The social and ethical challenges of sperm banking
International conference, Changsha, 5 May 2012
In both China and Europe, male infertility is reportedly on the rise. Growing numbers of involuntarily childless couples are therefore faced with having to decide whether they will opt to live without children, adopt or seek a sperm donor. In China alone, an estimated 2.5 million couples are in this situation. Moreover, in some European countries, donor insemination has been legalised for single and lesbian women giving rise to ‘fertility tourism’ between European countries. And finally, over the last decade, many European countries have prohibited anonymous donation of sperm. As a result, sperm banks in China and Europe as a whole are facing a shortage of sperm donors, as insufficient numbers of donors are being recruited to meet growing demand.
In May 2012, an international conference will be held in Changsha with the aim of exchanging ideas and research between China and Denmark on the social and ethical challenges of sperm banking. The conference will bring together an interdisciplinary group – including clinicians, nurses, life scientists, administrators, social scientists, ethicists and lawyers – of speakers and attendees from China and Europe.
Key issues to be discussed include:
Recruitment – altruism and compensation
In China and Europe, commercialisation of sperm donation is prohibited. However, most countries do allow for compensation of donors. This has raised a debate about whether donors are motivated by altruism or financial interests with some arguing that financial compensation may lead some donor candidates to withhold important information about their medical history. Is there a balance between altruism and compensation?
In the last decade, a number of European countries have prohibited donor anonymity on the grounds that a child has the right to know his or her biological heritage and medical history. Other countries, such as Denmark and China, allow anonymous donation as a way to respect the privacy of recipient couples and donors. What are some of the challenges raised by donor anonymity?
Recruitment of donors requires a comprehensive screening of potential candidates involving sperm quality analysis, physical examinations, blood tests, chromosome analyses, (in some cases) genetic tests and psychological evaluations. As a result, only a small percentage of candidates become qualified donors with implications for the self-esteem and mental well-being of candidates who are disqualified. At the same time, donor candidates with serious conditions (e.g. azospermia, HIV, hepatitis or chromosome abnormalities) may be discovered. What are the ethical and social challenges of such comprehensive screening, for example, when groups of friends or classmates visit a sperm bank together? How should counselling for candidates with a serious illness be organised?
In Europe and China, regulators have set a limit on the number of children that can be conceived using a single sperm donor in order to reduce the risk of inadvertent consanguineous marriage. At the same time, many donors indicate that they are nervous about the risk that their own offspring might inadvertently meet a donor offspring. How can consanguinity risks be effectively addressed?
AID counselling – secrecy and confidentiality
Male infertility (like female infertility) can pose a grave psychological burden for involuntarily childless couples. Some couples may insist on absolute confidentiality and secrecy and may never inform their donor-conceived child of his or her origin. On the other hand, following prohibition of anonymous donors in many European countries, children in these countries now have a right to know about their genetic origin. This raises a number of ethical and social challenges concerning psychological burdens for couples, their donor-conceived offspring and donors.
In China, only married couples can receive donor sperm in the treatment of male infertility or as a way to prevent transmission of a serious genetic disease. In some European countries, donor insemination is allowed for lesbian and single women. What are some of the social and ethical challenges surrounding legal determination of who should qualify as recipients of donor sperm?
For patients about to undergo chemotherapy and other forms of radiation treatment, reproductive insurance can be a way to insure their reproductive possibilities in the future. Moreover, some individuals may be interested in storing gametes at a young age if they will be working in a field where occupational hazards can impact on semen quality. In which situations is it appropriate to offer reproductive insurance?
Posthumous retrieval and use of sperm
With the growing availability of sperm banking, an increasing number of cases involving requests for posthumous retrieval and/or use of sperm are emerging. In which circumstances should this be allowed?
The conference is being organised by The Department of Anthropology, University of Copenhagen & the CITIC-Xiangya Reproductive and Genetic Hospital, Changsha