Sperm donor anonymity: a concept rendered obsolete by modern technology.

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Volume 109, Issue 2, Pages 230–231

Authors:

Peter G. McGovern, M.D., William D. Schlaff, M.D.

Abstract:

The use of donor sperm began as a medical practice with a level of secrecy bordering on shame. In the United States, donor sperm insemination was first performed by Dr. William Pancoast in 1884 at Thomas Jefferson Medical College in Philadelphia. The patient was never told, and it is unclear whether the husband was completely informed as to exactly what was occurring. This was done to prevent “irreparable harm” to the resultant child and the marriage. The case was not published until 1909, 25 years later.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

4 Comments

Go to the profile of Alice Ruby
Alice Ruby over 2 years ago

Thank you for raising this important issue!  As the pioneers of open-identity sperm donation, The Sperm Bank of California is always glad to see the ART community discussing these concerns.  I am writing to offer a correction to one of your citations.   The article listed in citation #5 is not from 2016.  That article and the comments about The Sperm Bank of California are actually quite outdated--the article is from 2002.  The Sperm Bank of California has not contracted any always-anonymous donors since 2014.  For the past few years all of our new donors are participating in our Identity-Release(r) Program (agreeing to release their identity to donor-conceived adults) and since 2016 we no longer offer the anonymous donor option to new families (only to parents who already have a child from an anonymous donor who wish to use the same donor for siblings).  Anyone interested in how our open-identity program is working may find more information in this article published in F&S last year: https://www.thespermbankofca.org/sites/default/files/scheibrubybenward_2017vol107pp483-493_0.pdf

Go to the profile of Joanna E. Scheib
Joanna E. Scheib over 2 years ago

Information transfer: From gamete providers and parents to DNA database members?

McGovern and Schlaff capture the growing transformation in how we think about donor anonymity in gamete donation, both in the US and internationally. Based on this change, they encourage us to consider whether we need to move to a system that makes available donor identities to donor-conceived adults. How serious need we take these issues?

The reevaluation of donor anonymity has been taking place outside the US for some time. McGovern & Schlaff cite the UK’s 2005 move to an all-open-identity donor conception system. But this move has been going on much longer. Sweden moved to all open-identity donation in 1985, followed by several other countries, both legislatively and informally (Blyth & Frith 2015). The Victorian state of Australia now has the best developed, government-implemented and supported system – VARTA – for open-identity donation (VARTA.org.au). Donor identities have been released to donor-conceived adults and their families through this system for several years now.

In 2016, Harper et al. reviewed how direct-to-consumer DNA testing means we can no longer guarantee donor anonymity. Because of the explosion of people using DNA-based tools in medicine, ancestry searches and curiosity-driven past times, growing numbers of families will have their donor and donor offspring genetic connections revealed in accidental and potentially traumatic ways. Johannes Evers, physician, researcher and ESHRE former chair, responded by publishing in Human Reproduction “Due to genetic testing donor anonymity does no longer exist” (June 2016). Similarly, Elaine Gordon packed the hall at a 2016 ASRM symposium on the need to re-think how we approach donor identifiability in her talk “The myth of anonymity: Are we misleading our patients?”  

In the US, we continue to question the benefits and feasibility of open-identity donation (Nelson et al. 2015). In Europe, influential bioethicist, Guido Pennings (2017), questioned whether child outcomes evidence could justify recommending that parents share their family’s donor origins with their children. Responses, including from those that generated the evidence (Golombok 2017), mental health professionals, policymakers, advocates, people with donor origins (Crawshaw et al. 2017) and others (Pasch et al. 2017) called for the need to re-focus the question away from sufficiency of evidence, to how to support parents, so they need never face the trauma of unintended disclosure for their families.

The time has come in the US to acknowledge that the current system of donor anonymity is no longer feasible. Further, we believe that many donor egg-IVF programs and donor agencies  have buried their heads in the sand with regard to responding to the growing requests from donor-conceived adults for information about their donors. Some sperm donation programs have taken a more varied approach with increasing options for openness. Although considerable financial investment is required, we now have 35 years of evidence from one American program that open-identity sperm donation can work (Scheib et al., 2017). We also have guidance on how to support these programs (e.g., Crawshaw et al. 2015; van den Akker et al. 2016; Visser et al. 2016).

There is now a substantial risk to all donor conception participants of being identified unexpectedly. If we, as practitioners, cannot prepare for donor identification and provide information in a manner to support all parties – parents, people conceived through donor conception, donors and the donor’s own families – those parties will go ahead without us. Control of information about one's genetic links is being transferred passively from gamete providers and parents to DNA database members, some of whom may be unprepared for what they find.
 
- Joanna E. Scheib, PhD, University of California, Davis & The Sperm Bank of California, Berkeley CA, USA
& Jean Benward, LCSW, Private Practice, San Ramon CA, USA
 
References

Blyth, E. &Frith, L. (2015). Access to genetic and biographical history in donor conception: An analysis of recent trends and future possibilities. In K. Horsey (ed.) Revisiting the Regulation of Human Fertilisation and Embryology, pp. 136-152. London: Routledge.

Crawshaw, M., Daniels, K., Adams, D., Bourne, K., van Hooff, J.A.P., Kramer, W., Pasch, L. & Thorn, P. (2015). Emerging models for facilitating contact between people genetically related through donor conception: a preliminary analysis and discussion. Reproductive Biomedicine Online 1, 71–80.

Crawshaw, M., Adams, D., Allan, S., Blyth, E., Bourne, K., Brügge, C. et al. (2017). Disclosure and donor-conceived children. Human Reproduction 32, 1535–1536.

Daniels, K. (2015). Understanding and managing relationships in donor assisted families. In K.  Fine (ed.) Donor Conception for Life: Psychoanalytic Reflections on New Ways of Conceiving the Family, pp.181-208. London: Karnac.

Evers, J.L.H. (2016) Due to genetic testing donor anonymity does no longer exist.
https://www.eshre.eu/Publications/Journals/Human-Reproduction/Editor-highlight/Previous-highlights_2016.aspx

Gordon, E. (2016). The myth of anonymity: Are we misleading our patients? American Society for Reproductive Medicine Annual Meeting, Salt Lake City, Utah.

Golombok, S. (2017). Disclosure and donor-conceived children. Human Reproduction 32, 1532–36.

Harper, J.C., Kennett, D. & Reisel, D. (2016). The end of donor anonymity: How genetic testing is
likely to drive anonymous gamete donation out of business. Human Reproduction 31, 1135-40.

McGovern, P.G. & Schlaff, W.D. (2018). Sperm donor anonymity: A concept rendered obsolete by modern technology. Fertility & Sterility 109, 230-231.

Nelson, M.K., Hertz, R. & Kramer, W. (2015). Gamete donor anonymity and limits on numbers of offspring: The views of three stakeholders. Journal of Law & the Biosciences 39–67.

Pasch, L.A., Benward, J., Scheib, J.E. & Woodward, J.T. (2017). Donor-conceived children: The view ahead. Human Reproduction 32, 1534.

Pennings, G. (2017). Disclosure of donor conception, age of disclosure and the well-being  of donor offspring. Human Reproduction 32, 969–970.

Scheib, J.E., Ruby, A. & Benward, J. (2017). Who requests their sperm donor’s identity? The first ten years of information releases to adults with open-identity donors. Fertility & Sterility 107, 483-493.

Van den Akker, O.B., Crawshaw, M.A., Blyth, E.D. & Frith, L.J. (2016). Expectations and experiences of gamete donors and donor-conceived adults searching for genetic relatives using DNA linking through a voluntary register. Human Reproduction 30, 111-121.

Visser, M., Mochtar, M.H., de Melker, A.A., van der Veen, F., Repping, S. & Gerrits, T. (2016). Psychosocial counseling of identifiable sperm donors. Human Reproduction 31, 1066-74.

Go to the profile of Jason Kovac
Jason Kovac over 2 years ago

Interesting commentary and concept.  The idea that sperm donor anonymity may be a concept that is rapidly disappearing is something that needs to be considered.

Go to the profile of Debbie Kennett
Debbie Kennett about 2 years ago

Just to add to Joanna Scheib's excellent comments, your readers might also be interested in the 2017 case report by Marilyn Crawshaw "Direct-to-consumer DNA testing: the fallout for individuals and their families unexpectedly learning of their donor conception origins".