Does Cryos have a global limit on how many families a sperm donor may help conceive?
Yes. For some of our sperm donors, we have set a worldwide family limit of either 15 or 50 families. When you choose one of these donors, you reserve your place as one of these families. Each family may have more than one child with the same donor, allowing siblings to share the same genetic origin.
In practice, most of our donors are used by far fewer families than the maximum limit. At the same time, Cryos always complies with the national regulations and donor quotas that apply in countries where donor sperm is used. These regulations vary from country to country and may be based on the number of families, children, or pregnancies. Learn more about our quota reservation system here.
Understanding donor limits and quotas
Cryos does not have a fixed global limit on the total number of children per donor. This is based on genetic health logic: what matters is not the total number of children worldwide, but their geographical distribution. Genetic diseases should not be considered a relevant factor when determining donor offspring limits. From a public health perspective, there is also no relation between the number of offspring per donor and the overall prevalence of genetic conditions in the population. The risk of consanguinity depends on whether children conceived with the same donor live within the same communities. Cryos manages this risk through geographical distribution and compliance with national quotas. ESHRE also states: “Several studies have modelled the risk of consanguinity between donor-conceived offspring and identified very low risk levels, especially in the context of international use of gametes, where there is a wide geographical spread of donor siblings.” They further write: “The risk of inbreeding is likely to be further reduced by parents increasingly being open about telling their children that they are donor conceived, and by donors increasingly being open about telling their own children about their donations, as well as by increased access to genetic testing. Therefore, inbreeding is no longer a pressing problem.” (3)
The debate on global quotas has arisen, among other things, in response to a few cases in which hereditary diseases have been transmitted via donor sperm (1, 2). This has prompted political and professional discussions about the need for international or global quotas, including recommendations from professional organizations such as ESHRE (3). However, it is important to emphasize that global quotas cannot eliminate the risk of hereditary diseases. All people carry genetic variations and potentially disease-causing mutations. The more diseases one tests for, the fewer donors will be eligible, and a very low quota does not reduce the total number of children born with genetic diseases, but may instead lead to a greater variety of rare diseases (4). The number of affected children is not reduced by the introduction of global quotas, which may therefore create a false sense of security.
Even though there is no scientifically based reason to worry about inbreeding or the spread of genetic diseases, a Cryos study (12) has shown that many people using donor sperm still have these concerns. They often think that not having strict limits on how many families can use the same donor worldwide could lead to risk of inbreeding and more genetic diseases. It is therefore important for fertility clinics, sperm banks, and authorities to clearly explain that the risk of related children meeting each other is extremely low and that limiting the number of families per donor does not reduce the overall genetic risk connected to donor conception.
There are differing experiences regarding the psychological aspects of having many donor half-siblings. For some, this can be a burden (5, 6), while others experience it as a resource (7, 8). For the donors themselves, research does not indicate that a high number of children in itself constitutes a psychological burden (9, 10, 11). Cryos acknowledges that the need for information and transparency varies among donors, recipients, and donor-conceived persons, and balances this in respect of all parties’ rights in accordance with Article 10 of the European Bioethics Convention.
Finally, many countries face a shortage of sperm donors at the same time as demand is increasing. Strict global quota limitations would likely lead to reduced availability, longer waiting times, higher prices, and increased reliance on unregulated markets. Ultimately, this could undermine safety for all parties involved and reduce the number of people who are able to fulfill their wish to become parents.
Links
1 Danish sperm donor passed neurofibromatosis on to five children | The BMJ
2 Sperm from donor with cancer-causing gene was used to conceive almost 200 children
3 ESHRE position paper: international limits on the number of offspring per gamete donor.
4 No reason for a reduction in the number of offspring per sperm donor because of possible transmission of autosomal dominant diseases - PubMed
5 Finding people like me: contact among young adults who share an open-identity sperm donor | Human Reproduction Open | Oxford Academic
6 The ongoing work of kinship among donor half-siblings in The Netherlands | BioSocieties
7 Searching for ‘relations’ using a DNA linking register by adults conceived following sperm donation | BioSocieties
8 Adolescents Conceived through Donor Insemination in Mother‐Headed Families: A Qualitative Study of Motivations and Experiences of Contacting and Meeting Same‐donor Offspring - Persaud - 2017 - Children & Society - Wiley Online Library
9 Oocyte and sperm donors' opinions on the acceptable number of offspring - Sydsjö - 2014 - Acta Obstetricia et Gynecologica Scandinavica - Wiley Online Library
10 Egg donors’ attitudes toward identifiability, offspring information, and genetic testing | Reproductive Biology and Endocrinology
11 Experiences and attitudes of Danish men who were sperm donors more than 10 years ago; a qualitative interview study | PLOS One
12 The attitude of (would-be) recipients of donor sperm and interested persons regarding a worldwide family limit per donor