Where to have treatment? What are the implications? What do you need to think about?
Choosing a fertility clinic can feel like a fraught process. If you are in the UK and lucky enough to be funded for your treatment through the NHS then you may have little or no choice about where your GP refers you, but as the majority of fertility procedures take place in the private sector, the choice can feel confusing and daunting. And that’s even without contemplating going abroad as many people are now doing.
Before choosing a clinic, one of the big questions people often have is around what country to have treatment in. Different countries have very different laws, guidelines and protocols on donor conception treatment, as well as different recruitment models for donors and different rights for donor conceived people. It’s important to know the differences so you can make an informed choice.
There can be advantages to staying in your home country for treatment, not least not having to factor in the time and costs of travel. However, there are also reasons to go to another country that specifically caters for what you’re looking for. This might be around donor availability, better matching potential, wider treatment options or different legal frameworks.
As our charity is based in the UK this is a summary of the situation in this country. Other countries vary enormously and aren’t covered in detail here. Lots of our members are having or have had treatment outside the UK who can share their experiences too.
Since April 2005, when the law changed, all donors used in UK clinics agreed to be identifiable to a child when they turn 18. The number of families that can be created from one donor was limited to 10. This is not easy to enforce with 100% certainty, but a donor recruited in the UK should be aware of the family limit and understand why it was introduced and would therefore, hopefully, be less likely to donate beyond that.
The Human Fertilisation and Embryology Authority (HFEA) regulates all UK clinics and holds information on donors, treatment cycles and children born in a register. Parents can ask for non-identifying information about the donor and details about any half-siblings on behalf of their child before they reach 18.
At 16 children can request non identifying about the donor and half-sibling numbers via the HFEA (their sex and year of birth). At 18 they can request identifying information about the donor via the HFEA, including contact information, although the donor is not under any obligation to respond or engage beyond the level they are comfortable with.
Children created through the same donor (half siblings) can be connected, by mutual consent, once they turn 18.
Donors can find out the number of children born as a result of their donation and the sex and year of birth. They aren’t able to access identifying information about these offspring and have to wait to be contacted. Donors’ own children are not included in the records and do not have the right to access any information.
If you use a UK clinic they will be following UK law and guidance. If they recruit their own donors you should be able to ask for information about potential donors although you may not get huge amounts of personal detail. If you use a UK egg or sperm bank or import from abroad you may get more information and this can be an attraction.
Bear in mind that if you are using imported sperm or eggs, they will only comply with UK law when used in the UK. If they are exported to or used in other countries any limits to children or families created in those countries may be different, and ignore any children born elsewhere. So in the UK the 10 family limit will apply, but globally it probably won’t.
Egg donors are unlikely to create as many children as sperm donors, as they are unlikely to produce anywhere near the same quantity of donations and are therefore unlikely to hit the 10 family limit, let alone exceed it. However, with the improvements in technology for egg harvesting and freezing, that may not be true in the future.
Most countries have very different laws and treatment guidelines to the UK and to each other in terms of surrogacy and donor conception. For example, in Spain all donors are anonymous and you get very little information about them, sometimes just age and blood type. The US has different rules in different states. Other countries may prohibit surrogacy or egg donation or donor conception altogether, or just for some family set-ups (eg single women or same-sex couples).
Make sure you do your research. Our members have had treatment in many countries so do connect with us to hear about a wide variety of experiences.
As with all big decisions, it’s really worth spending time thinking about what is important to you and working out which jurisdiction will work best for you. Also bear in mind that how you feel may be different from how your child feels and feelings themselves change over time.
