centre is a so-called penetration test. This test’s objective is to test sperm
cells’ capacity to move and penetrate. As part of this test, sperm cells are
placed within egg whites to test their ability to move. Thus, in effect, egg
whites stand in for the female body, chosen based on their similarity to
vaginal mucus. Their ability to perform this role is tested by using sperm
cells that have been declared to be motile in other egg whites. The test is
thus based on a model as part of which two actors are used to validate
each other’s reproductive capacity. Whether sperm cells will perform well
or not during this test, contributing to the kind of quality assessment a
specific semen sample will receive, and thus what kind of treatment pa-
tients will be offered, is in other words due to the characteristics of egg
whites and laboratory conditions as well as to sperm cell’s own capacities.
    In practice, the dynamic relationship between different actors (laboratory
staff, egg whites, glass tubes, sperm cells) during the test looks as follows:
Mohr and Hoeyer                                                                  17

Maria is looking at the first sample under the microscope and after a few seconds
she says: “One thing is for sure, these ones did not make it very far. And I also
knew that beforehand.” When analyzing the penetration test, Maria looks at how
far sperm cells have moved within the tubes containing the egg white (which are
called micro capillary tubes). In order to find out how far the sperm cells have ad-
vanced, she looks at the first tube and searches for sperm cells in its upper part
(farthest away from where the sperm cells started). If she cannot find any sperm
cells in that section she goes back to the lower part (closest to where the sperm
cells started) and examines whether sperm cells have moved at all and if so, how
far they have gotten. Maria explains that a normal sperm cell will be able to move
about 40 to 60 millimeters. But that is not what happened in this case. To the con-
trary, the sperm cells have barely moved at all. And she would have to be very
careful and precise when looking whether the sperm cells have “hidden some-
where”, as she phrases it. Without looking up from the microscope, she says:
“You can see that I am really concentrated. You have to look for every single
cell.” (Excerpt from fieldnotes)

    So, what does good quality mean in this specific setting? All the work
at the semen analysis lab is done in order to assure that a specific man will
be able to father a child with a specific woman. A sperm cell is good
enough if it is able to move through a woman’s body in order to realize
fertilization and thereby create a genetic relation between certain individ-
uals. Here, the objective is to secure that certain people become parents
by creating an environment that is as close as possible to fertilization due
to heterosexual intercourse – the penetration test. Quality assessments are
organized around this reproductive objective and based upon approxima-
tions and particular sets of measurements. A variety of important factors
when assessing the quality of semen is not measured or accounted for, for
example the state of sexual arousal at the time of ejaculation. Neverthe-
less, the outcome of the assessment is understood as a neutral and tech-
nical result, serving as the best possible and only available model to base
medical treatment plans upon. And even if conception in principal takes
only a single sperm and egg cell, and whilst it is unclear which sperm cells
are most likely to fuse with egg cells after sexual intercourse, it is still tests
for the number of sperm cells, their shape and their capacity to move that
are used to assess semen’s so-called quality. As we shall see when we now
turn from the clinic for male fertility to the sperm bank, the indicators
serving as ‘measures’ of good quality shift when the objective no longer is
to find out what treatment plan a given couple should follow, but to se-
lect the right donor.


5. Sperm Donation: Semen Quality as Abundance

   In contrast to the clinic where a minimum of vitality is good enough,
the measurement of semen quality as part of sperm donation aims at max-
18                                                           Tecnoscienza – 9 (1)

imum quality. Since sperm banks deal with semen samples that have an
abundance of vitality (defined by most sperm banks as at least 200 million
sperm cells per milliliter semen liquid), sperm banks need to establish
standards in order to manage this abundance. As a consequence, the as-
sessment of good quality at sperm banks includes additional measure-
ments to those used in the context of male infertility. The objective of
semen quality assessments at sperm banks is to screen for the best rather
than treating the subfertile individual man or couple. Within the legal and
state authorized frameworks set in place in Denmark (which, for exam-
ple, exclude gay men from being sperm donors)3, sperm banks thus un-
dertake a detailed sorting of applicants guided by what staff at sperm
banks deems to be indicators of ‘good quality’. Sperm banks screen men
as well as their semen: to identify good semen also means to find the good
donor and vice versa. As previous research on sperm donors has shown,
the performance of a particular kind of masculinity qualifies men – and
therewith also their semen – as valuable within the biomedical context of
sperm donation (Mohr 2010, 2014, 2016a, 2016b; Almeling 2011).
    Once a man has made the decision to become a sperm donor, he will
have to undergo a number of tests. While an initial assessment of men’s
semen based on similar tests for sperm count and motility as they are used
in the clinic for male infertility verify that men pass the entry threshold of
having an abundance of sperm cells, subsequent questionnaires relating
to men’s physical traits, their medical and genetic history, their family re-
lations, their behavioural characteristics, and their personality are
measures set into place to qualify that abundance. When sperm banks
pose questions about illnesses and diseases, alcohol consumption, drug
use, education and professional status, physical activity level, and sexual
partners and promiscuity, the obvious goal is to rule out potential bioge-
netic factors that could pose a risk to a future child’s health. But these as-
sessments are also about more than just health. They contain ideas about
who is suitable for reproduction and thus sort men according to specific
personal characteristics that identify potential donors as socially accepta-
ble. In order to do so, sperm banks rely on a negative list of characteris-
tics including drug use, criminal behaviour, sexual promiscuity, and bi-
and homosexuality, categories which – inside a biomedical logic – are all
understood as indicators of risk behaviour and thus their absence as indi-
cators of responsibility. When donors are asked to qualify themselves by
answering different questionnaires, men are thus asked to identify them-
selves as belonging, or not, to certain risk groups with the effect that men
are required to pass as ‘responsible’ when answering questions concern-
ing health status, education, and sexual activity. In this way, the abstract
ideal of responsibility becomes part of sperm banks’ attempt to secure
high quality semen, an extrapolation from the general to the particular
that is both technically and normatively problematic (Mohr 2010).
    Since responsibility is hard to measure on a scale from one to ten and
therefore cannot only be captured in laboratory based assessments, do-
Mohr and Hoeyer                                                                  19
nors have to continuously perform responsibility as part of their interac-
tion with sperm bank staff. One of the moments in which the performa-
tive dimension of responsibility is clearest is the screening interview po-
tential sperm donors have to attend. These interviews are arranged after
the applicant has delivered his first semen sample, and primarily serve the
purpose of checking medical history. Verifying these so called ‘facts’
about their medical history in person is part of performing responsibility
and takes place not just via verbal confirmation but also through the in-
teraction between staff and donor:

Stine now turns to the medical history: “I am assuming that you are well and
healthy’ she wants to know”. “There has never been anything wrong with me”,
the donor replies. He then adds that his sister is overweight. Stine wants to know
by how much. He explains that his sister would not have any problems in her dai-
ly life; she would just weigh more than other people. Looking at a piece of paper
that contains information about his relatives, he answers all of Stine’s questions.
He also mentions that his mother has an allergy: “But neither my sister nor I have
had any symptoms”, he reassures Stine. His uncle has had heart problems: “But
he was a drug and alcohol addict, so this was clearly due to his lifestyle”, he con-
cludes. As the interview is over, Stine and I talk about the donor candidate. “This
was a typical interview”, she says, “He didn’t ask a lot of questions.” But, Stine
points out to me, what made this candidate special was the fact that he could ac-
tually answer all the questions in regards to his medical history: “He was very well
prepared”, she says, “and that reassures me that I can actually trust what a candi-
date says, which is always an advantage.” (Excerpt from fieldnotes)

    Men who want to be sperm donors thus have to perform responsibil-
ity, if not in their daily life then at least in situations in which they meet
sperm bank staff. As the fieldnote demonstrates, coming forward with in-
formation relevant to one’s medical history is part of performing respon-
sibility. Also, pointing out that problematic health conditions are a result
of irresponsible lifestyle rather than genetics construes the donor candi-
dates as the responsible men that are sought after. Whereas good semen
quality at the male fertility clinic was about finding enough vitality in or-
der to determine a treatment plan, good semen quality at the sperm bank
always already encompasses an abundance of vitality. Vitality, as an ele-
ment of quality, thus operates differently at sperm banks. Here, vitality
needs to be upgraded, as it were, through a number of social characteris-
tics that the donors have to exhibit. These characteristics are partly
thought of as travelling with sperm cells and partly as lowering the risk of
potential illnesses and diseases. To assess quality at the sperm bank there-
fore means not only to evaluate each semen sample’s observable charac-
teristics, as in the male fertility clinic, but also involves the donors’ life-
styles, personality, and sexuality. Good quality in the sperm bank embod-
ies not only measurements of vitality, but also assessments of the person-
ality of donors. These measurements are strikingly absent when we now
move to the labs working with artificial sperm cells.
20                                                           Tecnoscienza – 9 (1)


6. Articifical/in-vitro Sperm: Semen Quality as Proof of
Principle

    In 2003, germ cells of male mice were produced for the first time in-
vitro, meaning outside of the animal body, with the help of a laboratory
setting (Toyooka et al. 2003). This was followed by experiments with hu-
man tissue (Clark et al. 2009). In 2006, a German research team was able
to create living mice offspring using in-vitro germ cells (Nayernia et al.
2006). As part of a publicly financed research project entitled Germ Cell
Potential, some researchers from this team are continuing their research
with tissue from subfertile men (Gromoll 2011). Social characteristics
such as responsibility are not part of the quality assessment of in-vitro
sperm; on the contrary, such characteristics are deemed utterly irrelevant
by researchers. The primary goal is instead, as one researcher phrased it
in an interview, “to get basic research as far as possible in order to secure
that it can be used to cure male infertility at some point.” Researchers im-
agine the production of in-vitro sperm as a solution to the cases of male
infertility which the male fertility clinic cannot treat. Thereby their re-
search can be read as an attempt to reify a kinship system which is based
on the ideal of the nuclear family – father, mother, child – in which no
“donor daddy” or “biological mother” interferes. Good quality sperm
cells here are sperm cells from the properly related person. The quest to
establish an unquestionable certainty, that genetic and social fatherhood
reside in one and the same person, can, in other words, also be under-
stood as an attempt to avoid the challenges to patriarchal kinship that
donor insemination introduces.
    If procreative cells can be created out of stem cells, a type of cell that
everyone possesses, potentially anybody can become a “father”. Sperm
cells made from stem cells, what scientist themselves call in-vitro sperm,
would not be found in semen anymore and, as a result, one of the central
points of reference of a heteronormative gender order – the male-female
dichotomy – would disappear4. While the queer implications of such re-
search are obvious, they nevertheless do not appear to be the main driver
of this research’s agenda.
    In comparison to the context of the male fertility clinic where the la-
boratory was acting as a stand-in for the female body, here the laboratory
serves as a stand-in for the male body. The objective is to produce sperm
cells that resemble the ‘natural original’ as much as possible, with the
work which the male body accomplishes in order to produce sperm cells
being imitated by researchers in the laboratory. In this setting, good qual-
ity sperm cells are primarily tied to a concept of purity. Cells have to be
recognizable as ‘pure’ cells since they otherwise will be sorted out, a sort-
ing practice which also manages the purity of the cell culture as a whole.
Mohr and Hoeyer                                                                 21
The culture mediums in which cells are grown are of utmost importance
for this process as a researcher explained in an interview:

The cells need to be cultivated within a certain time span in order to make sure
that you have a pure culture. That means that I isolate the cells and place them in
a medium and this medium needs to be changed, as far as I remember, after three
days. Of course there will also be other cells in there, but they don’t grow in the
petri dish and that’s why they can be washed out, so that just those stem cells
which actually have the potential to grow further will stay in the dish. (Excerpt
from interview)

    Securing a pure culture of cells with the help of a specific medium and
through particular working practices can be understood as an attempt to
imitate the process in the male body through which sperm cells are pro-
duced as part of spermatogenesis. Stem cells in testicles turn into sperm
cells via a chain of different developmental stages and splitting phases,
imitated in the lab by successive changes of the medium and by washing
out unwanted cells. The purity of the cells and culture – absence of bacte-
ria, presence of specific proteins – is an important quality criterion. Se-
men quality is therewith tied to an idea of purity that is believed to be
found in the healthy, that is, fertile man. But just as the definitive healthy
man does not exist, neither does the ultimately pure culture. In the inter-
views, researchers described problems they have trying to cultivate a pure
cell culture:

A big problem is of course the contamination of cell cultures. That happens all
the time, either when bacteria come in during times when everybody has a cold,
someone sneezes while the incubator is open, that kind of stuff. That is a typical
problem. Or when the cells which are supposed to be used for spermatogenesis
do not express the expected phenotype. (Excerpt from interview)

    The ideal of natural purity is not so easy to reach, and even its approx-
imation requires researchers to repeatedly intervene in the developmental
processes that take place in the petri dish.
    The culture mediums thus guarantee the growth of the desired cells
which helps researchers to identify the right cells. After the cells have
grown successfully, researchers rely on protein markers that signal which
cells have reached a certain state. Most experiments use fluorescent
markers, which attach to the specific proteins of interest, meaning that
“good” cells will light up under fluorescent light. The sorting of “good”
cells from “bad” cells is done by an automated device, echoing the ejacu-
lation of whole, mature sperm cells by the male body.
    The ultimate proof of success in creating good sperm cells is to show
that they can produce offspring, as another researcher explained in an in-
terview:
22                                                                Tecnoscienza – 9 (1)

Mohr: “What does having a good cell mean for you?”
Researcher: “That is not so important for us. We are interested in how we get
most of the cells successfully through meiosis, how we can raise the number of
haploid cells. But proof of principle is of course that we should find out if the
cells can fertilize or not, if we can get living animals out of them.” (Excerpt from
interview)

    Surviving offspring in these experiments is a sign of good enough
quality, in contrast to the quality assessments at sperm banks. But a dif-
ferent set of approximations is used for this assessment than when sub-
reproductive sperm samples are assessed at the male fertility clinic.
    Whereas the goal of sperm donation is to create children with desired
traits (and absence of disease), it is the genetic relationship between cer-
tain animals that is of importance in the context of in-vitro sperm. The
objective is to be able to say for sure who is father to whom instead of fa-
ther to what. Sperm cells do not need to be of excellent quality in order
to be good enough, just as it is the case at the male fertility clinic. The de-
ciding criterion is that an unwanted intervention in heteronormative kin-
ship can be avoided. Queer kinship relations remain only a future, unin-
tended consequence should new users adopt the technology. Semen qual-
ity in in-vitro research shifts from being an intrinsic quality of cells into a
constructed quality. In the course of this construction, the very word
“sperm cell” seems to change its meaning: it is not so much an entity any
longer, but rather a capacity, an action, namely to fertilize and reproduce.
It changes its associations from a noun to verb, we might say, with the
gender and ‘fatherhood’ attached to artificial germ cells becoming the re-
sult of a historic precedence rather than that of a social identity assigned
to the body from which the cells originate. That which makes the cells
good depends on the laboratory’s ability to produce and identify certain
markers which mark the cells as good cells. In the broadest sense, all this
is set in place in order to be able to control who is related genetically to
whom.


7. Conclusions

    By definition, quality reflects values and thus will always depend on
subjective assessments. By comparing three different contexts in which
the quality of semen is assessed, we have shown that these assessments re-
flect norms and desires which some people have in common and others
not and which those involved – medical professionals, patients, sperm
banks staff, sperm donors, or researchers – only seldom consciously and
autonomously choose or dismiss. In other words, whilst these norms and
desires surrounding reproduction and genetic relatedness shape meas-
urements with very concrete effects, they are seen as not worth discussing
in the clinical or research context. In this way, semen quality is made to
Mohr and Hoeyer                                                             23
appear as a purely “technical” matter used as background data when
making the “real” normative decisions about who gets to reproduce and
in which ways. We have shown, in contrast, that norms are not just added
at some later point when treatment decisions are made but go to the core
of the medical judgment.
    We have presented three different ways in which sperm cells can be
identified as being of good quality, reflecting different goals and implicit-
ly associated values. A sperm cell can be good enough if it is able to move
through a woman’s body in order to realize fertilization and thereby cre-
ate a genetic relation between certain individuals, as seen in the context
of subreproductive semen. Here, the objective is to secure that certain
people become parents by testing sperm cells in an environment that is as
close as possible to heterosexual intercourse. A sperm cell can also be
good, if it has an abundance of vitality, as is the case in sperm donation.
Here, however, sperm donors are also assessed, and personal characteris-
tics become a deciding factor when assessing if a man’s semen is good
enough. Last but not least, a sperm cell can be good, if it has the capacity
to perform a certain function, namely to fertilize, as is the case with in-
vitro sperm. Here the cell as an entity is no longer important. It is not
heterosexual intercourse that needs to be recreated but rather the devel-
opmental processes within the male body, the objective being to control
and minimize interventions in specific kin relations.
    Though public debates use and refer to semen quality as an unques-
tionable technical fact, most bio-analysts, clinic staff, and researchers are
aware that the standards they employ rely on approximations. Measure-
ments are made in order to support decisions – be they treatment plans or
interventions in petri dishes. When moving across the three different
fields of subreproductive semen, sperm donation, and in-vitro sperm it
becomes apparent that what ‘good quality’ means is very much depend-
ent on context. In fact, the whole idea of a sperm cell being a phenome-
non which is just out there with measurable qualities becomes increasing-
ly unconvincing when one moves across the different contexts. When we
look at semen and examine it, the way we look at it and from which per-
spective will be decisive for what we will define as a problem and what we
will think is appropriate to solve it. Normative choices are part of this
process, even when measurements are framed as “just” quality assess-
ments. Determining semen quality means to decide and plan who gets to
have children with whom, and exploring, changing, and negotiating what
semen is, and what it can do, means also structuring future family, kin-
ship, and gender relations.


Acknowledgements

    We are grateful for the time researchers, professionals at sperm banks and
labs as well as sperm donors dedicated in order to talk about their work and/or
24                                                                Tecnoscienza – 9 (1)

experiences. For their helpful and inspiring comments on earlier versions of this
article we want to thank Lene Andersen, Niels Jørgensen, Ayo Wahlberg, Morten
Bülow, Sarah Wadmann, Vibeke Pihl, and Louise Whiteley. We would also like
to thank Charlotte Kroløkke and Karen Hvidtfeldt Madsen as well as the editorial
team at Kultur & Klasse for opening up the opportunity to revise the original
Danish version of this article and not least we want to thank the two anonymous
reviewers for their helpful comments.


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    1
      It is important to note that the term “fertility” carries different meanings in
different contexts. In popular discourse and debate, it is typically used to describe
a man’s ability to have children. In the andrological literature, fertility means that
a man has actually had children. The potentiality embedded in the popular
understanding of fertility is instead referred to as “fecundity” within andrology.
For communication purposes, we follow the popular usage.
    2
      Biomedical interventions like IVF or ICSI are often referred to as treatments
within the clinical settings of reproductive biomedicine. While these treatments
also represent a particular medicalization of reproduction in general and the
female and male body in particular, the sense making of the use of reproductive
technologies also involves the (de)stabilization of gender identities, that is, while
28                                                               Tecnoscienza – 9 (1)


some women and men undergoing fertility treatment experience closure in the
sense that they become women and men through the successful birth of a child,
others come to realize the boundaries of their gendered selfhood and the pain that
this might entail due to not being able to have children (Franklin 1997; Tjørnhøj-
Thomsen 2009; Inhorn 2012). Our usage of the term treatment here tries to
capture this dynamic, the potency of reproductive technologies “to constitute
gender identities in which imaginations about, and norms pertaining to, what it
means to be a woman or a man are linked with the idea of the good citizen as a
reproductive citizen, someone who pursues having children as a collectively
shared ideal.” (Mohr and Koch 2016, 93).
     3
       The legal document states that men who have had sex with men should be
excluded, unlike in Spain and Great Britain – both countries of the European
Union. The Danish authorities based the guidelines for sperm donation on those
regulating blood donation, grounded in the assumption that men who have sex
with men have a higher risk of HIV infection. This risk is thought of as being
present no matter the actual behavior of an individual man. Sperm donors are
thus selected based on their sexual preference rather than on their actual risk
behavior.
     4
       It should be noted that the production of offspring using only genetically
female tissue and cells is more difficult. As researchers interviewed during
fieldwork explained, cells with two X-chromosomes have difficulties getting
further than meiosis, a critical developmental stage in the production of germ
cells.
