Home or overseas?

Donor information and selection

In the UK non-identifying information is given about both sperm and egg donors at the time of donor selection, although some clinics will withhold information beyond a basic physical description, age, nationality etc., until a woman has a confirmed pregnancy. The HFEA guidelines encourage clinics to show potential recipients, prior to selection, all the non-identifying information available, plus any pen portrait and ‘letter to the child’ that has been written by the donor, but some clinics still withhold the information until there is an established pregnancy. Most people will be able to make their own choice of donor, although choices may be limited in the case of some ethnic minorities and if people are wishing to match to specific features like red hair.

Outside the UK there is no standardisation of the non-identifying information about donors (including the reasons why the donor donated) that may be available. In some countries, such as the USA and to a slightly lesser extent Greece, South Africa, Ukraine and Russia, a large amount of information is obtainable about egg donors. There is also a lot of information available about Danish and US based sperm donors, including baby and sometimes adult photographs at extra cost. In most of the European countries where people from the UK go for egg donation there may be considerably less information given than in the UK. Most Spanish clinics claim that it is against their law to give more information than the age and blood group of a donor. Their law actually says that they can give all non-identifying information, although most choose not to do so. There is anecdotal evidence that some Spanish clinics are increasing the amount of information available because of demand from UK residents. You may want to consider using your power as a consumer to help change practice.

The UK is unique in having a central national register of donors and recipients. How records are kept and what might happen to them in the future (if, for instance, the clinic went out of business) may not be as clearly set out abroad as in the UK.

In most EU countries egg donors are selected by the clinic doctors and not by recipients. Requests can be made for specific hair, skin or eye colouring but parents have been known to be surprised, and sometimes unsettled, when their child has features that are typical of the country of origin of the donor, which may of course not be the country where treatment takes place. While unexpected features can crop up in any family, the focus on visual resemblances can become more laden with emotion in a donor family, particularly if the parents had anticipated not telling friends and other family members until the child was older. In a family where a positive decision to go abroad has been taken and parents plan on celebrating this connection, this is less likely to be a problem.

We also don’t know how children conceived with a sperm or egg donor from another country will feel about the half of their genetic heritage that comes from that country, particularly if their physical features make it obvious to themselves and to others. Feelings could range from pride in the special connection to discomfort at looking different and not ‘fitting in’ where they are growing up.

Half-sibling connections

We know that if children are conceived via sperm donation abroad then there may be very many half-siblings world-wide. If sperm is imported from the US or Denmark, then there may be up to ten families created from the same donor in the UK but an unspecified number of half-siblings around the world. Some donor conceived adults have said they feel very uncomfortable about the idea of there being the possibility of so many half-sibs. As egg donors usually donate far fewer times than sperm donors, the number of half-siblings is unlikely to pose the same issues for offspring.

Some heterosexual and lesbian couples and many single women are keen to explore the possibility of half-sibling contact to provide genetic links for their child. They need to be aware that conceiving a child by anonymous donation abroad may mean that this is less likely to be an option for their child, although independent donor sibling registries outside the US and UK are beginning to be set up and DNA testing may prove to be a game-changer in the future. Sometimes single women, and others, choose sperm donors from American banks so that they have the opportunity to link with half-siblings and potentially the donor via the privately run Donor Sibling Registry in the US or sperm bank message boards.

Treatments abroad not available in the UK or EU

Some clinics outside the UK and European Union carry out procedures and treatments that are not allowed by the HFEA and are banned by the European Tissues and Cells Directive. These include gender selection and the transfer of large numbers of embryos potentially resulting in a dangerous multiple pregnancy and sometimes selective termination of some of the foetuses. ‘Tandem cycles’ are also available in some clinics. This is where embryos are created with both donor eggs and the woman’s own eggs and then nurtured to maturity. Where embryos of both types are transferred, only subsequent DNA testing could prove which embryo had produced a pregnancy/resulting child.

These procedures are not allowed in the UK and the EU for ethical reasons. With regard to the transfer of more than two embryos the HFEA website shows that putting back more embryos does NOT improve your chances of a healthy live birth. We would recommend reading the information on their website before agreeing to multiple embryo transfers.

What we know and what we don’t know…

Due to the history of secrecy, there is no long-term research on donor conceived families, and little reliable knowledge. A number of individual sperm-donor-conceived adults have spoken up about their situation, with a variety of views, and there is now some research on their experiences and feelings. Most of those researched were told about their beginnings when they were teenagers or adults and often in very unsatisfactory circumstances. There is a growing body of research with some children who have ‘known’ since they were little but it is early days with this. So far there are only a few anecdotal accounts or small sample sizes of how teenagers and adults conceived by egg or embryo donation feel. No research has been carried out into how the feelings and needs of adults conceived with egg, double (egg and sperm) or embryo donation may differ from those conceived by sperm donation. It is possible that those who have no genetic connection to their parent(s) may have stronger feelings about their origins, but this remains unknown, as does any child or adult’s perspective on being conceived abroad.

Since identifiable donors are available in the UK, the best we can do is try to imagine our children’s feelings and reactions, and consider how we might explain our choices and decisions to them, and support them as they grow up.

What we do know is that psychologists and social workers experienced in this field say very clearly that openness between parents and children about donor conception (whether the donor is anonymous or identifiable) is supportive of warm family relationships, and parental confidence about choices made may be a key factor here. Many Network members have conceived abroad and are adopting different strategies about how to integrate the foreign connection into the story they tell their children. Some are encouraging their children to take an interest in the culture of the country by learning the language, deliberately taking holidays there or supporting that country’s team in international sporting events. Some see it as simply a fact to be shared and focus more on the ‘nurture’ side of cultural identity.