The Implications of Reducing the Number of Families per Donor Worldwide

BACKGROUND: Many countries impose legal limits on the number of families that may be created using the sperm of a single donor, yet these limits vary widely and are not supported by robust empirical justification. The globalization of the sperm donation market and the widespread use of international commercial sperm banks may potentially result in (very) large international groups of same-donor offspring. OBJECTIVES: The study intended to find out which ethical, psychosocial, and regulatory concerns, including risks of consanguinity, genetic disorders, and the impact on donor-conceived persons, follow from these developments. While there are increasing calls to establish a worldwide family limit per donor, the consequences of such a policy for the availability, accessibility, and affordability of donor sperm remain unclear. METHODS: This paper examines empirical data on donor use, donor types, and supply-demand dynamics in several jurisdictions. A search has been made of all available databases to find recent and relevant data on the average number of offspring per donor, differences in donor type, and effects of allowing donor selection by recipients. RESULTS: The predicted negative effects of a global family limit on sperm supply depend largely on the level at which the limit is set. The analysis further suggests that current inefficiencies are partly driven by recipient choice and reliance on foreign donors. Although restricting donor selection and importation could improve efficiency, such measures would reduce recipient autonomy. CONCLUSIONS: Overall, the impact of a mandatory European or global family limit is highly context-dependent, but low limits would significantly affect sperm availability and constrain recipient choice.