Sperm donor limits that control for the 'relative' risk associated with the use of open-identity donors

Israeli students' perceptions regarding sperm donation: dilemmas reflections with dominant demographic effect

BACKGROUND

Sperm donation has undergone significant medical and social transformations in recent decades. This study aimed to explore Israeli students' perceptions towards sperm donation and investigate the potential influence of demographic characteristics on these perceptions.

DESIGN

The study encompassed 254 students from Tel-Aviv University, who completed an anonymous online survey in January-February 2021. This cross-sectional quantitative online survey, comprised 35 questions categorized into three sections: demographic data, assessment of prior knowledge, and perceptions of sperm donation (general perceptions related to both positive and negative stigmas associated with sperm donation, the roles and activities of sperm banks, and considerations surrounding identity disclosure versus the anonymity of sperm donors and their offspring).

RESULTS

Participants exhibited a relatively low level of prior knowledge (mean 31.2 ± 19 of 100). Scores for positive and negative stigmas ranged from 1.3 to 2.2. Notably, the statement "Donors' anonymity preservation is crucial to maintain sperm donation" received a mean of 3.7. Seeking for anonymous sperm donation identity both by recipients and offspring was ranked with low means (1.5 and 1.7, respectively). However, the pursuit of half-siblings by mothers or siblings themselves received higher ratings ranging from 2.7 to 3. Women's stigma ranking were notably lower, while men emphasized the importance of donor anonymity.

CONCLUSIONS

Sperm Banks hold a position of medical authority rather than being perceived as being commercial entity. The preservation of donor anonymity is widely accepted as a crucial element, prioritized over the requests for identity disclosure from recipients and offspring. Demographic parameters exhibit a strong and precise effects on participants' perceptions.

Motivational stimuli to donate sperm among non-donor students

BACKGROUND

Sperm banks face a continuously evolving gap between the increasing demand for sperm donation (SD) vs. limited available reserve. To improve donors' recruitment and increase supply, motivations towards SD should be investigated specifically among young men who have the potential to become donors. Our aim was to evaluate factors which increase and decrease predisposition to donate sperm among non-donor students, who represent a "potential pool" for possible donors' recruitment.

RESULTS

Ninety-three men fulfilled the questionnaire with mean age of 28.2 ± 4.5 years. The most powerful incentive to donate sperm was financial reward followed by a willingness to help others to build a family (3.8 and 3.4, respectively). The most dominant consideration to decline donation was the fear of anonymity loss and future regret (4 and 3.8). While participants' willingness for anonymous SD was fair (2.8), the open-identity donation was rated significantly lower (1.75, p < 0.01). Familiarity with recipients and offspring had lower scores (1.9-2.2) as well.

CONCLUSIONS

Young single men represent a suitable cohort for anonymous donation. Financial reward and willingness to help others are important positive incentives while anonymity preservation is crucial to maintain their willingness towards SD. Regulatory shifting towards open-identity SD necessitates the establishment of an alternative "potential pool" population as a reliable source to recruit donors.

Finding people like me: contact among young adults who share an open-identity sperm donor

STUDY QUESTION

What interests and experiences do donor-conceived adults have with respect to same-donor peers/siblings, when they share an open-identity sperm donor?

SUMMARY ANSWER

Donor-conceived young adults report considerable interest in, and primarily positive experiences with, their same-donor peers, with some finding ‘people like me’.

WHAT IS KNOWN ALREADY

Through mutual-consent contact registries, director-to-consumer DNA testing and other means, donor-conceived people with anonymous (i.e. closed-identity) sperm donors are gaining identity-related information from, and establishing relationships with, people who share their donor.

STUDY DESIGN, SIZE, DURATION

Semi-structured, in depth telephone and Skype interviews with 47 donor-conceived young adults were carried out over a 31-month period. Inclusion criteria were being one of the first adults for each donor to obtain their identity and being at least 1-year post donor-information release.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Participants (aged 19–29 years, 68.1% women) were born to female same-sex couple parents (46.8%), a single mother (29.8%) or heterosexual couple parents (23.4%); all parents had conceived through the same US open-identity sperm donation program. The dataset was analyzed thematically and included interviews from only one participant per family. Each participant had a different donor.

MAIN RESULTS AND THE ROLE OF CHANCE

Interest in, and experiences with, same-donor peers suggested that they occupy a unique position in the lives of donor-conceived young adults who share their open-identity donor. Contact can provide identity-relevant information and support through the availability of relationships (whether actualized or potential), shared experiences, and easier relationships than with their donor. Most donor-conceived young adults felt positively about their contact experiences. Of those not yet linked, almost all expressed an interest to do so. Some had met the children raised by their donor. When asked, all expressed an interest in doing so.

LIMITATIONS, REASONS FOR CAUTION

Interviews were conducted with donor-conceived young adults who were uncommon in their generation in terms of: having an open-identity sperm donor; the majority knowing about their family’s origins from childhood; and having parents that accessed at the time one of the only open-identity sperm donation programs. Further research is needed to assess applicability to all donor-conceived adults; findings may be more relevant to the growing number of people who have an open-identity donor and learned in childhood about their family’s origins.

WIDER IMPLICATIONS OF THE FINDINGS

Participants were among the first generation of donor-conceived adults with an open-identity sperm donor. Their experiences and perspectives can provide essential guidance to programs and others with similar origins. Early disclosure of family origins and identifying the donor did not diminish the young adults’ interest in their same-donor peers. Positive experiences suggest that the benefits of contact include not only identity-relevant information (through shared traits and experiences), but also relationships with and support from people who understand the uncommon experience of being donor conceived. Implications include the need to educate families and intended parents about the potential benefits of knowing others who are donor conceived, and the risk of unexpected linking across families by donors, regardless of donor-conceived person or family interest.

STUDY FUNDING/COMPETING INTEREST(S)

The study was funded by the Lesbian Health Fund of GLMA: Health Professionals Advancing LGBTQ Equality. The authors have no conflict of interest to declare.

The attitudes of IVF patients treated in the Czech Republic towards informing children born after gamete donation

BACKGROUND

In recent decades gamete donation has received growing attention. Data from the Czech National Registry of Assisted Reproduction show that the number of cycles using donated oocytes has been increasing every year. According to Czech law, gamete donation is anonymous. Since 2011, some members of the Czech parliament have repeatedly made requests to revoke the anonymity but anonymity is one of the preconditions for such donation in this country. The aim of this study was to find out how the gamete recipients feel towards informing their child about the circumstances of their conception and their access to the identity of the donor.

METHODS

A total of 195 recipients (122 women undergoing treatment - 43 Czechs, 79 foreigners (Western Europe and the USA) and 73 male partners - 28 Czechs, 45 foreigners) participated in this survey. The data were obtained by anonymous questionnaire.

RESULTS

A significant difference between the attitude of the future Czech and foreign parents regarding disclosing the mode of conception was found (P = 0.003). The vast majority of Czechs were against disclosure. The foreign recipients were somewhat more divided. Regarding the donor's identity, there was no difference in atttitude between the groups. Recipients rarely consider that the knowledge of the donor's identity will be important for their child. The recipients overall, were convinced that the psychological aspects of parenting are far more important to the child than genetics, and see no reasons for disclosing the donor´s identity.

CONCLUSION

While the the foreign recipients were less adamant about non-disclosure, the overall finding was in accord with the current Czech law on anonymity and not in agreement with the proposed abolition. The recipient's attitudes towards disclosing were also culturally determined. The fact that some countries have revised their rules towards open idendity is not a rationale for such change in the Czech Republic.

The optimal number of offspring per gamete donor

Our aim was to create a mathematical basis to calculate the risks for unintended matings of consanguineous half-siblings from a donor in a society with approximately 10 million inhabitants. The Curie-Cohen model for calculation of the risk for consanguineous mating was used. When the number of offspring per donor is limited to 10, then the model gives a yearly risk for consanguineous matings below 1%. Thus 10 offspring gives a risk for consanguineous matings of 0.9% per year, or approximately once in every 100 years. The risk increases exponentially: with 15 offspring it exceeds 2% and with 25 it reaches up above 5%.

Gamete donation, information sharing and the best interests of the child: an overview of the psychosocial evidence

This paper overviews key empirical findings from social science research regarding the impact of gamete donation on child wellbeing. In particular, the paper addresses current regulatory debates concerning information sharing and the best interests of the child by considering psychosocial aspects of telling--or not telling--children about their donor conception and the identity of their donor. The paper identifies three core sets of empirical, ethical and policy concerns underpinning these debates relating to (i) the psychosocial impact of gamete donation per se on child wellbeing, (ii) the psychosocial impact of parental disclosure decisions on child wellbeing, and (iii) the psychosocial implications of donor identification for donor-conceived offspring. The paper illustrates how these concerns are framed by ideas about the significance-or not-of 'genetic relatedness'; ideas which have come to the fore in contemporary discussions about the potential consequences of donor-conceived individuals gaining access to their donor's identity. By drawing together research findings that may be pertinent to the regulation of gamete donation and information sharing, a further aim of this paper is to explore the potential use and misuse of empirical 'evidence' in ethical and policy debates. Whilst this paper starts from the premise that psychosocial data has a vital role in grounding normative discussions, it seeks to contribute to this dialogue by highlighting both the value and limitations of social science research. In particular, the paper argues for a cautious approach to applying psychosocial evidence to ethical issues that is sensitive to the caveats and nuances of research findings and the changing cultural and regulatory context.

Evolving minimum standards in responsible international sperm donor offspring quota

An international working group was established with the aim of making recommendations on the number of offspring for a sperm donor that should be allowable in cases of international use of his sperm. Considerations from genetic, psychosocial, operational and ethical points of view were debated. For these considerations, it was assumed that current developments in genetic testing and Internet possibilities mean that, now, all donors are potentially identifiable by their offspring, so no distinction was made between anonymous and non-anonymous donation. Genetic considerations did not lead to restrictive limits (indicating that up to 200 offspring or more per donor may be acceptable except in isolated social-minority situations). Psychosocial considerations on the other hand led to proposals of rather restrictive limits (10 families per donor or less). Operational and ethical considerations did not lead to more or less concrete limits per donor, but seemed to lie in-between those resulting from the aforementioned ways of viewing the issue. In the end, no unifying agreed figure could be reached; however the consensus was that the number should never exceed 100 families. The conclusions of the group are summarized in three recommendations.

A survey of 1700 women who formed their families using donor spermatozoa

This paper reports the results of an online survey of 1700 recipients of donor spermatozoa conducted by the Donor Sibling Registry, aiming to understand the perspectives of respondents who had used donor spermatozoa. The survey examined: choice of sperm bank and donor; reporting of births and genetic disorders; disclosure; contact with donor and half-siblings; regulation of sperm donor activity and genetic testing; and access to medical information. The respondents formed three groups: single women; women in a same-sex relationship; and women in a heterosexual relationship. Some differences between the three cohorts were observed: preinsemination counselling; acceptance of donors without medical records or with chronic or late-onset diseases; awareness of choice of bank and type of donor; and views on the right of offspring to know their genetic origins. However, important areas of common ground were identified: the wish by those who had used an anonymous donor that they had used an open-identity donor; support for, and willingness to pay for, comprehensive genetic testing of donors; and desire for access to their donor's family health information. The implications of these results for policies concerning the use and management of donor spermatozoa will be discussed. This paper reports the results of a survey of 1700 women who used donor spermatozoa to conceive a child. The survey considers their views on the following areas: choice of sperm bank and donor; reporting of births and genetic disorders; disclosure; contact with donor and half-siblings; regulation of sperm donor activity and genetic testing; and access to medical information. This was an online survey was designed and conducted by the Donor Sibling Registry (DSR), a US-based non-profit organization that supports donor sperm recipients, donors and donor-conceived people. The survey aimed to understand the experiences, perspectives and concerns of women who had used donor spermatozoa. The respondents formed three groups: single women; women in a same sex relationship; and women in a heterosexual relationship. Some differences between the three groups were observed: preinsemination counselling; acceptance of donors without medical records or with chronic or late-onset diseases; awareness of choice of bank and type of donor; and the right of offspring to know their genetic origins. However, despite these differences, important areas of common ground were identified: the wish by those who had used an anonymous donor that they had used an open-identity donor; support for, and a willingness to pay for, comprehensive genetic testing of donors; and desire for access to their donor's family health information. The implications of these results for policies concerning the use and management of donor spermatozoa will be discussed.

Sperm donation and its application in China: a 7-year multicenter retrospective study

Sperm donation in China is different from that in other countries due to cultural, social and political factors. This research presents the current status of sperm donation in Mainland China and highlights some problems. Between January 2003 and December 2009, 19 471 sperm donors were screened totally and 6467 donors (33.2%) were recruited. The primary reasons for non-recruitment were either inadequate semen parameters (55.0%) or positive results for sexually transmitted diseases (7.9%). There were 327 (1.7%) qualified donors who withdrew from the program because of frustration related to failed semen parameters, participation merely for free medical tests or job transfer. A questionnaire investigating donor intention, as well as other concerns associated with sperm donation, was distributed to 516 potential donors. All potential donors indicated their primary motivation as altruism, while 90.9% mentioned monetary reward as a second motivating factor. Approximately 93.4% of donors expressed some apprehension about the risk of consanguineous mating and the protection of their identity. Over the past 7 years, 488 389 vials of donors' semen have been cryopreserved. In 36 438 artificial insemination with donor sperm (AID) cycles, the clinical pregnancy rate was 23.9% and the live birth rate was 16.6%. In 7148 in vitro fertilization cycles, the clinical pregnancy rate was 45.8% and the live birth rate was 35.2%. Human sperm banks have been strictly monitored to ensure that each sperm donor can only impregnate five women nationwide. There is still a large gap between the supply and demand for sperm donation which may be solved by updated guidelines.

Sperm and oocyte donors' experiences of anonymous donation and subsequent contact with their donor offspring

BACKGROUND

This study examined the motivations and experiences of anonymous donors who decide to make themselves open to contact with their donor offspring.

METHODS

Online questionnaires were completed by 63 sperm donors and 11 oocyte donors recruited via the Donor Sibling Registry (http://www.donorsiblingregistry.com/), a US-based international registry that facilitates contact between donor-conceived offspring and their donors.

RESULTS

Donors' main reasons for donating were financial payment and wanting to help others. Sperm donors had donated between 1 and 950 times (median = 100) and oocyte donors had donated between 1 and 5 times (median = 2). The majority of sperm donors and more than one-third of oocyte donors expressed concerns about having donated. These concerns were mainly about the well-being of any children conceived using their gametes and not being able to make contact with them. Most sperm and oocyte donors felt that it was important to know how many offspring had been born using their donation, and 51% of sperm donors and 46% of oocyte donors wanted identifying information. All of the donors who had contact with their donor offspring reported positive experiences and the majority continued to have regular contact.

CONCLUSIONS

Although the sample may not be representative of all anonymous donors, this study highlights the importance of donors having access to information about their donor offspring and the positive consequences that may arise when contact is made.