Opinion 2.05 - Artificial Insemination by Anonymous Donor
Thorough medical histories must be taken of all candidates for anonymous semen donation. All potential donors must also be screened for infectious or inheritable diseases which could adversely affect the recipient or the resultant child. Frozen semen should be used for artificial insemination because it enables the donor to be tested for communicable disease agents and diseases at the time of donation, and again after an interval before the original semen is used, thus increasing the likelihood that the semen is free of blood-borne pathogens. Physicians should rely on the guidelines formulated by relevant professional organizations, such as the American Society of Reproductive Medicine, the Centers for Disease Control and Prevention, and the Food and Drug Administration, in determining which disorders to screen for and which procedures to use in screening. Physicians should maintain a permanent record which includes both identifying and non-identifying health and genetic screening information. Other than exceptional situations where identifying information may be required, physicians should release only non-identifying health-related information in order to preserve the confidentiality of the semen donor.
Physicians should maintain permanent records of donors to fulfill the following obligations: (1) to exclude individuals from the donor pool who test positive for infectious or inheritable diseases, (2) to limit the number of pregnancies resulting from a single donor source so as to avoid future consanguineous marriages or reproduction, (3) to notify donors of screening results which indicate the presence of an infectious or inheritable disease, and (4) to notify donors if a child born through artificial insemination has a disorder which may have been transmitted by the donor.
Informed consent for artificial insemination should include disclosure of risks, benefits, likely success rate of the method proposed and potential alternative methods, and costs. Both recipients and donors should be informed of the reasons for screening and confidentiality. They should also know the extent of access to non-identifying and identifying information about the donor. Participants should be advised to consider the legal ramifications, if any, of artificial insemination by anonymous donor.
The consent of the husband is ethically appropriate if he is to become the legal father of the resultant child from artificial insemination by anonymous donor. Anonymous donors cannot assume the rights or responsibilities of parenthood for children born through therapeutic donor insemination, nor should they be required to assume them.
In the case of single women or women who are part of a homosexual couple, it is not unethical to provide artificial insemination as a reproductive option.
Sex selection of sperm for the purposes of avoiding a sex-linked inheritable disease is appropriate. However, physicians should not participate in sex selection of sperm for reasons of gender preference. Physicians should encourage a prospective parent or parents to consider the value of both sexes.
In general, it is inappropriate to offer compensation to donors to encourage donation over and above reimbursement for time and actual expenses. (I, V)