ARTIFICIAL INSEMINATION DONATION

MEDICAL ETHICS
CASSANDRA BOOE

OBJECTIVES
Describe artificial insemination
Knowledge of the importance in obtaining informed consent
Understand the requirements of the screening process for donors
Know the regulations governing coverage of infertility treatments by employers and

insurance payers
Understand state regulation of sperm donors
Understand the Uniform Parentage Act (UPA)
Understand federal regulation of sperm donors

WHAT IS ARTIFICIAL INSEMINATION?

Artificial insemination is the process of placing sperm in to the reproductive tract of a

female, with the purpose of impregnating that female by using means other than sexual
intercourse.
According to Xytex, a large U.S. sperm bank, around 4,000 to 5,000 births a year are due to

artificial insemination.
There are two sources of sperm:
1) homologous artificial insemination uses the husbands semen to impregnate the female
2) heterologous artificial insemination (HIV) uses semen from a donor other than the womans

husband

INFORMED CONSENT
Informed consent should include disclosures for possible risks, benefits, success rates,

costs, and alternative methods.

Both recipients and donors should be made aware of the reasons for screening and

confidentiality.
They should know what personal information can and cannot be accessed about the donor.
The consent of the husband and wife must be acquired
The facility must obtain the husbands consent for HAI for liability reasons because, without it, he

could sue for damages.

Depending on the state, proof of consent may or may not be required, but it is in the

facilitys best interest to obtain some sort of proof of consent for liability reasons.
Anonymous donors cannot claim rights or responsibilities over a child born through

therapeutic artificial insemination.

OBLIGATIONS FOR SCREENING PROCESS

Some states require specific medical screening of potential donors before they are

permitted to donate sperm.

Physicians should maintain permanent records of donors to fulfill the following obligations:
In order to exclude certain individuals from the donor pool who test positive for certain diseases
In order to limit the number of pregnancies resulting from the same donor
Necessary in order to avoid marriages and reproduction between people who are related

In order to notify the donor of any infectious or inheritable diseases that were found
In order to notify the donor if a child born from artificial insemination has a disorder which may have

come from the donor

REGULATIONS OF INFERTILITY INSURANCE

State regulations on what is covered by insurance for infertility treatment differs depending

on the state.
According to the American Society for Reproductive Medicine , 14 states have laws

mandating that employers cover infertility or offer insurance for fertility treatment.
Some states cover in vitro fertilization only, excluding artificial insemination

Some states can exclude certain populations such as lesbian couples or single women
Employers with very few employees can sometimes be exempt from these regulations

STATE LAWS

The laws governing assisted reproduction vary from sate to state and a lot of times from

country to country as well.

All 50 states recognize that an anonymous donor has no financial responsibility or

obligation to children born by his sperm.

If the donor is known, some states do assign some parental rights to the donor.
In California, Wisconsin, and Ohio, if a physician performs the insemination, then the above law

does not apply and the known donor is freed from all responsibility.

UNIFORM PARENTAGE ACT (UPA)

Established in 1973
Nearly half of the states have enacted some form of the Uniform Parentage Act
This act typically states that a husband who provides in writing his consent for his wife to

be inseminated under the supervision of a physician is considered the legal father of any
resulting child.
Also states that any donor who provides semen to a licensed physician for use of artificial

insemination of someone other than his wife is not considered the legal father of any
resulting child.
The revised edition of the UPA in 2000, adopted by some states, does not require the donor

to provide semen to a licensed physician in order to be considered a non-parent.

Because there is no uniformity in the laws governing recipients and donors rights, there

have been many issues that have arisen as a result of artificial insemination.

FEDERAL LAWS
The Food and Drug Administration (FDA) requires sperm banks to apply specific criteria to determine if

a prospective sperm donor will be eligible in order to prevent spread of inherited or infectious
diseases.
The prospective sperm donor must pass 3 levels of screening:
Medical social history
A questionnaire
A physical exam and blood tests for specific diseases

Only if the person passes all three screenings can he be eligible to become a sperm donor.

The FDA also requires semen from an anonymous donor be quarantined for at least 180 days, pending

a negative retest of the donor before the sample can be used.

Federal regulations allow the use of ineligible sperm donors in very specific situations, only if specific

labeling is done and requirements to inform the recipients are followed.

RESOURCE PAGE
Wegner, C. (2015). Artificial insemination regulations.

http://www.livestrong.com/article/145229-artificial-insemination-regulations /
Pozgar, G. (2016). Legal and ethical issues for health professionals. Burlington, MA: Jones & Bartlett

Learning, LLC, an Ascend Learning Company.

American Medical Association. (2004). Opinion 2.05 artificial insemination by anonymous donor.

http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion205.page
?
Erickson, T. (2010). Fertility law.

http://
www.americanbar.org/newsletter/publications/gp_solo_magazine_home/gp_solo_magazine_index/erickson.ht
ml
Forman, D. (2011). Using a known sperm donor: understanding the legal risks and challenges.
http://
www.path2parenthood.org/article/using-a-known-sperm-donor-understanding-the-legal-risks-and-challenges