Use Of Donor Sperm Research Articles

Clinical perspectives on gamete and embryo donation

Clinical staff involved in assisted reproduction frequently encounter ethically complex clinical problems. Such difficulties often relate to the use of donor sperm, eggs or embryos. Despite a fall in the number of donor insemination (DI) cycles performed in the UK over the last few years, which is partly explained by the availability of intracytoplasmic sperm injection (ICSI), there is still a considerable demand for the treatment both in natural cycles and in IVF. The burden on clinics in providing sound recruitment and screening strategies for donors is enormous and is the subject reviewed in this report. If remuneration of donors were withdrawn, as proposed by the Human Fertilisation and Embryology Authority (HFEA), the capacity to maintain a clinical service would be in doubt. Advances in technology are now pushing to the extremes the limits of what is socially acceptable. Those involved in providing clinical services face decisions on rationing the limited funds available to treat patients, which in some instances may impinge on patient autonomy. Clinical ethics committees may have a role in assisting providers in reaching decisions regarding access to treatment. Inequity of access to treatment may relate to the inability to pay for treatment, with the consequent danger of different ethical standards applying to different sectors of the population.

Privacy and disclosure in infertility treatment

Infertility can be an extremely psychologically stressful experience. Seeking social support, through disclosure and discussion of the infertility to friends and family can be helpful to many infertile couples. When a couple is undergoing the assisted reproductive technologies (ARTs) including third-party reproduction, disclosure can have both a positive and negative impact on the couple. Disclosure about the use of donor sperm, donor egg, or a gestational carrier may lead to disapproval from others and/or reveal information a couple would prefer to keep private. Alternatively, disclosure can provide the couple with important social support and understanding from others. This article reviews the issues of privacy and disclosure, specifically focusing on a case illustration of a couple deciding whether to disclose their use of anonymous sperm donation. The role of the mental health professional as a facilitator in this process is emphasized. © 1996 John Wiley & Sons, Inc.

Marketed sperm: use and regulation in the United States

To collate information relating to the current use of marketed semen for therapeutic donor insemination (DI) in the United States. Literature was identified by Medline search and government document review. Materials selected for review included empirical studies, policy reviews, legal documents, and government surveys relating to use of donor sperm. Use of marketed (donor) sperm is associated with significant medical, genetic, and psychological risk. These risks directly affect the individuals involved in therapeutic DI. Also, the public's health is involved because these risks include transmission of infectious disease and genetic anomalies. Legal and social concerns associated with therapeutic DI include offspring's knowledge of genetic endowment, parental responsibility, and donor confidentiality. This analysis shows that policies currently in place regarding the use of marketed semen in therapeutic DI do not ensure consumer safety and do not protect society's interest. Current policies need to be improved to protect those directly involved in the therapeutic DI process and to address public health and societal concerns. Recommendations include: [1] programs to assure quality and safety of marketed sperm, [2] implementation of a central registry to collect information about the use and outcomes of therapeutic DI, and [3H] expansion of available therapeutic DI guidelines to address psychological and social support for persons involved in therapeutic DI.

Data base management system for assisted reproduction

A substantial amount of data are generated from a single cycle of in vitro fertilization (IVF), gamete intrafallopian transfer (GIFT), or related techniques. Maintaining an accurate and timely record of the flow of information is complicated by provision of service to many patients concurrently, diverse origins of data, and the use of donor sperm, donor oocytes, and/or cryopreservation. We have developed a data base management system for use on a network of personal computers that takes into account the volume, intricacy, and specialized features of data generated by IVF and GIFT programs. The major products of the system are (1) compact, individual patient reports on virtually all details of each treatment cycle; (2) reports on aggregate data (e.g., monthly, quarterly, or yearly); (3) automated summaries for submission to the American Fertility Society National Registry; and (4) creation of raw data files of user-specified variables that could be used for statistical analysis.

Transmission of sexually transmitted diseases by donor semen.

Therapeutic insemination by donor (TID) is being used with increasing frequency. Because many diseases, some of which are lethal, can be transmitted through semen, the American Fertility Society established guidelines for use of donor sperm. They limit TID to cases of male infertility or hereditary/genetic disorders. Donor selection requires good health and absence of genetic abnormalities; criteria for semen including normal sperm motility, concentration, and normal morphology, and blood screening for infectious agents. Human immunodeficiency virus (HIV) testing should be performed initially in donors for fresh semen inseminations. If positive, the assay is verified with a Western blot test; if negative, the donor should be screened at 6-month intervals. Frozen samples should not be used until the 180 day reevaluation of the donor. Many studies show higher pregnancy rates using fresh rather than frozen semen samples for insemination. New methods of cryopreservation minimize the deleterious effects of freezing. If these effects, namely decreased sperm motility and impaired penetration ability, are eliminated, pregnancy rates can be expected to rise. Frozen semen is preferable because it allows time for sexually transmitted diseases to manifest themselves and for specimens from those donors to be rejected prior to use.

The Use of Donor Sperm in the Management of Male Infertility in Australia

The Use of Donor Sperm in the Management of Male Infertility in Australia

Semen Banking and Artificial Insemination by Donor in France: Social and Medical Discourse

Artificial insemination with donor semen (AID) has recently come into public view—particularly in France—because of its association with a newer technique, the cryopreservation of semen. One of the oldest and simplest of reproductive techniques, used most frequently as a means of compensating for male infertility, artificial insemination was previously confined to the private clinician's office, where maximum confidentiality could be ensured. This shielded all of the parties involved—recipients, donor, and physician—from moral reprobation and the possible legal complications arising from the use of donor sperm. However, in the mid-twentieth century, some physicians and researchers in cyrogenics came up with the idea that the freezing and stocking of donor semen in banks might greatly improve the psychological conditions and facilitate the material arrangements for performing AID. Essentially, the donor's availability would no longer have to coincide with the woman's ovulation, meaning less inconvenience for the donor, more time for screening his medical history and running the necessary tests on his semen, and possibly a certain tempering of AID's adulterous connotations. Although results with frozen semen were not as satisfactory as with fresh (the probability of a pregnancy at any cycle is almost twice as great with fresh semen), the material and psychological benefits were considered greatly to outweigh the lesser efficiency of frozen sperm.