Healthcare professionals diverge on when to recontact sperm donors for expanded genetic testing
Genomic testing in gamete donors: clinicians’ perspectives on recontact and pre-donation genetic counseling. (Kaplan Idelchuk, 2025)
Kaplan Idelchuk, Y., Sabatello, M., Hochner, H., & Shkedi Rafid, S. (2025). Genomic testing in gamete donors: clinicians’ perspectives on recontact and pre-donation genetic counseling. Journal of Assisted Reproduction and Genetics. https://doi.org/10.1007/s10815-025-03694-0
Geographic Region: Israel
Research Question: What are clinicians’ perspectives on pre-donation genetic counseling and protocols for recontacting sperm donors when broader genetic testing is needed for donor-conceived offspring?
Design: Qualitative study that used semi-structured, in-depth interviews conducted between April 2022 and April 2024. The interview guide covered questions about pre-donation genetic testing, informed consent procedures, donor recontact protocols, and disclosure policies. Participants were recruited through professional networks and snowball sampling across 13 medical centers representing all major Israeli regions.
Sample: 19 healthcare professionals participated in the study, including six sperm bank directors (32%), five genetic counselors (26%), four medical geneticists (21%), and four IVF specialists (21%). Regarding years of professional experience, four participants (21%) had 5-10 years, four (21%) had 11-15 years, and eleven (58%) had more than 15 years of experience.
Key Findings
Approximately half of participants believed recontacting sperm donors prior to performing broader genetic tests (such as exome sequencing) represents the ethically appropriate approach, emphasizing that donors need advance notice about new testing types and potential health implications.
About one-third of participants advocated recontacting donors only after testing reveals pathogenic or clinically significant findings, citing practical considerations, including the time-consuming nature of locating former donors and the fact that most expanded tests yield normal results.
Almost all participants emphasized the critical importance of comprehensive pre-donation genetic counseling that extends beyond family history collection to include detailed explanations of potential future genetic tests, types of findings, and implications for both donor and offspring health.
Most genetic health professionals believed genetic counseling should ideally be provided by genetics specialists, though they acknowledged that non-genetics clinicians could provide counseling with appropriate training given workforce shortages.
Two main arguments supported pre-testing recontact: clinicians anticipated difficulties informing donors about unexpected positive health-implicating results without preparation, and recognition that donors’ opinions may change over time from initial consent given at younger ages.
Practical concerns about recipient and offspring well-being emerged as key considerations, particularly in urgent pregnancy situations where delays from locating donors might prove critical for medical decision-making.
Most participants agreed donors likely do not want recontact for every new test performed, suggesting that broad comprehensive consent obtained at initial donation could resolve recontact difficulties.
Two sperm bank directors reported that donors generally favor comprehensive genetic testing partly for personal health benefits, with most donors requesting to receive results relevant to their health when given the option.
Eleven participants suggested a potential compromise approach: asking donors at the time of donation which course of action they would prefer regarding future recontact and additional testing.
Three participants controversially suggested that donor attitude toward future testing should serve as a selection parameter, arguing donors refusing recontact or genetic information might not be suitable, though this raised concerns about violating the right not to know one’s genetic information.
Limitations: Participants primarily worked in the public healthcare sector, meaning private sector opinions may differ significantly. Israel’s high availability and uptake of prenatal genetic testing might have influenced findings, potentially limiting generalizability to countries with different genetic testing practices and cultural attitudes. The study did not include perspectives from donors themselves or recipient parents, representing an important gap for future research.
Applications: The findings suggest the need to implement dynamic consent platforms that enable ongoing bidirectional communication between donors and clinics. Industry could develop standardized documentation systems for donor preferences regarding genetic testing and recontact, making this information accessible to recipients during donor selection. Organizations and individuals could consider whether donor availability for future testing should influence donor recruitment and selection criteria.
Funding Source: Open access funding was provided by Hebrew University of Jerusalem.
Lead Author: Yulia Kaplan Idelchuk is affiliated with the Faculty of Medicine at Hebrew University of Jerusalem in Israel. No personal connection to donor conception was disclosed.
Regulatory Context
Israel’s regulatory framework for donor conception is governed by Ministry of Health guidelines established in 2007 for sperm donation and 2011 for egg donation.
Both sperm and oocyte donation must remain anonymous under Israeli law, with no access to identifying information about recipients or offspring.
No explicit limit exists on the number of recipients for sperm donation, while egg donors may contribute to a maximum of three recipients due to greater medical risks involved.
Jewish and Muslim donor donations can go only to Jewish and Muslim recipients (respectively), and only unmarried donors can donate eggs.
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Multi-bank study shows the importance of donor genetic testing follow-up (Lockwood, 2024)
Genetic carrier screening in gamete donation creates challenges for autonomy, decision-making, confidence, and supply (Porwal, 2025)
Super interesting how professionals split on pre-test vs post-result recontact. The practical tension here is real, half value donor autonomy upfront while others prioritze urgency. What caught me is the mention that donors at younger ages might not fully grasp future implications, which makes the dynamic consent platform idea even more critical. Theres also an understated point about how standardized preference documentation could actully streamline selection without forcing donors into binary choices.