CURRENT PRACTICES OF COMMERCIAL CRYOBANKS IN SCREENING PROSPECTIVE DONORS FOR GENETIC-DISEASE AND REPRODUCTIVE RISK

Objective-To determine how the screening practices of commercial semen banks vary from published guidelines, which factors influence cryoban ks to exclude prospective semen donors for genetic reasons, and the cu rrent role of clinical geneticists/genetic counselors in evaluating pr ospective semen donors. Design-The genetic screening of prospective do nors by commercial semen banks was evaluated using written questionnai res completed by bank directors. Responses were analyzed to determine exclusion criteria, adherence to published guidelines, and contributio n of genetic professionals. Setting and Participants-Semen banks were selected on the basis of membership in the American Association of Tis sue Banks and commercial use of semen for artificial insemination by d onor. Main Outcome Measure-Semen bank practices as reported by commerc ial semen bank directors. Results-Of 37 eligible banks, 16 responded. All screen prospective donors by medical/family history and physical e xamination; 94% have upper age limits; 63% examine for minor physical defects; 56% routinely karyotype; 81% screen men of ethnic groups at r isk for Tay Sachs disease, sickle cell disease and thalassemia; 19% sc reen all donors; 25% screen all donors for cystic fibrosis and 50% onl y screen if family history positive. Donor rejection was based on thre e criteria: mode of inheritance of familial disorder, severity of dise ase, and availability of carrier/confirmatory testing of donor genotyp e. Ten of 16 banks have no genetic professional on staff. Conclusion-C ommercial semen banks primarily rely on family history as the major ex clusion criterion in genetic screening of donors. Considerable differe nces exist among semen bank practices in accordance with guidelines pu blished by national agencies. Genetic professionals have a minimal eff ect overall on evaluation of semen donors.