Ethics Committee Reports On Family Members As Gamete Donors And Surrogates
American Society for Reproductive Medicine
When an egg donor, sperm donor, or surrogate is enlisted to assist an infertile couple trying to have children, the arrangement is, in most cases, anonymous. However, some patients choose to ask their relatives for help. This month, in Fertility and Sterility, the Ethics Committee of the American Society for Reproductive Medicine reports on the use of family members as gamete donors and surrogates. They found that, in most cases, these arrangements are ethical and beneficial to all involved, but certain cases raise serious problems and should not occur.
The Committee noted that these arrangements can present problems such as the appearance of incest or consanguinity, confused ideas of parentage for the resulting children, and undue pressure on family members to participate.
Familial donors were categorized generationally and by degree. (First degree relatives are members of the same nuclear family; second degree relatives include aunts, uncles, cousins, nieces and nephews.) Combinations that would create consanguinity, like a sister donating eggs to her brother's wife, should be prohibited, while others in which no consanguinity results, like a brother donating sperm to his infertile brother, are quite acceptable. Certain arrangements that create the impression of incest, like a brother donating sperm to his sister who is also using donated eggs, need to be evaluated carefully, even though there is no consanguinity. In a chart, the Committee outlines the most common arrangements, the resulting genetic and social relationships of the offspring, and special concerns the arrangement might cause.
ART providers are advised to take care in evaluating proposals for surrogacy and gamete donation within families and to recommend counseling to patients and donors who have decided to keep it in the family.
"Patients from close families willing to help them overcome their infertility are very fortunate, but as the Ethics Committee points out, we need to take care to ensure that the plan is in the best interest of everyone involved-intended parents, donors or surrogates, and especially the children," remarked Owen Davis, MD, President of the Society for Assisted Reproductive Technology.
(Ethics Committee, American Society for Reproductive Medicine, Family members as gamete donors and surrogates, Fertility and Sterility, Vol. 80, No.5, November 2003.)
The American Society for Reproductive Medicine, founded in 1944, is an organization of close to 9,000 physicians, researchers, nurses, technicians, and other professionals dedicated to advancing knowledge and expertise in reproductive biology. Affiliated societies include the Society for Assisted Reproductive Technology, The Society for Male Reproduction and Urology, the Society for Reproductive Endocrinology and Infertility, and the Society of Reproductive Surgeons.
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