Despite the appalling weather and the imminence of the Murray/Federer final at Wimbledon, there was a wonderful turn-out today of members of the N.London group of DC Network for a picnic in a local park. These annual events are always really heartwarming occasions with children frolicking on the grass and parents sitting around sharing food and chatting. There were several new members there, all either with children or pregnant by egg donation or contemplating undertaking DE. What was sad to hear from those yet to have treatment was that the myth of the two year waiting list in this country persists. It was true two or three years ago but these days there are more than a handful of UK clinics where waiting lists for egg donation are under six months. And this is not just for egg-sharing. The CARE group, to name just one collection of four clinics, has been very successful in recruiting altruistic donors so there really is no need for people to go abroad, unless they have a very particular reason for choosing to do so. What makes me angry is that many clinics continue to tell their clients that they are likely to have to wait at least two years for an egg donor in the UK, so why don’t they go abroad to this lovely clinic they just happen to have a partnership with in Spain, Cyprus or wherever. Giving misinformation like this goes to show the profound misunderstanding that many clinics have of what using donor gametes means in the creation of a family. They see their role as simply providing the means by which a baby is made. Whilst this can sometimes feel process driven and impersonal when clinic intervention is needed for IVF, because a couple’s own gametes are used, the final result is the creation of a genetically connected family. But when donated eggs, sperm or embryos are substituted for those that a couple or individual cannot supply themselves, then a different sort of family comes into being. Lip service is paid to this by most clinics in that most people contemplating donor procedures have a session with a counsellor before proceeding. However, many private clinics are now charging fees for counselling and as a result clients are resisting attending the sessions. Also ONE session can do little more than raise issues. What is really needed, prior to individual counselling if couples or individuals choose to attend (and counselling isn’t really counselling unless it is voluntary), is preparation for donor conception parenthood. Ideally a weekend, as in DC Network courses, or a minimum of a day, should be devoted to giving couples and individuals opportunities to think through the long-term implications of donor conception and the responsibilities that parenthood achieved this way brings. One of the most important elements of DCN Preparation workshops when working with heterosexual or lesbian couples, is separating the partners and giving them space to think about and express their own feelings away from their partner. So often on these weekends we have seen men who looked like they would prefer to be permanently dragged around Topshop rather than be where they are, emerge from the session for ‘men only’ with broad grins on their faces, chatting happily to other guys. Non-genetic mothers in lesbian couples also appreciate the time away from their partner to express anxieties and fears about their role and place in future children’s lives.
Sometimes parallels are drawn between donor conception and adoption…and there are many similarities (although significant differences as well). But one huge advantage that adoption has is that those who administer the systems are all family welfare focused and trained. Doctors just don’t come into the equation. There is no question about not putting the welfare of children and families first. Donor conception is led by doctors and as such is focused on the medical science and clinical procedures involved in bringing about conception. Viewed through this lense, without the social science filter, moving on to donor conception is the next logical step when a person’s own gametes are absent or have let them down. As intimated above, this may be fine (and I recognise it is not always OK) for IVF or IVF/ICSI, but donated gametes contributing to family formation are different and need to be recognised as such.
We need the doctors…of course we do and they mostly carry out their role brilliantly, BUT we also need a change of culture in our clinics. All staff members, from receptionists to consultants, need to understand the family building nature of what it is they are doing and support their clients in recognising the differences and preparing for the future when a donor is introduced into the equation.
We may well have to wait for the next generation of fertility specialists for this to happen, but it is important that we work with the doctors now so that these much resisted ideas filter through. I have to be optimistic so instead of ending with…And Pigs Might Fly…I’ll say, We’ll get there.