Genomic testing in gamete donors: clinicians’ perspectives on recontact and pre-donation genetic counseling

Purpose: Widespread use of genome-wide testing during pregnancy and throughout life raises clinical, legal, and ethical questions. Results from such tests in the context of gamete donation have implications also for the donor and other recipients. Current guidelines do not fully address this matter. We aim to provide empirical data on clinician’s perspectives towards pre-donation genetic counseling and recontacting sperm donors for additional genome-wide genetic testing. Methods: In-depth interviews were conducted with 19 healthcare professionals across Israel from different disciplines (sperm bank directors, fertility and genetic specialists) and were analyzed using the grounded theory approach. Results: Overall participants emphasized the importance of pre-donation comprehensive genetic counseling, which should cover future potential genetic tests findings, and their implications for both donor and offspring health, along with offering donors the choice to allow recontact later on. Approximately half of the participants believed recontacting donors should happen before performing broader genetic tests on the offspring, mainly due to possible implications for the donor’s health. In contrast, about a third of participants advocated recontacting donors only if clinically significant findings are identified, driven by practical reasons concerning the benefit to the offspring and time-sensitive situations, like pregnancy. Conclusion: This study highlights the need for clear guidelines regarding donor recontact in the context of expanding genetic testing. A strong consensus exists on the necessity of comprehensive pre-donation genetic counseling, divergent views on recontact emphasize the need to balance the implications for donor health with practical considerations for offspring and timely medical interventions.