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Gamete Donation in the UK: Time to think again

12 April 2010
Appeared in BioNews 553
The regulations governing the reimbursement of donors and the withdrawal of donor anonymity in the UK have combined to ensure that there are insufficient egg donors to meet requirements - hence the explosive growth of 'fertility tourism'. Overseas centres in a dozen countries now provide donor egg treatment opportunities and will continue to do so until the UK shortage is eliminated.

It is, unfortunately, a multi-faceted problem involving the crucial questions of donor compensation and anonymity, which have arisen as a consequence of the social regulation of fertility treatment. Sperm donation has also been affected and this shortage of UK donors has led to steeply rising costs and a growing inflow of imported sperm - both undesirable consequences.

A necessary change is a more enlightened approach to expenses and donor compensation that ensures that egg and sperm donation does not lead to donors experiencing unfair financial losses. This is certainly possible within the constraints of the European Human Tissue Act.

The right solution will involve realistic, even generous, expense allowances to remove any possibility that all legitimate donor expenses will not be covered in full. In addition, the right level of compensation for the substantial input of time involved must be allowed. Both the extent and value of the time involved have been seriously underestimated. For egg donors, recognition of the invasive discomfort and slight risks inherent in the egg donation process must also be allowed for in the compensation package. The total level of reimbursement and compensation should not be sufficient to encourage multiple egg donations and, in this context, limits on donation could be reviewed. There must still be an element of motivation and commitment on the part of the donor that transcends the financial considerations.

Donor anonymity is a more difficult subject, but it has to be addressed if a complete and workable solution is to be implemented.

The withdrawal of donor anonymity on its own gives no guarantee that donor-conceived children can, on reaching adulthood, discover the identity of a genetic parent. The knowledge of donor conception remains in the hands of the parents and we know, from the UK, Sweden and Australia, that a significant majority have no intention of ever passing this knowledge to their children. While parents have freedom of choice in this matter, the compulsory withdrawal of donor anonymity is as illogical as it is damaging. A voluntary system could easily be introduced and donor numbers would surely increase if the option of anonymity is available.

Would the 'rights' of donor-conceived children be harmed by this? We think not.

The idea that donor-conceived children should have an absolute right to know the identity of their genetic parent(s) is in a sharp contrast to the position of naturally-conceived children who have no such hypothetical right. The knowledge of all children is totally governed by what their parents decide to tell them, and by what is put on the birth certificate.

It is estimated that close to five per cent of the UK's naturally-conceived children (around 30,000 a year) will never know the identity of their true genetic father - yet special, but unenforceable, 'rights' are granted to a very much smaller number of donor-conceived children. It is hard to see how this regulation is non-discriminatory. It is Bridge's view that there can only be one approach governing access to knowledge of genetic inheritance and that approach must apply in exactly the same way to naturally-conceived and donor-conceived children alike.

The cost, confusion and damage of what many believe now to be failed anonymity legislation is there for all to see. It is manifested in the shortage of donor gametes, growing fertility tourism (with all its associated risks), sperm imports and a huge and unnecessary financial outflow from this country. Furthermore, parents are able to render this provision of the HFE Act ineffective simply by never revealing that their child is donor-conceived. An enlightened solution is necessary.

The changes necessary to reverse the unwelcome trends of recent years first require recognition that we do not live in an altruistic society in which donors can be expected to make sacrifices to donate. Secondly, either we must accept a high degree of social regulation to govern the way every UK parent deals with the issues of genetic inheritance or we should relax the discriminatory and unworkable regulation of the infertile and allow a voluntary approach to anonymity for donors. Parents can exercise their own discretion thereafter.

We cannot continue to allow the current regulations to act as a major disincentive. It is only when these shortcomings are addressed and corrected that the boom in fertility tourism will come to an end and centres like Bridge will be able to treat patients requiring donor eggs in their home country.

SOURCES & REFERENCES
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