The first recorded sperm donation that took place in a medical center was carried out with few of the ethical considerations that are man­dated in clinics today: it was performed in 1884 at Philadelphia medical school for an infertile couple. Instead of taking the sperm from the husband, the doctor chloroformed the woman, then let his medical students vote which of them was the ‘best looking’, with that elected one providing the sperm for the insemination. After talking to the husband, they decided it was best not to let the woman know.

Sperm donation can be a morally contentious issue. Couples in heterosexual relationships considering sperm donation as a solution to childlessness may view it as preserving the sexual integrity of their relationship. However, sperm donation does not maintain the repro­ductive integrity of a relationship in that the woman’s sexual partner is not the biological father of her child, and it is the sperm donor, not the partner, who has reproduced himself.

However, others point out that the process is essentially a sexual one: a woman’s innate sexuality may be the reason why a child is wanted, the donor has to be screened for sexually transmitted diseases which could be passed on through the use of his sperm, and the donor has to sexually stimulate himself in order to produce the sperm samples which are used for achieving pregnancies in women to whom he is not related. Some would argue that it is impossible to distinguish sexuality from reproduction, and that the reason for preserving sexual integrity is to preserve reproductive integrity.

The use of sperm donation is increasingly popular among unmar­ried women and single or coupled lesbians. Indeed, some sperm banks and fertility clinics, particularly in the us, Denmark and the uk have a predominance of women being treated with donor sperm who fall within these groups and their publicity is aimed at them. This produces many ethical issues around the ideals of conventional parenting and has wider issues for society as a whole, including the issues of the role of men as parents, the issue of family support for children, and the issue of financial support for women with children.

Some donor children grow up wishing to find out who their fathers were, but others may be wary of embarking on such a search since they fear they may find scores of half-siblings who have been produced from the same sperm donor. Even though local laws or rules may restrict the numbers of offspring from a single donor, there are no worldwide limitations or controls and most sperm banks will ‘onsell’ and export all their remaining stocks of vials of sperm when local maxima have been attained.

However, others would argue that sperm donation has liberated the way in which women can control their reproductive lives and that it has enabled many men as sperm donors to father children which they would not want or wish to support but which they know will fulfil a desperate biological and social need for the women who bear them.

Many donees do not tell the child that they were conceived as a re­sult of sperm donation, or, when non-anonymous donor sperm has been used, they do not tell the child until it is old enough for the clinic to provide the contact information about the donor.

For children who find out after a long period of secrecy, their main grief is usually not the fact that they are not the genetic child of the couple who have raised them, but the fact that the parent or parents have kept information from them or lied to them, causing loss of trust. Furthermore, the overturning of their knowledge of who their parents are may cause a lasting sense of imbalance and loss of control.

However, there are certain circumstances where the child very likely should be told: when many relatives know about the insemina­tion, so that the child might find it out from somebody else; when the husband carries a significant genetic disease, relieving the child from fear of being a carrier; or where the child is found to suffer from a genetically transmitted disorder and it is necessary to take legal action which then identifies the donor.

Anonymous sperm donation is where the child and/or receiving couple will never get to know the identity of the donor, and non-anony­mous when they will. A donor who makes a non-anonymous sperm donation is termed a known donor, open-identity or identity-release donor. Non-anonymous sperm donors are, to a substantially higher degree, driven by altruistic motives for their donations.

In any case, some information about the donor may be released to the woman/couple at the time of treatment. A limited donor informa­tion at most includes height, weight, eye, skin and hair colour. In Sweden, this is all the information a receiver gets. In the us, on the other hand, additional information may be given, such as a compre­hensive biography and sound/video samples.

For most sperm recipients, anonymity of the donor is not of major importance at the obtainment or tryer-stage. The main reason for anonymity is that recipients think it would be easiest if the donor was completely out of the picture. However, some recipients regret not having chosen a non-anonymous donor years later, for instance when the child desperately wants to know more about the donor anyway.

There is a risk of bias in the information given by clinics or sperm banks regarding anonymity, making anonymous sperm donation seem more favourable than it may actually be, resulting from the fact that anonymous sperm donations are easier for the clinic or sperm bank to handle in the long term, because anonymity doesn’t make them responsible for safely storing donor information for a long period of time. In addition, a majority of donors are anonymous, causing a rela­tive deficit in non-anonymous sperm supply.

The law usually protects sperm donors from being responsible for children produced from their donations, and the law also usually pro­vides that sperm donors have no rights over the children which they produce. Several countries, e. g. Sweden, Norway, the Netherlands, Britain, Switzerland, Australia and New Zealand only allow non­anonymous sperm donation. The child may, when grown up (15-18 years old), get contact information from the sperm bank about his/her biological father. In Denmark, however, a sperm donor may choose to be either anonymous or non-anonymous. Nevertheless, the initial information which the receiving woman/couple will receive is the same. In the United States, sperm banks are permitted to disclose the identity of a non-anonymous donor to any children brought to the world by that donor, once the child turns eighteen.

Where a sperm donor donates sperm through a sperm bank, the sperm bank will generally undertake a number of medical and scientific checks to ensure that the donor produces sperm of sufficient quantity and quality and that the donor is healthy and will not pass diseases through the use of his sperm. The donor’s sperm must also withstand the freezing and thawing process necessary to store and quarantine the sperm. The cost to the sperm bank for such tests is not inconsiderable. This normally means that clinics may use the same donor to produce a number of pregnancies in a number of different women.

The number of children permitted to be born from a single donor varies according to law and practice. These laws are designed to pro­tect the children produced by sperm donation from consanguinity in later life: they are not intended to protect the sperm donor himself and those donating sperm will be aware that their donations may give rise to numerous pregnancies in different jurisdictions. Such laws, where they exist, vary from state to state, and a sperm bank may also impose its own limits. The latter will be based on the reports of pregnancies which the sperm bank receives, although this relies upon the accuracy of the returns and the actual number of pregnancies may therefore be somewhat higher. Nevertheless, sperm banks frequently impose a lower limit on geographical numbers than some us states and may also limit the overall number of pregnancies which are permitted from a single donor. When calculating the numbers of children born from each donor, the number of siblings produced in any ‘family’ as a result of sperm donation from the same donor are almost always excluded (but see below for the provisions in various states). There is, of course, no limit to the number of offspring which may be produced from a single donor where he supplies his sperm privately.

Despite the laws limiting the number of offspring, some donors may produce substantial numbers of children, particularly where they donate through different clinics, where sperm is onsold or is exported to different jurisdictions, and where countries or states do not have a central register of donors.

Sperm agencies, in contrast to sperm banks, rarely impose or en­force limits on the numbers of children which may be produced by a particular donor partly because they are not empowered to demand a report of a pregnancy from recipients and they are rarely, if ever, able to guarantee that a woman may have a subsequent sibling by the donor who was the biological father of her first or earlier children.

Countries that have banned anonymous sperm donation have a substantial sperm shortage, because only a fraction of sperm donors want to continue their contributions if they know that the donor – conceived children may contact them one day. Banning of payment to donors has also caused shortages. This has prompted fertility tourism to other countries to get the treatment.

For instance, when Sweden banned anonymous sperm donation in 1980, the number of active sperm donors dropped from approximately 200 to 30. Sweden now has an eighteen-month-long waiting list for donor sperm. After the United Kingdom ended anonymous sperm donation in 2005, the numbers of sperm donors went up, reversing a three-year decline. However, there is still a shortage, and some doctors have suggested raising the limit of children per donor. Sperm exports from Britain are legal (subject to the eu Directive on Tissue Exports) and donors may remain anonymous in this context. Some uk clinics export sperm which may in turn be used in treatments for fertility tourists in other countries. uk clinics also import sperm from Scandinavia. Canada also has a shortage because it has been made unlawful to pay people for donating it, requiring recipients who wish to purchase it to import it from the United States. The United States, on the other hand, has had an increase in sperm donors during the late 2000s recession, with donors finding the monetary compensation more favorable.

Naturally, waiting times have gone up, and as a result more and more patients look for a donor by themselves: brothers, brothers-in – law, cousins, close friends, etc. In addition donors advertise, though this raises questions about the quality and safety of the sperm. Waiting times of almost two years also drive patients abroad to countries like Belgium, where there is still complete anonymity.

Do parents tell their children that they have been conceived with the help of a donor? With single people and lesbian couples the ques­tion doesn’t arise. The greatest dilemma is whether children and sperm donor actually want to get to know each other. Suppose someone in late adolescence is told that his father is not his biological father, what will their reaction be? It’s hard to imagine. Very probably few sixteen – year-olds are dying to trace their ‘roots’. It would seem more obvious for them to do that when genealogical factors like birth, death, marriage or divorce come into the picture.

In my hospital donors are recruited through adverts in the regional daily newspaper. Men of 55 and over are excluded, since their gener­ally poor sperm quality entails a higher risk of a child being born with a chromosomal abnormality. More than 80 per cent of volunteers are rejected, usually for the same reason, though occasionally a hereditary problem is grounds for rejection. Traceability and potential pressure have led to the number of families a donor may help to create being limited to five. This means that the number of times he may be approached in future is limited. The recipient of the sperm is promised that she may also have a second or subsequent child from the same donor, so that her children are true brothers and sisters. The restric­tion on the number of women per donor also has the advantage that the period of donorship need only be short. The men come for a period of between one and two years, every two or three weeks, in order to build up a large quantity of sperm. Of course some basic information is recorded, including height, weight, skin, eye and hair colour and certain personality features.

The sperm is released only after it has been in quarantine for six months. Meanwhile the donor has been screened again for hepatitis в and c, syphilis, chlamydia, cytomegalia and hiv. Experience has shown that the chance of a full-term pregnancy for each artificial donor insemination is approximately one in eight.