Adoption is often recommended as an alternative to IVF and the creation of spare embryos that are then destroyed. In the US the adoption of embryos is a further well-publicised alternative to destroying ‘spare’ embryos left after fertility treatment.
Whilst adoption (including embryo adoption) is a mutually beneficial act that provides a child for a childless couple and a loving home for a child who is in need, and one that we strongly encourage, we should nevertheless be aware of the challenges it involves. While adoption is and has been a tremendously good thing in the lives of many, its history is not without problems. Some mothers were coerced and even forced into giving up their children; some children grew up with secrets and lies, and with questions of identity and place that bear many similarities to the stories of the donor-conceived women and men today.
Embryo adoption, too, should not leave us completely untroubled. While many are rightly concerned about the creation and long-term storage of so-called ‘spare’ or ‘surplus’ embryos it seems reasonable to expect that those who were adopted as embryos will have some of the same questions about identity, place and family that adopted persons face.
However of greater concern is the increasing use of donated gametes in infertility treatment and the current drive in the UK to recruit even more donors, as highlighted in a recent blog by Peter Saunders.
Jennifer Lahl, Director of the Centre for Bioethics and Culture in the US comments that: ‘There is a stark contrast between adoption (and embryo adoption), which seek to address existing situations, and reproductive technologies that involve spending thousands and thousands of pounds to create situations that need remedying.’
In the UK there have been a few recent news articles reporting on an increase (of 448%!) in the numbers of single women having IVF, and an increase of over 200% for lesbian women. While there are comments (including from myself) on the importance of fathers for children born to single and lesbian women, in fact the concerns go deeper.
For many children born to single women it is not simply that the father is not physically around, but that the father may forever be anonymous – or unknown – and they may never know about half their biological heritage and history. This is because treatment for singles and gay couples generally involves use of donated gametes. Donor anonymity was removed in 2005 so now donor-conceived people born after this date can obtain some information about the identity of their biological father – or mother – when they reach the age of 18. For those born before 2005, the amount of information they receive will depend on their age, the information provided by the donor and whether their donor has re-registered after 2005.
But that is not the full story. Even now, children can only find out about their origins if the parents who brought them up tell them that they were donor conceived. Many parents of donor conceived children choose not to tell them about their genetic origins.
It also appears that some clinics are failing to comply with guidance about provision of non-identifying information to parents before age 18.
Guidance set out in the current HFEA Code of Practice (2), is clear that clinics should provide non-identifying donor information to parents both prospectively and once the child is born and they should inform parents of their and their children’s rights to access information from the HFEA Register, including about donor-conceived siblings (Sections 11 and 20).
The fact that some clinics appear to be failing to comply with this guidance is prompting patients’ complaints. There seem to be three main reasons. First, worries about prospective parents selecting ‘desirable characteristics’ in donors – the so-called ‘designer baby syndrome’. Second, concerns from donors reluctant to have their information disclosed so soon after they have donated. Third, anxieties that donors may be traced through their non-identifying details. However this refusal by clinics to release donor information is highly concerning.
A new film by Lahl effectively and visually expresses some of the concerns with donor conception and anonymous conception. Anonymous Father’s Day films people who were conceived via sperm donation as they talk about the use of sperm donation. One commentator says in the film: ‘If we are going to have these technologies, then they need to work first and foremost for the people they directly affect. And although that can seem like it’s the patient, in reality it’s really the children who are being born.’
Many donor-conceived persons have concerns about donor conception, several of whom blog about their perspectives and their concerns. Lahl has also been contacted by mothers who used donor sperm to conceive children as well as by sperm donors who resonate with the concerns raised in the film. I have recently blogged on this too. As Lahl says, these concerns are widespread.
The UK Nuffield Council on Bioethics currently has a project underway to ‘explore the ethical issues that arise around the disclosure of information in connection with donor-conceived people.’ In the Australian state of Victoria, a parliamentary committee has recommended that donor-conceived persons should be told the identity of their biological parent, even if the sperm donor was originally promised anonymity. And a case regarding sperm-donor anonymity is currently working its way through Canadian court system, and will likely end up before the Supreme Court of Canada.
As Lahl says, in answer to the question, ‘Are ‘Anonymous Fathers’ Really a Problem?’ the response is ‘yes, and we are only beginning to find out just how much of a problem.’