Julius Center, Department of Medical Ethics, University Medical Center Utrecht, Stratenum 6.131, 3508 GA Utrecht, The Netherlands.
Hum Reprod. 2012 May;27(5):1286-91. doi: 10.1093/humrep/des071. Epub 2012 Mar 7.
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.
在不断变化的生殖医学领域，诊所经常面临对新型医学辅助生殖方法的需求。特别是涉及卵母细胞或精子供体的第三方（辅助）生殖，由于涉及到各方，因此在伦理和心理上都非常复杂，但仍然被广泛接受。一种特殊类型的第三方生殖涉及家族内医学辅助生殖（IMAR），其中供体是接受者的家庭成员。在 IMAR 中，与第三方生殖相关的一些伦理和心理问题更加严重。但是，由于缺乏关于 IMAR 的信息，其确切影响和后果仍在推测之中。ESHRE 伦理与法律工作组和人类受精与胚胎管理局最近都强调了缺乏信息和需要进行辩论的问题。为了为 IMAR 的讨论和知识做出贡献，我们介绍了一对夫妇最近访问我们学术诊所的情况，他们要求进行一种非常特殊的 IMAR 变体：一级，代际父亲到儿子的精子捐赠。由于我们的学术医院在这种 IMAR 变体方面没有经验，我们的生殖医学跨学科伦理委员会广泛讨论了这一请求，最终就 IMAR 的伦理问题，特别是父亲到儿子的精子捐赠问题提出了咨询报告。在这里，我们将首先介绍这对夫妇的男科和社会背景，然后讨论导致批准他们请求的伦理考虑因素。最后，我们将提出关于 IMAR 道德实践的建议。
