Donor insemination and human immunodeficiency virus: a risk/benefit analysis.

In 1988 the American Fertility Society revised its guidelines for the use of semen in donor insemination by stating that "the use of fresh semen for donor insemination is no longer warranted." Although the consequences of this recommendation include an approximate doubling of the patient's cost of treatment, a 50% reduction in both cycle fecundity and 3-month life-table pregnancy rates, a reduction in the number of pregnancies because of patient dropout, and an ethically troubling increase in physician income as a direct result of the diminished efficacy of treatment, an analysis of the risk of transmission of human immunodeficiency virus through donor insemination has not been presented. All available data suggest that neither safety nor efficacy need be sacrificed in the current practice of donor insemination by offering patients the choice of appropriately screened fresh or frozen sperm.