Physicians should be cautious about participating in fertility treatments or conceptions that involve anyone but the couple under treatment. Many states have specific laws on artificial insemination that specify that the donor father has no legal rights. However, if a couple wants to choose their own donor or to arrange a contract pregnancy, the laws are not as clear. Custody fights and criminal charges of baby selling are known problems with these arrangements. The control of infectious and genetic diseases must also be considered. The use of any tissue from a third party requires that the physician have a complete genetic history and that the donor be tested for infectious diseases as would an anonymous donor.

The presence of contracts or sperm donation laws may not prevent the parties from ending up in a court case or a custody battle. Even without legal entanglements, the social dislocations may be considerable. A man may believe that he can be indifferent when the child is only a theoretical possibility and find that he cannot keep away from the child when he or she is born. The mother and her husband may also have ambivalent feelings. It is very difficult to accept paternity as an abstraction or as a legal concept when all the people involved know one another well.

The use of banked sperm from an unidentified donor is legally safer than using a chosen donor. The anonymous donor has been screened for disease and has relinquished any right to the child conceived. The donor is unlikely to know who his biologic children are, and in general he is barred from making any legal claim to them. Conversely, the child is cut off from important information about the biologic parent’s medical and psychiatric history.