Anonymous Gamete Donation Research Articles

How best to protect the vital interests of donor-conceived individuals: prohibiting or mandating anonymity in gamete donations?

Anonymous gamete donation continues to be practised in most jurisdictions around the world, but this practice has come under increased scrutiny. Thus, several countries now mandate that donors be identifiable to their genetic offspring. Critics contend that anonymous gamete donation harms the interests of donor-conceived individuals and that protection of these interests calls for legal prohibition of anonymous donations. Among the vital interests that critics claim are thwarted by anonymous donation are an interest in having a strong family relationship, health interests, and an interest in forming a healthy identity. This article discusses each of these interests and examines what they could involve. The legislation in two countries is considered: Spain, which mandates anonymous gamete donation, and the UK, which prohibits such practice, to assess how these different legislations might or might not protect these vital interests.

Drinking from the Data Well: Response to Gamete donor anonymity and limits on numbers of offspring: the views of three stakeholders.

Drinking from the Data Well: Response to Gamete donor anonymity and limits on numbers of offspring: the views of three stakeholders.

The limits of empirical data: how to understand survey results with respect to gamete donor anonymity

The limits of empirical data: how to understand survey results with respect to gamete donor anonymity

The end of donor anonymity: how genetic testing is likely to drive anonymous gamete donation out of business.

Thousands of people worldwide have been conceived using donor gametes, but not all parents tell their children of their origin. Several countries now allow donor-conceived offspring to potentially know their genetic parent if they are informed of their donor-conceived status. At the same time, personal genetic testing is a rapidly expanding field. Over 3 million people have already used direct-to-consumer genetic testing to find information about their ancestry, and many are participating in international genetic genealogy databases that will match them with relatives. The increased prevalence of these technologies poses numerous challenges to the current practice of gamete donation. (i) Whether they are donating in a country that practices anonymous donation or not, donors should be informed that their anonymity is not guaranteed, as they may be traced if their DNA, or that of a relative, is added to a database. (ii) Donor-conceived adults who have not been informed of their status may find out that they are donor-conceived. (iii) Parents using donor conception need to be fully informed that their children's DNA will identify that they are not the biological parents and they should be encouraged to disclose the use of donor gametes to their children. Together, these concerns make urgent a wide-ranging societal conversation about how to best safeguard and promote the interests of donor-conceived offspring and protect the rights of donors. Specifically, there is a need to ensure that new genetic information is communicated in a way that promotes both the safety and the privacy rights of offspring and donors alike. All parties concerned must be aware that, in 2016, donor anonymity does not exist.

Gamete donor anonymity and limits on numbers of offspring: the views of three stakeholders.

This paper discusses the attitudes of three groups of stakeholders in the world of assisted reproduction gamete donors, parents who use donated gamete, and offspring conceived with donated gametes with respect to the two issues of donor anonymity and limits on the number of offspring a single donor can produce. The data are drawn from on-line surveys which were made available between May 12, 2104 and August 15, 2014 to gamete donors, donor-conceived offspring, and parents who used donated gametes to conceive. A total of 325 donors (176 egg donors; 149 sperm donors) responded to the survey as did 2134 parents and 419 offspring. The data show that offspring are more opposed to donor anonymity than are parents and donors. Among offspring opposition to anonymity grows as they age. On the other hand, parents are most in favor of limits on numbers of offspring produced by a single donor. Parents worry about health and accidental contact between people conceived from the same donor.

The limits of evidence: evidence based policy and the removal of gamete donor anonymity in the UK.

This paper will critically examine the use of evidence in creating policy in the area of reproductive technologies. The use of evidence in health care and policy is not a new phenomenon. However, codified strategies for evidence appraisal in health care technology assessments and attempts to create evidence based policy initiatives suggest that the way evidence is used in practice and policy has changed. This paper will examine this trend by considering what is counted as 'good' evidence, difficulties in translating evidence into policy and practice and how evidence interacts with principles. To illustrate these points the removal of gamete donor anonymity in the UK in 2005 and the debates that preceded this change in the law will be examined. It will be argued that evidence will only ever take us so far and attention should also be paid to the underlying principles that guide policy. The paper will conclude with suggestions for how underlying principles can be more rigorously used in policy formation.

Personal identity as a form of freedom.

A commentary on "The Ethics of Anonymous Gamete Donation: Is There a Right to Know One's Genetic Origins?" by Inmaculada de Melo-Martín, in the March-April 2014 issue.

The right to know genetic origins: a harmful value.

A commentary on “The Ethics of Anonymous Gamete Donation: Is There a Right to Know One's Genetic Origins?,” by Inmaculada de Melo-Martin, and “Autonomous Choice and the Right to Know One's Genetic Origins,” by Vardit Ravitsky, bothin the January-February 2014 issue.

Beyond sperm cells: a qualitative study on constructed meanings of the sperm donor in lesbian families

What meanings do lesbian couples construct regarding their sperm donor? For some parents, the donor was increasingly presented as a person, whereas for other parents, the donor was seen as an instrument from the moment they received the sperm donation. Few studies specifically focus on how lesbian couples deal with the issue of third-party anonymous gamete donation. It is often assumed that they have fewer difficulties than heterosexual couples with the involvement of a male procreator, since their status as a donor conception family is 'socially visible' and there is no social father who fears exclusion. Semi-structured interviews were conducted with 10 lesbian couples (20 participants), recruited via the Ghent University Hospital. All couples had at least one child, conceived through anonymous donor insemination, between 7 and 10 years old. Within the data corpus, a particular data set was analyzed where couples referred to their donor and his position in their family. Step-by-step inductive thematic analysis was performed resulting in themes that are grounded in the data. All phases of the analysis were followed by team discussion. This study reveals different donor constructs, indicating different ways of dealing with the third-party involvement in the family. Some parents diminish the role of the donor throughout family life and continue to present him as an instrument: something they needed in order to become parents. Others show an increasing interest in the donor as the children mature, which results in a more personalized account of the donor. In our qualitative cross-sectional study, we collected retrospectively constructed stories. Longitudinal qualitative and quantitative research is required to allow for an extrapolation of the conclusions made. This study shows how the concept of the donor is constructed within lesbian families and how it is challenged by the child's developing personality and features. When counseling prospective parents, it could therefore be useful to discuss the concept of the anonymous donor beyond the conception phase. The project was funded by the Research Fund of Ghent University, Belgium. There are no competing interests.

Autonomous Choice and the Right to Know One's Genetic Origins

AbstractIn “The Ethics of Anonymous Gamete Donation: Is There a Right to Know One's Genetic Origins?,” Inmaculada de Melo‐Martín deconstructs the interests the right is supposed to protect. She argues that these interests are not set back or thwarted when one has no access to one's genetic origins. The basis of her argument is that we lack robust empirical evidence that donor‐conceived individuals suffer certain alleged harms, and that even when such harms are present, they do not provide strong enough justification to ground the right.Indeed, the research on the needs, preferences, and well‐being of donor‐conceived individuals is scant. In fact, we lack robust empirical evidence regarding all aspects of donor conception. I argue, however, that the right to know one's genetic origins does not rest on empirical evidence. Some donor‐conceived individuals who are unable to know their genetic origins may suffer great harms. Others may suffer no harm at all. But all are treated wrongly when they are deprived of the ability to access information about their genetic origins. They are deprived of an important aspect of their autonomy: the liberty to choose what meaning they assign to the genetic components of their identity.

La procréation médicalement assistée en France : une question d’égalité ?

The equality principle is not stated in French law. It is deduced from a series of rules that provide for an identical treatment of different situations. Applied to the gamete donation, it exploits the female body by placing it under a unique regime of sperm donation, entirely harmless, and ovum donation, significantly more dangerous. Only one requirement ensures the protection of donors: their written consent. This is why some people would like the legislator to validate the gestational surrogacy by presenting it as “gestation donation.” However, this qualification is totally inappropriate for a contractual approach. When applied to infertile heterosexual couples, which the law recognizes as sole receivers, the equality principle ignores the fact that the woman’s body is the sole tool employed in the medical acts required in human reproduction. The parental project promotes the notion of equality imposed on the couple. It allows the biological dimension of reproduction to be ignored by prioritizing consent to use anonymous gamete donation. This consent always takes the form of a genuine consent that, ignoring their unequal participation in the child’s conception, engages the man and the woman—equally—as intended parents. Reproductive services, practised outside the legal context, allow fertile people to conceive by using an anonymous sperm donation or gestational surrogacy in order to deprive the child of a father or a mother. This abuse sheds light on the inequality of situations that are fundamental to the quality of the mother or father. The equality principle does not lead to any kind of equality but, instead, establishes an indisputable mess in parentage due to reproductive services.

La procréation médicalement assistée en France : une question d’anonymat

Anonymity has been established as a principle in French law that forbids research into determining the identity of gamete donors. Its violation is also subject to criminal penalties. It is thus a fundamental rule rarely disputed, even though it is not necessarily implemented in foreign legislation. Due to its general nature and the importance that French law gives it, this anonymity principle raises concerns. Identified as an ethical principle, is anonymity justified when applied to gamete donation and medically assisted reproduction? It is important to distinguish anonymous gamete donation from the donation of elements and products of the human body. In the latter case, the ethical foundations of the rule of anonymity leave little room for doubt. Nevertheless, with respect to gamete donation, anonymity raises more difficulties. Indeed, many explain this principle by the fact that it is a sine qua non condition to obtaining the gametes necessary to implementing heterologous medically assisted reproduction. One could dispute this position, and some states have lifted donation anonymity without compromising their sources. However, this utilitarian consideration should not be viewed as being without an ethical dimension. In addition, anonymity not only concerns the receiving couple but also is imposed on a third party, the conceived child. Anonymity allows her to maintain a secret, about the circumstance of her conception, and its ethical nature may be legitimately doubted, particularly when one considers that secrecy makes possible the manipulation of the child’s condition.

Whose Right to Know? The Subjectivity of Mothers in Mandatory Paternity Testing

Although anonymous gamete donation is the norm in the United States (US), recent scholarship has queried whether Western European prohibitions on anonymity could or should be applied in the states (Cohen 2012, Cahn 2012). Most recently, An Ravelingien and Guido Pennings’ “The Right to Know Your Genetic Parents: From Open-Identity Gamete Donation to Routine Paternity Testing,” uses the argument for open-identity sperm donation as the premise for broader social policy regarding paternity identification. The authors argue that if anonymous sperm donation is forbidden, then anonymous or misattributed paternity in coital reproduction should also be forbidden. Ravelingien and Pennings recognize that paternity testing concerns the rights of all of the members of a family unit, yet they assert that potential benefits for a child—in genetic information and potential family formation—outweigh any incursions on other individuals’ rights. While we agree that knowledge of one’s genetic origins should not be dependent on the mode of conception, we argue that Ravelingien and Pennings’ analysis of rights creates a problematic hierarchy of interests as their analysis fails to locate a central subject in mandatory paternity testing: the mother. This absence of the mother is especially troubling in light of institutional enforcement of paternity identification in welfare programs in US political history.

To Criticize the Right to Know We Must Question the Value of Genetic Relatedness

In an essay published in 1997, Guido Pennings defends as a solution to the ethical problems associated with anonymous gamete donation a “double track” policy where people interested in assisted rep...

The Right to Know Your Genetic Parents: From Open-Identity Gamete Donation to Routine Paternity Testing

Over the years a number of countries have abolished anonymous gamete donation and shifted toward open-identity policies. Donor-conceived children are said to have a fundamental “right to know” the identity of their donor. In this article, we trace the arguments that underlie this claim and question its implications. We argue that, given the status attributed to the right to know one's gamete donor, it would be discriminatory not to extend this right to naturally conceived children with misattributed paternity. One way to facilitate this would be through routine paternity testing at birth. While this proposal is likely to raise concerns about the conflicting interests and rights of other people involved, we show that similar concerns apply to the context of open-identity gamete donation. Unless one can identify a rational basis for treating the two groups differently, one's stance toward both cases should be the same.

The right of the donor to information about children conceived from his or her gametes

The field of gamete donation for medically assisted reproduction purposes is evolving. While anonymous gamete donation was long the preferred practice, a new focus on the rights and interests of donor-conceived children has led a number of countries to shift towards an open-identity system. However, this evolution appears to overlook whether information exchange could also be of interest to the other parties involved, in particular the gamete donors. In this article, we analyse the question whether donors should be granted a right to some information about the offspring conceived by their donations. We constructed five arguments which donors could use in support of such a claim: (i) It can be of great importance to the donors' and their own children's health that they receive medical information (in particular, evidence of an unsuspected genetic disease) about the donor offspring; (ii) basic information (such as whether any children were born) could be a way to acknowledge donors for their altruistic behaviour; (iii) general information (information about the child's wellbeing) about the donor offspring could ease the donors' potential concern about and sense of responsibility for the offspring; (iv) basic information could provide an important enrichment of the donors' identities; (v) identifying information would be useful for donors who want to contact the donor offspring. No strong arguments in favour of granting donors the right to identifying information were found. An exchange of this type of information should only be accepted when all parties agree. Taken together, the four first arguments form a strong case for granting donors a right to several types of anonymous information about the donor offspring.

Unintended Consequences: Prohibitions on Gamete Donor Anonymity and the Fragile Practice of Surrogacy

Prohibitions on anonymous egg and sperm donations are a growing international trend. U.S. law does not prohibit anonymous gamete donations. However, an expanding movement is advocating a shift to an open identity regime that will ban anonymity. My earlier study of three jurisdictions: Sweden, Victoria (Australia) and the United Kingdom, which adopted prohibitions on gamete donor anonymity, showed that these prohibitions played a role in creating shortages in egg and sperm supplies. Adoption of prohibitions on anonymity in the United States could result in similar shortages. This Article focuses on the potential effects of prohibitions on anonymity on the practice of surrogacy. The practice of surrogacy in the United States is highly dependent on donor eggs. Unlike most jurisdictions that prohibit gamete donor anonymity, the majority of U.S. states that permit surrogacy, distinguish between gestational and traditional surrogacy. These states provide legal certainty only to gestational surrogacy while leaving traditional surrogacy in a legal limbo. Infertility practitioners endorse the legal preference for gestational surrogacy. Donor eggs are used only in gestational surrogacy but not in traditional surrogacy. In traditional surrogacy, the surrogate uses her own eggs and is the genetic mother of the conceived baby. However, in gestational surrogacy, the eggs of the intended mother or a donor are used and the surrogate is not the genetic mother. The Article advises that a shift toward an open identity system in the United Stares should be considered with extra caution because of the potential consequences to the practice of surrogacy. Prohibitions on gamete donor anonymity causing a scarcity in donor eggs could force a return to traditional surrogacy, with the accompanying legal uncertainty. Alternatively, the legal uncertainty enveloping traditional surrogacy could deter those in need of surrogacy from seeking it altogether thereby significantly contracting the practice of surrogacy.

How to kill gamete donation: retrospective legislation and donor anonymity

Victoria (Australia) is considering retrospective legislation on the abolition of gamete donor anonymity. Retrospective legislation evokes many negative emotions mainly because it is considered unfair. It also makes it impossible for citizens to organize their life with reasonable certainty of the consequences. Introduction of this law for donor anonymity is defended by the right of the child to know its genetic origins. Against this law, people appeal to the right to privacy and confidentiality of the donor. This paper analyses the arguments for and against a retrospective law on donor anonymity by looking at the conditions that should be respected when two principles (the donor's right to privacy and the child's right to genetic information) have to be balanced. It is concluded that the justification for introducing retrospective law is lacking: the conditions are not fulfilled. Moreover, retroactive laws in the context of gamete donation may jeopardize the whole practice by destroying the trust of candidate donors and recipients in the government.

Full-sibling embryos created by anonymous gamete donation in unrelated recipients

To report the rare occurrence of full-sibling embryos in unrelated women using independently chosen donor sperm and donor oocytes in two different cycles unintentionally created at our IVF program, and to discuss the concept of disclosure to the patients. Case report. Academic IVF program. Two women independently undergoing donor recipient cycles with anonymous donor oocytes and donor sperm. Both women received oocytes from the same donor several months apart and then by coincidence selected the same anonymous sperm donor to create anonymous full-sibling embryos. Clinical pregnancy after donor-recipient IVF cycle. Both women conceived using the same donor sperm and donor oocytes in independent cycles, resulting in simultaneous pregnancy of full siblings. As providers with the knowledge that anonymous full sibling embryos have been created, we may have an obligation to disclose this information to the patients.

The long path to pregnancy: early experience with dual anonymous gamete donation in a European in vitro fertilisation referral centre

BackgroundThis investigation describes features of patients undergoing in vitro fertilisation (IVF) and embryo transfer (ET) where both gametes were obtained from anonymous donors.MethodsGamete unsuitability or loss was confirmed in both members of seven otherwise healthy couples presenting for reproductive endocrinology consultation over a 12-month interval in Ireland. IVF was undertaken with fresh oocytes provided by anonymous donors in Ukraine; frozen sperm (anonymous donor) was obtained from a licensed tissue establishment. For recipients, saline-enhanced sonography was used to assess intrauterine contour with endometrial preparation via transdermal estrogen.ResultsAmong commissioning couples, mean±SD female and male age was 41.9 ± 3.7 and 44.6 ± 3.5 yrs, respectively. During this period, female age for non dual anonymous gamete donation IVF patients was 37.9 ± 3 yrs (p < 0.001). Infertility duration was ≥3 yrs for couples enrolling in dual gamete donation, and each had ≥2 prior failed fertility treatments using native oocytes. All seven recipient couples proceeded to embryo transfer, although one patient had two transfers. Clinical pregnancy was achieved for 5/7 (71.4%) patients. Non-transferred cryopreserved embryos were available for all seven couples.ConclusionsMean age of females undergoing dual anonymous donor gamete donation with IVF is significantly higher than the background IVF patient population. Even when neither partner is able to contribute any gametes for IVF, the clinical pregnancy rate per transfer can be satisfactory if both anonymous egg and sperm donation are used concurrently. Our report emphasises the role of pre-treatment counselling in dual anonymous gamete donation, and presents a coordinated screening and treatment approach in IVF where this option may be contemplated.