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A meta-analysis of sperm donation offspring health outcomes

  • D. H. Adams (a1), R. A. Clark (a1), M. J. Davies (a2) and S. de Lacey (a1)

Although the use of donor sperm as a treatment modality for male infertility has become common place, the health outcomes for those conceived has been poorly studied. A structured search of the literature using PubMed, EMBASE and Cochrane Reviews was performed to investigate the health outcomes of offspring conceived from donor sperm. Eight studies were eligible and included in the review, and of these, three were included in a meta-analysis. Meta-analysis of clinical outcomes showed that donor sperm neonates are not at increased risk of being born of low birth weight (<2500 g), preterm (<37 weeks) or with increased incidences of birth defects, than spontaneously conceived neonates.

Corresponding author
*Address for correspondence: D. Adams, School of Nursing and Midwifery, Flinders University, Bedford Park, SA 5042, Australia. (Email:
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1. Gregoire, AT, Mayer, RC. The impregnators. Fertil Steril. 1965; 16, 130134.
2. Boulet, SL, Mehta, A, Kissin, DM, et al. Trends in use of and reproductive outcomes associated with intracytoplasmic sperm injection. JAMA. 2015; 313, 255263.
3. Jain, T, Gupta, RS. Trends in the use of intracytoplasmic sperm injection in the United States. N Engl J Med. 2007; 357, 251257.
4. Moskovtsev, SI, Dacanay, D, Baratz, A, et al. Significant increase in utilization of donor sperm by lesbian couples after the ligalization of same sex marriages in Ontario, Canada. Fertil Steril. 2013; 100, S67, O-219.
5. Viloria, T, Garrido, N, Minaya, F, et al. Report of results obtained in 2934 women using donor sperm: donor insemination versus in vitro fertilization according to indication. Fertil Steril. 2011; 96, 11341137.
6. Jadva, V, Badger, S, Morrissette, M, Golombok, S. ‘Mom by choice, single by life’s circumstance…’ Findings from a large scale survey of the experiences of single mothers by choice. Hum Fertil (Camb). 2009; 12, 175184.
7. González-Comadran, M, Urresta Avila, J, Saavedra Tascón, A, et al. The impact of donor insemination on the risk of preeclampsia: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2014; 182, 160166.
8. Smith, GN, Walker, M, Tessier, JL, Millar, KG. Increased incidence of preeclampsia in women conceiving by intrauterine insemination with donor versus partner sperm for treatment of primary infertility. Am J Obstet Gynecol. 1997; 177, 455458.
9. Hoy, J, Venn, A, Halliday, J, Kovacs, G, Waalwyk, K. Perinatal and obstetric outcomes of donor insemination using cryopreserved semen in Victoria, Australia. Hum Reprod. 1999; 14, 17601764.
10. Salha, O, Sharma, V, Dada, T, et al. The influence of donated gametes on the incidence of hypertensive disorders of pregnancy. Hum Reprod. 1999; 14, 22682273.
11. Need, JA, Bell, B, Meffin, E, Jones, WR. Pre-eclampsia in pregnancies from donor inseminations. J Reprod Immunol. 1983; 5, 329338.
12. Challis, JR, Lockwood, CJ, Myatt, L, et al. Inflammation and pregnancy. Reprod Sci. 2009; 16, 206215.
13. Zetterström, K, Lindeberg, SN, Haglund, B, Hanson, U. Chronic hypertension as a risk factor for offspring to be born small for gestational age. Acta Obstet Gynecol Scand. 2006; 85, 10461050.
14. Geelhoed, JJ, Fraser, A, Tilling, K, et al. Preeclampsia and gestational hypertension are associated with childhood blood pressure independently of family adiposity measures: the Avon Longitudinal Study of Parents and Children. Circulation. 2010; 122, 11921199.
15. Jayet, PY, Rimoldi, SF, Stuber, T, et al. Pulmonary and systemic vascular dysfunction in young offspring of mothers with preeclampsia. Circulation. 2010; 122, 488494.
16. Himmelmann, A. Blood pressure and left ventricular mass in children and adolescents: the Hypertension in Pregnancy Offspring Study. Blood Press Suppl. 1994; 3, 146.
17. Davis, EF, Newton, L, Lewandowski, AJ, et al. Pre-eclampsia and offspring cardiovascular health: mechanistic insights from experimental studies. Clin Sci (Lond). 2012; 123, 5372.
18. Davis, EF, Lazdam, M, Lewandowski, AJ, et al. Cardiovascular risk factors in children and young adults born to preeclamptic pregnancies: a systematic review. Pediatrics. 2012; 129, e1552e1561.
19. Wu, CS, Sun, Y, Vestergaard, M, et al. Preeclampsia and risk for epilepsy in offspring. Pediatrics. 2008; 122, 10721078.
20. Wu, CS, Nohr, EA, Bech, BH, et al. Health of children born to mothers who had preeclampsia: a population-based cohort study. Am J Obstet Gynecol. 2009; 201, 269.e1269.e10.
21. Kajantie, E, Eriksson, JG, Osmond, C, Thornburg, K, Barker, DJ. Pre-eclampsia is associated with increased risk of stroke in the adult offspring: the Helsinki Birth Cohort Study. Stroke. 2009; 40, 11761180.
22. Mann, JR, McDermott, S, Bao, H, Hardin, J, Gregg, A. Pre-eclampsia, birth weight, and autism spectrum disorders. J Autism Dev Disord. 2010; 40, 548554.
23. Saito, S, Shiozaki, A, Nakashima, A, Sakai, M, Sasaki, Y. The role of the immune system in preeclampsia. Mol Aspects Med. 2007; 28, 192209.
24. Sargent, IL, Borzychowski, AM, Redman, CW. Immunoregulation in normal pregnancy and pre-eclampsia: an overview. Reprod Biomed Online. 2006; 13, 680686.
25. Kyrou, D, Kolibianakis, EM, Devroey, P, Fatemi, HM. Is the use of donor sperm associated with a higher incidence of preeclampsia in women who achieve pregnancy after intrauterine insemination? Fertil Steril. 2010; 93, 11241127.
26. Johnson v. Superior Ct., 80 Cal. App. 4th 1050, 1056-57 (Ct. App. 2000).
27. Gebhardt, D. Sperm donor suffers years later from inherited disease. J Med Ethics. 2002; 28, 213214.
28. Callum, P, Messiaen, L, Bower, P, et al. Gonosomal mosaicism for an NF1 deletion in a sperm donor: evidence of the need for co-ordinated, long-term communication of health information among relevant parties. Hum Reprod. 2012; 27, 12231226.
29. Stewart, GJ, Tyler, JP, Cunningham, AL, et al. Transmission of human T-cell lymphotropic virus type III (HTLV-IIl) by artificial insemination by donor. Lancet. 1985; 2, 581585.
30. Zribi, N, Feki Chakroun, N, El Euch, H, et al. Effects of cryopreservation on human sperm deoxyribonucleic acid integrity. Fertil Steril. 2010; 93, 159166.
31. Dalzell, LH, McVicar, CM, McClure, N, Lutton, D, Lewis, SE. Effects of short and long incubations on DNA fragmentation of testicular sperm. Fertil Steril. 2004; 82, 14431445.
32. Di Santo, M, Tarozzi, N, Nadalini, M, Borini, A. Human sperm cryopreservation: update on techniques, effect on DNA integrity, and implications for ART. Adv Urol. 2012; 2012, 854837.
33. Toro, E, Fernández, S, Colomar, A, et al. Processing of semen can result in increased sperm DNA fragmentation. Fertil Steril. 2009; 92, 21092112.
34. Thomson, LK, Fleming, SD, Aitken, RJ, et al. Cryopreservation-induced human sperm DNA damage is predominantly mediated by oxidative stress rather than apoptosis. Hum Reprod. 2009; 24, 20612070.
35. Tatone, C, Di Emidio, G, Vento, M, Ciriminna, R, Artini, PG. Cryopreservation and oxidative stress in reproductive cells. Gynecol Endocrinol. 2010; 26, 563567.
36. Adams, DH, Clark, RA, Davies, MJ, de Lacey, S. A meta-analysis of neonatal health outcomes from oocyte donation. J Dev Orig Health Dis. 2016; 7, 257272.
37. Class, QA, Rickert, ME, Lichtenstein, P, D’Onofrio, BM. Birth weight, physical morbidity, and mortality: a population-based sibling-comparison study. Am J Epidemiol. 2014; 179, 550558.
38. Calkins, K, Devaskar, SU. Fetal origins of adult disease. Curr Probl Pediatr Adolesc Health Care. 2011; 41, 158176.
39. Barker, DJP. The fetal and infant origins of adult disease. 1992. BMJ Books: London.
40. Skora, D, Frankfurter, D. Adverse perinatal events associated with ART. Semin Reprod Med. 2012; 30, 8491.
41. Barrington, KJ, Janvier, A. The paediatric consequences of assisted reproductive technologies, with special emphasis on multiple pregnancies. Acta Paediatr. 2013; 102, 340348.
42. Joanna Briggs Institute. Reviewers’ Manual. 2011. Joanna Briggs Institute, University of Adelaide: Adelaide, Australia.
43. Thapar, A, Harold, G, Rice, F, et al. Do intrauterine or genetic influences explain the foetal origins of chronic disease? A novel experimental method for disentangling effects. BMC Med Res Methodol. 2007; 7, 25.
44. Gaudoin, M, Dobbie, R, Finlayson, A, et al. Ovulation induction/intrauterine insemination in infertile couples is associated with low-birth-weight infants. Am J Obstet Gynecol. 2003; 188, 611616.
45. Amuzu, B, Laxova, R, Shapiro, SS. Pregnancy outcome, health of children, and family adjustment after donor insemination. Obstet Gynecol. 1990; 75, 899905.
46. Iizuka, R, Sawada, Y, Nishina, N, Ohi, M. The physical and mental development of children born following artificial insemination. Int J Fertil. 1968; 13, 2432.
47. Davies, MJ, Moore, VM, Willson, KJ, et al. Reproductive technologies and the risk of birth defects. N Engl J Med. 2012; 366, 18031813.
48. Lansac, J, Thepot, F, Mayaux, MJ, et al. Pregnancy outcome after artificial insemination or IVF with frozen semen donor: a collaborative study of the French CECOS Federation on 21597 pregnancies. Eur J Obstet Gynecol Reprod Biol. 1997; 74, 223228.
49. Forse, RA, Ackman, CF, Fraser, FC. Possible teratogenic effects of artificial insemination by donor. Clin Genet. 1985; 28, 2326.
50. Tanaka, K. An Intelligence Test by Tanaka and Binet. 1954. Nippon-Bunkasha: Tokyo.
51. Society for Assisted Reproductive Technology, American Society for Reproductive Medicine. Assisted reproductive technology in the United States and Canada: 1995 results generated from the American Society for Reproductive Medicine/Society for Assisted Reproductive Technology Registry. Fertil Steril. 1998; 69, 389398.
52. Society for Assisted Reproductive Technology, American Society for Reproductive Medicine. Assisted reproductive technology in the United States and Canada: 1994 results generated from the American Society for Reproductive Medicine/Society for Assisted Reproductive Technology Registry. Fertil Steril. 1996; 66, 697705.
53. Society for Assisted Reproductive Technology, American Society for Reproductive Medicine. Assisted reproductive technology in the United States and Canada: 1993 results generated from the American Society for Reproductive Medicine/Society for Assisted Reproductive Technology Registry. Fertil Steril. 1995; 64, 1321.
54. American Fertility Society & Society of Assisted Reproductive Technology. Assisted reproductive technology in the United States and Canada: 1992 results generated from the American Fertility Society/Society for Assisted Reproductive Technology Registry. Fertil Steril. 1994; 62, 11211128.
55. Luke, B, Keith, LG. The contribution of singletons, twins and triplets to low birth weight, infant mortality and handicap in the United States. J Reprod Med. 1992; 37, 661666.
56. Blondel, B, Kogan, MD, Alexander, GR, et al. The impact of the increasing number of multiple births on the rates of preterm birth and low birthweight: an international study. Am J Public Health. 2002; 92, 13231330.
57. Poikkeus, P, Saisto, T, Punamaki, RL, et al. Birth experience of women conceiving with assisted reproduction: a prospective multicenter study. Acta Obstet Gynecol Scand. 2014; 93, 880887.
58. Gillet, E, Martens, E, Martens, G, Cammu, H. Prelabour caesarean section following IVF/ICSI in older-term nulliparous women: too precious to push? J Pregnancy. 2011; 2011, 362518.
59. Human Fertilisation and Embryology Authority. Code of Practice, 1st edn, 1991. HFEA: London.
60. Tyler, JP, Dobler, KJ, Driscoll, GL, Stewart, GJ. The impact of AIDS on artificial insemination by donor. Clin Reprod Fertil. 1986; 4, 305317.
61. American Fertility Society. Revised new guidelines for the use of semen-donor insemination. Fertil Steril. 1988; 49, 211.
62. Canadian Fertility and Andrology Society. Guidelines for Therapeutic Donor Insemination. 1988. CFAS: Montreal.
63. Brant, AM, Munakata, Y, Boomsma, DI, et al. The nature and nurture of high IQ: an extended sensitive period for intellectual development. Psychol Sci. 2013; 24, 14871495.
64. Committee to Consider the Social, Ethical and Legal Issues Arising from In Vitro Fertilization. Issues paper on donor gametes in IVF. 1983. Victorian Government: Melbourne.
65. Paul, S, Harbottle, S, Stewart, JA. Recruitment of sperm donors: the Newcastle-upon-Tyne experience 1994-2003. Hum Reprod. 2006; 21, 150158.
66. Cushing, AL. ‘I just want more information about who I am’: the search experience of sperm-donor offspring, searching for information about their donors and genetic heritage. Inform Res. 2010; 15, 428.
67. Tomlinson, MJ, Pooley, K, Pierce, A, Hopkisson, JF. Sperm donor recruitment within an NHS fertility service since the removal of anonymity. Hum Fertil (Camb). 2010; 13, 159167.
68. Shukla, U, Deval, B, Jansa Perez, M, et al. Sperm donor recruitment, attitudes and provider practices – 5 years after the removal of donor anonymity. Hum Reprod. 2013; 28, 676682.
69. Pacey, A. Sperm donor recruitment in the UK. TOG. 2010; 12, 4348.
70. American Academy of Pediatrics, Section on Ophthalmology, Council on Children with Disabilities; American Academy of Ophthalmology; American Association for Pediatric Ophthalmology and Strabismus; American Association of Certified Orthoptists. Joint statement – learning disabilities, dyslexia, and vision. Pediatrics. 2009; 124, 837844.
71. Scruggs, TE, Mastropieri, MA. On babies and bathwater: addressing the problems of identification of learning disabilities. Learn Disabil Q. 2002; 25, 155168.
72. Lyon, GR. Learning disabilities. Future Child. 1996; 6, 5476.
73. Boyle, CA, Decouflé, P, Yeargin-Allsopp, M. Prevalence and health impact of developmental disabilities in US children. Pediatrics. 1994; 93, 399403.
74. Pfeiffer, SI. Identifying gifted and talented students. J Appl School Psychol. 2002; 19, 3150.
75. Halliday, J, Wilson, C, Hammarberg, K, et al. Comparing indicators of health and development of singleton young adults conceived with and without assisted reproductive technology. Fertil Steril. 2014; 101, 10551063.
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