Just set back from London’s busy Tottenham Court Road and round the corner from University College Hospital’s very swizzy new Cancer Centre is the old Royal Ear Hospital, now taken over by UCL’s Bartlett School of Architecture. This rather cold and slightly strange venue was where Progress Educational Trust’s first of three free evening events on gamete donation took place on Wednesday night. It was titled Giving: The Donor Perspective. What seemed odd at the beginning was that there was only one donor on the panel, but on reflection I suspect it was probably the funding from the Wellcome Trust that determined the range of speakers, some of whom contributed more than others to understanding the donor perspective. But could it be something else as well…
Kriss Fearon a former egg donor and regular commentator on this blog kicked off the evening by exposing and then exploding the myth that egg donors are saints and sperm donors sleazy old men. She paid tribute to the privations that sperm donors have to agree to in order to be accepted by a clinic and their commitment to a changed life-style during their period of donating and put in a plea for Thank-You cards for sperm as well as egg donors. A great idea. Kriss herself is insistent that she is just an ordinary person wanting to help but also someone who, childless herself, is interested in passing on her genes – her biological legacy – as it was put by one of the two sperm donor stories featured in the information packs provided. Kriss also felt that money was a facilitator rather than a motivator for donation. She could not have donated on the three occasions that she did without all her expenses being covered, although this was at a time before significant money was involved in gamete donation. (If I’ve got anything wrong here Kriss just let me know and I’ll correct it).
DC Network opposed the increased payment, euphemistically known as compensation, for donors that came about as part of a review of donation services in 2011. The current situation as set out on the HFEA website is –
Egg donor payment – As an egg donor you can receive compensation of up to £750 per cycle of donation, to reasonably cover any financial losses incurred in connection with the donation, with the provision to claim an excess to cover higher expenses (such as for travel, accommodation or childcare).
Sperm donor payment – Payment of donors is prohibited. As a sperm donors you can receive compensation of up to £35 per clinic visit, to reasonably cover any financial losses incurred in connection with the donation, with the provision to claim an excess to cover higher expenses (such as for travel, accommodation or childcare).
It is clear from the above that considerably more than £750 or £35 is available to be claimed. We heard at the meeting that many donors do not actually claim any money at all – although it was unclear if this applied more to sperm than egg donors – but some anecdotal evidence from recipients that has come DC Network’s way regarding the profile/potential motivation of egg donors that they have been offered, leads the organisation to believe that what is needed is some good qualitative research on donors who have come forward since the £750 plus payment has become available. Shorter waiting lists and more UK egg donors is on the face of it wonderful news, but they do need to be the right people. It’s quality, in terms of identifiability at 18, and not quantity that counts in the end.
Sorry, that’s a bit of a detour from the PET meeting, which next featured Venessa Smith, Co-ordinator of Donor Services at the London Women’s Clinic (LWC) and the London Sperm Bank as well as sometimes giving professional in-put on DCN’s Preparation for Donor Conception Parenthood workshops. LWC has an incredibly dynamic, go-ahead and almost scarily market-oriented approach to donor recruitment. In response to a plea by the National Gamete Donation Trust ten years ago they have made enormous efforts to make donors feel wanted and respected by responding to enquiries promptly and pleasantly and giving them lots of information before they come through the door. In this way expectations are managed and although only five per cent of potential sperm donors actually make it through to the programme, they have sufficient men coming forward to be able to offer a good choice to recipients.
Erika Tranfield from the parenting connection web site Pride Angel was not able to be at the meeting in person because of illness. However, from her sick-bed she impressively put together a power-point presentation with co-ordinated sound that put a powerful argument for known donation.
In these blogs I have often found myself writing about the negative flip-side of known donation, the agreements that have turned sour, the changed emotions and expectations once a child is born and the horrible court decisions that have led to children being made to spend time with a donor ‘parent’ against their will. Of course there is a very positive side too. These arrangements can be wonderful for children and parents alike. Erika’s organisation is undoubtedly the responsible and ethical face of known donation. Donors and recipients are encouraged to use HFEA licensed clinics, consult counsellors and put in place agreements with solicitors. No ‘natural insemination’ allowed and safe-guards are in place to prevent donors being in touch with too many women, thereby potentially flouting the ten family HFEA rule. As anxious as I continue to feel about known donation I couldn’t help feeling that what Pride Angel is offering is coming close to a future that has long been envisaged by Walter and I. This would be a time when some kind of non-profit agency would bring together donors and recipients and that clinics would only be involved in actual insemination or egg collection/embryo transfer. In this way donors and recipients could choose each other, possibly with support and guidance from non-partisan intermediaries who had the interests of families in mind, and doctors could do what they are best at. Which reminds me how wonderful it was to hear Allan Pacey, Chair of the British Fertility Society, say that he was just a scientist and should not be expected to know about what was best for families. Wish there were more of his sort around!
Lucy Frith, bioethicist from University of Liverpool, raised the issue of conditionality in donation, but even though the question was raised from the floor about recipients being able to place reciprocal conditions, the issue that I sometimes wonder about did not come to the fore. This is a bit controversial but I wonder if recipients are told the sexuality of their donor or given the choice about having a gay, lesbian or heterosexual donor. I am not homophobic and nor do I believe that sexuality is genetically inherited but I do know that young people, and often boys in particular, often go through a period of homophobia during their teenage years and that knowing that their donor was gay or lesbian might make coming to terms with their identity of being a donor conceived person more difficult for them. It might also be a shock for a young person to discover the sexuality of their donor if they choose to make contact post 18, although I would hope that by 2023 when first post 2005 conception young people have option of contact, that homosexuality would be so accepted as to be beyond comment. Of course if parents are comfortable with the sexuality of their donor and include this in discussions with the child then the issue is likely to be of less relevance. But in order to do this, recipients would need to know and I don’t know if they are currently told.
The final speaker, Allan Pacey, admitted at the end of the meeting that he had been expecting to be asked all sorts of difficult questions to do with his topic of donor screening, but it appeared that the radical deaf lobby had not heard about this event and Allan was untroubled by controversy.
What interested me in the long period devoted to question and comment from the audience was the difficulty that many people had in focusing on the donor. There were many questions to do with recipients and donor conceived people and their families, each the focus of the next two events. At one point I really felt the panel should have been referring questions to the five members of DC Network sitting on the wonderful lime green chairs in the audience. Could this be to do with the historically shadowy nature of the donor in donor conception, the unmentionable other (fertile) person who has for so long been unacknowledged. Could this have been the unintentional meaning behind having only one donor on the panel?