Sperm Donation, A Practice Which Involves Certain Risks

Sperm donation, A practice which involves certain risks

Sperm donation is a practice which involves certain risks. This is highlighted by a warning received from Belgium.

A sperm donor, exhibiting a high risk of cancer

In neighbouring Belgium, the sperm from a Danish donor was used for the conception of 52 children. The male donor apparently has been found to be carrying a rare gene mutation (TP53) which predisposes the appearance of cancer. Currently, 67 children have been identified who were fathered by that same donor, all nations included. 23 of the children are carriers of the mutation and 10 have been diagnosed with cancer. The European Sperm Bank (ESB), a Danish private company which collects the sperm was established in 2004 and regularly delivers male gametes to several nations. According to the media, the scandal was revealed during a meeting of biologists in Milan, and was made public by the Belgian health minister. 37 women in Belgium are concerned by the use of his sperm, distributed by ESB between 2008 and 2017. What makes matters worse: Belgian law specifies a maximum of 6 children per donor. A safeguard which has therefore been breached.

On the ESB web site, a reassuring statement is displayed on the first page: “Every donor is subjected to a scrupulous selection process, and each application is validated individually by our medical team, consisting of clinical genetic experts. By choosing one of our donors, you are certain of the very highest quality available“. What is such an assurance really worth? The question is all the more poignant following the recent revelations. The human genome contains over 20,000 genes and it would appear illusory to be able to check everything, especially as they are not all known and since, regularly, new discoveries in genetics reveal new links between mutations and predispositions for diseases.

It is therefore quite false to claim to provide a form of “quality assurance” on the health of the children conceived by a donation.

Through this example, it is obvious that the massive “use” of the same donor for the conception of tens of children is damaging for human biodiversity and contributes to the spread of genetic predispositions which would be limited naturally in the context of births within a couple.

A long list of worrying news items

This new scandal has been added to the long and worrying list associated with this practice. The following can be mentioned:

• The scandal of mass donors in Holland,
• The mad case of the Dutch male “with a thousand children”,
• Gynaecologists using their own sperm without the knowledge of the women seeking ART (Assisted Reproductive Technology) in France.
• The same fraud is also occurring in the United States. At least 50 doctors have been accused of secretly using their own sperm for patients. Years later, a young woman in Connecticut, on the East Coast, realised that she had had a relationship with a half-brother.

The practice of sperm donation: 4 ethical questions to be considered

All this information raises a basic question: is sperm donation an ethically satisfactory practice?

Four subjects need to be considered when answering the question.

Can a regulatory framework be sustained without serious abuse?

As shown by ancient and recent examples, the establishment of a regulatory framework is not sufficient, quite the opposite.

First of all, the framework has regularly been bypassed. For instance, the maximum limit in Belgium of 6 children, or in Holland of 25 and later 12 children.

Furthermore, the existence of a framework does not prevent so-called “unofficial” practices, i.e. outside of any framework. Recently, the French police arrested a man in Lille. He was suspected to have contributed to an illicit site for sperm donations and to have “exploited the vulnerability of victims and to have received various payments through that activity”. The web site was followed by some 7,000 members. The police at the time stated that “the non-regulated donation of gametes can expose the parties concerned to multiple hazards (sanitary, consanguinity, genetics risks etc…) and improper behaviours (offences of a sexual nature)”. In the United States and in France, many social networks host exchange groups for sperm samples.

Far from being discouraged by the presence of regulations, the practice may on the contrary foster its dissemination. This effect is well known in many domains. For instance, regarding surrogate motherhood, the specialist Cécile Revel-Dumas recalled during an Alliance VITA Université de la vie: illegal practices make use of the legal regulatory frameworks.

Another more exotic example: a scientific study published in 2016 established that the legal hunting authorisation for a regulated species (wolves in two US States) increased the rate of poaching. Although that might seem counter-intuitive, the authors identified a “green light effect” associated with the authorisation provided by the regulation which established a framework.

More generally, the law has a mere dissuasive effect in defending or prohibiting a practice. It has a prescriptive side: whatever is legal is more easily considered as normal, or even moral.

How can one avoid the trafficking of sperm donations?

The French regulations are explicit and frequently recalled: The donation of gametes is free of charge and donors are not paid. Nevertheless, as shown in the recent French example, behind the “donation”, there is an entire marketing chain which sets up, through “unofficial” exchange groups as well as through the accredited sperm banks. The Cryosbank web site, on its page for potential donors displays the slogan: “Help others. Earn up to 800 euros per month”.

The ESB site explains the rates: A “MOT20+” sperm straw (i.e. containing over ten million sperm) costs 1110 euros if the donor is revealed. It is 810 euros for an anonymous donation.

In France, could the strong rise in demand for sperm straws lead to the importation of male gametes coming from private banks? In the case of Belgium, clinics have suggested that 75% of the sperm straws used are sourced in Denmark. A commercial offer is established and subsequently evolves according to the demand. In order to reassure following the scandal of the multiple-child donors, the ESB web site proposes “packs” promising “family limit options”. The site states that “The majority of our donors observe a limit of 75 families, but in certain markets (United Kingdom, Ireland, Australia and Holland), we also offer donors observing a worldwide limit of 25 families. For those who prefer an even lower family limit, we have donors who help a more limited number of families “. If you wish to limit the number of (childless) families to 15, it will cost 11,000 euros. For 5 families, it increases to 25,000 euros and for a promise of exclusivity: 39,000 euros. The mad case of the “serial donor” shows however that certain men may not keep their promise of exclusivity to a private or public sperm bank.

In an article for Elle magazine intended for women seeking a donor in the United States, the journalist noted that “buying sperm, is really like buying anything else on line”. Although France is resisting for the time being against such limitless marketing, demand and the consumerist culture, could result in a move in that direction.

Screening of donors: Yet another risk of eugenics migration?

On the ESB web site, it states that donors pass psychological and medical tests before being approved by a bank. They are also listed on a page of the web site. By supplying her email address, a woman can then “use a whole set of filters in order to find the donor exhibiting the physical characteristics required”. Women can select height, eye colour, and by paying a supplement, can hear the voice of the donor and see a photo of the donor at an adult age.

Advertisements by potential donors can promote more intellectual characteristics or a socio-professional category: “financial manager, doctor’s son, Master’s degree, comfortable income”.

In the 70s, a “Nobel prize bank” caused a scandal with its intention of proposing sperm straws reputed to come from men with a high IQ. Eugenics abuses had been denounced, in particular since one of the rare donors, Nobel Prize holder William Shockley, flaunted eugenics and racist ideas.

By proposing filters on numerous criteria, there is a risk of encouraging a dehumanising culture, which neglects the persona for the benefit of certain “sought after” characteristics (physical appearance, assumed intellectual aptitude etc).

Can it be a good thing to separate fathering and paternal responsibility?

By separating the ability for becoming the biological father and the joint responsibility, with the mother, for the education of the child, sperm donation causes a major dissociation. Much evidence has however shown the need, and the desire, of children born from sperm donation, to know their biological father. The 2021 bioethics law overturned the previous regulation by instituting systematic access to data for the children, once adult. This proves that the donor is not a mere donor, and that giving gametes is not at all the same thing as giving blood.

Moreover, natural paternity within a couple ensures in fact an effective limit which the regulations have failed to impose. Educational responsibility, with all its material, psychological and emotional implications, constitutes a safeguard against the abuse observed in practice with sperm donations, in particular genetic risks for many children, and the lack of knowledge of family antecedents.

Furthermore, sperm donation constitutes an infringement against children’s rights. Our nation – which has ratified the International Convention of Children’s Rights which establishes the right, for any child, from birth, to have a name, a nationality and, as far as possible, to know its parents and to be brought up by them – has gone back on its word. Our law, which organises in advance and deliberately, the conception of a child in a manner which eliminates the father and merely allows the child to know the “identity” of his/her father on reaching adulthood, is clearly not compliant with such right.

Conclusion

The desire for a child is a powerful incentive driving the expansion of medically assisted procreation practices. The practice of sperm donation is nevertheless not risk-free. At each scandalous revelation, the media point out the absence of control of the regulatory framework. But after decades of experience, the question remains: is it possible to establish a framework which holds? Who can check the compliance with the current regulations? Other questions need also to be considered. What information should be provided to children born from such practices? To what extent is the selection of donors acceptable? The absence of a definitive and satisfactory reply to so many questions throws a serious doubt on the very practice of sperm donation.