This is a very difficult question because the answer is so often yes. A woman who asks this question should be warned that choosing a father at random may be as risky as conceiving with her husband. Artificial insemination is a standard option that allows the woman to avoid genetic disease. But most programs will not inseminate a woman unless she is married and her husband consents. If the woman does not want her husband to know that he is not the genetic father, then she will have to seek help outside the traditional medical care system.

A physician who suspects that a patient is considering such private selection should be sure that she understands the risks. If she is the carrier, she must understand that another father will not alter the risk. If the problem is a recessive disease with a high gene prevalence, such as sickle cell disease or cystic fibrosis, she may have the bad luck to pick a father who is also a carrier. On the other hand, if her husband is the carrier and she is not, her idea is medically sound, if socially questionable. Although it is reasonable to try to talk a woman out of seeking a surrogate father without telling her husband, it would violate her privacy to tell her husband. A physician who is uncomfortable with the situation should withdraw from the case. He or she should not try to control the actions of an independent adult.