The HFEA’s recent decision to allow mitochondrial donation is to be welcomed. At long last families affected by mitochondrial disease will be able to have a child whose life is highly unlikely to be shortened by this devastating disease. But this decision does highlight, once again, the premium put (by individuals, by society) on having a child genetically related to both parents. An alternative, long available to couples at risk of having a child with a mitochondrial disorder, is egg donation, a technique used by many, many people around the world to circumvent female infertility but always resulting in a child not genetically related to the mother. Women carrying mitochondrial disease are not infertile. The argument goes that they should have the opportunity to have a genetically connected child ‘like anyone else’…except that, as we know, thousands of us every year don’t have that choice.
The awkward truth is that every heterosexual couple with children conceived by egg, sperm or embryo donation would have preferred to have the genetic child of their chosen partner. We use donor conception because that is not possible. If we have faced and mourned this loss and moved to a place where we feel we have something to offer as a parent more than needing a child ‘just like us’then it is likely that once the children arrive it will be difficult to imagine having any other child. For others, in the past and sometimes still, lost fertility, hopes and dreams mean that a donor conceived child is a painful reminder of what could not be. In the former families, honesty is likely to prevail. In the latter the secret of donor conception is likely to be kept with corrosive results.
Honesty in donor conception families, however, needs to go beyond straightforward openness about the means of conception. We need first of all to own up to ourselves that genetic connection is what we would have preferred – although we love our DC children to bits – and to admit that genetics might just be important for them too. Positively choosing an identifiable donor is an integral part of owning our own preference for genetic connection and honouring our children’s right to know their own genetic background at the same time. Many parents hope that openness with their children from the beginning will mean that they will not be curious and want to seek out their donor at 18. But if we as parents can only recall our own sadness at finding that donor conception was going to be the only way we could have a family it should be easier to recognise that curiosity and a need for knowledge about genetic inheritance by our children is no different. If accepted as just that it is highly unlikely to be a threat to family life…indeed it has possibilities for enhancement. We owe it to our children to be honest with ourselves first.