Sperm donor or dad?

Ronnie Coleman of Arlington, VA, has just won a legal case saying that as a sperm donor he isn’t legally responsible for the child support he’s been paying for the last five years. That couldn’t happen in the UK, could it? In 2006, Coleman donated through a California sperm bank to a longstanding friend (and …

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Canada follows the trend?

Over the water in British Columbia, Canada, the state government is appealing a judge’s ruling that people conceived by egg and sperm donation should be able to find out who their donor was. Olivia Pratten and Shelley Deacon, both donor-conceived adults from BC, took the government to court arguing that donor-conceived people are discriminated against …

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Genes reunited?

In a recent scientific breakthrough at Newcastle University, doctors have found a way to replace faulty DNA inherited through the female line with DNA from another healthy woman. So does this mean a child conceived that way has two mums? Mitochondrial cells convert the energy from our food into energy that can be used in …

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Dragon babies

In the Chinese year of the Dragon, many couples are trying to have a child because it’s considered a lucky year to be born. The same applies to people who need a donor. Bevan Chuang from Auckland is hoping to get pregnant through sperm donation and her request for a donor has attracted interest from …

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Sperm donors redundant?

Scientists have created artificial mouse sperm in the lab, in a breakthrough which means in five years infertile men may no longer need a sperm donor. Researchers grew viable sperm in a petrie dish using mouse germ cells, which are found in testicles and are responsible for sperm production. For the first time the sperm …

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Sperm donor or dad? Canada follows the trend? Genes reunited? Dragon babies Sperm donors redundant?

Nov
28

Fairer on children – fairer on donors too

by gametedonation

Ireland’s Special Rapporteur on child protection has expressed ‘profound concern’ that the complete lack of legislation on assisted reproduction in Ireland is not in the best interests of the child.

Geoffrey Shannon, a lawyer who specialises in child law, is concerned about a number of issues relating to egg and sperm donation. Egg and sperm donors are anonymous in Ireland, meaning that donor-conceived children have limited or no information about their biological parent or genetic heritage, and this is just one of the issues he has raised.

In the absence of any laws, Ireland’s fertility clinics follow guidelines set out by the Irish Medical Council or the UK’s HFEA, which are not always appropriate in a different legal and cultural setting. The Irish Medical Council’s guidelines forbid the destruction of stored embryos, so clinics are legally obliged to continue storing them even if they have been abandoned by the patients who created them, and there has recently been a case where an Irish fertility doctor declined to treat an unmarried couple.

One difficulty with this is that it is not clear who the legal parent is of a child born through egg or sperm donation and there are many discussions about whether removing anonymity would affect the number of donors – issues which we are very familiar with on the other side of the Irish sea.

The law is an important reference point that reflects and guides both ethics and practice. While many would argue that UK fertility law is far from perfect, at least it is clear that a sperm or egg donor gives up parental responsibility and that they are no longer anonymous. This means donors know what they are getting into before they donate, and that there are mechanisms for donor-conceived adults to trace their donor should they wish to. This may not be to everyone’s liking, but it is fairer on donors as well as donor-conceived people.

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Nov
15

Some job!

by gametedonation

Rene Ameling, in her book Sex Cells: The Medical Market for Eggs and Sperm, explores the different approaches which US agencies use to recruit egg donors and sperm donors.

In a recent YouTube interview for Yale University, she explains that women donors tend to downplay their role in creating a pregnancy, arguing that they just provide the genetic material and they don’t carry the child, give birth or bring it up, so donation doesn’t make them a mother. The recruitment material targeted at egg donors uses the language of gift-giving and altruism, caring and helping, an approach which focuses more on cultural expectations of female behaviour.

Sperm donors, on the other hand, are told that their donation is ‘just a job’, and encouraged to treat it in a very businesslike and detached way, yet despite this distinctly different framing, they tend to think of themselves as fathers. Ameling argues that this is because culturally the man who provides the sperm is considered the father regardless of the context of the decision. Given this attitude, compared to the ease with which women can separate their role as donor from the role of mother, sperm donation seems more than ever an act of generosity and compassion.

One consequence of this is that men are given less emotional support during the process and less encouragement to have implications counselling. After all, who needs counselling just to do a job? Ameling takes issue with this attitude, saying that men need implications counselling just as much as egg donors, particularly as they are likely to produce more offspring: ‘They [sperm banks] are content to let men focus on short-term financial gain rather than long-term implications, and I think it does sperm donors a disservice. ‘

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Nov
07

Ask Dr Ruth: OHSS

by gametedonation

Fears over “intensive farming of eggs” as reported in the Daily Telegraph this month must be a worry for all women having IVF, not just women offering to donate eggs. This is however alarmist reporting and doesn’t really explain the true situation:

Each menstrual cycle a woman has a number of immature eggs waiting to develop and the number of these varies greatly from woman to woman. In a normal menstrual cycle all the eggs start to mature but one (or occasionally two) get ahead of the others and their development suppresses the other immature eggs which then die.

Predicting how many eggs per cycle there are likely to be for an individual woman is done by looking at her ovaries with an ultrasound scan at the time of menstruation and checking her blood hormone levels at the same time. The little pools of fluid, called follicles, each containing a single immature egg, can be seen on the scan and counted. Any woman with 20 or more follicles per ovary is at risk of ovarian hyperstimulation, a condition which can have serious consequences. These women are described as having polycystic ovaries.

Stimulation of the ovaries with drugs cannot increase the number of eggs that can mature. In an IVF cycle the doctor is usually trying to get all the available eggs for that cycle to develop unless they can see that there are a large number that could potentially develop. In those circumstances the doctor is in the position of trying to find strategies to reduce the number of eggs that mature, which can prove very difficult.

So I don’t think that doctors are deliberately carrying out “intensive farming” of eggs. It is just sometimes very difficult to get it right. However, I do think the doctor is obliged to caution the woman that this is a risk and also obliged to look after that woman if she runs into problems with ovarian hyperstimulation.

Women who are having IVF for their own treatment may go ahead with treatment understanding the risks. And these women may offer to donate some of their eggs in an egg sharing arrangement. 

However there is some evidence that polycystic ovaries are inheritable and some clinics think this is a reason not to take on women with ovaries like these as a donor.

It is certainly questionable whether altruistic egg donors should be exposed to the risk of ovarian hyperstimulation. Certainly they should be very carefully counselled and made aware of the risks. They should also understand exactly what to do if they run into any problems and feel comfortable that they will be properly supported.

If during stimulation it becomes clear that large numbers of eggs are maturing the stimulation drugs can be stopped and the ovaries will return to normal without further problems.

In addition, problems with ovarian hyperstimulation usually arise after embryo transfer. Because an egg donor does not have embryos replaced, she is to some extent protected from ovarian hyperstimulation.

All these things need to be taken into consideration and discussed with the doctor in charge of the treatment.

And the message as usual is to be fully informed and only offer to undergo treatment in a clinic where you feel secure. 

Dr Ruth Curson

Dr Ruth is a retired fertility specialist. She is only able to give general advice. For more personal care you should contact your family doctor or local fertility service.

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Oct
31

Some facts about OHSS

by gametedonation

Following an HFEA report that a small number of donors produced over 70 eggs in a single cycle of treatment, there have been a number of concerned articles in the news suggesting that egg donors are at particular risk of ovarian hyperstimulation. Is this true and what could be done to avoid it?

Ovarian Hyperstimulation Syndrome (OHSS) is a potentially serious side-effect of ovarian stimulation, the process of getting a woman’s ovaries to produce lots of eggs, rather than the single egg that she would normally produce each month.

It affects about 7% of women who undergo fertility treatment; 1% get it severely. Severe cases are very unpleasant and in very rare cases can be fatal.

You are more at risk of OHSS if:

  • You are in your 20s
  • You have a low bodyweight
  • You are more than usually fertile (as most egg donors are)
  • You produce more than 30 eggs in a single cycle of treatment

The HFEA advises clinics to use the lowest possible effective dose of stimulation drugs with both donors and patients as this reduces the risk of OHSS. Overstimulation does produce more eggs but that doesn’t mean that recipients are more likely to get pregnant, as the eggs are not necessarily good enough quality to produce embryos.

So what are the symptoms to look out for?

The main symptoms are stomach ache, diarrhoea and digestive discomfort, and weight gain. You may feel bloated and put on weight – both are due to having extra fluid in your abdomen.

Sometimes the fluid buildup can be bad enough to make you throw up or feel out of breath. Or you may start to feel thirsty or stop going to the loo – at this point you should tell the clinic immediately, and if it is out of hours, go to A and E for a checkup.

These symptoms will only occur in the ten days to two weeks you are taking stimulation drugs, or soon after egg collection. The clinic will know you are at risk if you produce a lot of eggs, but there isn’t a simple relationship between the drug dosage, how well a woman responds to the drugs and her risk of OHSS, so it’s not always easy to predict who is most at risk.

The most important things you can do to protect yourself are learn the symptoms and tell the clinic. Talk to your donor coordinator at your scan visits about how you feel physically (or phone if you start to get symptoms that worry you). They can scale down the drug dosage or stop collection to stop you getting overstimulated, so it’s important you tell them about any changes. And if you end up producing a large number of eggs, it’s worth checking how the clinic will look after you.

The vast majority of donors have no or minor problems, but it’s always better to be safe and look after yourself.

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Oct
24

Expenses for donors – payment or compensation?

by gametedonation

The HFEA has now announced the results of its review on payment and expenses for egg and sperm donors.

Both egg and sperm donors will receive a fixed sum of money: sperm donors will receive £35 per visit and egg donors, a sum of £750 per cycle of donation. The fees are intended to cover any expenses the donor incurs.

So what does this mean in terms of the commitment donors need to make?

The decision to compensate egg donors £750 has received a lot of attention in the media; there is a widely-held perception that sperm donors attend the clinic once and that’s the extent of their commitment – this is far from the truth. Sperm donors need to visit two or three times a week over a period of weeks to complete a single donation cycle. Twice a week for two months adds up to around £600.

All donors visit the clinic two or three times for testing, counselling and follow up. Egg donors generally attend the clinic 6-8 times over the course of the three week treatment cycle, take a day off work for the collection procedure and probably a day of recovery as well, with advice to do no heavy lifting (harder than you might think if you have a toddler).

So, given that for most donors the fee needs to cover time off work, childcare costs, travel and related expenses, the sums start to look less like payment and more like reasonable compensation.

Potential donors are usually unaware of the time commitment when they enquire: a significant number drop out once they realise what is involved, while occasionally donors drop out during a cycle because they cannot afford to continue, meaning their donation cannot be used. Increasing compensation will make donation more convenient and accessible.

To give someone who craves a baby with her whole being the chance of being a mother is probably one of the most generous things you could ever do.
Paula Moyes

Men and women who donate are already motivated by generosity and compassion. Most do so because they know someone who has struggled with infertility and has seen the pain they go through. Giving a reasonable sum to cover expenses does not make the act any less generous or compassionate.

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Oct
17

Altruism and money

by gametedonation

A report on the ethics of donation from the Nuffield Council for Bioethics has recommended that donors should be fully reimbursed for loss of earnings.

Currently there is a cap on the sum that can be claimed back for expenses which includes childcare costs, travel and loss of earnings. This has meant that some donors have not been able to fully cover the cost of their donation and in some cases they are not reimbursed for the days of holiday they lose to attend the clinic or to recover from collection.

There have been longstanding concerns that if true loss of earnings were to be covered, this would increase the cost for parents and make it harder for clinics to manage their finances, especially given that some donors are well paid.

The HFEA does not collect donor demographics so it is not possible to assess what kind of impact this could have, as we don’t have an accurate picture of who donors are and what they earn. From the Trust’s experience, donors come from all walks of life and all earnings levels are represented.

Fair acknowledgement of the time and effort that donors put in to attend the clinic is important, especially where donors are not paid. Donors are meant to be altruistic, but this does not mean they should lose out financially.

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Oct
13

Talk to the media!

by gametedonation

Journalists often contact the Trust to speak to donors and recipients about their story. They range from parenting magazines to mainstream newspapers and TV.

We put these up on our website on our Media requests page. Requests come in weekly and at any one time there are usually several journalists looking for stories, with contact details so you can get in touch easily.

These stories help keep donation in the public eye and raise awareness, so over time they do help recruit more donors.

If you’d love to talk about your donation or your search for a donor, please keep an eye on our Media requests page. Thank you!

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Oct
10

The land of the free?

by gametedonation

The US is known for paying donors, and this is usually given as the main reason US fertility clinics have no shortage. But with both donors and recipients looking for a different experience of creating and raising a child, free sperm donation is growing in popularity.

Some couples cannot afford the cost of fertility treatment at a clinic. Health checks for sperm donors are expensive and, even without a donor fee, costs need to be covered. There is a risk to taking sperm from a man who can’t prove he is healthy, but for recipients whose options are limited, it’s a risk some are prepared to take.

And it’s not just about the money. Most American fertility clinics provide sperm from donors who are either anonymous until the donor-conceived person is 18, or permanently. As the voice of donor-conceived adults gets louder, it is becoming less acceptable to keep a child’s biological heritage a secret from them.

So why do the donors do it? For some it is a desire to sire as many children as possible, to have ‘lots of people out there related to you’. Alongside this is a respect for the child’s right to know and genuine warmth and compassion for people going through the pain of infertility.

Trent Arsenault is an American donor who has helped couples have ten children through free sperm donation. His reasons include ‘wanting to bring a child into someone’s loving family’ and ‘allowing a family to save on some costs, [so] more may be put towards their children’. He wanted to be sure the child knew his motivation was kindness, rather than money, and that the child could easily have contact with him and any half-brothers and sisters.

Donors and recipients want more flexibility, more information and often more contact than US clinics can offer them. When the UK is reconsidering payment for donors to encourage more men and women to come forward, it’s important to look at why free sperm donation is thriving in the US.

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Oct
03

‘A kind of donor godfather’: donor recruitment and the London Sperm Bank

by gametedonation

Many said in 2005 that removing donor anonymity would mean donor numbers would drop and the only way to prevent this was payment. Six years on, one London clinic is proving that isn’t true.

In March 2010 the London Sperm Bank launched a new sperm donor recruitment campaign which took a different approach. They decided to focus on recruiting altruistic, emotionally mature men who wanted to do something kind to help others.

Many know the LSB from their cheeky logo, which is prominently used in their advertising on the Tube. But they backed up good publicity with great donor care: dedicated facilities, trained and sensitive reception staff, well-appointed donation rooms, post-donation follow-up and an environment where donors are listened to and respected.

Their work has been a fantastic success, massively increasing the number of enquiries and donors. And the commitment of their donors is amazing: one man fits in donating around a high-flying job in the City, while another commutes weekly from Paris on Eurostar. They now have enough stored sperm to treat half the waiting lists in the country.

It is standard NGDT advice to clinics to look after their donors well and make them feel valued and respected: it’s great to see that the approach is highly effective in practice and that the LSB’s hard work and creativitity is paying off.

There are other lessons to be learned from this. One is a reminder of the high rate of attrition for donor recruitment campaigns. Out of 3000 enquirers, 397 went to the clinic for assessment and only 124 went on to donate. Publicity needs to be inspiring, frequent and high profile.

Another is that there are enough men out there who genuinely want to help others without payment. These men expect to be treated with respect and, because of their responsible, considered approach, may raise what some consider to be ‘awkward’ questions. Are parents vetted? What support do I have if a donor-conceived adult wants to trace me? How do I tell my kids? Publicity to recruit this type of donor must reflect their concerns and needs.

Later this month the HFEA will announce its decision on paying donors. The Director of the London Sperm Bank, Dr Kamal Ahuja, has used this experience to argue that recruitment can be improved without payment. Until other avenues have been fully explored payment should be a last resort.

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Sep
26

Aussie egg donor breaks world record

by gametedonation

When we think about whether donors should be able to help more than ten families, we assume that this only relates to sperm donors. But one Aussie egg donor is proving that wrong.

Faith Haugh is an office worker from Altona, near Melbourne. She became an egg donor 18 years ago and to date her donations have produced 19 children in ten Australian families.

But for Faith, whose husband Glenn is also a sperm donor, this was not enough. She went on to donate in other countries after she’d reached the limit in Australia and has been through 41 donor cycles in total. This is a phenomenal feat of physical endurance, as anyone who’s gone through IVF treatment will know, donor or not.

Why does she do it? She says, “I think about the people who have these problems and it’s emotionally crippling. They’d give their soul just to become parents, so why wouldn’t you help?”

While this has led to calls for the ten-family limit to be reassessed, this is still less likely to affect egg than sperm donors: the success rate per cycle is only 1 in 4 and the largest number of children ever produced by one egg donor in the UK is ten.

That makes what Faith has done even more exceptional.

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