Legal issues and recommendations for public sperm bank

Approximately 15% of couples hoping to conceive are infertile. Male factor infertility is the only cause in 40% of those couples. Approximately 20% of men with infertility have azoospermia. Of these patients, roughly 40% are experience obstruction or absence of sperm passage. However, the other 60% of patients must seek out adoption or conceive using a sperm bank. Currently, recommendations regarding legal issues are needed for sperm banks to be operated safely and effectively, and this paper provides a set of such recommendations.

Reasons of shortage for donated sperm and plan to resolve deficiencies in the sperm donor system

Sperm banking from recruited donors is an important way to help infertile couples who want to achieve pregnancy by therapeutic artificial insemination, even in the era of in vitro fertilization. Korea has the lowest population density of newborns among all Organization for Economic Co-operation and Development countries, with a total fertility rate of 1.17 and an annual birth rate of 300,000 or less as of 2017. This situation emerged due to various causes, including late marriage, fecundity problems, and air pollution. Nevertheless, we have imposed strict limits on basic research and clinical activities, including the operation of sperm banks, in the field of human reproduction under the 2005 Bioethics and Safety Act. Therefore, cryopreserved sperm for artificial insemination is almost absent in the sperm banks of major human reproduction centers. To resolve this difficult situation, as well as to increase the operation of sperm banks in Korea to the global standard level, the author evaluates the underlying reasons for donor sperm use by azoospermic patients from medical, ethical, legal, religious, and cultural perspectives, and then proposes a plan to resolve this situation including highly regulated standard operating procedures to ensure comprehensive safety practices for voluntary sperm donors and infertile couples, as well as to build an ideal sperm donation program.

The Attitudes of Infertile Male Patients Toward the Use of Artificial Insemination by Donor: A Korean Regional Survey

PURPOSE: Infertile couples interested in nonspouse artificial insemination by donor (AID) not only require a thorough understanding of the medical procedure but also must scrutinize the effects it will have on family relationships, including those on the infant to be born. We conducted a series of surveys in couples with male infertility to collect information necessary for AID counseling. MATERIALS AND METHODS: A total of 384 cases with noncurable male infertility were enrolled in this inquiry survey. The questionnaire consisted of 18 items that assessed demographic characteristics, background information concerning the choice to use AID, subjective experiences, long-term effects, and an overall evaluation. RESULTS: A total of 126 surveys were returned (32.8%). AID was first suggested by the husband in about half of the cases. The major reason for considering the procedure was to form a complete family. Two-thirds of the couples were anxious about the procedure, most often about possible congenital or acquired deformities in the infant. After the birth of the child, most couples were positive about their decision to have used AID. About half of the couples felt that the child was their own and expected not to tell the child about AID. Overall, about 50% of the couples were satisfied with the procedure. CONCLUSIONS: Those who underwent AID experienced various psychological effects, including anxiety about the child to be born. To overcome these problems, sufficient medical information and consultation about the process of selecting the donor and about AID procedures should be provided before the procedure is used.

Sperm banking for male cancer patients: social and semen profiles

PURPOSE: Report the characteristics of cryopreserved semen from a cohort of male cancer patients, attitudes towards cryopreservation and outcomes of semen samples based on a 12-year cryopreservation program. MATERIAL AND METHODS: Data from 98 male cancer patients whose sperm samples were banked were evaluated. Demographic parameters, semen characteristics, destination of sperm banked samples and questionnaires answered by the patients regarding cryopreservation time were evaluated. RESULTS: The cancer diagnoses were testicle (56.1 percent), prostate (15.3 percent), Hodgkin’s lymphomas (9.2 percent), non-Hodgkin’s lymphomas (7.1 percent), leukemia (3.1 percent) and other malignancies (9.2 percent). The patients with testicular cancer presented lower sperm concentration (p < 0.001); however, there were no differences with the percentage of normozoospermic patients among cancer type groups (p = 0.185). A shorter time between cancer diagnosis and sperm banking was observed for testicular and prostate cancer patients (p < 0.001). Most of the patients (89.5 percent) favored sperm banking as a fertility preservation method. CONCLUSIONS: Although less than 20 percent of banked sperm samples were disposed of, the majority of patients related sperm banking with safe for fertility preservation. Our results show that all male cancer patients of reproductive age facing cancer treatment could be offered sperm banking.