Ethics of intergenerational (father-to-son) sperm donation

In the ever changing field of reproductive medicine, clinics are regularly confronted with requests for novel variants of medically assisted reproduction. Particularly third-party (assisted) reproduction, which requires the involvement of an oocyte or sperm donor, is ethically and psychologically complex due to the parties involved, but nevertheless widely accepted. A particular type of third party reproduction concerns intrafamilial medically assisted reproduction (IMAR), where the donor is a family member of the recipients. In IMAR, some of the ethical and psychological issues associated with third party reproduction are intensified. The precise impact and consequences, however, remain speculative due to the lack of information regarding IMAR. Both the ESHRE Task Force on Ethics and Law and the Human Fertilization and Embryology Authority have recently highlighted the lack of information and the need for debate. In order to contribute to the discussion and knowledge on IMAR, we present a couple that recently visited our academic clinic with a request for a very particular variant of IMAR: first degree, intergenerational father-to-son sperm donation. As our academic hospital did not have experience with this variant of IMAR, our interdisciplinary Ethics Committee for Reproductive Medicine extensively discussed the request, resulting in an advisory report on the ethics of IMAR in general and father-to-son sperm donation in particular. Here, we will first present the andrological and social background of the couple and subsequently discuss the ethical considerations that led to the approval of their request. We will conclude the paper with recommendations for a morally sound practice of IMAR.