Risk management and the further use of gametes from a donor with a known pathogenic variant

Some donor-conceived persons are born with an autosomal recessive genetic condition. In response, some fertility clinics categorically restrict the further use of the gametes from the donor who transmitted the pathogenic variant, although the chance of recurrence is usually very low. The level of specific risk that a recipient or physician is willing to accept depends on various factors, including severity, lived experiences and personal preferences. However, on a policy level, we argue for consistency and guidance on the principled question of whether the (further) use of gametes from donors who are carriers of a known pathogenic variant with autosomal recessive inheritance is acceptable. Provided that the identified risk is comparable to the general risk of genetic conditions, the continued use of the donor gametes can remain an acceptable option.