Intended for healthcare professionals

Views & Reviews Personal View

Withdrawal of consent by sperm donors

BMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b4297 (Published 20 October 2009) Cite this as: BMJ 2009;339:b4297
  1. Peter D Sozou, research associate13,
  2. Sally Sheldon, professor of law2,
  3. Geraldine M Hartshorne, professorial research fellow3
  1. 1Centre for Philosophy of Natural and Social Science, London School of Economics and Political Science, London WC2A 2AE
  2. 2University of Kent, Canterbury
  3. 3Clinical Sciences Research Institute, Warwick Medical School, Coventry
  1. Correspondence to: p.sozou{at}lse.ac.uk

    Since 1991, sperm donors in the UK have had the legal right to withdraw consent for the use of their sperm in fertility treatment. This has the potential to adversely affect patients. It may mean that previous recipients of a donor’s sperm cannot have further children who are full biological siblings to an existing child, and that embryos created from the donor’s sperm and a patient’s eggs must be destroyed.

    We have informally investigated withdrawal of consent by sperm donors donating after 1 April 2005, when lifelong anonymity for gamete donors ended. An email in November 2008 to colleagues at five UK fertility centres asked if recipients knew of cases where a sperm donor had withdrawn consent after his sperm had been released for use. One reported that this had happened at their centre. This was followed by an email in March 2009, kindly circulated by the Association of Clinical Embryologists, asking each recipient how many donors recruited at their centre since April 2005 had withdrawn consent after their sperm had been released for use. In response, two further centres each reported one donor who had withdrawn consent after sperm had been released, as well as several who had withdrawn after donation but before such release.

    In total, therefore, we have found three centres where there has been an instance, since April 2005, of a sperm donor withdrawing consent after his sperm had been released for use.

    In one of these cases, the consequences included stored embryos and sperm reserved for creating siblings being destroyed. We have therefore established that withdrawal of consent by sperm donors is not just a hypothetical problem. It has serious consequences for patients. This raises the question of whether the laws governing sperm donors’ rights to withdraw consent should be re-examined. However, major amendments to UK fertility laws were made in the Human Fertilisation and Embryology Act (2008), and UK fertility laws do not seem likely to be revisited in the near future. Can steps be taken, within existing laws, to reduce the chances of these most serious consequences occurring?

    We propose that a sperm donor expressing a wish to withdraw consent should be offered the following three options:

    (a) No new families to be begun; embryos already created to be kept and sperm to create full siblings of children created from his sperm to be retained.

    (b) All sperm to be destroyed but embryos already created to be kept.

    (c) All sperm and embryos to be destroyed (with destruction of embryos subject to the mandatory 12 month cooling off period to be required from 1 October 2009).

    We would expect some donors to choose options (a) or (b), resulting in less impact on patients than option (c). Presenting the three options as a standard menu would allow a donor to make a nuanced decision about withdrawal of consent. And our proposal creates a facility for a donor to make such a nuanced decision without him necessarily being given details about how his sperm had been used.

    Why do sperm donors withdraw consent? Positive responses to our initial email and subsequent email survey were followed up to ask if respondents knew why the donor had withdrawn consent, unless this information had already been volunteered. In two of the three cases, the donor indicated that he was withdrawing consent because of the influence of a new female partner. In the third case communication was very limited between the fertility centre and the donor and the donor did not offer a reason for withdrawal of consent.

    Counselling of prospective sperm donors is probably effective at helping them work through any concerns they may have about donation at the time when they volunteer to be donors. However, it may be less effective at enabling donors to anticipate the impact of new events, for example new relationships, and in particular any resulting pressure from a new partner. While the number of cases we have found of sperm donors withdrawing consent after their sperm has been released for use is small, they do clearly illustrate the potential influence of new partners. It is possible that a contributory factor in donors’ decisions to withdraw consent in these circumstances is the removal of lifetime donor anonymity, and the consequent prospect that a donor will be contacted by children conceived from his donated sperm when they reach the age of 18. The possible effect of such contact on the donor, his partner, and any children born to them is an understandable concern of the new partner and her views may be expected to influence the donor’s actions. While donors are encouraged to discuss their wish to donate with their current partner, the influence of new partners on donors has not been considered, and merits further investigation.

    Notes

    Cite this as: BMJ 2009;339:b4297

    Footnotes

    • PDS was supported by the Wellcome Trust. This work was carried out while PDS was based at Warwick Medical School.

    • Competing interests: None declared.

    • See also: Experts suggest ways to tackle shortage of sperm donors. BMJ 2009;338:b2620

    View Abstract

    Log in

    Log in through your institution

    Subscribe

    * For online subscription