Although an inadequate number of sperm contributes to approximately a third of all infertility, there had been little, if any, effective treatment for low sperm counts until the introduction of intracytoplasmic sperm injection in the late 1990s. As a result, the insemination of women with the sperm of anonymous donors, known as donor insemination (DI), has been widely practiced in this and other countries for almost half a century and has resulted in the births of hundreds of thousands of children. Although DI is not illegal anywhere in the United States, only a minority of states have laws guaranteeing the legality and legitimacy of DI. Often these laws are cursory or limited to specifying financial support obligations.
Sperm for DI is purchased from commercial sperm banks that screen and test prospective donors to minimize the risk of a sperm-transmitted infection and to reduce the chances of birth defects and genetic diseases. Because of concerns about human immunodeficiency virus (HIV) transmission, the tested sperm is frozen and quarantined for 6 months. Available information about the donor may range from the rudimentary physical characteristics of height, weight, eye color, hair color, and ethnicity to more detailed personal information such as education, occupation, interests, and hobbies. Although most sperm donors remain anonymous, the relative candor about infertility and the social and ethical questions raised by the introduction of advanced reproductive technologies, including egg donation, may well lead to changes in how DI is practiced in the future.
Although the majority of DI parents in the United States have not planned to tell their offspring how they were conceived, this issue remains highly controversial. Indeed, the disclosure decision is a serious and ongoing issue for DI parents that in many cases remains incompletely resolved or even undecided for many years. Psychologists, ethicists, and social workers have generally concluded that the use of donor sperm is ethically suspect and psychologically burdensome (or even harmful) if practiced in an atmosphere of secrecy, frequently referring to an adoption model that holds that children raised without knowledge of their genetic heritage have an incomplete sense of identity. Yet as very few studies have actually looked at the psychological and social functioning of families created through the use of a donor, current opinions concerning the well-being of the couple and their children cannot be reliably verified or refuted.
Parents who disclose to their children usually cite honesty or the principle that it is the child’s right to know his or her biologic origins, while parents who do not plan to tell their children usually refer to a broad concept of privacy and confidentiality that suggests that they are wary of subjecting themselves and their children to public scrutiny and judgment. Regardless of their disclosure decision, most DI parents emphasize the importance of a spiritual and emotional connection with their children and often state a belief in the preeminence of the social parenting role, asserting that parental responsiveness, rather than biological relatedness, is responsible for fostering healthy social and emotional development. Although most DI parents come to a united disclosure decision that reflects and supports their beliefs in what is best for the child and the family unit, they continue to grapple with a broad range of issues and concerns that interacts in complex and subtle ways. Because the disclosure decision-making process involves an interaction between the psychological states of the parents and the social, cultural, and familial context within which this decision must be negotiated, DI parents will likely experience some degree of ongoing tension until cultural attitudes concerning the relative values and meanings of biological versus social fatherhood have further evolved.
- Nachtigall, D. (1993). Secrecy: An unresolved issue in the practice of donor insemination. American Journal of Obstetrics and Gynecology, 168, 1846.
- Nachtigall, R. D., Becker, G., Szkupinski-Quiroga, S. S., & Tschann, M. (1997). The disclosure decision: Concerns and issues of parents of children conceived through donor insemination. American Journal of Obstetrics and Gynecology, 178, 1165–1170.
- Nachtigall, D., Tschann, J. M., Pitcher, L., SzkupinskiQuiroga, S. S., & Becker, G. (1997). Stigma, disclosure, and family functioning among parents of children conceived through donor insemination. Fertility and Sterility, 68, 83–89.