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Of family and finance: Israeli citizens without rights and HFEA remuneration

12 December 2011
By Dr Ruth Shidlo
Working in independent practice, Tel Aviv and founder of Israeli Donor Families
Appeared in BioNews 637
Living in Israel, where gamete donor anonymity still rules supreme, I confess I envy the UK's clear focus on the welfare of the donor conceived child and the evolution of the legal rights of offspring (children, adolescents and adults). This culminated in April 2005 with the stripping of donor anonymity, and is evident in the Human Fertility and Embryology Authority's (HFEA) facilitation of the re-registration of anonymous donors and offspring's search for donors and/or siblings.

Sadly, amongst Israelis, it appears that the rights and needs of the donor conceived come last, if at all, amongst those of the various adult stakeholders involved in assisted reproduction. Not only are the donor conceived not allowed to learn the identity of their biological donor parent, but they are blocked in their search for half-siblings.

Sparse donor details are provided upon inquiry, with some couched in general terms so as to conceal identity. While a general area of study may be mentioned, specific details regarding when and where the donor studied, or if he or she actually graduated, are not revealed (as is customary in the US, which, lacking a federal policy, has a preponderance of anonymous donors).

Moreover, the recipient is not informed of the donor's date of birth, how old he or she was upon donating, nor the time span of donation. While the existence of half-siblings may be acknowledged, their number, gender and dates of birth are also concealed. Often, details are only provided orally.

If nothing else, this deliberate lack of transparency protects fertility clinics and sperm banks from accountability with respect to the exact number of offspring per donor allowed in the context of general recommendations (1). It also prevents the voluntary exchange of relevant medical information regarding siblings among donor families sharing the same donor.

As offspring grow up, both they and their parent(s) often wish they had brothers and sisters. When circumstances conspire to make it impractical to have a second child this wish is thwarted, and the possibility of contacting half-siblings might provide an extended family they could all enjoy. This is particularly true for Israel, a country with a great emphasis on family and whose size (approximately that of the American state of New Jersey) is small enough to make contact feasible.

With the advent of search engines such as UK DonorLink and the US-based but worldwide Donor Sibling Registry (DSR) it has become possible for those families lucky enough to find a match to make contact. Since its inception in 2000, just under 9,000 people have found one via the DSR alone. The probability of finding a match increases when the donor's known details include a non-identifying donor code (provided to both donor and recipient by the US clinic or sperm bank).

Recent research findings have unanimously shown that siblings and their families hope for contact, including heterosexual families and those with more than one child. And when offspring have actually met half-siblings it has, by and large, been a win-win situation (2). In the largest study to date, 85 percent of offspring (34 individuals) who met half-siblings reported 'very positive' or 'fairly positive' experiences, with only one person having a negative one. A survey of donor experiences gave similar results (3).

In Israel, although allowed to find out if they are related upon marriage, numerous offspring remain vulnerable to risks of consanguinity and associated genetic defects (4). Such concerns are shared by young adults and their families, propelling Orthodox Jews to use sperm of non-Jewish donors.

A lack of updated medical or genetic data, as well as more personal information regarding their invisible donor – such as their name, a picture, an explanation of why they donated, or background about their education or interests – confounds the donor conceived child's natural curiosity. At the same time it thwarts their developmental need to anchor and consolidate their sense of identity and selfhood (5-7).

Additionally, given this mandatory cloak of secrecy, some parents choose to keep the birth circumstances from their children, often rationalising it as a way of sparing them unnecessary angst. Much has been written about the consequences of such family secrets and the need for a parental relationship based on honesty (7).

Although sperm banks are loth to share this information, Israeli sperm donors are paid anywhere between 300-600 shekels per donation (roughly £50-100). The Egg Donation Law (2010) permits remuneration of 'voluntary' egg donors as specified by the State (8). Since demand is always greater than supply, without payment a dire shortage of Israeli donors is seen as inevitable. This is especially so as no systematic attempt has been made to educate the general public regarding the need for gamete donors and recruitment campaigns have not been publically implemented, despite reports of successful experiences abroad. Furthermore, societal recognition for donors is almost non-existent, and secrecy and shame (especially with respect to sperm donation) prevail.

The perennial fear of lack of donors is used to whip back into line those brave enough to contemplate change in the status quo (for example, the Aloni Commission in 1994). This may involve the stepwise relinquishing of complete anonymity and concomitant provision of non-identifying information or, heaven forbid, the abolition of anonymity for new donors (4,9). The fertility industry and some of its beneficiaries, as well as the media, view progress in human rights as a deathblow to Israeli sperm banking (9-11).

Despite being part-British I am, in essence, an outsider to the lively UK debate surrounding recent HFEA revisions (12). From where I stand, the rights and needs of the donor conceived take centre stage over and above the ongoing debate concerning donor remuneration. This debate is, if you will, one of the 'rich'; the well-earned luxury of a society that has kept the welfare of the donor conceived well within its sights.

01) Regulations regarding the management of the sperm bank and directives for performing artificial insemination.
Circular of the Director General No. 20/07. Unpublished paper. Jerusalem: Ministry of Health. [Hebrew] |  2007
02) Experiences of offspring searching for and contacting their donor siblings and donor (Jadva, V., Freeman, T., Kramer, W. & Golombok, S.)
Reproductive BioMedicine Online |  3 February 2010
03) Sperm and oocyte  donors’ experiences of anonymous donation and their subsequent contact with their donor offspring (Jadva,V., Freeman, T., Kramer, W. & Golombok, S.)
Human Reproduction |  26 November 2010
04) Safeguarding information about biological parenthood (Halperin, M.)
Assia 17 (1-2), 83-111 [Hebrew] |  1999
05) What does it mean to be a donor offspring? The identity experiences of adults conceived by donor insemination and the implications for counselling and therapy (Turner, A & Coyle.)
Human Reproduction |  14 June 2000
06) The views of adult offspring of sperm donation: Essential feedback for the development of ethical guidelines within the practice of assisted reproductive technology in the United States (Mahlstedt, P., LaBounty, K., & Kennedy, W.T.)
Fertility and Sterility |  1 May 2010
07) The management of genetic origins: secrecy and openness in donor assisted conception of Israel and elsewhere (Landau, R.)
Human Reproduction |  31 July 1998
08) Ministry of Justice Egg Donations Act.
Book of Laws 1577, p. 176. Jerusalem: State of Israel [Hebrew] |  2010
09) Sperm Donation in Israel (Mei-Ami, N.)
Presented to the Committee on the Rights of the Child ( |  03/05
10) Knesset Committee for the Advancement of the Status of Women.
Minutes No. 159 (from the meeting of 31.5.05 re: 'The intention of revealing sperm donor details endangers future donations.') [Hebrew] |  2005
11) State overhauls monitoring system for sperm banks (Even, D.)
Haaretz |  29 June 2011
12) HFEA agrees new policies to improve sperm and egg donation services.
HFEA |  19 October 2011
4 March 2013 - by Dr Ruth Shidlo 
Once again, the voices of people and families conceived as a result of gamete donation in Israel are going unheeded...
6 June 2012 - by Dr Ruth Shidlo 
Two weeks ago, the Israeli Ministry of Health published recommendations regarding fertility and birth and its legislation. I applaud this attempt to review and improve upon existing laws and MOH regulations (some of which are not consistent with international commitments) and to codify them...
6 June 2012 - by Sarah Pritchard 
Gay men should be allowed to use a surrogate to have children, an Israeli public health committee has recommended. It also suggested single women should be permitted to use a surrogate to conceive and favoured non-anonymous sperm donation....
15 May 2012 - by Dr Vardit Ravitsky and Professor David Heyd 
Sex reassignment is an intricate and sensitive physiological, psychological, and social process that usually entails the loss of reproductive capacity. Reproductive technology can prevent this loss, but should it be used for that purpose? A recent case in Israel raises this question...
16 April 2012 - by Dr Rosie Morley 
The Human Fertilisation and Embryology Authority (HFEA) has launched a new strategy to increase awareness of egg and sperm donation and to improve the care of donors. It aims to address perceived obstacles to donor recruitment aired during its consultation on gamete donation last year....
17 October 2011 - by Professor Eric Blyth, Jennie Hunt and Professor Olga van den Akker 
We welcome much of what Kamal Ahuja wrote in his recent BioNews Commentary 'If it ain't broke don't fix it'. Like him, we believe there is no good evidence to demonstrate that paying 'donors' would increase the supply of donated sperm or oocytes. On the contrary, there is evidence to suggest that properly constructed donor recruitment programmes – such as the one pioneered at the London Women's Clinic – are capable of recruiting a good supply of altruistic donors...
30 September 2011 - by Dr Kamal Ahuja 
The Human Fertilisation and Embryology Authority (HFEA) has already made two decisions following its public consultation and review of gamete donation policies in the UK: first, intra-familial gamete donation can continue as before (subject to certain provisions); and second, the number of families which a single donor might help create remains limited to ten. The bigger question on compensation and benefit in kind to donors will not be answered until later this year...
17 November 2009 - by Professor Margaret Somerville 
A recent article by journalist, Allison Cross, described how a shortage of Canadian donor sperm could be prompting women and their partners to turn to the Internet to find free donors: 'Many of these people want 'do-it-yourself' donor insemination, without intervention by doctors'...
5 October 2009 - by MacKenna Roberts 
Beginning from last Thursday, new disclosure laws for donor-conceived individuals and gamete/embryo donors came into force which will broaden access to donor genetic information. The provisions were enacted together with the vast majority of the new Human Fertilisation & Embryology Act 2008, approved by Parliament last year and aimed at updating its predecessor 1990 statute to be more inline with contemporary liberal attitudes and advances in reproductive technolog...
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