A comparison of the characteristics, motivations, preferences and expectations of men donating sperm online or through a sperm bank

Acceptance and rejection of "morally challenging" behaviour in online sperm donation communities: narrative interviews with recipients and donors

Introduction

Online sperm donation allows those hoping to conceive a baby ("recipients") to meet prospective sperm donors online, via "connection" websites or social media. These sites offer some advantages to clinical donation (including lower costs and greater choice over donation arrangements) but previous research has suggested that these sites may also pose risks and challenges to those who use them. Therefore, the aim of this exploratory research was to better understand online sperm donation communities and the experiences of both recipients and donors, particularly with respect to situations that could be "morally challenging" or involve harm.

Methods

Three prolific donors and five recipients were interviewed using an in-depth narrative approach. Carol Gilligan's Listening Guide was employed to analyse the data.

Results

The findings demonstrated that the donors sought to find ways to maintain autonomy in their donating practices and were concerned about the character and parenting abilities of recipients, as well as the potential for recipients to make unwarranted complaints. The recipients were concerned about their safety and finding a donor they could trust, discussing issues relating to donor "dishonesty", online abuse, and a lack of support from connection sites and related authorities. Both donors and recipients identified "morally challenging" behaviour relating to donor anonymity (donor use of fake online profiles or aliases) and the sexual motivations or (mis)conduct of some donors. The participants each discussed the ways in which they managed perceived risks.

Discussion

The degree to which the participants voiced their acceptance or rejection of challenging behaviour in online sperm donation communities varied across and within participants, highlighting the complexity of the way in which people interact in this environment. Further research is required to understand how this form of sperm donation can be as safe and supportive as possible, while also respecting the importance to donors and recipients of autonomy and choice when making donation arrangements.

Sperm Donors' Identity Disclosure: Is It REALLY Crucial? For Whom?

OBJECTIVE

To study the preference of sperm donors with identity disclosure (ID) versus anonymous donors (AD) and to understand if this selection affects clinical outcomes in an Israeli population.

METHODS

This retrospective study included patients who chose imported sperm donation during 2017-2021. Of these, 526 used their own (autologous) oocytes and 43 patients used donated oocytes (DO). The primary endpoint was the type of chosen donor with ID versus AD. We examined the tendency toward ID according to demographic parameters and the theoretical impact of donor-type selection on reproductive outcome and compared patients who performed cycles with autologous oocytes with those using DO.

RESULTS

Single women had a significantly higher probability of choosing sperm donors with ID than heterosexual couples (55.6% vs. 33.3%, OR 2.5, CI 95% 1.52-4.11, P < 0.001). Although not significant, same-sex couples were more likely to choose sperm donors with ID than heterosexual couples (49.1% vs. 33.3%, OR 1.93, CI 95% 0.97-3.85, P = 0.06). Sperm donor samples, 2501 vials, were imported. It was performed 698 intra-uterine insemination and 812 in vitro fertilization cycles were performed, respectively, resulting in 283 pregnancies without differences between patients who chose sperm donors with ID versus AD sperm. No significant differences were observed regarding the option for sperm donors with ID between patients using DO (44.2%) and those using autologous oocytes (51.3%).

CONCLUSION

While ID is important for a certain section (mainly single) of recipients, it is far from the only dominant factor during donor selection. Sperm donation type does not impact clinical outcomes.

Direct-to-consumer DNA testing: the perspectives and experiences of donor conceived young adults in the UK

RESEARCH QUESTION

What meanings do donor conceived young adults give to direct-to-consumer DNA testing, and how does direct-to-consumer DNA testing relate to their lived experiences?

DESIGN

Thirty-three young adults participated in in-depth interviews in November 2020 and September 2021 as part of a study of donor conceived people in the UK that focuses on the period of young adulthood. All participants were aged between 18 and 31 years, had been conceived by sperm donation at a time of legal donor anonymity, and were mainly resident in the UK. Interviews were analysed using reflexive thematic analysis.

RESULTS

Nineteen participants (58%) had used at least one direct-to-consumer DNA test, and 14 (46%) had not. Three participants (9%) had learned about their donor conception inadvertently through a direct-to-consumer DNA test. Twelve participants (36%) had matched with their donor, someone conceived using the same donor, or both. Four related themes that capture participants' perspectives and experiences of direct-to-consumer DNA testing were identified: ruptures, disclosures, webs and temporalities.

CONCLUSIONS

To the authors' knowledge, this is the first study to evidence both active interest and disinterest in direct-to-consumer DNA testing among individuals who are donor conceived. The meanings ascribed to, and uses of, direct-to-consumer DNA testing vary significantly among donor conceived young adults. Findings relating to the relationship between 'informal' and 'formal' information systems, and the absence of guidance and support for those using direct-to-consumer DNA tests, should be considered carefully by practitioners, regulatory bodies and policymakers going forward.

The case for reframing known donation

Contemporary UK egg and sperm donation exists in two predominant forms: (i) clinic-based, identity-release donation; and (ii) known donation, which can take place either inside or outside of the clinic context. Regulatory and clinical discussions of the latter currently focus, almost exclusively, on risk whereas identity-release is widely presented as the default route for both donors and recipients. Consequently, there is little support available for those potential donors and recipient parents who might prefer a known donor arrangement. In this commentary, we reflect on our sociological research with donors and parents through donor conception and argue that there are a number of reasons why known donation may, in some contexts, offer advantages over identity-release donation. Whilst this research also demonstrates that there can be challenges involved in known donation, these are not inevitable nor are challenges absent from identity-release routes. It is timely and important to question whether the current de-valuing of known donation compared with identity-release donation holds up to academic scrutiny. We argue for a more balanced approach in which the benefits and challenges of both known and identity-release routes are discussed with donors and recipients and for increased support for known donation in clinics and by regulatory bodies.

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.

Medical ethics when moving towards non-anonymous gamete donation: the views of donors and recipients

Drawing on the views of donors and recipients about anonymity in a country that is experiencing a transition towards non-anonymous gamete donation mandated by the Constitutional Court, we explore how the intersection between rights-based approaches and an empirical framework enhances recommendations for ethical policy and healthcare. Between July 2017 and April 2018, 69 donors and 147 recipients, recruited at the Portuguese Public Bank of Gametes, participated in this cross-sectional study. Position towards anonymity was assessed through an open-ended question in a self-report questionnaire, which was subject to content analysis. Preference for an anonymous donation regime was mentioned by 82.6% of donors and 89.8% of recipients; and all those with children. Instead of the rights-based reasoning used by the Constitutional Court, donors highlighted concerns over future relationships and recipients focused on socioethical values linked with the safeguard of safety, privacy and confidentiality. The remaining participants advocated the choice between anonymity or non-anonymity (double-track policy), invoking respect for their autonomy. The complex, diverse ethical views and reasoning of donors and recipients expand a traditionally dichotomous discussion. Their perspectives challenge the transition towards non-anonymity and international guidelines, raising awareness to the need for their involvement in the design of policies to enable choice according to their values and preferences, and of psychosocial counselling responsive to their socioethical concerns and sensitive to their parental status. Empirical frameworks complement rights-based approaches to uphold justice, fairness and equal respect, and to incorporate utility, beneficence and non-maleficence in policymaking and healthcare in the transition towards non-anonymity.

The opposite of a step parent - The genetics without any of the emotion: 'sperm donors' reflections on identity-release donation and relatedness

This paper draws upon data from an online survey with closed- and open-ended questions completed by 168 identity-release sperm donors who had all donated in the UK between 2010 and 2016. Paying particular attention to the qualitative data obtained from the donors' responses to the open-ended questions, this paper explores the sperm donors' thoughts and feelings about being an identity-release donor and about future information exchange and contact with offspring conceived with their gametes. It shows that the majority of donors regarded identity-release donation as their preferred method of donation, supported the removal of anonymity, did not have concerns about being an identity-release donor and indeed saw positives for both the donor-conceived offspring and themselves. However, it also highlights that the donors' thoughts and feelings about being an identity-release sperm donor, how they saw themselves in relation to the individual conceived with their donation, and their preferences for information exchange and contact, varied greatly. The paper explores how identity-release donation is surrounding by many unknowns and consequentially sperm donors struggle to conceptualize what it means to be an identity-release sperm donor. As well as adding to the literature on donor conception, relatedness and kinship, by giving voice to sperm donors' own views and experience of the identity-release regulatory context, and their thoughts and feelings about future information exchange, this paper will help policy makers and clinicians prepare for the imminent time when donor-conceived individuals in the UK can start requesting their donor's identity.

Status of online sperm donation and sperm bank in Japan

Facilities worldwide offering donor sperm insemination face sperm donor shortages. There are also known dangers of online information about sperm donation and using donated sperm to conceive without the involvement of medical professionals. Therefore, the authors investigated 140 Web sites retrieved by common Japanese search engines using sperm donation-related keywords. The authors assessed them according to criteria, but most were deemed unsafe (96.4%). Ultimately, 2 personal and 3 company Web sites provided adequate information. However, the personal Web sites lacked representative individual information and the company Web sites had issues including high costs, overseas location of facilities performing insemination, and possible non-Japanese origin of donated sperm.