Elon Musk’s turn to surrogacy to expand his lineage raises questions: Is sperm donation safe?

Elon Musk is actively seeking to increase the size of his family by recruiting women and promoting surrogacy as a means of quickly creating a "legion" of children using his riches, power, and platform X, according to The Wall Street Journal. As conversations around Musk’s plans to have more children via surrogacy emerge, it's important to examine the safety and ethics of assisted reproductive methods like sperm donation and surrogacy.

Dr. Prachi Benara, senior consultant, Birla Fertility & IVF says, “Sperm donation is considered medically safe, with studies showing no increased health risks to children born through donor sperm. However, concerns arise when donor regulation is weak. In India, the ART (Regulation) Act, 2022, limits the number of donations to curb unethical practices.”

Surrogacy, while a pathway to parenthood for many, poses medical risks such as pre-eclampsia and postpartum complications for surrogate mothers. India banned commercial surrogacy in 2021 to curb exploitation, allowing only altruistic surrogacy for Indian citizens under strict conditions.

Ethically, both practices must prioritize the rights and well-being of the child, the donor, and the surrogate. While science enables new paths to parenthood, India continues to balance innovation with strong regulation and ethical safeguards.

- Anonymity vs. Identity Disclosure

According to Dr. Usha BR, Consultant - OBGYN, Fertility & Laparoscopic Surgeon, Fortis Hospital, Bannerghatta Road, Bengaluru, “There's an ongoing debate about whether donors should remain anonymous. Many donor-conceived individuals express a desire to know their biological origins, which can impact their psychological well-being and identity formation.” ​

-Limiting Offspring Numbers: To prevent accidental consanguinity and psychological distress among donor-conceived individuals, it's ethically advisable to limit the number of offspring per donor. ​

-Informed Consent and Transparency: Both donors and recipients should be fully informed about the processes, potential risks, and implications of sperm donation. ​

-Medical Screening: Donors should undergo comprehensive screening for genetic disorders and infectious diseases to ensure the health and safety of the offspring. ​


-Quarantine Protocols: Sperm samples are typically quarantined for a period (e.g., six months) and retested to ensure they're free from infections before use. ​

Assisted Reproductive Technology (Regulation) Act, 2021: This act regulates ART services, including sperm donation. It mandates that sperm donors be between 21 and 55 years old and prohibits a donor's sperm from being used for more than one commissioning couple. ​

-Surrogacy (Regulation) Act, 2021: Initially, this act prohibited the use of donor gametes in surrogacy. However, an amendment in February 2024 allows the use of donor sperm or eggs if one of the intending parents has a medical condition necessitating it. ​

-Netherlands Case: A Dutch sperm donor fathered over 550 children, raising concerns about the lack of regulation.

USA Case: A U.S. sperm bank faced lawsuits after it was revealed that a donor had a history of schizophrenia and criminal activity, which was not disclosed to recipients.

Establish a centralized donor registry: To track the number of offspring per donor and prevent overuse.