In law there is a saying: Hard facts make bad law. It’s always dangerous to make decisions based on the extreme, but sometimes it takes the extreme to capture our attention. Well, this is certainly extreme, and it certainly captured my attention. The New York Times reports today on a sperm donor who has fathered 150 children. Nope, my friends, that zero is not a typo. At what point is the risk of
overregulation outweighed by the risk to families and children?
Although 150 children from one sperm donor is not the norm, more than 40 is not all that unusual. Perhaps surprisingly, we don’t really know how many children are born from donor sperm each year or from one particular donor. Some estimates put the number at 30,000 to 60,000 sperm donor conceived children per year. Reporting a pregnancy and birth after using donor sperm is voluntary, but many parents, especially in heterosexual couples, tell no one, not even the children. Wendy Kramer, founder of the Donor Sibling Registry, estimates that only 20 to 40% of woman report the birth of a donor conceived child.
There is growing concern among parents, donors and medical experts about potential negative consequences of having so many children fathered by the same donors, including the possibility that genes for rare diseases could be spread more widely through the population. Parents and donor conceived people are also concerned about accidental incest (consanguinity) between half-sisters and half-brothers, who often live close to one another. Besides the strong “ick” factor, there are health issues for any subsequent children resulting from such matches.
Although other countries, including Britain, France and Sweden, limit how many children a sperm donor can father, there is no such limit in the United States. In Britain a donor can only father 10 children. The American Society for Reproductive Medicine (ASRM), has guidelines that recommend restricting conceptions by individual donors to 25 births per population of 800,000. With growing evidence of high number of children from specific donors, the ASRM is beginning to rethink this guideline, but has made no changes. Note that the ASRM has no way to enforce their guidelines.
The infertility professional community has long resisted more regulation fearing that regulation would make infertility treatment less available and more expensive. The cynics might add “less profitable” as well. The United States has long abhorred unnecessary regulation of anything, but have we reached the point where regulating the number of children conceived by a single donor has become necessary. Our standard when we make any decision in infertility should be ‘What is in the best interests of the child to be born?’ What do you think?
Image credit: June Freeman