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With the rise of reproductive and genetic technologies, the world has increased the number of options people have when it comes to having children.  Technology has enhanced the power of choice.  What technology has not done is enable culture to live with the consequences.  This last point is perhaps most acute in the area of the use of donor sperm.  Let me explain.

• First of all, there is the problem of using the same donor sperm for multiple conceptions.  Further, in using the same donor sperm in this manner, the donor is always anonymous and the children conceived using this sperm do not know who their father is.  Hence, our culture now faces the sociological phenomenon known as half-siblings; in this case referring to multiple children conceived using the same donor sperm.  Using a web-based registry, it is now possible to track children conceived using the same donor sperm.  One woman, living in a lesbian relationship and who had a child seven years ago using donor sperm, has tracked the number of half-siblings related to her son.  That number is now a staggering 150 half-siblings related to her son!  Half-sibling groups are now forming and they chat online, interact on Facebook and even get together in large groups to get to know one another.  But there are growing concerns about using the same donor sperm to father so many children.  Medical specialists are concerned about the potential of spreading the genes of rare diseases more widely through the population.  In recent years, sperm with a host of serious diseases and disorders has been sold to hundreds of women, according to medical journals and other published reports.  Further, it is quite conceivable that children of the same father (via donor sperm) could fall in love and get married.  Such a union, unbeknownst to the man and woman, could actually be an incestuous union, with all the resulting biological consequences for the children of such a union.  For these reasons, many are calling for more intense scrutiny and regulation of the fertility clinics that promote the use of donor sperm.  [Among the industrialized nations on earth, the US does not have any regulation of this industry.]  This is a very lucrative business and in the US there are really more regulatory rules for buying a used car than buying donor sperm.  Should there be greater insistence on accurate information provided to the mother and eventually to the children conceived using the same sperm?  Should there be an imposed limit on the number of children that can be conceived using the same donor sperm?  For the most part, this is an unregulated industry and we are beginning to see the unintended consequences of this reproductive option.  The stunning reality is that no one knows how many children are conceived each year in the US using donor sperm.  Most estimates range from 30,000 to 60,000; but no one really knows.  Mothers of donor children are asked to report the birth of their donor child but only between 20 to 40% do so each year.  In the 1980s the United Kingdom commissioned a report to analyze and give counsel on all issues dealing with the use of donor sperm.  Called the Warnock Report, the report proposed regulation of human sperm and embryos use and sale and proposed strict limits on the number of children a donor could father (10 per donor).  The UK adopted many of the suggestions from the Warnock Report.  With the growing reality that fertility clinics are, in effect, permitting hundreds of children to be fathered by the same donor sperm and that unintended incest is a real possibility, regulation of this industry seems wise and necessary.  There is one further unintended consequence of the use of the same donor sperm to father so many children:  When children realize that they may have dozens or perhaps even a hundred half-siblings, many will want to make connections with their half-brothers and ?sisters.  Are they then a family?  What are the psychological and emotional consequences for such children?  We have never faced anything like this in the history of humanity.  We are truly in unchartered waters as a civilization.  It certainly illustrates the unintended consequences of empowering human beings to take almost complete control of reproduction.  Is such manipulation of the reproductive process a positive development?  My intuition tells me this is not necessarily a positive advance for the human race.

• Second, to deal with the huge costs of using donor sperm at a fertility clinic (often $2,000 per donor sperm injection), couples and single individuals are using free sperm donor search engines to contact men who are willing to give their sperm free to prospective mothers.  [In the US, for example, a college student can make $12,000 per year from American sperm banks for twice weekly anonymous sperm donations.]  Typically, this option of using free sperm permits careful vetting by the mother, including using questionnaires, doing interviews, reference checks and STD checks.  But this market for free sperm raises other important questions:  What if the donor sues for custody?  What if he lies about an STD or other medical condition?  What is the real motive of someone who donates sperm freely?  Only altruism?  This we know:  There is now a growing population?gay, straight, single and married? using this option.  These non-clinic options now available include six Yahoo groups, three Google sites and about a dozen fee-based websites dedicated to providing free or inexpensive donor sperm.  Most of them are in the UK, Canada and Australia, and have developed because of the tight regulations now present in these nations.  In the US, the Food and Drug Administration is only now beginning to express interest in overseeing and regulating this growing practice.

But our culture no longer has an ethical foundation for evaluating these practices.  For example, is it ethically valid to permit a widespread industry?via fertility clinics and the ?free? options?where sperm are donated by men who must use masturbation, often accompanied by pornography to maximize the ?sexual? experience?  Is it ethically valid to permit widespread use of artificial insemination using donor sperm for women who desire children?  Is it ethically valid for single mothers to use this process?  Is it ethically valid for lesbian couples to use this process?  Is it ethically valid for married couples to use this process?  As a culture, we have never had this ethical discussion.  Instead, our culture has gone full speed ahead into the ethical morass of reproductive and genetic technologies.  In this area of technology, there is no ethical compass guiding our civilization.  Instead, we have bought the pragmatic approach that if we can do something we must do it.  We are now facing the consequences.  Ethical questions are now catching up with technology?and it may be too late to frame the ethical guidelines to prevent further tragedy and destructive consequences.

See Tony Dokoupil in Newsweek (4 October 2011) and Jacqueline Mroz in the New York Times (6 September 2011). PRINT PDF