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O'Reilly D, Bowen JM, Perampaladas K, Qureshi R, Xie F, Hughes E. Feasibility of an altruistic sperm donation program in Canada: results from a population-based model. Reprod Health 2017; 14:8. [PMID: 28088240 PMCID: PMC5237486 DOI: 10.1186/s12978-016-0275-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 12/28/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stringent donor-screening criteria and legislation prohibiting payment for donor gametes have contributed to the radical decline of donor insemination (DI) using sperm provided by Canadian men. Thus, many individuals rely on imported sperm. This paper examines the feasibility of an altruistic sperm donation (ASD) program to meet the needs of Canadians. METHODS Using Canadian census data, published literature and expert opinions, two population-based, top-down mathematical models were developed to estimate the supply and demand for donor sperm and the feasibility of an ASD program. RESULTS It was estimated that 63 donors would pass Canadian screening criteria, which would provide 1,575 donations. The demand for DI by women was 7,866 samples (4,319 same sex couples, 1,287 single women and 2,260 heterosexual couples). CONCLUSION Considerable effort would be necessary to create the required increase in awareness of the program and change in societal behaviour towards sperm donation for an ASD program to be feasible in Canada.
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Affiliation(s)
- Daria O'Reilly
- Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada, L8S 4 K1. .,Programs for Assessment of Technology in Health (PATH) Research Institute, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada, L8P 1H1.
| | - James M Bowen
- Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada, L8S 4 K1.,Programs for Assessment of Technology in Health (PATH) Research Institute, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada, L8P 1H1
| | - Kuhan Perampaladas
- Toronto Health Economics and Technology Assessment Collaborative, Leslie Dan Pharmacy Building, University of Toronto, Toronto, ON, Canada, M5S 3 M2
| | - Riaz Qureshi
- Masters of Science student of Epidemiology and Biostatistics at the University of Western Ontario, London, ON, Canada, N6A 3 K7
| | - Feng Xie
- Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada, L8S 4 K1
| | - Edward Hughes
- Department of Obstetrics & Gynecology, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada, L8N 3Z5
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Semen donors who are open to contact with their offspring: issues and implications for them and their families. Reprod Biomed Online 2012; 25:670-7. [DOI: 10.1016/j.rbmo.2012.09.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Revised: 09/13/2012] [Accepted: 09/13/2012] [Indexed: 11/19/2022]
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Abstract
Placental tissues are frequently utilized by scientists studying pregnancy and reproduction and in diverse fields including immunology, stem cell research, genetics, cancer research, and tissue engineering, as well as by clinicians in many therapies. Though the utilization of the human placenta in science and medicine has benefitted many people, little is known about public perspectives of this phenomenon. This review addresses placental donation, collection, and utilization in science and medicine, focusing on public perspectives. Cultural values and traditions, ethical paradigms and concerns, public understandings of science and medicine, and political considerations may impact perceptions of the utilization of the placenta in science and medicine, but systematic study is lacking. It is argued that knowledge of public views gained from empirical investigation may underpin the development of collection protocols and research projects that are more responsive to public will, spur more extensive utilization in science and medicine of this unique organ, and/or aid in the realization of the mobilization of knowledge about the placenta for clinical and educational ends. New avenues for research on public perspectives of the placenta are proposed.
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Hudson N, Culley L, Rapport F, Johnson M, Bharadwaj A. "Public" perceptions of gamete donation: a research review. PUBLIC UNDERSTANDING OF SCIENCE (BRISTOL, ENGLAND) 2009; 18:61-77. [PMID: 19579535 DOI: 10.1177/0963662507078396] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This paper reviews the literature on "public" perceptions of the practice of gamete (egg and sperm) donation in the treatment of infertility. Despite regular "consultation" exercises in the UK on the manner in which infertility treatments should be regulated, there is little sense of how a range of public groups respond to developments in this area. The key themes from thirty-three articles, chapters and reports are discussed. The review reveals the limited nature of our current knowledge of public understandings of and attitudes towards gamete donation as a form of infertility treatment which has been readily available and widely practiced for many years. The review is critical of the methodological and epistemological basis of much of the work in this area and argues that there is a strong case for social scientific research to attempt to capture the perceptions of a wider range of people who are rarely included in formal public consultations and often similarly excluded from research studies.
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Affiliation(s)
- Nicky Hudson
- School of Applied Social Sciences, De Montfort University, Leicester, UK.
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Onah HE, Agbata TA, Obi SN. Attitude to sperm donation among medical students in Enugu, South-eastern Nigeria. J OBSTET GYNAECOL 2008; 28:96-9. [PMID: 18259910 DOI: 10.1080/01443610701811928] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study investigated the knowledge, attitude and practices of a sample of Nigerian medical students towards sperm donation. It was a self-administered semi-structured questionnaire survey of fifth and final year medical students of the College of Medicine, University of Nigeria, Enugu campus, South-eastern Nigeria. Out of 205 eligible medical students in both classes, 180 (87.8%) responded. There were 99 male and 81 female respondents. Their ages ranged from 20 to 30 years with a mean of 24.0 +/- 2.0 years. All the participants were Christians. A total of 177 (98.3%) of the respondents were aware of the practice of sperm donation for the treatment of infertility, while three students had never heard of it. A total of 15 (15.2%) of the male respondents reported their willingness to donate their sperm for infertile couples. The main motivation for wanting to donate sperm was a desire to help infertile couples. A total of 24 (30%) of the female respondents were willing to accept donor semen should the need arise. The leading factors which discouraged the male respondents from donating semen were that the practice was either against their religious belief (41.7%) or in their opinion, was morally wrong (22.6%). Some 10.7% were afraid of a possible adverse effect on future fertility, while 9.5% were afraid of being screened for sexually transmitted infections; 20 (35%) of the female respondents would not accept donor semen because of the psychological and emotional effects of having to bring up a child that is not their husband's; 13 (23%) said it was against their religious faith, while 10 (18%) believed that adopting a child was better than accepting donor semen. Eight (14%) were afraid of contracting HIV infection through donor semen, while six (11%) declined because they would not want the paternity of their child to be questioned later. With respect to the participants' views on identity disclosure, 35 (90%) of the 39 respondents willing to donate or accept sperm objected to their identities being disclosed to the recipient couples or the donor, while four (10%) did not mind. It was concluded that, despite the high level of awareness of sperm donation among medical students in Enugu, the majority of them were unfavourably disposed to it and none had ever practiced it. Public enlightenment through the mass media and correction of false notions about infertility treatment will go a long way in addressing this problem.
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Affiliation(s)
- H E Onah
- Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, Nigeria
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Paul S, Harbottle S, Stewart JA. Recruitment of sperm donors: the Newcastle-upon-Tyne experience 1994–2003. Hum Reprod 2005; 21:150-8. [PMID: 16284065 DOI: 10.1093/humrep/dei354] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The demand for sperm donors has continued despite the introduction of ICSI. This study was undertaken in the light of impending changes in donor anonymity laws to evaluate the recruitment process of sperm donors. METHODS Retrospective analysis of 1101 potential sperm donors in a tertiary referral centre between January 1994 and August 2003. The main outcome measures were to determine the demographic details, recruitment rate and reasons for rejection of donors. RESULTS The majority of the applicants were aged <36 years (88.07%), students (54.88%), without a partner (53.47%), unmarried (85.38%) and without proven fecundity (78.67%). Only 3.63% of the applicants were released as donors, 30.79% defaulted, whilst 64.48% were rejected. The most common reason for rejection was suboptimal semen quality (85.07%). Over the years, the numbers of the applicants and released donors have declined significantly. The overall clinical pregnancy rate from donor sperm during this period was 23.52%. CONCLUSIONS In this successful anonymous sperm donor programme only a small proportion of the applicants are released as donors. The significant decline in released sperm donors coupled with the potential effects of loss of donor anonymity means that new strategies for sperm donor recruitment are urgently required.
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Affiliation(s)
- S Paul
- Newcastle Fertility Centre at Life, Bioscience Centre, International Centre for Life, Times Square, Newcastle-upon-Tyne NE1 4EP, UK
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Kirkman M. Saviours and satyrs: ambivalence in narrative meanings of sperm provision. CULTURE, HEALTH & SEXUALITY 2004; 6:319-334. [PMID: 21972905 DOI: 10.1080/13691050310001645041] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This paper reports on the complex representations of sperm providers in the narratives of donors, recipients and offspring involved in donor-assisted conception. Eighty-seven volunteers from Australia, Canada, UK, USA and Argentina participated in qualitative narrative research. Sperm provision was perceived to be publicly represented as sexualized, provoking both disgust and hilarity; this is interpreted as arising from its association with masturbation and the metaphorical representation of the donor sperm as cuckolding the recipient's husband. Recipients' representations of providers were found to mix gratitude with resentment, embarrassment, and anxiety; their constructions are strongly influenced by the position of the social father. The complex representation of the provider as a genetic father is considered: providers can be seen as threatening the integrity of parents if they become involved in the life of their offspring and abandoning their offspring to confusion and despair if they do not. The research demonstrates that, in spite of its relative frequency and familiarity, donor insemination is still represented ambivalently, including by those who may be said to benefit from it.
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Abstract
The interests of gamete donors have only recently been recognized in assisted reproduction; traditionally, the interests of the patients (typically a couple) and the prospective child are paramount. However, assisted reproduction would not be possible without donors, and the simple utilitarian view would be to place their interests first to maximize the availability of the practice. There are several ethical issues on both sides of the donor--recipient equation, some of which are mutual and others are in conflict. For example, the word 'donation' implies there is no payment. Informed consent for donation is essential if the autonomy of the donor is to be respected, and includes information about the results of screening. This is a sensitive issue, especially when pathology is found in a donor who is not being screened for his or her own immediate benefit. Counselling may result in donors refusing to take part, but may also lead to selection by the person recruiting the donors, sometimes as a consequence of examining the motivation of the donor. In this case, the main problem is the ethical basis of the selection process. Other aspects of gamete donation may lead to a conflict of interests between the donor, the recipients and even the prospective child, particularly in terms of anonymity and the information that is made available about the specific circumstances of donation. Implications and support counselling are essential tools in achieving an acceptable balance for all parties involved.
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Affiliation(s)
- Francoise Shenfield
- Reproductive Medicine Unit, University College Hospital, Huntley Street, London WCI 6AU, UK
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Abstract
Donor insemination (DI) is the oldest and simplest method of "treating" male infertility. The medical profession, prospective parents, legislators, and society in general are increasingly recognizing that providing DI services involves far more than facilitation of conception. This paper explores a multidisciplinary family-building approach to DI as an alternative to a treatment-of-infertility approach, and describes the need to provide patients with a broader and deeper preparation for this special type of parenthood. The short-term medical ease of the procedure is contrasted with the complexity and seriousness of the long-term social and psychological issues generated for the gamete provider, the recipient couple, and the offspring by the secrecy surrounding the procedure.
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MESH Headings
- Adaptation, Psychological
- Attitude of Health Personnel
- Attitude to Health
- Communication
- Confidentiality/legislation & jurisprudence
- Family/psychology
- Female
- Health Knowledge, Attitudes, Practice
- Humans
- Infertility, Male/psychology
- Infertility, Male/therapy
- Insemination, Artificial, Heterologous/legislation & jurisprudence
- Insemination, Artificial, Heterologous/psychology
- Male
- Parents/education
- Parents/psychology
- Patient Care Team/organization & administration
- Philosophy, Medical
- Semen
- Shame
- Tissue Donors/education
- Tissue Donors/legislation & jurisprudence
- Tissue Donors/psychology
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Guido P. The reduction of sperm donor candidates due to the abolition of the anonymity rule: analysis of an argument. J Assist Reprod Genet 2001; 18:617-22. [PMID: 11804432 PMCID: PMC3455698 DOI: 10.1023/a:1013169207315] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- P Guido
- Department of Philosophy, Free University Brussels, Belgium.
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11
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Abstract
The authors report on a comparative questionnaire study of semen donors at two London clinics offering donor insemination (DI). Results presented here include donors' attitudes towards the storage of identifying information on the UK Human Fertilisation and Embryology Authority's central register, the importance of anonymity when donating, feelings about being traced by DI offspring, and views on the release of identifying donor information to mature offspring. Donors from the two clinics were found to differ on some, although not all, of the above points; in particular, donors from one clinic offered more support for the eventual release of identifying information to DI offspring. The discussion brings in the results of other studies and highlights the complexity of the anonymity question. The authors conclude that some donors may be willing to move towards greater openness of information under controlled conditions using the existing central register and a "veto" system.
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Affiliation(s)
- K R Daniels
- Department of Social Work, University of Canterbury, Christchurch, New Zealand
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Gillett WR, Daniels KR, Herbison GP. Feelings of couples who have had a child by donor insemination: the degree of congruence. J Psychosom Obstet Gynaecol 1996; 17:135-42. [PMID: 8892159 DOI: 10.3109/01674829609025674] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The study aimed to assess the congruence of feelings about donor insemination (DI) in couples who have had a child by this means. Male and female partners of 50 couples (in continuing relationships) who had had a child by DI individually completed a questionnaire. A Likert scale (0, very unhappy to 7, very happy) was used to assess feelings before, during and after treatment, and the perception of their partner's feelings. Individual partner's responses were also compared for views about the donor and assessment of their relationship. For both males and females, their feelings about DI before, during and after treatment did not correlate with their perceived view of their partner's feelings. This difference was much more striking before treatment started with male feelings (mean +/- SD) being 4.1 +/- 1.8 compared to the females' perception of the males' feelings of 3.5 +/- 1.9 (t test, p = 0.004) and females' feelings of 3.7 +/- 2.0 compared to the males' perception of female feelings of 4.3 +/- 2.0 (p = 0.05). In comparing attitudes about the donor, individual couples' views did not correlate well, the exceptions being their views on whether or not to have another child and whether they wanted the same donor. All but one couple agreed that the DI child had brought them closer together as well as agreeing that they confided in each other. The marital interaction assessment showed close compatibility in most issues. The impact of DI on couples affected by male factor infertility raises many issues, the views of which may not be shared between partners. This is especially the case of attitudes about the donor and is of some concern when viewed in the wider context of marital and parent-child relationships. It is not known whether these opposing views have an impact on the later development of these relationships but they should be considered as part of the preparation for beginning treatment.
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Affiliation(s)
- W R Gillett
- Department of Obstetrics and Gynecology, University of Otago, Dunedin, New Zealand
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Abstract
The authors examine the implications for individuals and society of how semen is provided for use in donor insemination treatment. In particular, they focus on whether 'donors' make a gift of their semen or are paid. The role of health professionals in shaping the nature and meaning of semen provision is also explored. The currently predominant practice of buying semen is compared with other reproductive and biomedical exchanges: oocyte and embryo donation, surrogacy, and blood, organ and fetal tissue donation. The authors suggest that the commercialisation of semen determines and reflects the type of men frequently recruited to provide semen. This in turn influences the meaning that donors themselves, recipients, offspring, health professionals and society at large attribute to the provision of semen.
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MESH Headings
- Age Distribution
- Altruism
- Bioethics
- Commerce
- Confidentiality
- Ethics, Medical
- Family/psychology
- Female
- Humans
- Infertility, Male/ethnology
- Infertility, Male/psychology
- Insemination, Artificial, Heterologous/economics
- Insemination, Artificial, Heterologous/methods
- Insemination, Artificial, Heterologous/psychology
- Living Donors/psychology
- Male
- Motivation
- Parent-Child Relations
- Physician's Role
- Reimbursement Mechanisms
- Selection, Genetic
- Self Disclosure
- Semen
- Social Perception
- Truth Disclosure
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Affiliation(s)
- K R Daniels
- Department of Social Work, University of Canterbury, Christchurch, New Zealand
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Daniels K, Lewis GM. Openness of information in the use of donor gametes: Developments in New Zealand. J Reprod Infant Psychol 1996. [DOI: 10.1080/02646839608405859] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Applegarth L, Goldberg NC, Cholst I, McGoff N, Fantini D, Zellers N, Black A, Rosenwaks Z. Families created through ovum donation: a preliminary investigation of obstetrical outcome and psychosocial adjustment. J Assist Reprod Genet 1995; 12:574-80. [PMID: 8580652 DOI: 10.1007/bf02212577] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
PURPOSE This study attempted to obtain preliminary follow-up information regarding obstetrical outcomes and the psychosocial well-being of families created through the ovum donation. There is presently very little known about this population with respect to obstetrical care, health status of offspring, family and marital relationships of recipient couples, or how couples feel about having chosen ovum donation as a family-building option. RESULTS Fifty-nine couples were initially surveyed and, ultimately, extensive information was obtained for 30 husbands, 31 wives, and 51 offspring. There was a very high percentage of cesarean section deliveries (81.6%), and although a few children experienced health problems at birth, they are all now in good health and developmental milestones are within normal limits. Information was also obtained about breast-feeding experiences, choice of donor (known [sister] or anonymous), reasons for choosing ovum donation over other parenting options, and the impact of this choice on marital and family relationships. Demographic data were also obtained. CONCLUSIONS For many infertile couples, the long struggle to become parents culminated in a successful birth, and the experience of pregnancy seemed to meet a need to be both biological and psychosocial parents. In general, subjects were extremely cooperative with the investigation and they indicated a desire to learn as much as possible about the psychosocial status of families created through ovum donation. As the assisted reproductive technologies move rapidly into the 21st century, it now seems imperative that health and mental health professionals gain more knowledge about the impact of third party reproduction and the psychosocial adjustment and well-being of families created by this medical technology.
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Affiliation(s)
- L Applegarth
- Center for Reproductive Medicine and Infertility, Cornell University Medical College, New York, New York 10021, USA
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