Donor issues relevant to fertility treatment abroad

For many couples, donor eggs or sperm are their only option, as one partner is unable to produce gametes of their own. Single people and couples in same sex relationships must also use donors or surrogates in order to have a family. In vitro fertilisation (IVF) and surrogacy both allow a couple to contribute one partner’s gametes to their child. This can never be true of adoption or fostering.

Although this is an advantage to many couples, the processes involved in using donor gametes or donor embryos create social and ethical dilemmas for many individuals and governments. Before embarking on fertility treatment abroad using donors, you need to look into all the potential donor issues that you might come up against.

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Why use donor eggs or sperm?

There are many reasons why you may need to consider using donor eggs or sperm as part of your assisted reproduction. These include:

• Advanced age or early menopause in the female partner.
• Lack of natural egg or sperm production.
• Damage or disease in the reproductive organs.
• The risk of passing on a genetic disease or disorder.
• Lack of a partner of the opposite sex.
• Unexplained failure of fertility treatment using other methods.

Screening of donors

One of the most important donor issues is the screening of donors. You should insist on a thorough medical history of any donor, whether they are donating eggs, sperm or embryos, as well as recent tests for diseases such as HIV. Many fertility clinics will also undertake psychological profiling to ensure that donors are suitable.

You may also wish to screen donors for their physical attributes, such as height and hair colour, to ensure that your child bears a reasonable family resemblance and will fit in more easily. Sperm banks in some countries go further, allowing you to see the academic and professional achievements of sperm donors, but this is frowned on in others.

Payment of donors

Payment for donated eggs or sperm is highly controversial in many countries. In some respects, high remuneration rates may encourage people to donate for the wrong reasons, and could even encourage them to hide negative aspects of their genetic or medical history in order to cash in. Conversely, if the compensation is limited to a small expenses payment, you may find that this limits donation to the poorer end of society, whose health may be compromised by nutrition and living conditions.

Some fertility clinics in some countries will allow you to offset the costs of IVF treatment overseas by donating any sperm, eggs or even embryos that are not needed. Such cross donor or shared egg programmes can help create a chain in which all the couples involved get the gametes they need without spending time on a waiting list.

Donor anonymity

Perhaps the biggest of all donor issues is that of anonymity. This varies widely from country to country, and can have a significant effect on the availability of donor sperm and eggs. In the UK, for example, since the law changed in 2005 giving children from donated sperm the right to the details of their genetic father, the availability of sperm donors has dropped dramatically. This has forced many couples to seek fertility treatment abroad.

Countries that provide offspring with donor information by law include:

• Australia
• Finland
• The Netherlands
• Germany
• Sweden
• The UK

Countries where donor anonymity is protected by law include:

• Belgium
• The Czech Republic
• Denmark
• France
• Greece
• South Africa
• Spain

In India donor information is only available via a court order, and in the USA a court order must be made in advance showing consent for the release of the information.

Legal donor issues

If you are considering using donor eggs or sperm, it is important that you clear up any legal donor issues in advance. In most cases, your fertility clinic will draw up the necessary paperwork, but it is always worth having this checked by your own independent expert solicitor to be sure.

Your donor should agree to relinquish any claim to the offspring produced by their donation, and you in turn absolve them of any responsibility, financial or otherwise, for the child.

Donor issues and religion

Different religions have different views on donor issues, and these can often influence national legislation. This is particularly true in strongly religious countries such as Italy or Saudi Arabia.

• Some Christian religions, especially Catholicism, do not approve of IVF except with the gametes of the natural parents.
• Sunni Muslims are not permitted to use donors, however Shi’ites may accept donor eggs.
• Jews may use egg donation with the approval of their Rabbi, although this can cause confusion as to whether the resulting child is also Jewish.

What to tell the child

Donor issues do not go away once your baby is born as you need to decide what to tell your child as they grow. You may decide to keep their conception method secret, but studies have shown that this can be devastating for the child if they find out in later life. Most donor-conceived children are more upset that they were deceived, than by their actual genetic origin.

Many people believe that donor-conceived children also have the right to seek out their genetic parents or half siblings. This may be a problem if donation was anonymous, but many fertility clinics will still provide a donor number to help offspring to find their genetic siblings, even if they can’t trace their genetic parent.

Personal donor issues

Having considered all of the above donor issues, the last thing you need to be sure of is your own personal feelings. Will you be able to come to terms with raising a child that you are not directly related to? Will the genetically-related partner feel differently about the child, and about your relationship, than you do?

There are many places to turn for counselling on these donor issues, such as the British Infertility Counselling Association (BICA), the Donor Conception Support Group (DCSG) in Australia or Donor Conception Support (DCS) in the USA. It is well worth contacting organisations such as these to talk through your feelings before you embark on any fertility treatment abroad that involves a donor.