Health Tips

Ethics involving gamete donation

Image Credit: Netflix “Our Father” 

If you have watched “Our Father” documentary on Netflix based on a true story, it shows the unethical practice of a top fertility Indiana-based doctor inseminating multiple women using his own sperm during the In Vitro Fertilization (IVF) process. As if in a horror movie, there were at least 94 half siblings (or more?!) living in the same area, unaware that they were genetically linked to the same parent. It certainly was a shock and traumatizing experience for the parents, especially the children themselves. This case was a serious breach of trust and medical sexual assault, but the doctor was never really punished for his crimes as there was no law or legislation about fertility fraud at the time.  

This was not the only controversial case. In Austin, Texas, a woman unexpectedly discovered the truth about her biological father via an online ancestry DNA test. She realized that she was not conceived by the sperm donor chosen by her parents, but by her mother’s fertility doctor. You can watch the full story here. In both cases mentioned above, the ethical issues are concerning the donation of sperm or egg donations in IVF.

Introduction to gametes donation

Image credit: The Independent 

Gamtes donation is using someone else’s eggs or sperm to help an intended parent to conceive a child. The word “intended parent” refers to the person(s) who will raise the child. The donors may be someone close to the intended parent, introduced through a fertility clinic or donor agency or they can choose to remain anonymous. Counseling, screening and evaluation methods for sperm, egg and embryo are all different. 
 

You may wonder, why do some people require gametes donation? 

This is usually due to one or both partners unable to produce their own sperm or eggs. Causes are due to medical issues including lacking or poor quality eggs or sperms, high risk of passing down genetic diseases to offspring or social reasons such as single male or female or same-sex couples. Thus, egg or sperm donation provides an opportunity for the intended parent to have a biological link to the child via pregnancy. On the other hand, there is no genetic link for embryo donation, but the intended parent will be able to experience pregnancy and childbirth. 

Potential Unintended Consanguineous Marriage 

What does the term “consanguinity'' mean? 

Consanguinity is when 2 or more people are related to the same blood or origin. Intra-family weddings, also known as consanguineous marriage may still be commonly practiced in some ethnicities or communities. Possible reasons for consanguineous marriage in these communities may be to minimize the risk of health and financial concerns, strengthen family ties and solidarity, and maintain cultural values within the family.  

Why is Consanguineous marriage shunned in society? 

As shown in the “Our Father” documentary on Netflix, there may be a high chance that unintended consanguineous marriages have occurred. As inbreeding among genetically related persons may occur, there is a high risk of birth defects and abnormalities in offspring. For example, studies have shown that the risk of stillbirth, infant mortality rates, birth defects frequency and autosomal recessive disorder increases as a result of consanguineous marriages. The probability of offspring receiving one or more harmful recessive genes is greater if the biological relationship between parents is closely related. For instance, an Emirates woman revealed that due to consanguineous marriage, her family had many health issues including diabetes, thalassemia and heart attack. What’s more, consanguinity has been linked to mental health issues such as generalized anxiety disorder, social phobia, impulse control disorder, specific phobia, bipolar disorder, major depression, separation anxiety disorders, schizophrenia, and personality disorders. 

Several factors must be considered in terms of ethics of gamete donation:

*The above sections clarify the rights of the various parties involved in sperm donation and their controversial concerns. These rights were evolved through medical ethics and informed consent principles, and they are not strictly mandated by legislation.  

Reference

1. What are the Ethical Considerations for Sperm Donation?- Stanford; 2022. Accessed June 14, 2022. http://web.stanford.edu/class/siw198q/websites/reprotech/New%20Ways%20of%20Making%20Babies/spermeth.htm 

2. Is Our Father on Netflix based on a true story? -Mads Lennon. Accessed June 14, 2022. https://netflixlife.com/2022/05/23/is-our-father-netflix-based-on-a-true-story/#:~:text=Unfortunately%2C%20Our%20Father%20is%20very,Ballard%2C%20one%20of%20Cline's%20children. 

3. Gamete (Eggs And Sperm) And Embryo Donation. - American Society for Reproductive Medicines. Accessed June 14, 2022. https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/gamete-eggs-and-sperm-and-embryo-donation/#:~:text=Egg%20or%20sperm%20donation%20allows,there%20is%20no%20genetic%20link. 

4. Consanguineous marriage- wikipedia. Accessed June 14, 2022. https://en.wikipedia.org/wiki/Consanguine_marriage 

5. Consanguineous marriages- NCBI. Accessed June 14, 2022. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3419292/ 

Emirati Women’s Experiences of Consanguineous Marriage: a Qualitative Exploration of Attitudes, Health Challenges, and Coping Styles- Springer. Accessed June 14, 2022. https://link.springer.com/article/10.1007/s11469-019-00123-z

Medically reviewed by Ashwini Nair, MB BCh BAO.

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DOC2US Editorial Team