O-181 It takes more than genes to build a family

Abstract

Abstract Sperm donation has been known to mankind possibly for a very long time, although first medical reports come from the late 18th century. Initially, most inseminations in married couples were homologous, involving the husband’s semen. The first publicized breakthrough that came in 1884 would today be considered unethical, as an anesthetized woman was subjected to an injection of semen from a handsome (as duly reported) student of medicine, without any consent of both her and her spouse. The veil of secrecy that covered heterologous insemination was finally lifted when Dr Mary Barton openly acknowledged the practice in her clinic and published the first manual on “artificial insemination.” It set the ethical standards for such procedures—including mutual anonymity of donors and recipients and maintaining absolute secrecy of the fact of donor insemination—for decades to come. The cost was of course the lost identity of the conceived children and the often reported emotional detachment of the fathers from their social, but not genetical, offspring. The grave consequences of the limited pool of donors were yet to be discovered with the advent of DNA testing. In the UK, Barton’s husband and another collaborator were confirmed to father at least 100 children each. In the Netherlands, the country was shaken by the case of Jan Karbaat who used the sperm of an anonymous donor—who probably should not have even passed psychological screening—to bring more than 200 babies to the world. Suddenly, lots of adults learnt of the existence of their never expected siblings. Concomitantly, more and more parents revealed the fact of donor conception to their children motivated by openness. The secrets could not be held any longer and Joanna Rose was the first British woman that won a court case in 2002 against her own country that was wilfully breaking her right to respect for private and family life guaranteed by European Convention on Human Rights. The proponents of open donation found support also in Convention on the Rights of the Child. More and more countries started enforcing either open or at least double-track donation from then on. However, even more legislations blissfully ignore these ethical developments and maintain complete anonymity of the donor insemination procedures. This is where my personal story begins, as a father of twins born in 2012 from in vitro fertilization thanks to the semen of an anonymous donor. At that time, Poland even did not have an actual law on fertility treatment. The ART centres adopted their own policies on anonymous donation and signed contracts with their patients on a case by case basis. The legal status in my country was further cemented with the long overdue adoption in 2015 of Act on Fertility Treatment that forbids non-anonymous donation and even excludes the prospective parents from the decision process on the choice of the donor. The burden of partially lost identity of my kids will be with me possibly my entire life. But I don’t want it to cast a shadow on our family relations. We have to deal with my non-genetic fatherhood one way or another. We maintain our family ties in full knowledge of the fact of the existence of some unnamed benefactor that made this possible. Maybe one day my children will find some unsuspected genetic relatives via increasingly popular public DNA banks if they choose so, thus sticking together parts of their identity. Only time will tell.