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Donor conception: a question of perspective

26 November 2012
Appeared in BioNews 683

Gamete donation is big business at the Fertility Show. Why do clinics from far and wide pay thousands of pounds to exhibit in London?

The simple answer is to make money. But why come to the UK? Because in the UK there is a shortage of gamete donors, or at least a perceived shortage, that's why. Whether or not there is a shortage depends who you speak to.

Some British clinics have invested in advertising campaigns and the infrastructure to deal with the enquiries they generate and so have an excellent track record in recruiting donors. Other clinics appear to have given up and would rather refer patients to clinics overseas than to their colleagues (and competitors) down the street. So your impression of the situation depends very much on who you speak to at the Fertility Show.

But what is the picture outside the microcosm of a wet weekend at Kensington Olympia? No one seems to know and this may be a stumbling block to finding a solution to this so-called shortage.

The National Gamete Donation Strategy Group (NGDSG), a group set up by the Human Fertilisation and Embryology Authority (HFEA), aims to find new approaches to raising awareness of donation and improving the care of donors in the UK. The Group needs to understand what the shortage is to assess the scale of the problem.

I was honoured to be invited to join the NGDSG and am fully committed to its core objectives to:

1. increase awareness of donation and the information that donors receive

2. improve the 'customer service' that donors receive when they contact clinics

3. help donors provide better information about themselves for future families

The NGDSG has only had one meeting (1), so it hasn't got all the answers yet, but if the enthusiasm and determination around the table at the first meeting are anything to go by I wouldn't rule it out.

Other messages you hear about gamete donation at the exhibition stands at the Fertility Show are far from clear at best and downright misleading at their worst. There are clinics offering 'educated' donors, 'attractive' donors and 'caring' donors. While these attributes are something we may look for in a partner and we may desire for our children – who judges whether the donors meet these criteria and what difference does it make to the resulting child?

For example, just considering the 'educated' description. What does this mean? According to the dictionary 'educated ' means 'having undergone education' or 'characterised by or displaying qualities of culture and learning'. Is being 'educated' therefore something children can inherit from a gamete donor? It is the old nature or nurture question all over again and to me it sounds more like nurture than nature.

If you accept that it is nurture and you are using an anonymous donor from overseas that your child will never meet, what is the relevance of the 'educated' descriptor? If your child has the option of meeting the donor at 18 is it more important to you that the donor was educated? And if so, why?

These questions are some of many which we will be addressing in our project 'When It Takes More Than Two'. The aim of the project is to clarify public and professional understanding of issues relating to donor conception, particularly in relation to identity and genetics. Donors are frequently sought and marketed on the basis of characteristics like being 'educated' whose heritability is complex or disputed at best, and non-existent at worst.

The heritability of such personal predispositions is far more complex and contentious than the marketing materials would suggest. But even with more basic physical attributes – such as height (tallness is an almost universally preferred donor characteristic), hair and eye colour, which contain an element of Mendelian inheritance – observations show that strict Mendelian patterns of inheritance are not followed down the generations.

The first event in a series of three is 'GIVING: THE GAMETE DONOR PERSPECTIVE'.

A panel of speakers will address issues including what motivates people to donate, the criteria used to screen donors for their physiological and psychological health, and the placing of conditions upon the use of sperm or eggs one has donated. The latter is a controversial area where the HFEA has recently issued new policy, and where different parts of UK law are potentially in conflict. For example, a sperm donor may want to prevent his sperm from being used by a lesbian.

The event it will take place on 12 December, for more details of this free event and others in the series please see the Progress Educational Trust's forthcoming events.

1) National Donation Strategy Group meeting - September 2012
Human Fertilisation and Embryology Authority |  1 October 2012
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