Donor-assisted reproduction, in layman’s terms, is when a couple uses the sperm of a voluntary donor deposited in a human sperm bank (called a “sperm bank” abroad) to conceive a woman and have a child who is not genetically related to her husband. For some people, sperm donation is the only way they can have a healthy child. Male factor causes infertility in 10-20% of infertile couples. Donor sperm brings a boon to families with azoospermia in the male partner and a family history of genetic disorders in the male partner.
The Human Sperm Bank freezes and preserves the semen of voluntary sperm donors after a rigorous medical examination and screening process, and then supplies it to couples in need for the production of offspring under specific conditions that meet national regulations. Frozen sperm from a human sperm bank provides another option for reproduction. For example, the use of donor sperm provides an alternative method of eugenics for couples who are consanguineous or where the male partner has a family history of genetic disease; human sperm banks can also provide reproductive insurance for men in need (e.g., oncology patients requiring chemotherapy), etc.
However, there are also significant ethical issues associated with the use of donor sperm for the production of offspring. In order to implement human assisted reproduction technology safely, effectively and rationally, to protect the health and interests of individuals, families and offspring, and to maintain the social welfare, the following ethical principles must be followed when applying this technology.
I. The principle of benefiting sperm donors and recipients
Sperm banks in the selection of sperm donors to conduct strict screening of sperm donors, semen through quarantine before use, in order to avoid or reduce birth defects, to prevent the spread of sexually transmitted diseases and the spread.
Second, the principle of informed consent
The sperm donor should donate semen completely voluntarily, and has the right to know the use of his semen and the need to limit the number of times the semen is donated (to prevent the offspring from blood relatives intermarriage), should sign a written informed consent
Third, the principle of protecting offspring
The sperm donor has no rights and obligations to the offspring born from his donated semen. The sperm bank is obliged to provide marriage counseling services for future artificial insemination offspring with medical information under anonymous circumstances.
IV. Principles of social welfare
Establish a perfect sperm donor management mechanism, and strictly prohibit the same sperm donor from donating semen in multiple places and impregnating more than five women. Do not implement sperm screening without medical indications.
V. Principle of confidentiality
To protect the rights and interests of the offspring born to the sperm donor and recipient couple, the donor and recipient couple should remain mutually blind, the donor and the medical personnel implementing assisted human reproduction techniques should remain mutually blind, the donor and the offspring remain mutually blind. Sperm banks and medical personnel have a duty of anonymity and confidentiality to all participants (donors and recipients) using assisted human reproductive technologies. Anonymity is to conceal the identity of the donor; confidentiality is to conceal the fact that the recipient is involved in gamete donation and the confidentiality of information about the recipient; the recipient couple and the medical staff of the institution implementing assisted human reproductive technology are not entitled to access information about the true identity of the sperm donor, the sperm donor is not entitled to access all information about the identity of the recipient and the offspring.
Sixth, the principle of strict prevention of commercialization
Donation of semen is a voluntary humanitarian act, the state prohibits the donation of semen for profit. Human sperm banks can only provide frozen semen that meets the requirements of national technical specifications to institutions that have obtained the Ministry of Health’s certificate of approval for human assisted reproductive technology. Sperm from sperm banks may not be traded in the market as a commodity.
These are the basic requirements for the use of donor sperm in assisted reproduction in our country. It is imperative that we comply with them when helping patients with assisted reproduction. At present, there is no uniform understanding or regulation of artificial insemination by donor sperm worldwide, but it is indeed a complex issue.
The World Health Organization statistics in 2006 said that 60 to 80 million families worldwide are unable to have children. Also with the global tolerance of attitudes toward homosexuality and single families, the world’s demand for sperm is enormous and perhaps even unlimited. Sperm has become a lucrative product. In many countries, sperm freezing is already commercially available. In Europe, for example, sperm banking costs between 3,000 and 4,000 euros per treatment. In the United States, sperm donors are paid, and they are paid differently depending on their height profile and education level. Ben Sessler, who is tall, athletic and intelligent, has donated sperm to two clinics. Sessler completed his college law school with the income he received from donating sperm to two clinics. U.S. sperm banks not only operate in the United States, but also export overseas. Last year, U.S. sperm banking exports have reached about $100 million. One survey says the four largest U.S. sperm banks control 65 percent of the global market share and export sperm to at least 60 countries.
Sperm is bought and sold as a product, and the boom in this industry also raises many ethical, legal and medical questions. Is it possible that a biological heir, who is far away overseas, could ask the biological father who donated the sperm to acknowledge paternity and eventually be able to inherit a large portion of the biological father’s estate? When a sperm donor eventually settles down to marry and have children, will his children want to be recognized with other biological siblings? An even greater concern is that the sperm donor may inadvertently transmit genetic diseases. If a family receiving sperm overseas is not satisfied with the “product,” such as a child born with a genetic defect, what resources are available to them to address the problem and protect their rights and the rights of their child? A Texas couple is suing a New England sperm bank for their child’s cystic fibrosis (a genetic disease that attacks multiple organs and causes gradual difficulty moving and early death, but which is not included in the genetic disease screening required by U.S. federal law for sperm banks). Any new industry has its own developmental pains, but in the sperm trading industry, all problems can be lifelong.
There is also no world-wide consensus on the number of offspring produced by sperm donation. In the UK, a man who donated sperm consistently over a 30-year period produced at least 1,000 offspring. Similar ridiculous stories prompted legislation in the UK to limit the number of this offspring donated, including legitimate offspring, to no more than 10 offspring for the sperm donor. The U.S. Food and Drug Administration does not have specific regulations on the number of offspring for U.S. sperm donors, but most sperm banks limit it to between 25 and 30. However, a sperm bank does not know if a donor has “business” with another sperm bank or clinic, and there is nothing to prevent a donor from giving freely. Ben Sessler, as mentioned above, entered his donor number into the Sperm Donor Brother and Sister Registry, and he has found more than 70 offspring in the United States and around the world, plus families that are not registered, and he estimates his entire offspring count to be around 140. In some European countries, there are also private donors like Dutchman Ed Hoben. Hoben is a private sperm donor. He has donated his sperm to women who need to conceive for free for nine years and has now given birth to 82 children, with 10 more on the way, in several countries in the Netherlands, Germany, Spain, Belgium and New Zealand.
To prevent donors from having too many offspring, the UK passed a bill in 2004 requiring sperm donors to disclose their identity, and since then sperm donors have declined significantly. The situation is similar in Canada and Australia, where sperm banks are nearly depleted. In Europe, countries such as the Netherlands, Denmark, Spain and the Czech Republic do not require sperm donors to disclose information about their identity. The country protects the anonymity of sperm donors and controls the number of offspring born to each donor to no more than five by establishing a central information bank. For private donors, there is no law in Europe that regulates this. Although Ed Hoben and the women who receive the sperm donations are not yet in compliance with the law, they do not have the same rights. Hoben has a private agreement with the woman who receives the sperm, but this has no effect in the eyes of the law. If the offspring he produces through sperm donation grow up wanting to know who their father is, perhaps wanting to have a close relationship with him, or asking him for paternal love or even financial support, there is no law to protect them.
The starting point for limiting the number of offspring of sperm donors is to prevent marriages between offspring and to prevent the unethical situation of intermarriage between blood relatives. China limits the number to 5. In our large population, the chances of 5 offspring of the same father meeting and intermarrying with each other can be considered negligible.
Conditions to be met by the sperm donor.
Sperm donors must be Chinese citizens by origin and between the ages of 22 and 45. Be able to truthfully provide a general medical and genetic history of themselves and their family members, answer relevant questions from the sperm bank physician, and provide semen specimens for examination as required. Should not have systemic diseases and serious organic disorders, such as heart disease, diabetes, tuberculosis, liver disease, genitourinary system diseases, hematological system diseases, hypertension, mental illness and leprosy. There should be no long-term exposure to radiation and toxic and harmful substances, no drug addiction, alcoholism, tobacco addiction and other undesirable habits, and no history of homosexuality or sex tourism. The eyes should not be more than 500 degrees nearsighted, and the color discrimination should be free of color blindness and color weakness. The sperm bank will conduct medical examinations and semen tests on all applicants for sperm donation, and only those who pass will be allowed to donate. The human sperm bank will keep the identity of the couples who do not trace the artificial insemination of the provided semen strictly confidential.