Rajoo, 20 years-old son, accidentally found the medical report of his father that revealed about his father's infertility. This shocking news confused his identity and provoked many questions related to it. His identity became questionable in his eyes, and he felt ashamed of his existence. One day, he attempted suicide but fortunately survived. During his treatment, a psychologist discovered that Rajoo is fighting for his identity issue. This was a challenging situation for the entire family, but it was the time to reveal the truth. His parents told him regarding their infertility, and assured him that taking sperms from a donor was the only solution to get a baby. Rajoo wants to know about his biological father (donor), but parents were not aware of the details due to the institutes policy of maintaining the donor's anonymity.

This scenario arises different ethical questions. Can the autonomy of the sperm donor override the autonomy of donor-conceived child and recipient? Should parents hide reality from the child? Who would be the father of donor- conceived child, genetic or social one? What is the right time to disclose the truth before the child? What if the child founds the truth accidentally and develops social and psychological disorders, and how to deal with such severe consequences?

Anonymity versus non-anonymity in sperm donation is a delicate inquiry for the recipient, donors, and donorconceived child. However, the majority of the sperm donors prefered to be anonymous. It is a donor's autonomy, either he wants to disclose it or not? If he does not want to disclose it, then no one can force him to disclose his identity in respect of his autonomy. Sperm banks keep the record of the sperm donor, and identity could be revealed when required, but sometimes recipients demand for an anonymous sperm donor to avoid related adversarial consequences (Hudson, 2015).

The donor may perceive that sperm donation is an altruistic act, however, his family may see it differently (Wheatley, 2018). The reason why donors prefer the anonymity could be due to fear that their children might feel angry if they would come to know about their father's sperm donation. Additionally, it is a possibility to contact by his donorconceived children, when they come to know about their assisted birth and want to meet their biological father (Ezugwu et al., 2018). If looked upon the donor by the lens of autonomy, it is noted that if the sperm donor wants to be anonymous, then it is his right, and it should be protected, but by keeping into considerations the shortcoming of anonymous sperm donor; it is ideal to keep the sperm donor non-anonymous. Non-anonymity would help to secure genetic information, which is necessary to protect one's health. However, it is a dilemma that unfortunately, at some point of time, it is difficult to maintain the autonomy of both donor and child.

With respect to the autonomy of donor-conceived child, it is a fundamental and legal human right to know about their biological father and hiding the reality is violating the autonomy of the child (Ezugwu et al., 2018; Quigley, 2012). To respect the person's autonomy, it is necessary to acknowledge that person's right to make choices and to take action according to his or her values and belief. Moreover, Beauchamp and Childress do emphasis that the autonomous actions should not be controlled by others (Beauchamp & Childress, 2001). Keeping in views of autonomy, the analysis of the above scenario depicts that child's autonomy was not taken into consideration. Firstly, when the parent decided for their pregnancy and secondly, when the child came to know about it accidentally and wanted to know about his genetic father. The fundamental right of the child was violated because parents were unaware of sperm donor due to institutional policy of anonymity, the child was not an autonomous person in the scenario.

It is debatable, weather parent should disclose this to their child by respecting their autonomy; or should they hide it to protect the well-being of the child. The family belonged to a country where the parents are valued and have the authority of making decisions for their children. Parents' decision to hide the information from the child, keeps their infertility issue confidential, reduces the risk of rejection of the non-genetic parents by the child and prevents from stigmatization in the society where sperm donation practices were not accepted.

Keeping into consideration of contextual view, the couple decided to hide the truth from the child. This supports the parent's obligation of paternalism over child's autonomy. Moreover, the social and cultural context could affect the decisions of a person and that is the reason why these contexts must be considered.

In the discussed (in the introduction) scenario, an ethical principle of veracity was violated, as the truth has been deliberately hidden from the child. However, disclosing the truth and producing ambiguity related to the child's origin could affect the child adversely, and it is maleficence that is directly harming the child. Doubts on child's identity not only affect him psychologically, but it could also result in the disruption in family relationships, which directly harms the child. Furthermore, the consequences could be more severe if the child discovers the truth accidentally because of a medical test (Frith, Blyth, & Farrand, 2007). Furthermore, anonymity could complicate the matters of kinship, ancestry, and legacy and could interfere with the legal rights of a child in inheritance father from that is immoral and unfair (Inhorn & Tremayne, 2016). Besides, genetic information is necessary to protect a person's health, and it is another ethical concern in anonymous sperm donation (Somerville, 2011).

Generally, sperm donation is kept anonymous in China, Denmark, Holland, France, and Spain, where the law of the counting protects anonymity. Considering the morality of such practices, Sweden was the first country to pass legislation in favour of children's right to know about their biological father once the child attains maturity (Melo Martín, 2014). Afterward, USA, UK, and Australia passed legislation to assure non-anonymous sperm donation and children are authorized to know their genetic parents on their request at 18 years of age. British Columbia banned anonymous gamete donation in 2011 (Frith et al., 2007).

Although sperm donation has social significance in helping the infertile couple to have a child, it has social implications. In Mainland China, citizens prefer anonymous sperm donation due to different family values as compared to West. In Singapore, Thailand, China, India, and Israel, these practices are evident but the sperm donors are also being kept anonymous. Contrary to this, Asian countries have negative attitudes towards these practices (Burr, 2010; Gong, Liu, Zheng, Tian, & Li, 2009). Similarly, in Pakistan, donor technologies are not conventional (Jajja, 2013). Moreover, if a couple conceives a child by this means, it would be considered to have violated Pakistan's Hudood Ordinance.

All types of third-party assistance either by donor sperm or eggs are considered impermissible in the majority of the Muslims context. This is to protect paternity as according to Al-Azhar fatwa, reproduction without having a marital relationship is equal to adultery. According to the 9^th Islamic Law and Medicine Conference recommendations, third-party reproductive assistance is banned in the Sunni-dominant countries and the couples who want to avail third-party assistance must be informed that it is against the religion (Moosa, 2003). Majority of Shia religious authorities agreed with it, but in the 1990s, a notable Shia scholar Ayatollah Ali al-Husseini al-Khamene'i, issued a fatwa allowing both egg and sperm donation and justified that these technologies serve to protect the marital relationship. In that case, the child would inherit from the genetic father while taking the name from adoptive father. As majority of infertile couples of Shia Muslim world prefer to use sperms of their close relatives, e.g., a brother donates his sperm to his brother's wife, that violate the concept of Mahram in Islam, and would be equal to incest and adultery that are not acceptable in majority of the societies (Frith, Blyth, & Farrand 2007; Inhorn, 2006).

By taking into consideration all of the possible contexts, it is obvious that infertility is a significant issue in reproductive health and donor assistive modalities are being practiced around the globe. All available treatment options should be viewed in social, cultural and religious contexts of the patients. Additionally, in countries where people have negative connotation for having a baby by third person's sperm should be considered carefully before availing it.

If some countries facilitate the infertile couple by allowing them to use a third person's sperm, then the right of child's autonomy and donor anonymity should be viewed carefully. Furthermore, if a couple decide to avail this option then there should be answers of following questions before taking a decision 1) the unborn child would follow the name of the biological father or social father? 2) the child would inherit from the biological father or social father? 3) who would disclose the truth before the child 4) what information would be given to the child and at what age?

As the trend of donor-conceived children is growing popular, viewing the ethical considerations related to psycho-social well-being and right of the donor-conceived child are equally important. Moreover, it is essential to review the issue in the cultural and religious context. The donor should ponder over the wellbeing of the unborn child before sperm donation and parents should respect the child's right before taking a decision. Healthcare professionals should consider the patient's context before offering treatment possibilities and policymakers should keep in view all the dimension and related consequences before making any policy regarding it. Furthermore, the stigma of infertility should be reduced by providing health education sessions, and infertility should be acceptable in common societies. Counselling facilities should be available to deal with emotional disturbances related to infertility.