Maximum number of live births per donor in artificial insemination

Understanding the Reasons Why Men and Women Do Not Donate Gametes

The global under-supply of sperm and oocyte donors is a serious concern for assisted reproductive medicine. Research has explored self-selected populations of gamete donors and their ex-post rationalisations of why they chose to donate. However, such studies may not provide the necessary insight into why the majority of people do not donate. Utilising the unique open form responses of a large sample (n = 1035) of online survey respondents, we examine the reasons participants cite when asked: “Why haven’t you donated your sperm/eggs?.” We categorise these responses into four core themes (conditional willingness, barriers, unconsidered, and conscientious objector) and eleven lower-order themes. We find that, on average, women are more conditionally willing (8.2% difference; p = 0.008) to participate in gamete donation than men. We also find that women are more likely than men to justify their non-donation based on their reproductive history (21.3% difference; p = 0.000) or kin selection and inclusive fitness (5.7% difference; p = 0.008). However, compared to women, men are more likely to validate their non-donation based on sociocultural or social norms (6% difference; p = 0.000) or religion (1.7% difference; p = 0.030). That so many of our study participants report in-principal willingness for future participation in gamete donation speaks to the need for increased research on understanding non-donor population preferences, motivations, and behaviours.

Maximum number of children per sperm donor based on false paternity rate

PURPOSE

The aim of this study is to estimate the weight of each relevant factor in such unions of inadvertent consanguinity and to determine a "reasonable" limit for the number of children per donor, matching the probability of inadvertent consanguinity arising from the use of sperm donor in assisted reproduction with that of such a union arising from false paternity.

METHODS

In this study, we applied to Spanish data a mathematical model of consanguineous unions, taking into account the following factors: maximum number of live births/donor, fertility rate, average number of births per donor in a pregnancy, donor success rate, matings per phenotype, number of newborns/year, and number of donors needed in the population/year and births by false paternity.

RESULTS

In Spain, the number of inadvertent unions between descendants of the same donor in Spain has been estimated at 0.4/year (one every two and a half years), although this frequency decreases as the reference population increases. On the other hand, the frequency of unions between family members due to false paternity has been estimated at 6.1/year. Thus, only 6% of such unions are due to the use of donor sperm.

CONCLUSION

A total of 25 children per sperm donor are needed to align the probability of inadvertant consanguinity arising from the use of assisted reproduction with that due to false paternity. Therefore, we consider this number to be the maximum "reasonable" number of children born per donor in Spain.

Sperm donor limits that control for the 'relative' risk associated with the use of open-identity donors

The majority of countries that support the use of donor insemination (DI) in artificial reproductive technology (ART) limit the number of children born from one donor. The setting of these donor limits, though intended to control for the risk of inadvertent half-sibling unions between the offspring of anonymous donors, actually have no evidence base. Controlling for the risk of inadvertent half-sibling unions may soon become unnecessary due to the increasing world-wide use of open-identity sperm donors and the revocation of donor anonymity in many countries. With the shift from anonymous to open-identity donation, the central issue is not the risk of genetic abnormality from inadvertent half-sibling consanguinity; it is the psycho-social impact of the multiple use of open-identity sperm donors. Despite this, the jurisdictions that allow or mandate the use of open-identity donors continue to observe existing limits that do not consider nor specifically control for the psycho-social impact of the multiple use of open-identity sperm donors. It is proposed that: (i) conservative interim donor limits be placed on the multiple use of open-identity donors, while research into the psycho-social impact of disclosure is undertaken to inform the establishment of evidence-based limits; and (ii) the existing limits in jurisdictions where anonymity is still commonly practiced or protected could be raised, if an updated mathematical model was used for calculating evidence-based anonymous donor limits.

A review of mathematical models used to determine sperm donor limits for infertility treatment

OBJECTIVE

To review mathematical models used to determine sperm donor limits for infertility treatment and to consider the need to develop a new, internationally recognized and applicable model for calculating limits.

DESIGN

Literature review.

SETTING

Models for determining sperm donor limits were identified through bibliographic databases.

PATIENT(S)

Published models.

INTERVENTION(S)

Variables used in the models were defined, evaluated, and assessed for relevancy and applicability.

MAIN OUTCOME MEASURE(S)

Relevance and applicability of model variables used to predict the number of consanguineous matings, probability of unwitting sibling mating and contribution to F (coefficient of inbreeding).

RESULT(S)

Models found to be outdated and inadequate for the present-day.

CONCLUSION(S)

Many countries have introduced limits to the number of offspring each anonymous sperm donor can father but these limits vary considerably. Published models for calculating sperm donor limits are in need of improvement and it is recommended that an enhanced, internationally applicable formula be developed for calculating acceptable limits. Moreover, it is recommended that further research be undertaken into the social and familial consequences of the revocation of sperm donor anonymity and the implications for the setting of sperm donor limits.

Donor insemination and infertility: what general urologists need to know

Therapeutic donor insemination (TDI), also known as artificial insemination by donor, is one of the oldest forms of male infertility treatment. With the advent of assisted reproductive technologies and in vitro fertilization techniques over the past few decades, the use of TDI in male infertility treatment has decreased dramatically. Knowledge of its use, indications, efficacy, and related psychosocial issues has also declined among urologists treating male infertility. Despite the change in popularity of the procedure, though, TDI remains an appropriate therapeutic option for certain cases of male infertility, particularly in patients who have failed multiple cycles of in vitro fertilization/intracytoplasmic sperm injection or in men with no available sperm even after attempted microdissection testicular sperm extraction. Further consideration and research should be focused on the potential uses and indications for TDI.