Feasibility of an altruistic sperm donation program in Canada: results from a population-based model

Mapping Ethical, Legal, and Social Implications (ELSI) of gamete donation

RESEARCH QUESTION

This scoping review investigates the Ethical, Legal, and Social Implications (ELSI) of gamete donation, a critical facet of Assisted Reproductive Technologies, by analyzing the evolving research scope, methodological approaches, and the geographical skew in the literature. Despite the increased global uptake of donor gametes, current scholarship predominantly emanates from Western contexts and focuses on majoritized groups. This bias constrains the universality of research findings and limits their applicability across varied legal, cultural, and social contexts, underscoring a need for broader inclusivity.

DESIGN

We addressed 867 pivotal articles published between 1999 and 2019.

RESULTS

Our analysis reveals a discernible escalation in research volume, with 62% based on empirical research. The intellectual landscape unfolds into four dominant clusters: Regulatory Frameworks, Incentives, and Access; Family Dynamics and Genetic Linkages; Identity and Privacy in Donor Conception; and Cultural and Societal Attitudes towards GD. Each cluster highlights nuanced dimensions of gamete donation, from regulatory intricacies and psychological welfare to identity ethics and cultural perceptions.

CONCLUSION

Our findings advocate for a shift towards more globally representative and methodologically inclusive research. By integrating diverse cultural narratives and expanding geographical breadth, future research can offer holistic understandings of gamete donation, fostering equitable and culturally resonant practices and policies worldwide.

'Once you open that Pandora's box, you cannot close it': a qualitative study on family relationships following insemination fraud

RESEARCH QUESTION

Insemination fraud occurs when the spermatozoa intended for insemination have been intentionally swapped for another person's without the knowledge of the intended family. In what ways is this experienced by recipient parents and their offspring?

DESIGN

This was a qualitative study involving semi-structured interviews with 15 participants (seven parents and eight donor-conceived individuals) affected by insemination fraud involving the same doctor in Canada.

RESULTS

This study documents how insemination fraud is experienced by recipient parents and (their) offspring at the personal and relational levels. At the personal level, insemination fraud can induce a sense of agency loss for the recipient parents and a (temporary) sense of identity realignment for the offspring. At the relational level, it can lead to a reshuffling of genetic ties through the new genetic mapping it involves. This reshuffling can, in turn, disrupt kinship ties, leaving a deep imprint that some families struggle to overcome. Experiences differ depending on whether or not the progenitor is known, and when he is known, on whether it is another donor or the doctor himself.

CONCLUSIONS

Given the significant challenges that insemination fraud poses to the families who experience it, it is important that this practice be subjected to the medical, legal and social scrutiny it deserves.

The ethical case for non-directed postmortem sperm donation

In this article we outline and defend the concept of voluntary non-directed postmortem sperm donation. This approach offers a potential means of increasing the quantity and heterogeneity of donor sperm. This is pertinent given the present context of a donor sperm shortage in the UK. Beyond making the case that it is technically feasible for dead men to donate their sperm for use in reproduction, we argue that this is ethically permissible. The inability to access donor sperm and the suffering this causes, we argue, justifies allowing access to sperm donated after death. Moreover, it is known that individuals and couples have desires for certain sperm donor characteristics which may not be fulfilled when numbers of sperm donors are low. Enacting these preferences contributes significantly to the well-being of intended parents, so we argue that this provides a pro tanto reason for respecting them. Finally, we explore the benefits and possible disadvantages of such a system for the various parties affected.