Wednesday, June 7, 2006
This week's New York Times Science section has an interesting article on some of the concerns raised by anonymous sperm donors. The article reports,
Sperm donor No. F827 aced all the tests. He was healthy, and he said his parents and grandparents were, too. Under a microscope, his chromosomes looked perfect. He also turned out to be quite prolific: his deposits to a Michigan sperm bank during the 1990's produced 11 children.
But he passed a serious gene defect to five of those children, a blood disease that leaves them at risk for leukemia and in need of daily shots of an expensive drug to prevent infections. They also have a 50-50 chance of passing the disease to their children.
Shouldn't the sperm bank have detected the bad gene and rejected the donor?
Geneticists say no, because the disease is extremely rare and sperm banks cannot be expected to test for every possible mutation.
But that bit of uncertainty raises other questions. Should any donor produce so many children, when they will be scattered far and wide, making it harder to recognize a pattern of illness than it would be if they all lived under one roof? It's also worth asking whether damage could be limited by requiring sperm banks to keep track of donors' babies so that if one or more got sick, other families who had used the same donor could be warned, sale of the sperm stopped and the donor notified.
The Michigan case, described last month in The Journal of Pediatrics, could be a warning signal to sperm banks and their customers — or it could be just a fluke, such a weird set of circumstances that it has no bearing on anyone else. It's hard to tell for sure, because the buying and selling of sperm is an intensely private, largely unregulated business. A lot is not known, and many participants want it that way. . . . . . .
Still, sperm banking seems to have a good track record, at least as far as anybody can tell. Donors are tested repeatedly for H.I.V., hepatitis and other infections. As for genetic disorders, there have been few other published reports of problems traced back to donors. The known cases include a donor in California who passed on a hereditary kidney disease and one in the Netherlands who fathered 18 children and was later found to have a serious neurological disease that his offspring have a 50-50 chance of inheriting.
The Food and Drug Administration has tissue-banking rules that apply to sperm banks, but those rules concern infectious diseases rather than genetics, and do not limit the number of pregnancies per donor or require tracking of the children's health. A trade group, the American Association of Tissue Banks, accredits sperm banks that meet its standards, but few banks participate in the program.
The Michigan cases came to light only because all four families with sick children happened to consult the same specialist at the University of Michigan, Dr. Laurence A. Boxer. The disorder, severe congenital neutropenia, is so rare — it affects only one child in five million — that when Dr. Boxer suddenly saw several cases in one year he suspected that something strange was going on.
Although the tone of the entire article appears to be quite positive about the safety of sperm banks, some greater regulations may be necessary in the future. The lack of information and tracking seems to create a potential for future problems. [bm]