Managing risks for genetic conditions in donor sperm treatment: current practices in Belgian fertility clinics

Abstract

Research questionHow do fertility clinics in Belgium manage risks for genetic conditions in donor sperm treatment? DesignAn electronic questionnaire was distributed to all fertility clinics in Belgium in June 2023, focusing on treatments with anonymous sperm donors from 2018 to 2022. Responses from 15 clinics were analyzed anonymously with IBM SPSS statistics. ResultsAll clinics assessed donor risks, including a personal and family history, conventional karyotyping, and (for 83% of the clinics) carrier screening for common autosomal recessive conditions. For recipients, 58% of the clinics relied only on a personal and family history. Despite efforts, the suspicion or detection of genetic conditions in donor sperm treatment was prevalent, with 9.4 adverse events reported per 100 children born. When adverse events occurred, most clinics (58%) would not inform the donor if no additional genetic testing was needed. Around 1 in 4 (27%) clinics always informed recipients about an adverse event possibly related to their donor. An equal number (27%) categorically rule out the use of sperm from a donor after an adverse event is traced back to his DNA, and 53% would not consider using the donor when the adverse event was not genetically confirmed. For the other clinics, deciding when to disclose new genetic risk information or when to allow the use of a donor linked to an adverse event is a complex matter involving different considerations. ConclusionWhile suspected or detected genetic conditions linked to donor treatments were common, there was wide variation in how Belgian clinics prevent and manage these situations.