Clinical considerations in donor sperm use

The use of donor sperm has increased substantially over the past two decades, creating a growing need for clinicians to navigate the medical, genetic, psychosocial, and regulatory considerations associated with donor insemination. This review summarizes recommended recipient evaluation, including ovarian reserve assessment, uterine and tubal evaluation, infectious disease screening, and expanded carrier screening, as well as key principles of donor selection and genetic reconciliation. We discuss current guidance regarding directed and nondirected donors, psychosocial counseling, and practical considerations such as donor availability, disclosure, and family-building goals. Finally, we highlight emerging challenges related to donor anonymity, direct-to-consumer genetic testing, and the evolving perspectives of donor-conceived individuals in contemporary reproductive care.