A lot of DC Network members have children conceived at clinics in Spain…a country that must derive a huge amount of it’s foreign income from cycles of fertility treatment. The laws are liberal in this country. Much more so than in many other European countries. Single women and lesbians, as well as heterosexual couples, can receive treatment which may be sperm, egg or embryo donation. Some clinics have reported great success – similar to fresh cycles – with eggs that have been vitrified. Couples and individuals who have attended Spanish clinics are glowing in their praise of the organisation, cleanliness, dazzling high-tech efficiency and above all friendly customer service they find. Staff mostly speak English – the most popular clinics have native English speaking co-ordinators in their ‘foreign’ department and best of all, donors are plentiful. All this means that Spain draws to it from the UK, Germany, France, Italy and beyond many, many women seeking fertility treatment, above all egg donation.
The big problem with Spain, certainly as far as DCN members are concerned, has always been that not only are donors anonymous but they are chosen by clinic staff, rather than recipients themselves, and that very little information is available. This varies from centre to centre but in many it is just the age of the donor and her blood group. Many will not even given the donor’s nationality or ethnic background. The clinic promises that they will match physical characteristics between donor and recipient but the number of very beautiful, obviously Spanish looking, children at DCN meetings with typically English looking parents belies this. It’s not a problem when children are small and parents are being open with their child, but differences in looks may well mean that children have a lot more questions as they get older. And there is no chance at all as far as I can see of parents or children being able to get information in the future. Although it is interesting that in the paper that has just come my way, the writer predicts that it will be the children themselves who will eventually demand a change.
Something that has been hard to establish is exactly what Spanish law says about how much information can be given to recipients about donors. Many clinics hide behind a presumption that local law actually prevents them from being able to give more information. This allows them to retain significant control, something we know from UK experience that clinics do not give up easily. But this presumption was challenged when a clinic opened in Barcelona that gave a large amount of information…their lead doctor having trained at the Hammersmith Hospital in London and been influenced by Jennie Hunt, the senior counsellor there who is a fierce advocate of information and contact. An enquiry by me, and some UK counsellors, to a Spanish psychologist colleague has brought forth a paper that sets out just what the Spanish system can and cannot do.
Firstly, it is clear that it is within Spanish law to give all information about the physical features of a donor to a recipient. The paper says nothing about ethnic background, reasons for donating, occupation, educational level or values and I have made further enquiries about these aspects.
Secondly, the Spanish seem to have a rather ambiguous relationship to money. Their Law 14/2006 of May 20th says, “The donation will always be non-profit or commercial. The financial compensation can be set to only compensate strictly physical discomfort and travel and labour expenses that may arise from the donation and must not entail an economic incentive for this”. Now this obviously started off in Spanish and may have lost something in translation but the emphasis on ‘no economic incentive’ seems clear. However, the paper goes on to say that in research carried out in Spain amongst donors, the primary motivation for donating was financial. So much for the HFEA copying the Spanish model in setting a fee for egg donation that did not amount to an incentive.
But the greatest criticism of the Spanish system is that there is no National Donor Registry and as a result there is no central control over how their information and information relating to recipients is held. There is also no control over the number of donations a donor may make – the nominal number is six but no-one oversees this. In addition Spain is in breach of many EU directives relating to the donation, procurement and control of tissues and cells of human origin and technical requirements of traceability and notification and side-effects and certain technical requirements related to the processing, preservation, storage and distribution of human tissues and cells.
Provision was made in the first Spanish ART Act (1988) and in the current Act (2006) for a National Donor Registry but this has never happened. Could it be that the commercial interests of all the clinics has proved an irresistible incentive for the government to turn a blind eye to legislation that might be seen to curb the practices of doctors who earn so much foreign currency for the Spanish economy?
My correspondent calls for the immediate establishment of the donor registry which could then link with other registries across Europe in order to establish traceability of gametes and donors. Without a registry there is very little chance that children, either retrospectively or in the future, will be able to have information that may help them make sense of their background and secure their identity. Without the demand from those who use – or in the past have used – Spain’s fertility services, what incentive will Spanish clinic owners have to ease their control and enact their law? If this matters to YOU, please speak up.