The latest event produced by PET (the Progress Educational Trust) focused on the issue of limits on the number of people and families, worldwide, who can be created from the sperm or eggs of the same donor.
Current practice is to limit the number of donor-created families to ten in the UK, although back in 1984 it was a ten-child limit that was originally recommended in the Warnock Report. The limit was intended originally to prevent 'inadvertent incest', and to manage the social and psychological implications of donor conception.
Sarah Norcross, director of PET, opened the event by discussing how circumstances have changed. She highlighted that the Warnock Committee did not envisage a global market for sperm donation, evolving over decades. Different countries have varying regulations and practices, which can complicate the tracking and tracing of donors. Nor was it possible, at the time of the Warnock Report, to trace donors through direct-to-consumer genetic testing.
An ability to trace genetic connections across borders necessitates a careful reevaluation of existing limits and practices. Is having dozens (or even hundreds) of half-siblings a problem?
The first speaker was Professor Jackson Kirkman-Brown, chair of the Association of Reproductive and Clinical Scientists and a professor of reproductive biology at the University of Birmingham. He opened his presentation by illustrating the scale of donor conception: 4100 donor-conceived babies are born annually in the UK, approximately 1 in every 170 births. He highlighted a tripling in children born from donor sperm between 2006 and 2019, a trend largely driven by single patients and same-sex couples seeking donor sperm.
Professor Kirkman-Brown pointed out that donor anonymity is increasingly untenable in the age of widespread genetic testing. Additionally, gametes can now be kept in storage for up to 55 years (see BioNews 1111), potentially resulting in future half-siblings with significant age gaps and related emotional and psychological impacts on children seeking donors who may be deceased.
Professor Kirkman-Brown also pointed out logistical issues, noting that travel from London to central Europe can now be quicker than travel from London to Scotland, making the utility of UK-only family limits questionable. Furthermore, over half of the sperm used in UK clinics is imported, primarily from countries like Denmark and the USA where different rules apply.
He concluded by emphasising the need for better data on the psychological impact of donor conception on children, and called for the Human Fertilisation and Embryology Authority (HFEA) to take a definitive stance and advocate for internationally policed family limits.
Next to speak was Christina Sommerlund, business development manager at Born Donor Bank. She opened her presentation by citing a paper recommending a global limit of 100 families per donor, and described how Born works to a maximum of 75 families per donor, making this very clear on its website. To ensure that this is not exceeded, Born allocates 'pregnancy slots', permitting a recipient to use the same donor for multiple children.
Sommerlund argued that sperm banks should be actively responsible, to make sure that the limits are adhered to. However, she also argued that clinics, donors and recipients share the responsibility for preventing an excessive number of families being created per donor.
She raised an interesting point, regarding the shifting definition of families to highlight the layers of complexity that need to be considered in the regulation of donor limits. She said that the HFEA's Code of Practice now covers scenarios such as if a female same-sex couple splits up, whether both parties would be allowed to continue using the same donor sperm after separation and whether this counts as one family or two.
The third speaker Kevin Moore shared his personal experience as both a donor-conceived person and as a sperm donor. He described being part of a WhatsApp group with seven half-siblings and their donor, emphasising that finding out about their genetic relationships at different times and through various methods was a complex experience.
Some of the siblings in the group discovered their connections through genetic testing, which came as a surprise to them. Moore reflected that emotional bonds are easier to maintain when the number of siblings is relatively small, and acknowledged that larger numbers could be overwhelming emotionally, particularly when trying to maintain a level of contact with such large groups.
He pointed out the potential challenges posed by cultural and language differences among siblings from different countries, which can complicate relationship-building. Despite these challenges, he noted the rewarding aspects of having a large network of siblings, such as providing mutual support and discussing similar experiences.
The fourth speaker was Dr Astrid Indekeu, a research fellow at the Catholic University of Leuven and who has published research and commentary on kinship, psychosocial challenges and voluntary DNA databases in relation to donor-conceived half-siblings and donors.
Dr Indekeu discussed her findings concerning the psychosocial dynamics of having multiple donor family connections. This included the positive aspects of discovering similarities among donor-conceived siblings, such as shared physical traits and interests.
However, she also highlighted several challenges, including the transition from individual identities to forming a cohesive group. Regulating closeness and distance within the group, and balancing individual needs against group dynamics, are significant hurdles that need to be overcome. She asked how donor-conceived individuals transition from being strangers to forming a sense of belonging within a group. Factors such as resemblance, shared genetics, beliefs, values and humour all play a role.
Dr Indekeu quoted a participant from her research who preferred not to be forced into a group identity based solely on shared DNA, emphasising that group dynamics should evolve naturally and not through any expectation. She also raised the issue of managing expectations within growing groups, noting that some participants feel overwhelmed by the expanding number of siblings, and the realisation that maintaining contact with everyone is not possible.
She concluded by pointing out practical challenges such as language and cultural barriers, and physical distance between half-siblings in a global context. Dr Indekeu stressed that these psychosocial aspects should be actively considered, when setting limits on the number of offspring per donor.
The final presentation was from Dr Grace Halden, co-director of the Centre for Medical and Health Humanities at Birkbeck University of London. She shared her experience as a solo mother using donor sperm, and highlighted the lack of transparency regarding the exportation of sperm after a donor has reached the ten-family limit within the UK. She said that she and other donor recipients were surprised to find out that their donors' profiles had changed, to note that the donor's sperm is unavailable for further UK recipients but is still available for export (see BioNews 1222).
Dr Halden called for clearer communication about the possibility of sperm being exported to create more families after the UK limit is reached, suggesting that this information should be prominently displayed in relevant sections of donor profiles, clinic websites and FAQs. She also suggested that differences between UK limits and global limits should be raised at the point of consultation, and that the possibility of export should be mentioned every time a UK family limit comes up.
She concluded that transparency is crucial, in order for recipients to make informed decisions and manage their expectations about the potential size and distribution of their donor-conceived family network.
A lively question-and-answer session followed, underscoring the complexities and ever evolving nature of donor conception practices in the UK, and the difficulty of establishing global limits. Key themes included the need for continuous review and updates to donor limits, considering global markets and advances in practice. The speaker panel also emphasised the importance of international consensus, better data collection, and addressing the psychosocial impacts on donor-conceived children.
Overall, the event highlighted that while donor conception offers significant benefits to many families, it also presents complex challenges that require careful regulation, ongoing research into the impact on all involved, and – most importantly – regard for to the needs and wellbeing of donor-conceived people.
PET is grateful to the Association of Reproductive and Clinical Scientists for supporting this event.
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