Back to Chapter 4 Genetics & Reproductive Medicine
Opinion 4.2.2

Gamete Donation

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Donating eggs or sperm for others to use in reproduction can enable individuals who would not otherwise be able to do so to have children. However, gamete donation also raises ethical concerns about the privacy of donors and the nature of relationships among donors and children born through use of their gametes by means of assisted reproductive technologies.

Physicians who participate in gamete retrieval and storage should:

  1. Inform prospective donors of sperm or ova:
    1. about the clinical risks of gamete donation, including the near and long-term risks and the discomforts of ovarian hyperstimulation and egg retrieval as appropriate;
    2. about the need for full medical disclosure and that prospective donors will be tested for infectious disease agents and genetic disorders;
    3. whether and how the donor will be informed if testing indicates the presence of infectious disease or genetic disorder;
    4. that all information collected, including test results, will be stored indefinitely;
    5. what additional personal information will be collected about the donor;
    6. under what circumstances and with whom personal information, including identifying information, will be shared for clinical purposes;
    7. how donated gametes will be stored and policies and procedures governing the use of stored gametes;
    8. whether and how the donor will be compensated;
    9. the fact that state law will govern the relationship between the donor and any resulting child (or children).
  2. Exclude prospective donors for whom testing reveals the presence of infectious disease agents.
  3. Obtain the prospective donor’s consent for gamete retrieval.
  4. Discuss, document and respect the prospective donor’s preferences for how gametes may be used, including whether they may be donated for research purposes.
  5. Discuss, document, and respect the prospective donor’s preferences regarding release of identifying information to any child (or children) resulting from use of the donated gametes.
  6. Adhere to good clinical practices, including ensuring that identifying information is maintained indefinitely so that:
    1. donors can be notified in the event a child born through use of his/her gametes subsequently tests positive for infectious disease or genetic disorder that may have been transmitted by the donor;
    2. the number of pregnancies resulting from a single gamete donor is limited.
AMA Principles of Medical Ethics: I, V
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Opinion 1.1.7

Physician Exercise of Conscience

Preserving opportunity for physicians to act (or to refrain from acting) in accordance with the dictates of conscience is important for preserving the integrity of the medical profession as well as the integrity of the individual physician; Physicians’ freedom to act according to conscience is not unlimited; They are expected to provide care in emergencies, honor patients’ informed decisions to refuse life-sustaining treatment, respect basic civil liberties and not discriminate against patients on the basis of arbitrary characteristics.
Opinion 2.1.2

Decisions for Adult Patients Who Lack Capacity

Physicians should engage patients whose capacity is impaired in decisions involving their own care to the greatest extent possible, including when the patient has previously designated a surrogate to make decisions on his or her behalf.
Opinion 4.2.1

Assisted Reproductive Technology

Assisted reproduction offers hope to patients who want children but are unable to have a child without medical assistance. In many cases, patients who seek assistance have been repeatedly frustrated in their attempts to have a child and are psychologically vulnerable. Those patients whose health insurance does not cover assisted reproductive services may also be financially vulnerable. Candor and respect are thus essential for ethical practice.