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Necessity of Formal Genetic Screening in Artificial Insemination by Donor

From the Department of Obstetrics and Gynecology, Northwestern University Medical School, Northwestern Memorial Hospital, and The Fertility Institute, Ltd, Chicago, Illinois.

After observing abnormal offspring following artificial insemination by donor, several authors recently have proposed intensive genetic screening of donors. The screening would be beyond that practiced by most infertility specialists. To determine the necessity for formal genetic investigation of donors, the authors analyzed the outcome of artificial insemination pregnancies in which donors were screened with careful medical and family histories, but were not subjected to formal pedigree analysis, karyotyping, or extensive metabolic screening. Fewer than 10% of potential donors were disqualified for genetic reasons. The study, limited to ascertaining the presence or absence of overt anomalies evident at birth, showed that such malformations were not more frequent in artificial insemination pregnancies (1.7%) than in controls (2.3%). It is concluded that extensive and formalized genetic screening is probably not necessary provided a thorough medical history is obtained. In addition, a practical approach to identifying donors at increased risk for siring abnormal offspring is offered.