Gamete donation—A review of ethical and legal issues

Abstract

Sperm and oocytes are building blocks in assisted reproduction. Sperm and ovum donation permit separation of the biological act of producing a child from the psychological process of nurturing and raising the child. However, the art of obtaining and use of these gametes are fraught with ethical and legal challenges. Relevant aspects concerning anonymity, genetic screening, consanguinity, informed consent and risk disclosure, compensation for donors, and child welfare are discussed. Though the issue of anonymity remains controversial, the importance of the welfare of the offspring has come to the fore as a result of the debate. Calls for more rigorous genetic testing for donated gametes to avoid genetic disease transmission, though supported by the principle of beneficence, has to be balanced by its possible deleterious effects on the donors and their relatives especially if findings reveal a serious genetic risk that has no medical treatment as yet. Reimbursement for direct and indirect costs, as well as fair compensation for time lost, inconveniences and risks suffered during treatment is recommended for oocyte donors. The risk of consanguinity remains a problem across the world even though the different guidelines limiting the number of pregnancies by a single gamete may be helpful, if enforceable. It is important that egg donors be clearly made to understand in simple language during the informed consent process of the yet unknown health risks involved so that the consent can be truly voluntary. This will protect donors from the backlash of the doctrine of “Volenti Non Fit Injuria”. It is also suggested that specific legislation with regards to gamete donation, parenthood, and ART should be passed in countries where these are absent, to avoid controversies that may arise due to current gaps in the law.