1. Mary Casey Jacob, Ph.D., ABPP
An Identified Sperm Donor Case Illustrating the Role of the Mental Health Professional
Mary Casey Jacob, Ph.D., ABPP
August 12, 2017

2. Learning objectives
Participants will be able to: 1.explain clearly to patients why mental health consultations are a part of the informed consent process in cases of directed donations ­­2. articulate the ethical principles to consider in cases of directed donation

3. The recipients
Married heterosexual couple Female: 27 y.o, G0, work-up WNL Male: 27 y.o., azoospermic secondary to treatment for childhood leukemia

4. The proposed donor
21 year old single brother of recipient No children In long-term relationship

5. What is your protocol?

6. UCONN protocol Mandatory informed consent counseling for recipients
Mandatory informed consent counseling AND screening for donor, including psychological testing
Donor partners participate and consent if relationship is “committed”
Mandatory meeting with all participants to outline agreement
Psychologist approval is required to proceed

7. Recipient counseling Focus on informed consent Family history
Relationships between the two recipients, the donor and donor’s partner
Unique issues to consider in known donation

8. Additional information
Recipient female argued strongly that donor’s girlfriend be excluded, stating that the donor was not old enough to know if the relationship was committed, or not.
How would this influence you?

9. Donor/partner counseling
Donor and partner seen alone and together
The relationship was long term and committed
Partner engaged in counseling, reading and reflection, but could not become comfortable and could not consent
Donor declined

10. Ethical Principles
Autonomy
Benficience
Nonmaleficience
Justice

11. Informed Consent Competent to make the decision Informed
Comprehension of the information
Voluntary

12. ASRM Guidelines for family member donors
Ok if…
Donors are adults
All parties are fully informed and consenting
No real (ever) or appearance (generally) of consanguineous relationships
Fertility and Sterility 107 (5), , 2017
-Counseling should include partners and children of donors, recipients and surrogates
- Just “strongly recommends” counseling

13. Who must give informed consent?

14. Does your program have established guidelines for family members as donors?

15. Treatment and Outcome
Treatment with anonymous donor sperm IUI x 3, unsuccessful IVF #1: pregnant, miscarriage IVF #2: pregnant, son born Jan 2012; 2 blasts frozen IVF #3 (cryo transfer), son born Dec 2014 Couple returns 2017 for more guidance on disclosure

16. Learning objectives
Participants will be able to: 1.explain clearly to patients why mental health consultations are a part of the informed consent process in cases of directed donations ­­2. articulate the ethical principles to consider in cases of directed donation