Sperm Banking as a Strategy to Reduce Harms Associated with Advancing Paternal Age.

Medical studies increasingly link paternal age with disorders in offspring. Associated disorders include autism, bipolar disorder, schizophrenia, and ADHD. Banking one's sperm earlier in life, thereby reducing the effective paternal age at conception, would therefore seem to be a successful strategy for reducing risk to one's eventual offspring. But could a cryopreservation equipment manufacturer or a sperm bank lawfully claim that cryopreservation does more than preserve fertility--that it also prevents disease? This article considers arguments for and against FDA's jurisdiction over such claims, and then makes recommendations for how the agency and Congress should respond.

A content analysis of posthumous sperm procurement protocols with considerations for developing an institutional policy.

OBJECTIVE: To identify and analyze existing posthumous sperm procurement (PSP) protocols in order to outline central themes for institutions to consider when developing future policies. DESIGN: Qualitative content analysis. SETTING: Large academic institutions across the United States. PATIENT(S) N/A INTERVENTION(S): We performed a literature search and contacted 40 institutions to obtain nine full PSP protocols. We then performed a content analysis on these policies to identify major themes and factors to consider when developing a PSP protocol. MAIN OUTCOME MEASURE(S): Presence of a PSP policy. RESULT(S): We identified six components of a thorough PSP protocol: Standard of Evidence, Terms of Eligibility, Sperm Designee, Restrictions on Use in Reproduction, Logistics, and Contraindications. We also identified two different approaches to policy structure. In the Limited Role approach, institutions have stricter consent requirements and limit their involvement to the time of procurement. In the Family-Centered approach, substituted judgment is permitted but a mandatory wait period is enforced before sperm use in reproduction. CONCLUSION(S): Institutions seeking to implement a PSP protocol will benefit from considering the six major building blocks of a thorough protocol and where they would like to fall on the spectrum from a Limited Role to a Family-Centered approach.

"Obligated aliens": recognizing sperm donors' ethical obligation to disclose genetic information.

Sperm donors' obligations are typically constrained to the immediate circumstances surrounding the donation and to its time frame. This paper makes the case for recognizing an ongoing ethical obligation that binds sperm donors to disclose, in a timely manner, meaningful genetic information to recipients and donor-conceived children. The paper delineates and conceptualizes the suggested (potentially reciprocal) duty and argues that it is not the genetic link between the donor and the donor-conceived child that binds donors by said duty, but rather social responsibility. Accordingly, an original perception of the donor as an obligated alien is suggested and developed. The main thesis of the paper is supported inter alia by a comparison between transmitting infectious diseases and passing faulty genes on to donor-conceived children. The paper also provides an in-depth analysis of the conflicting interests of the parties generated by such an obligation and proposes a model for embedding this ethical duty in a (legal) contractual framework.

Recommendations for gamete and embryo donation: a committee opinion.

This document provides the latest recommendations for evaluation of potential sperm, oocyte, and embryo donors, incorporating recent information about optimal screening and testing for sexually transmitted infections, genetic diseases, and psychological assessments. This revised document incorporates recent information from the U.S. Centers for Disease Control and Prevention, the US Food and Drug Administration, and the American Association of Tissue Banks, with which all programs offering gamete and embryo donation services must be thoroughly familiar, and replaces the document titled, "2008 Guidelines for Gamete and Embryo Donation: A Practice Committee Report," last published in Fertil Steril 2008;90:S30-44.

Gamete donation in France: the future of the anonymity doctrine.

In France, since the approval of the first bioethics laws in 1994, the principle of the anonymity of sperm donors has prevailed. This choice is regularly challenged, namely by children who have been conceived under these conditions and have now reached adulthood. In this paper, we will briefly describe the reasons that led practitioners of assisted reproduction to endorse the anonymity principle in 1994. Secondly, we will elaborate on the reasons why this principle is becoming so controversial today. Finally, we shall examine two possible outcomes of the debate, highlighting their respective legitimacy as well as their consequences, as far as the rights of children, the notion of the family, and medical practice are concerned.

Lost property? Legal compensation for destroyed sperm: a reflection and comparison drawing on UK and French perspectives.

In a recent case in the UK, six men stored their sperm before undergoing chemotherapy treatment for cancer in case they proved to be infertile after the treatment. The sperm was not properly stored and as a result was inadvertently destroyed. The men sued the NHS Trust that stored the sperm and were in the end successful. This paper questions the basis on which the judgement was made and the rationale behind it, namely that the men 'had ownership' of the sperm, and that compensation was thus due on the grounds that the men's property had been destroyed. We first argue that the claim is erroneous and enhances the tendency towards the commodification of body parts. We then suggest that the men could have been compensated for the harm done to them without granting property rights, and that this would, at least in philosophical and ethical terms, have been more appropriate. To help illustrate this, we draw on a parallel case in French law in which a couple whose embryos had been destroyed were overtly denied ownership rights in them. Finally, we suggest some possible ethical and practical problems if the proprietary view expressed in the UK ruling were to become dominant in law, with particular focus on the storing of genetic information in biobanks. We conclude that, although compensation claims should not necessarily be ruled out, a 'no property in the body' approach should be the default position in cases of detached bodily materials, the alternative being significantly ethically problematic.

Nationwide use of postmortem retrieved sperm in Israel: a follow-up report.

A follow-up study of the subsequent use of all postmortem frozen sperm samples during 2003-2010 is reported. Only the sister of one of the 10 unmarried deceased men was in contact with the bank. Four widows elected to discard the frozen sperm and all of the remaining spouses were uninterested in its fate. Because none of the samples were requested for use, the need for sperm procurement should be reconsidered.

Yearworth v. North Bristol NHS trust: a property case of uncertain significance?

It has long been the position in law that, subject to some minor but important exceptions, property cannot be held in the human body, whether living or dead. In the recent case of Yearworth and Others v North Bristol NHS Trust, however, the Court of Appeal for England and Wales revisited the property debate and threw into doubt a number of doctrines with respect to property and the body. This brief article analyses Yearworth, (1) reviewing the facts and the Court's decision with respect to the originators' proprietary and contractual interests in their body and bodily products, (2) considering the significance of relying on property and its use a legal metaphor, (3) questioning the scope of the property right created, and (4) querying whether an alternate conceptual approach to extending rights and a remedy was warranted. It concludes that, while Yearworth engages with, and impacts on, important theoretical and practical issues--from legal, healthcare and research perspectives--it does not offer a great deal of guidance and, for that reason, its precedential significance is in doubt.

Don't ask, don't tell . . . and don't donate.

Did you know that gay men can't donate blood, nor can they donate sperm anonymously to sperm banks? I applaud the 18 senators who have banded together to urge FDA Commissioner Margaret Hamburg to revisit this issue, as current scientific data on infectious diseases does not lend credence to these policies.

Managing novel reproductive injuries in the law of tort: the curious case of destroyed sperm.

In view of developments in reproductive medicine, clinical mishaps in this domain are beginning to give rise to 'injuries' not easily accommodated within the English law of negligence. While 'personal injury' is typically understood as manifesting a deleterious 'physical' dimension, cases involving the negligent destruction of cryopreserved sperm, as recently litigated in Yearworth & Ors v Bristol NNN Trust (2009), and other media reported mishaps in fertility treatment do not straightforwardly possess this quality. Without modification, the traditional tortious conception of 'personal injury' in English law will not be able to address novel claims. Critically, however, nor do alternative modes of redress seem to offer ease of application. Focusing upon the controversial Yearworth case and exploring what is seen as an unpromising framing of loss, the note argues that there is now an urgent need to rethink what counts as 'personal injury'. Arguing for the formal recognition of'reproductive injury' as an independent head of damage in negligence, and illustrating the presence of judicial support for that approach, the comment suggests that in light of the difficult challenges that lie in the wake of Yearworth, such a development may be not only desirable but necessary.

Sperm retrieval from terminally ill or recently deceased patients: a review.

OBJECTIVE: Requests for sperm extraction in terminally ill or recently deceased patients have been increasing with the gained acceptance and success of assisted reproductive techniques such as in vitro fertilization and intracytoplasmic sperm injection. This review aims to outline the many challenges associated with these requests. MATERIALS AND METHODS: The medical literature surrounding ethical and legal issues of posthumous sperm extraction was examined. RESULTS: Several issues within the field of sperm extraction in the terminally ill patient and the postmortem patient still arouse a significant amount of debate and controversy. One controversial factor surrounds the issue of consent for the tissue extraction and determining when family consent is valid. Other discussions have involved ethical issues, logistics (including cost), and legal issues. CONCLUSIONS: A medical center protocol governing sperm extraction from terminally ill or recently deceased patients would be beneficial, and would likely alleviate stress among the patients' families and healthcare providers. To overcome some of the difficulties surrounding the issue of consent, it might also be valuable for men about to get married or enter into a similar relationship to document their wishes for sperm retrieval should a tragic situation arise. This could be done in the same way that they would prepare a living will.