REPRODUCTIVE technology has always forced society to examine its deepest moral and religious beliefs. In the UK next month, it will receive one of its toughest cultural tests yet, when children born from donated sperm, eggs and embryos gain the right to trace their biological parents. Fertility experts are warning of potential disaster because the new law will discourage donors from coming forward at a time when donations are already in short supply. The change, they say, could ultimately be self-defeating.
The UK鈥檚 move follows that of several other countries, including Sweden, Austria and the Netherlands, in putting the welfare of children before all other considerations. Studies have shown that some children need to know about their biological origins to help them form a strong sense of identity. Concealing those origins can be harmful 鈥� especially if children find out the truth by accident. By letting children born from donated eggs and sperm trace their biological parents once they reach 18, the UK is giving them the same rights as adopted children.
The decision to change the law was made after a long public consultation, yet with surprisingly little knowledge of how potential donors might feel. In the latest issue of Reproductive BioMedicine (vol 10, p 325), Ian Craft and colleagues at the London Fertility Centre begin to fill that gap. Based on their results, they say that unless radical action is taken egg donation is likely to plummet, leading to 鈥渁 further restriction in an already unsatisfactory service鈥�.
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Craft and colleagues collected answers from 504 former egg donors and 363 former recipients. Among the donors, they found that nearly 70 per cent would consider donating again if their anonymity was assured. But this figure fell by half if their identities were to be released to children born from the donated eggs. Recipients were even more unhappy about the new rules. While 96 per cent said they would be happy to receive another egg donated anonymously, only 53 per cent would accept one if the donor鈥檚 anonymity was not assured.
Extrapolating from these figures, Craft argues that 700 fewer egg donation cycles a year would be available in future 鈥� a fall of around 40 per cent. He raises the spectre of a black market in which eggs change hands for large sums of money as long as anonymity is preserved.
There is no doubt that many couples consider infertility to be an intensely private matter 鈥� especially if they receive donated sperm or eggs. So private that 9 out of 10 of these couples never tell their children the truth about their conception. So it is perfectly possible to imagine that couples will travel abroad to countries where donation is still anonymous. This would defeat the whole purpose of the new legislation. But is this scenario inevitable?
Not necessarily. When sperm donors lost their anonymity in Sweden in 1985, the number of donors fell 鈥� but only initially. And the profile of the donor group changed. The new rules attracted more older men in stable relationships who already had children of their own. It may be that the new UK rules will attract different groups of egg donors. And for the recipients, many of whom are desperate to have a child, the new rules may be just one more psychological barrier to overcome.
鈥淭o many couples infertility is an intensely private matter, especially if they receive donated sperm or eggs鈥�
The UK government鈥檚 Human Fertilisation and Embryology Authority is aware that the new law could put donors off. It has, in fact, just finished another public consultation on ways to improve donation programmes, including how to increase the numbers of donors. At present, these donors receive a token payment of 拢15 together with expenses. The HFEA is keen to maintain the altruistic nature of donations.
Yet Craft and colleagues want a greater financial incentive. To keep donations up they argue for a payment that takes into account the inconvenience of repeated attendance at clinics and the pain of egg recovery. The size of the payment should reflect the risk involved, they say. To head off charges of commercialisation, the number of times a woman can donate eggs should be limited.
Such changes would need a complete rethink of the principles on which donation in the UK is based. But reproductive technology does nothing if not challenge values. If donations fall after 1 April and do not recover, radical action may be unavoidable.
