Genomics and donor conception

One way in which biology is important is when it impacts on health. And assisted conception using donor gametes presents a unique challenge in this regard.

With donor conception, the child receives half their DNA from the donor. This means that there is a biological link between the donor and the donor-conceived child, which can sometimes lead to ethical dilemmas.

Consider for example, the case of a sperm donor who has six offspring. Several years after donating, he undergoes genetic testing and finds out that he has a genetic condition that might be passed on through his genes.

Many fertility clinics now arrange for genetic testing of donors. Yet the number of conditions that can be tested for increases every year, and many more people are now accessing such tests.

What should a donor do in this case? One option is to contact the fertility clinic and ask them to inform the recipient parents that their child might be at risk of a genetic condition.

Yet what is the responsibility of the fertility clinic when parents haven’t told the child that they are donor-conceived? And what is the responsibility of the fertility clinic towards that child when they become an adult?

Information can of course also be passed on in the opposite direction, if a donor-conceived child finds out about their DNA and then contacts either the donor or the fertility clinic.

Most at-home genetic test kits also include biological ancestry analysis, meaning that a person who never knew they were donor-conceived might discover that their biological family is different than they thought it was by using such tests.

In fact, there have now been many cases where donor-conceived adults found their biological parent via direct-to-consumer testing, which is now readily available in many countries.

For an in-depth review of the problems that genomics pose for anonymous donor conception, please take a look at a recent editorial in the journal Human Reproduction which can be found at the bottom of this step.

For your discussion: What do you think? Should a clinic tell parents of a donor-conceived child if the donor informs them of a hereditary condition? And what is the clinic’s responsibility towards the child, in the event that the parents haven’t disclosed to the child that they are donor-conceived?