tag:theconversation.com,2011:/ca/topics/sperm-donors-18350/articlesSperm donors – The Conversation2022-07-04T13:45:54Ztag:theconversation.com,2011:article/1860872022-07-04T13:45:54Z2022-07-04T13:45:54ZEggs and sperm can now be stored for up to 55 years – here’s what that means for donors and people seeking fertility treatment<figure><img src="https://images.theconversation.com/files/472277/original/file-20220704-14-dhlxdy.jpg?ixlib=rb-1.1.0&rect=0%2C16%2C5463%2C3620&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The new storage limits may give people more flexibility when it comes to their fertility treatment.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/embryologist-pulls-out-dewar-liquid-nitrogen-1225484992">Ekaterina Georgievskaia/ Shutterstock</a></span></figcaption></figure><p>The UK government has just extended the period that gametes (eggs and sperm) and embryos can be stored from <a href="https://www.legislation.gov.uk/ukpga/2022/31/schedule/17/enacted">ten years to 55 years</a>. While this change will probably be welcomed by people who wish to have fertility treatment, it could have important implications for egg and sperm donors.</p>
<p>A growing number of people in the UK are choosing to <a href="https://academic.oup.com/humupd/article/22/4/440/2573626">freeze their eggs, sperm and embryos</a> for use in their own fertility treatment. Previously, the storage limit was <a href="https://www.legislation.gov.uk/ukpga/1990/37">ten years</a> – though extensions were permitted for people who could prove a medical need (such as premature infertility) up to 55 years.</p>
<p>But many felt that the storage limits restricted the choices of people who freeze eggs and sperm for their own fertility treatment. If they couldn’t give a medical reason to increase the storage period, these gametes had to be destroyed after ten years. </p>
<p>Cryopreservation techniques – which involve freezing gametes to preserve them – have also improved significantly since the previous storage limits were set. <a href="https://academic.oup.com/humupd/article/22/4/440/2573626">Studies now show</a> that eggs frozen using current preservation techniques are likely to develop in the same way as fresh eggs. Pregnancy rates from frozen embryos are also equivalent to those using fresh embryo transfer. As such, there is no longer a scientific reason for storage to be restricted to a maximum of ten years. </p>
<p>After launching a public consultation in February 2020, the government has now legislated to extend the storage limit for everyone (regardless of medical need) to 55 years. </p>
<h2>Considering donors</h2>
<p>Following the change to the storage limit (which took effect on July 1), people will now need to give consent every ten years to continue storing their gametes and embryos for use in their own fertility treatment. However, egg and sperm donors who aren’t seeking fertility treatment won’t be asked to renew consent every ten years – though they will be able to specify upfront whether or not they want their donation stored for up to 55 years. </p>
<p>There are potentially important consequences of these new storage times for both donors and children born from donated eggs or sperm. Although donors are already offered counselling to make sure that they are comfortable with what they are going to do, counselling will now need to address issues raised by the extended storage period. The most significant of these issues is that some donors’ eggs or sperm will be available for use over a considerably longer period than under the previous rules. The obligation that clinics have to ensure donors fully understand the implications of their decision will become even more important as this extension to storage times is implemented.</p>
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<img alt="A young couple speaks with their female doctor in her office." src="https://images.theconversation.com/files/472278/original/file-20220704-18-rpfgtg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/472278/original/file-20220704-18-rpfgtg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/472278/original/file-20220704-18-rpfgtg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/472278/original/file-20220704-18-rpfgtg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/472278/original/file-20220704-18-rpfgtg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/472278/original/file-20220704-18-rpfgtg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/472278/original/file-20220704-18-rpfgtg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">People seeking fertility treatment should also be made aware of the implications of new storage limits.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/african-american-millennial-couple-sit-couch-1446009716">fizkes/ Shutterstock</a></span>
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<p>For example, if a person donates sperm at age 35 and their sperm is stored for 55 years, children might be born from that donation when the donor is 90 years old. This also means that, for the children born from that person’s donation, they might have donor siblings who are older than their parents. Donor-conceived people should be aware of the possibility that their donor might be a very elderly person – or already deceased – and that they may have donor siblings, and possibly nephews and nieces, who are significantly older than them.</p>
<p>This change takes place in the context that, since the law changed in April 2005, donor-conceived people are <a href="https://www.legislation.gov.uk/uksi/2004/1511/contents/made">entitled at age 18</a> to find out who their donor was. </p>
<p>Fertility professionals are also worried about the speed with which these potentially far-reaching changes are coming into effect – leaving little time for them to prepare. Although the changes have already come into effect, new guidance still needs to be adopted in fertility clinics, and training and instruction provided to staff. Many clinics also haven’t been able to produce updated advice for donors. This is essential for ensuring everyone fully understands what they’re consenting to.</p>
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Read more:
<a href="https://theconversation.com/egg-freezing-the-reality-of-putting-your-fertility-on-ice-101223">Egg freezing: the reality of putting your fertility on ice</a>
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<p>It’s also important to ensure that people seeking fertility treatment with donated eggs and sperm are fully informed about the implications storage-limit changes could have on starting a family this way. Although the <a href="https://pubmed.ncbi.nlm.nih.gov/35178481">European Society for Human Reproduction and Embryology</a> already has information available about what to consider when donating or accessing fertility treatment with donated gametes, it will be important for fertility clinics in the UK to produce their own information reflecting the changes in storage limits. </p>
<p>The effects of this legislative change will play out over many years. There are clearly significant benefits of extending the maximum storage period of eggs and sperm for those needing to use them in their treatment. But attention will need to be paid – sooner rather than later – to the implications these changes have for gamete donors and donor-conceived people.</p><img src="https://counter.theconversation.com/content/186087/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Caroline Redhead is a Research Fellow on the ConnecteDNA study which is funded by UKRI ESRC</span></em></p><p class="fine-print"><em><span><a href="mailto:j.kirkmanbrown@bham.ac.uk">j.kirkmanbrown@bham.ac.uk</a> receives research funding from a number of government and commercial funding bodies, further details can be found on his team research website <a href="http://www.spermeggembryo.com">www.spermeggembryo.com</a>. He is affiliated with the University of Birmingham and Birmingham Women's and Children's NHS Foundation Trust. </span></em></p><p class="fine-print"><em><span>Leah Gilman is a Research Fellow on the ConnecteDNA study which is funded by UKRI ESRC.</span></em></p><p class="fine-print"><em><span><a href="mailto:lucy.frith@manchester.ac.uk">lucy.frith@manchester.ac.uk</a> receives funding from UKRI ESRC</span></em></p>Previously, eggs and sperm (gametes) and embryos were typically only stored for a maximum of ten years.Caroline A B Redhead, Research Fellow, Centre for Social Ethics and Policy, The University of Manchester, University of ManchesterJackson Kirkman-Brown, Reader in Human Reproductive Biology, University of BirminghamLeah Gilman, Research Fellow, Centre for Social Ethics and Policy, University of ManchesterLucy Frith, Reader, Bioethics, University of ManchesterLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1743892022-01-18T13:40:25Z2022-01-18T13:40:25ZSperm donation is largely unregulated, but that could soon change as lawsuits multiply<figure><img src="https://images.theconversation.com/files/440766/original/file-20220113-19-14yu4a4.jpg?ixlib=rb-1.1.0&rect=101%2C14%2C1895%2C1302&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Freezing and storing sperm vials has proved easier than regulating artificial insemination.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/lab-technician-jessica-kenyon-puts-sperm-vials-into-liquid-news-photo/1290396268">MediaNews Group/Boston Herald via Getty Images</a></span></figcaption></figure><p>When Wendy and Janet Norman decided to have a baby, they went sperm shopping through Xytex Corp., a <a href="https://www.mayoclinic.org/tests-procedures/sperm-donation/about/pac-20395032">sperm bank</a>.</p>
<p>The couple chose Donor #9623. Xytex, the Normans later claimed, told them the man <a href="https://www.gpb.org/news/2020/09/28/georgia-supreme-court-rules-sperm-donor-case-falls-in-line-consumer-fraud">spoke multiple languages</a> and was <a href="https://www.gasupreme.us/wp-content/uploads/2020/09/s19g1486.pdf">pursuing a doctorate</a>.</p>
<p>Xytex had also assured them that it carefully screened all donors by reviewing their family health history and criminal records and that it subjected donors to intensive physical exams and interviews to <a href="https://www.gasupreme.us/wp-content/uploads/2020/09/s19g1486.pdf">verify the information</a>.</p>
<p>But after Wendy Norman gave birth to a son in 2002, the couple learned their child had inherited a genetic blood disorder for which Wendy was not a carrier. He would, much later, require extended hospitalizations because of suicidal and homicidal thoughts.</p>
<p>Even later, they learned that the donor, James Christopher Aggeles, had <a href="https://scholar.google.com/scholar_case?case=2684447592603399491&hl=en&as_sdt=6&as_vis=1&oi=scholarr">lied to the sperm bank</a> about his background and that the sperm bank had not verified the information he provided. Nor did it make him supply his medical records or sign a release that would have made it possible to obtain them.</p>
<p>As <a href="https://www.law.virginia.edu/faculty/profile/nrc8g/2915359">law professors</a> who study <a href="https://www.law.gwu.edu/sonia-m-suter">reproductive technology</a>, we see this case and others like it as showing why the government should tighten regulations over sperm and egg donation so that prospective parents and <a href="https://doi.org/10.1093/hropen/hoaa057">donor-conceived adults</a> receive accurate and complete details about their donors’ medical, academic and criminal history. </p>
<h2>A ‘wrongful birth’?</h2>
<p>Aggeles wasn’t pursuing an advanced degree when he began donating sperm. He didn’t even have a college degree at that point. He also failed to disclose his diagnosis of <a href="https://www.mayoclinic.org/diseases-conditions/schizophrenia/diagnosis-treatment/drc-20354449">schizophrenia</a>, a severe mental health condition requiring lifelong treatment. Schizophrenia has a <a href="https://www.healthline.com/health/is-schizophrenia-hereditary">high level of heritability</a> in families. He had also been arrested at the time of his donation and was later <a href="https://scholar.google.com/scholar_case?case=2684447592603399491&hl=en&as_sdt=20000006&as_vis=1">incarcerated for burglary</a>.</p>
<p>When the Normans sued Xytex, a local court initially dismissed <a href="https://scholar.google.com/scholar_case?case=2684447592603399491&hl=en&as_sdt=6&as_vis=1&oi=scholarr">almost all claims in</a> their case. They appealed to Georgia’s Supreme Court, which in 2020 <a href="https://www.gasupreme.us/wp-content/uploads/2020/09/s19g1486.pdf">allowed several of their claims to go forward</a>. </p>
<p>The Normans could, for instance, seek financial compensation, partly to cover the additional expenses they might have avoided had they learned about the donor’s medical history sooner. The court also told the Normans they could try to recover the price difference between what they paid for the sperm they received and <a href="https://www.nytimes.com/2021/01/08/business/sperm-donors-facebook-groups.html">its market value</a>.</p>
<p>Finally, the Normans were allowed to allege under the state’s <a href="https://law.justia.com/codes/georgia/2010/title-10/chapter-1/article-15/part-2/">Fair Business Practice Act</a> that the sperm bank had misrepresented to the public the quality of its sperm and its screening process.</p>
<p>The Supreme Court of Georgia did not, however, permit the couple to sue over what is known as a “<a href="https://lawdigitalcommons.bc.edu/jlsj/vol34/iss2/8/">wrongful birth</a>” claim. These claims are negligence actions brought by parents based on the birth of a child with disabilities or genetic disorders because of a provider’s failure to identify the risk.</p>
<p>The case is still pending.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/440478/original/file-20220112-25-14gowjp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Blue-tinted sperm swim in a liquid." src="https://images.theconversation.com/files/440478/original/file-20220112-25-14gowjp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/440478/original/file-20220112-25-14gowjp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/440478/original/file-20220112-25-14gowjp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/440478/original/file-20220112-25-14gowjp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/440478/original/file-20220112-25-14gowjp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/440478/original/file-20220112-25-14gowjp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/440478/original/file-20220112-25-14gowjp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Screening sperm donors is often limited to seeing if they have communicable diseases.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/illustration/human-sperm-royalty-free-illustration/674416385">Sebastian Kaulitzki/Science Photo Library</a></span>
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<h2>Limited regulation</h2>
<p>The Normans’ lawsuit is hardly unique.</p>
<p>Other families have <a href="https://www.nytimes.com/2012/05/15/health/in-sperm-banks-a-matrix-of-untested-genetic-diseases.html">sued sperm banks</a> after having donor-conceived children who wound up with a variety of <a href="https://www.riverfronttimes.com/newsblog/2019/02/08/st-louis-dad-sues-sperm-bank-after-baby-is-born-with-genetic-disorder">genetic disorders</a>.</p>
<p>In many of those cases, the sperm banks said they routinely test sperm and exclude donors who could pass along genes that cause genetic diseases. In those instances, the families have grounds for accusing the sperm banks of fraud and negligence.</p>
<p>Some <a href="https://apnews.com/article/lifestyle-technology-health-new-york-lawsuits-3c4280eb72f05f9b5f33238b0b608da6">donor-conceived adults</a> are also <a href="https://www.voiceofsandiego.org/topics/news/dna-testing-is-unearthing-local-fertility-fraud-cases/">suing doctors</a> who lied to the plaintiffs’ parents about <a href="https://apnews.com/article/a86db8b20d5a36213dfbb169a5a031fe">whose sperm</a> they were receiving and instead <a href="https://apnews.com/article/lifestyle-technology-health-new-york-lawsuits-3c4280eb72f05f9b5f33238b0b608da6">used their own</a>. Several states now ban this kind of “<a href="https://khn.org/news/conceived-through-fertility-fraud-she-now-needs-fertility-treatment/">fertility fraud</a>.” </p>
<p>This <a href="https://www.wsj.com/articles/a-grieving-family-wonders-what-if-they-had-known-the-medical-history-of-sperm-donor-1558-11641119405">litigation is on the rise</a> because of the growing popularity of direct-to-consumer DNA testing, which makes it <a href="https://www.cbsnews.com/news/woman-finds-sperm-donor-after-using-dna-test-raising-questions-about-donor-anonymity/">easier to identify previously anonymous</a> sperm donors and to learn about genetic risks donor-conceived people may have inherited from them. </p>
<p>It’s also happening because of the <a href="https://www.nytimes.com/2021/02/01/health/sperm-donor-fertility-meijer.html">absence of clear rules and laws regulating</a> sperm banks. There is <a href="https://theconversation.com/the-fertility-industry-is-poorly-regulated-and-would-be-parents-can-lose-out-on-having-children-as-a-result-163792">little regulation of reproductive technologies</a> of any kind, including in <a href="https://theconversation.com/40-years-after-the-birth-of-ivf-researchers-push-boundaries-to-preserve-fertility-in-women-men-and-children-99485">vitro fertilization</a>, a procedure that fertilizes the egg with sperm in the laboratory instead of the body, at the state or federal level.</p>
<p>Because the <a href="https://dx.doi.org/10.1016%2Fj.fertnstert.2019.05.031">government does not track artificial insemination</a>, the number of donor-conceived people is unknown.</p>
<p>The federal government requires only that donated sperm and eggs be treated like other human tissue and <a href="https://www.fda.gov/vaccines-blood-biologics/tissue-tissue-products/donor-eligibility-final-rule-and-guidance-questions-and-answers">tested for communicable diseases</a> – <a href="https://www.dhs.wisconsin.gov/disease/communicable.htm">infectious conditions</a> that spread through viruses, bacteria and other means – but not genetic diseases.</p>
<p>There are also <a href="https://ilr.law.uiowa.edu/print/volume-106-issue-2/dr-i-dont-want-your-baby-why-america-needs-a-fertility-patient-protection-act/">no federal requirements</a> that sperm banks obtain and verify information about a donor’s medical history, educational background or criminal record.</p>
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<figcaption><span class="caption">The movie ‘Delivery Man’ revolves around what happens when a sperm bank uses a single donor’s sperm to make hundreds of babies.</span></figcaption>
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<h2>What is the basis for these lawsuits?</h2>
<p>The allowable grounds for fertility negligence vary by state.</p>
<p>Some states let families sue clinics that <a href="https://casetext.com/case/paretta-v-med-offices-for-human-reproduction">fail to screen donors</a>, even when the parents seek damages associated with the birth of the child with a dangerous genetic condition. This would essentially allow a wrongful birth claim to go forward.</p>
<p>But a growing number of states, at least 14 so far, <a href="https://faculty.westacademic.com/Book/Detail?id=320412">prohibit such claims</a>. That is leading many courts, like the Supreme Court of Georgia, to define the injury as distinct from the birth of the donor-conceived child.</p>
<h2>The end of anonymity</h2>
<p>One complication in terms of resolving these disputes is that <a href="https://dx.doi.org/10.1093%2Fjlb%2Flsw052">most sperm donations are anonymous</a>.</p>
<p>At odds with the donor’s interest in keeping their his identity a secret, we argue, are <a href="https://repository.law.umich.edu/mjgl/vol16/iss1/4/">donor-conceived people’s strong interests</a> in learning about their donors, including their medical, educational and criminal history – and <a href="https://scholarlycommons.law.hofstra.edu/hlr/vol42/iss4/3">even identity</a>.</p>
<p>DNA tests, including direct-to-consumer kits like 23andMe, are rendering <a href="https://pubmed.ncbi.nlm.nih.gov/28697325/">donor anonymity impossible to maintain</a>. And internet searches, as the Normans discovered, can make it possible to see whether a donor, once identified, has misrepresented their personal information.</p>
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<figcaption><span class="caption">The movie ‘The Kids Are All Right’ hinged on the complications that can arise when a family gets to know a sperm donor.</span></figcaption>
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<h2>States are beginning to set rules</h2>
<p>Because Congress has taken <a href="https://www.cdc.gov/art/nass/policy.html">no action regarding assisted reproductive technology since 1992</a>, states have slowly begun to step in.</p>
<p>In 2011, Washington required the disclosure of <a href="https://app.leg.wa.gov/RCW/default.aspx?cite=26.26A.820">donor-identifying information and medical history when a child turns 18</a>. </p>
<p>On Jan. 1, 2022, Connecticut enacted the <a href="https://www.uniformlaws.org/HigherLogic/System/DownloadDocumentFile.ashx?DocumentFileKey=e4a82c2a-f7cc-b33e-ed68-47ba88c36d92&forceDialog=0">Uniform Parentage Act</a>, which is based on model legislation drafted by a national nonpartisan commission to fill widespread legislative gaps. The measure requires that fertility clinics <a href="https://www.cga.ct.gov/2021/act/pa/pdf/2021PA-00015-R00HB-06321-PA.pdf">collect identifying information from donors</a> and indicate whether donors have agreed to disclosure.</p>
<p>Another pending measure in <a href="https://www.nysenate.gov/legislation/bills/2021/s7602">New York</a> would require sperm and egg donor banks “to collect and verify medical, educational and criminal felony conviction history information” from any donor. That legislation would also provide prospective parents who purchase eggs or sperm and donor-conceived people with the right to obtain such information without personally identifying the donor. This option could make it possible to preserve donor anonymity, at least theoretically.</p>
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<p>The bill was drafted at least partially in response to the experience of Laura and David Gunner, <a href="https://www.wsj.com/articles/a-grieving-family-wonders-what-if-they-had-known-the-medical-history-of-sperm-donor-1558-11641119405">whose donor-conceived son died of an opioid overdose</a>. After their son’s death, the Gunners learned that a few years earlier, the donor himself had died and that he had been diagnosed with schizophrenia. The donor had not disclosed his mental illness or hospitalizations for behavioral issues.</p>
<h2>Costs are not a barrier</h2>
<p>It’s possible that measures like the one pending in New York state would make fertility treatment somewhat more expensive.</p>
<p>Currently, a vial of donor sperm may <a href="https://www.marketplace.org/2019/10/24/the-cost-of-building-a-family-using-donor-sperm/">cost close to $1,000</a>, with the <a href="https://www.marketplace.org/2019/10/24/the-cost-of-building-a-family-using-donor-sperm/">donor often being paid up to $150</a>.</p>
<p>Genetic testing, however, might not add much to the cost because it would only be done once, rather than each time a patient obtains a vial of sperm. With artificial insemination, it’s <a href="https://www.verywellfamily.com/donor-insemination-4685684">rare for a pregnancy to occur on the first or second try</a>.</p>
<p>As we learned from <a href="https://www.adoptionnetwork.org/news-events/archive.html/article/2021/03/25/adoption-network-cleveland-supports-fertility-fraud-legislation">Tyler Sniff</a>, an advocate for the New York bill and a director of the nonprofit <a href="https://www.dcc-usa.org/2021/11/14/what-donors-need-to-know/">U.S. Donor Conceived Council</a>, DNA testing companies offer relatively inexpensive options that can cost less than $300. </p>
<p>To be sure, disclosure requirements might overpromise how much <a href="https://www.wsj.com/articles/a-grieving-family-wonders-what-if-they-had-known-the-medical-history-of-sperm-donor-1558-11641119405">prospective parents can learn about their future children</a>. But we are certain that <a href="https://bioethics.umn.edu/news/who-am-i-ethics-sperm-and-egg-donation">these issues will become even more critical</a> as technology continues to outpace its regulation – and as both <a href="https://www.wearedonorconceived.com/">donor-conceived adults</a> and an increasing number of people who used sperm banks advocate for their interests.</p><img src="https://counter.theconversation.com/content/174389/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Many people are filing lawsuits after discovering that sperm banks failed to verify information from donors about their medical and personal backgrounds.Naomi Cahn, Professor of Law, University of VirginiaSonia Suter, Professor of Law, George Washington UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1175672019-06-03T12:49:53Z2019-06-03T12:49:53ZSperm banks recruit unpaid donors by playing into masculine stereotypes<figure><img src="https://images.theconversation.com/files/277593/original/file-20190603-69075-1wfjfat.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/colorful-balloons-spermatozoid-shape-on-blue-1100465771?src=Mjdki6TZ2PsjS5mto-yWtw-1-4">Shutterstock</a></span></figcaption></figure><p>The sperm bank market is growing as an increasing number of people rely on sperm donation to have babies, from lesbian couples to heterosexual ones where the male partner is infertile, and single mothers who <a href="https://www.thetimes.co.uk/article/going-solo-why-i-became-a-single-mum-by-using-a-sperm-donor-mb7053nk2">decide to have a child on their own</a>. Faced with this increasing demand, sperm banks must recruit more donors. But it is not always an easy task – especially in the UK and Australia where it is illegal to pay donors or preserve their anonymity. </p>
<p>In a study recently published in <a href="https://journals.sagepub.com/doi/10.1177/1470593119847250">Marketing Theory</a>, my colleagues and I found that sperm banks in these countries solved this challenge by playing into traditional male stereotypes and selling sperm donation as an experience that makes donors feel more masculine. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/277591/original/file-20190603-69087-jhyywx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/277591/original/file-20190603-69087-jhyywx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/277591/original/file-20190603-69087-jhyywx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=321&fit=crop&dpr=1 600w, https://images.theconversation.com/files/277591/original/file-20190603-69087-jhyywx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=321&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/277591/original/file-20190603-69087-jhyywx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=321&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/277591/original/file-20190603-69087-jhyywx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=404&fit=crop&dpr=1 754w, https://images.theconversation.com/files/277591/original/file-20190603-69087-jhyywx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=404&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/277591/original/file-20190603-69087-jhyywx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=404&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A stereotypical hero figure.</span>
<span class="attribution"><span class="source">IVF Australia</span></span>
</figcaption>
</figure>
<p>Sperm banks used imagery of heroes saving “damsels in distress” and soldiers defending their country against the <a href="https://www.telegraph.co.uk/men/active/mens-health/11836263/National-sperm-bank-challenges-men-to-prove-their-manhood.html">idea of foreign sperm invading</a>. This followed reports of “sperm shortages” that meant sperm had to be imported to meet <a href="https://www.hfea.gov.uk/media/2808/trends-in-egg-and-sperm-donation-final.pdf">rising domestic demand</a>. And it seems to have worked. These strategies helped the UK and Australian sperm donation markets to recover from the dip in the number of donors experienced <a href="https://www.hfea.gov.uk/media/2808/trends-in-egg-and-sperm-donation-final.pdf">between 2012 and 2015</a>.</p>
<h2>Time and effort</h2>
<p>Donating sperm will often involve several visits, a variety of medical checks, and the provision of a large amount of personal information. So donors must be willing to give their time and effort. Yet, in the UK and Australia, sperm banks cannot pay their donors for this. </p>
<p>Plus, donors must provide their name and details if potential children decide to contact them upon turning 18. As a result, it is quite a challenge for UK and Australian sperm banks to recruit donors. The survival of sperm banks in the UK and Australia was threatened and they had to find a new strategy.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/277592/original/file-20190603-69071-d6p8f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/277592/original/file-20190603-69071-d6p8f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/277592/original/file-20190603-69071-d6p8f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=900&fit=crop&dpr=1 600w, https://images.theconversation.com/files/277592/original/file-20190603-69071-d6p8f.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=900&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/277592/original/file-20190603-69071-d6p8f.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=900&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/277592/original/file-20190603-69071-d6p8f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1131&fit=crop&dpr=1 754w, https://images.theconversation.com/files/277592/original/file-20190603-69071-d6p8f.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1131&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/277592/original/file-20190603-69071-d6p8f.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1131&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Playing on patriotic instincts.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/tarrant-hinton-dorset-uk-august-30-1411785653">Andrew Harker/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>In this research, we studied the advertising campaigns of eight fertility clinics and five sperm banks in the UK and Australia to try and understand how to recruit sperm donors without paying them. We saw that the advertising strategy of sperm banks relied on two main ideas of stereotypical masculinity: the hero and the soldier. </p>
<p>When using the idea of the soldier, ads represented the sperm donor as fighting off foreign invasion, doing his part for the nation, and being noble and selfless. We saw ads that referenced old World War I recruitment posters claiming that their country needed them (and their sperm). </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/FyxJhqSiDjs?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
</figure>
<p>Here the propaganda imagery and phrases are used to associate sperm donation with duty, honour, and patriotism. A more humorous version can be found in a short video clip where British sperm cartoons (proudly wearing the British flag) rally to frighten foreign sperms away. This frames the act of donating sperm as a (safer) way to fight a war for Britain. </p>
<p>The second image that we found sperm bank advertisers playing into was that of the everyday hero. In this example, the act of sperm donation is associated with saving lives. Central to this is the idea that creating a life and saving a life are equivalent using the imagery of lifesaving professions such as firefighters and lifeguards. </p>
<p>In these ads, sperm banks present sperm donation as an (easier) way to prove your heroism. Another image used was of a white collar man in a grey suit with a purple superhero cape. The ad seemed to suggest that he could achieve this sense of heroism simply by donating his sperm. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/277587/original/file-20190603-69067-spapy9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/277587/original/file-20190603-69067-spapy9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/277587/original/file-20190603-69067-spapy9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=321&fit=crop&dpr=1 600w, https://images.theconversation.com/files/277587/original/file-20190603-69067-spapy9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=321&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/277587/original/file-20190603-69067-spapy9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=321&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/277587/original/file-20190603-69067-spapy9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=404&fit=crop&dpr=1 754w, https://images.theconversation.com/files/277587/original/file-20190603-69067-spapy9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=404&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/277587/original/file-20190603-69067-spapy9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=404&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Humour helps deliver the hero imagery.</span>
<span class="attribution"><span class="source">IVF Australia</span></span>
</figcaption>
</figure>
<p>It is quite fascinating to see how traditional gender imagery can be used to reframe the experience of sperm donation as positive and masculinity-affirming as opposed to awkward, scary, or even degrading. It seems that offering a valuable experience provides a much stronger motivation than simply appealing to people’s desire to be altruistic. </p>
<p>This can offer lessons to other organisations, such as charities, that struggle to motivate their donors to give time or money. The challenge is to frame the experience as valuable to donors in the right way. </p>
<p>For sperm banks, the risk is falling into simplistic, sexist tropes. There’s a fine line between appealing to and repelling donors. We found that the use of humour and irony seems to help avoid this trap. And, in doing so, it provides a valuable experience for men of reaffirming their sense of masculinity – though this may well have to evolve, as society increasingly challenges the ideas of traditional gender roles.</p><img src="https://counter.theconversation.com/content/117567/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Laetitia Mimoun does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>How sperm bank marketing meets the growing demand for donations.Laetitia Mimoun, Lecturer in Marketing at Cass Business School, City, University of LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/941972018-04-02T22:18:05Z2018-04-02T22:18:05ZPaying surrogates, sperm and egg donors goes against Canadian values<figure><img src="https://images.theconversation.com/files/212772/original/file-20180401-189804-15d9agr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A Canadian politician has announced he plans to introduce a private member’s bill to remove the legal prohibitions on payments to surrogate mothers and to sperm and egg donors.
</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>In Canada, it’s illegal to pay for the services of a surrogate mother or to purchase human gametes — sperm and eggs. These prohibitions are entrenched in the <a href="http://laws-lois.justice.gc.ca/eng/acts/a-13.4/">Assisted Human Reproduction Act</a>. Some Liberal members of Parliament want to change this.</p>
<p><a href="http://www.ourcommons.ca/Parliamentarians/en/members/Anthony-Housefather">Anthony Housefather</a>, MP for Mount Royal and chair of the House of Commons Standing Committee on Justice and Human Rights, recently held a <a href="https://www.facebook.com/anthonyhousefather/videos/1877831872257893/">news conference</a> to announce that he plans to introduce a private member’s bill to remove the legal prohibitions on payments.</p>
<p>Flanked by fertility doctors, lawyers, intended parents, surrogates and fertility agents, Housefather argued that Canadians should be able to pay — and be paid — for surrogacy, as well as human sperm and eggs.</p>
<p>But the planned private member’s bill is <a href="http://www.cbc.ca/player/play/1197697091796">ill-conceived</a> (pun intended) <a href="https://impactethics.ca/2018/04/02/lets-ask-a-different-question-about-surrogacy/">for several reasons</a>.</p>
<h2>‘Sound ethical reasons’</h2>
<p>At the outset, it’s important to remember there are sound ethical reasons to prohibit “<a href="http://laws-lois.justice.gc.ca/eng/acts/a-13.4/page-1.html#h-2">trade in the reproductive capabilities of women and men and the exploitation of children, women and men for commercial ends</a>,” as stated in the Assisted Human Reproduction Act. </p>
<p>Among these reasons are the need to avoid both the commodification of the human body and the twin risks of exploitation and coercion. That’s why the federal government introduced criminal prohibitions on payment for surrogacy as well as human sperm and eggs in 2004. </p>
<p>Why criminal prohibitions? Because according to our Constitution, the only mechanism available to the federal government to enforce a ban on payment is criminal law. The division of powers between the federal and provincial governments is such that health is a provincial responsibility and criminal law is a federal responsibility. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/212771/original/file-20180401-189821-1fju5u7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/212771/original/file-20180401-189821-1fju5u7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/212771/original/file-20180401-189821-1fju5u7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/212771/original/file-20180401-189821-1fju5u7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/212771/original/file-20180401-189821-1fju5u7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/212771/original/file-20180401-189821-1fju5u7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/212771/original/file-20180401-189821-1fju5u7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Anthony Housefather, MP for Mont Royal, says he plans to introduce a private member’s bill to remove the legal prohibitions on payments to surrogate mothers or for sperm or eggs.</span>
<span class="attribution"><span class="source">Liberal.ca</span></span>
</figcaption>
</figure>
<p>The Assisted Human Reproduction Act was carefully drafted to ensure that access to reproductive technologies would not be a gateway to commerce in the body. This was a challenging piece of legislation to craft, involving considerable study, consultation and compromise. </p>
<p>The process began in the mid-1980s with the call for a <a href="http://www.thecanadianencyclopedia.ca/en/article/new-reproductive-technologies-royal-commission-on/">Royal Commission on New Reproductive Technologies </a> and continued through the 1990s and into the 2000s. It included numerous consultations with stakeholders and the public, several failed attempts at legislation and very careful consideration of how this issue should move forward.</p>
<h2>Act outdated?</h2>
<p>When the act finally passed 14 years ago, there was all-party agreement that payment for surrogacy and sperm and eggs was not the way forward. </p>
<p>Housefather suggests that the act is outdated; that it did not anticipate the creation of non-traditional families. But this is inaccurate. </p>
<p><a href="https://www.dailyxtra.com/gay-bloc-mp-real-menard-leaves-federal-politics-35895">Réal Ménard,</a> for example, one of the first openly gay MPs, worked with members of the LGBTQ community to ensure that sexual orientation would not be a barrier to access. It’s important not to ignore or misrepresent the intense challenges of a legislative process that was nearly 30 years in the making. </p>
<p>Housefather also suggests that Canadian values have changed since the act came into force. However, recent public commitment to <a href="http://www.cbc.ca/radio/thesundayedition/the-sunday-edition-march-4-2018-1.4559064/canadian-blood-services-ceo-responds-to-listener-mail-1.4559077">keeping payment out of the blood supply system</a> indicates that Canadian values about payment for bodily tissues may not have changed all that much.</p>
<p>The Assisted Human Reproduction Act permits reimbursement of receipted expenditures for surrogates and gamete donors in accordance with regulations. The problem with this feature of the act, however, is that there are no published regulations. This is finally about to change. </p>
<p>After many years of inaction, Health Canada has made a public commitment to <a href="https://www.canada.ca/en/health-canada/programs/consultation-assisted-human-reproduction/document.html">strengthen the Assisted Human Reproduction Act</a> that includes drafting the regulations for reimbursement. </p>
<p>These long-anticipated regulations will provide much-needed clarity and transparency. Housefather’s proposed bill will undermine the development of the regulations by attempting to eliminate the framework for reimbursement completely. </p>
<p>The federal government has an obligation to address the health and safety of surrogates, sperm donors and egg donors. It also has an obligation to provide clear regulations on reimbursement of expenditures so that Canadians who want to use surrogates and donor sperm and eggs can do so without running afoul of the law. </p>
<p>The governance of assisted human reproduction is too important to the future of Canadian families to be undermined by a private member’s bill calling for an open market in human reproduction.</p><img src="https://counter.theconversation.com/content/94197/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Françoise Baylis has received research funding from CIHR and the Canada Research Chairs program</span></em></p><p class="fine-print"><em><span>Alana Cattapan has received funding from the Social Sciences and Humanities Research Council, the Canadian Institutes of Health Research, and the Saskatchewan Health Research Foundation. She is on the Board of the Canadian Research Institute for the Advancement of Women. </span></em></p>There are sound ethical reasons behind Canada’s decision to ban payment to surrogate mothers and sperm and egg donors in 2004. A new push to remove the restrictions ignores the risks.Françoise Baylis, Professor and Canada Research Chair in Bioethics and Philosophy, Dalhousie UniversityAlana Cattapan, Assistant Professor, Johnson Shoyama Graduate School of Public Policy, University of SaskatchewanLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/724172017-02-28T19:10:28Z2017-02-28T19:10:28ZVictoria’s world-first change to share sperm or egg donors’ names with children<figure><img src="https://images.theconversation.com/files/157467/original/image-20170220-15900-zel070.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">New legislation provides greater access to sperm and egg donors' details, while acknowledging some donors' concerns.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/572391421?src=DvB9HM_jFeCIbiXioSd1DQ-1-6&size=medium_jpg">from www.shutterstock.com</a></span></figcaption></figure><p>More people conceived using donor sperm or eggs in Victoria will from today have the legal right to know details about their donor, even if the donation was made anonymously or the donor didn’t give consent to being identified.</p>
<p>However, donors who didn’t give consent to being identified when they donated can choose how to be contacted, if at all.</p>
<p>The newly implemented <a href="http://www.austlii.edu.au/au/legis/vic/consol_act/arta2008360/">donor conception legislation</a> is a world first as it allows all people, regardless of when conceived with donor eggs or sperm, to find out the donor’s name, date of birth and donor code, if available.</p>
<p>The new legislation covers people born before 1988, when sperm and egg donations in Victoria were made anonymously, and those born from egg, sperm or embryos donated between 1988 and 1998, when a donor’s consent was needed before their offspring could access information about them.</p>
<p>People who donated eggs or sperm before 1998, who may have concerns about how the changes will affect them and their families, can choose how they and any of their own children under 18 years of age are contacted. They can choose to be contacted by email, phone or letter, or by using a donor linking service. They can also choose not to be contacted.</p>
<p>While some donors support people’s right to know their biological origins, <a href="https://academic.oup.com/humrep/article/29/2/286/625958/Proposed-legislative-change-mandating">others are fearful</a> of their donor-conceived offspring knowing their identity, as they may not have revealed to their partner or children they were once a donor.</p>
<p>A person conceived with donor sperm or egg can also lodge a contact preference or refuse the release of identifying details if their donor seeks identifying information about them.</p>
<p>The new legislation also requires that donor conception registers, which record information about people involved in donor treatment, are managed by the <a href="https://www.varta.org.au/">Victorian Assisted Reproduction Treatment Authority</a>. (As noted in this article’s disclosure statement, the author and co-author of this article work for VARTA.) This is also where people – including those conceived using donor eggs and sperm, their parents, the donors and all of their families – can find out more and get support with making <a href="https://www.varta.org.au/resources/news/new-law-gives-all-donor-conceived-victorians-right-know-their-heritage">applications to the donor conception registers</a>.</p>
<h2>The history of donor conception legislation in Victoria</h2>
<p>Medical facilities have used donor sperm to treat couples with male infertility since <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1479-828X.1970.tb00413.x/abstract">at least the 1940s</a>; egg donation became possible <a href="https://www.ncbi.nlm.nih.gov/pubmed/6435749">some 30 years ago</a>. </p>
<p>In the early days, children born as a result of donated sperm or eggs were often not told how they were conceived and it was expected donors would remain anonymous. But, over time, it became more acceptable for people to be told how they were conceived and to have information about their donor, a shift from <a href="https://www.jstor.org/stable/4235940?seq=1#page_scan_tab_contents">advocating secrecy to promoting openness</a>. </p>
<p>This shift stems from a growing awareness that people have a <a href="http://www.fertstert.org/article/S0015-0282(13)00319-1/pdf">fundamental interest</a> in knowing their biological origins. For many donor-conceived people, knowing their origins is an important part of understanding who they are and where they come from. Studies show they want as <a href="http://www.rbmojournal.com/article/S1472-6483(10)00727-3/pdf">much information as possible</a> about the donor. </p>
<p>As knowledge about the inheritance of disease increases, it also becomes more important for donor-conceived people to know their genetic and medical history.</p>
<h2>What are the rules elsewhere?</h2>
<p>In 1988, Victoria was one of the first jurisdictions in the world to implement laws to recognise the right of donor-conceived people to be able to access information about the donor. Subsequent legislation (1998 and 2010) gave donor-conceived people progressively <a href="https://www.ncbi.nlm.nih.gov/pubmed/22908621">more rights</a>.</p>
<p>While the idea that people have the right to know where they come from is generally gaining momentum around the world, there is still great variation between jurisdictions in how donor conception is regulated.</p>
<p>Some countries mandate that <a href="https://www.ncbi.nlm.nih.gov/pubmed/27073260">donors are anonymous</a> (such as Spain and France); <a href="http://lucyfrith.net/wp-content/uploads/2016/01/36-Blyth-Frith-2009.pdf">others ban anonymous donations and keep registers</a> of people involved in donor conception or facilitate information exchange between donor-conceived people and donors (eg. Sweden, Austria, UK).</p>
<p>In Australia, anonymous donation of eggs and sperm is banned in all states and territories. Some states have have state-run registers, for example, Western Australia and New South Wales. However, unlike Victoria, parents of donor-conceived children under 18 years of age cannot make applications for information about their donor and donor-conceived people need to wait until adulthood to make an application. Donor-conceived people in those states can lodge information on a voluntary register hoping their donor or donor-siblings also lodge information to allow them to exchange information.</p>
<p>In states without legislation, donor-conceived people who seek information about the donor or their parents rely on the willingness of treating clinics to search for and approach the donor.</p>
<h2>Watch with interest</h2>
<p>However, Victoria has Australia’s most far-reaching donor conception laws. </p>
<p>They promote openness and give all those who wish, particularly donor-conceived people, the opportunity to connect with people they are related to through donor conception. They also provide safeguards to donors who donated under conditions of anonymity by allowing them to state whether and how they wish to be contacted. However, some donors may still be concerned about the possibility of others knowing they once donated sperm or eggs.</p>
<p>Other jurisdictions around the world and in Australia will watch with interest how the most recent changes to donor conception laws in Victoria are managed and how the people affected by them respond.</p>
<hr>
<p><em>This article was co-authored by Louise Johnson, the chief executive officer of the Victorian Assisted Reproductive Treatment Authority (<a href="https://www.varta.org.au/">VARTA</a>).</em></p><img src="https://counter.theconversation.com/content/72417/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Karin Hammarberg is Senior Research Officer at the Victorian Assisted Reproductive Treatment Authority. In her role she monitors and translates research relevant to the Authority's obligation to provide public education on matters relating to fertility, infertility and assisted reproductive technology.
This article was co-authored by Louise Johnson, the chief executive officer of the Victorian Assisted Reproductive Treatment Authority.</span></em></p>From today, more people conceived with donor sperm or eggs in Victoria will have the legal right to know details about their donor – even if the donation was made anonymously.Karin Hammarberg, Senior Research Fellow, Jean Hailes Research Unit, School of Public Health & Preventive Medicine, Monash UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/619272016-07-11T11:06:36Z2016-07-11T11:06:36ZIf you can screen for brown eyes, you should be able to edit out genetic disease<figure><img src="https://images.theconversation.com/files/129225/original/image-20160704-19118-1x98p3b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Not everyone's choice of scarf.</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-153908174/stock-photo-cute-baby-with-scarf.html?src=YSFeullqTXG0nDGWRnlaJg-1-8">Shutterstock</a></span></figcaption></figure><p>It has long been known that cognitive diversity is important to <a href="http://press.princeton.edu/titles/8757.html">collective performance</a>. Diverse groups are more productive, more innovative and better at solving complex problems than less diverse groups. And recent research suggests that cognitive diversity also <a href="http://link.springer.com/article/10.1007/s11229-016-1147-4">drives scientific progress</a>. </p>
<p>Such research has direct implications for how we regulate reproductive technologies. Late last year, the London Sperm Bank <a href="https://www.theguardian.com/commentisfree/2015/dec/30/screening-sperm-donors-dyslexia-clinic">was criticised</a> for its decision to ban sperm donors who suffer from minor neurological disorders, including dyslexia and Asperger’s syndrome.</p>
<p>Selection against these conditions <a href="http://onlinelibrary.wiley.com/doi/10.1111/japp.12199/abstract">may be problematic</a> because it could reduce valuable forms of cognitive diversity. People with dyslexia and Asperger’s syndrome see problems from unique perspectives and use different methods to solve problems. </p>
<p>The fact that the London Sperm Bank could implement such a policy highlights the great inconsistency in how the selection for and against different inherited conditions is regulated. </p>
<p>Gamete screening (GS) – the screening of sperm and egg donors based on their features – is widely unregulated. Not only can it be used to select against mild disabilities such as dyslexia, but it can also be used to select for non-disease traits such as eye colour and height. Companies such as Elite Egg Donors, allow you to choose between various donors based on a wide variety of factors including education, weight, and ethnicity. While GS is still relatively imprecise, it is becoming more powerful. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/129230/original/image-20160704-19103-9lgy3t.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/129230/original/image-20160704-19103-9lgy3t.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/129230/original/image-20160704-19103-9lgy3t.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/129230/original/image-20160704-19103-9lgy3t.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/129230/original/image-20160704-19103-9lgy3t.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/129230/original/image-20160704-19103-9lgy3t.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/129230/original/image-20160704-19103-9lgy3t.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Only candidate.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-321836126/stock-photo-fertilization-insemination-of-human-egg-cell-by-sperm-cell.html?src=3MLrXOxZ6ZcgjwSjligkjQ-1-58">Shutterstock</a></span>
</figcaption>
</figure>
<p>In 2013, personal genomics company 23andMe received <a href="http://www.google.co.uk/patents/US8543339">a patent to a technology</a> called “gamete donor selection based on genetic calculations”. This technology uses DNA tests from sperm recipients and donors to calculate the likelihood of embryos being created with particular traits. Someone wanting to increase the chance of having a child with green eyes, a low predisposition to smoking, and a low risk of colon cancer, for example, could use 23andMe’s technology to identify donors which gave them the highest probability of achieving these traits. </p>
<p><a href="http://www.hfea.gov.uk/preimplantation-genetic-diagnosis.html">Pre-implantation genetic diagnosis</a> (PGD) is the process of creating a range of embryos through IVF, performing genetic tests on them and then selectively implanting one with particular genes. It is far more widely regulated than gamete screening. In the UK, <a href="http://guide.hfea.gov.uk/pgd/">regulations</a> limit its use to selecting against “serious” inherited conditions. However, what is regarded as serious is considered on a case-by-case basis. Each proposed use of PGD is examined individually. Those that are risky or frivolous can be rejected. </p>
<p>There is no reason why such a system could not work for gamete screening. If a sperm bank or fertility clinic wants to offer gamete screening for or against particular conditions, it should also be assessed on an individual basis. This would provide a system to protect the public interest, and prevent the loss of valuable forms of diversity. </p>
<p>Such a regulatory system should also be implemented for new <a href="https://theconversation.com/how-close-are-we-to-successfully-editing-genes-in-human-embryos-52326">gene editing technologies</a>, once they are shown to be safe. While these technologies are still in in their infancy, they are developing rapidly. In a decade, it is likely that somatic gene editing – or gene therapy – will be used to treat common cancers. We will be eating <a href="https://theconversation.com/royal-society-president-gm-crops-feed-much-of-the-world-today-why-not-tomorrows-generations-59715">gene edited crops and animals</a>. At some point, gene editing technologies will be widespread, cheap and precise.</p>
<p>Many jurisdictions, including the UK, explicitly outlaw using gene editing technologies to influence the inheritance of a condition. Reproductive gene editing is treated as an absolute moral limit that is never permissible, no matter how great the benefits that may accrue from it. </p>
<h2>What’s the difference?</h2>
<p>It seems bizarre that the method we use to select for or against an inherited condition makes such a significant difference to its legal status. A woman wanting to have a green-eyed child with blond hair, a low predisposition to obesity and high intelligence, for example, is legally able to use gamete selection to find a donor. Yet a couple who wants to use gene editing technology to save their child from developing <a href="http://www.nhs.uk/conditions/Tay-Sachs-disease/Pages/Introduction.aspx">Tay Sachs disease</a> – a degenerative disease which results in death by age three – cannot do so, even if it is the only way they can avoid it. </p>
<p>When compared to gamete screening, gene editing may seem like a radical way of transforming our features. We have never used technologies to change our genetic code before. However, our code is constantly changing anyway. The only difference between intentional gene edits and natural mutations, is that the former are directional rather than random. Whether this is good or bad depends on which direction we choose to go. Moving towards a world with less disease and suffering is surely desirable.</p>
<p>We need a coordinated approach to the regulation of inheritance; and PGD should serve as the model. Each proposed use of gamete selection and gene editing should be assessed on a case-by-case basis. When therapies are shown to be safe and effective, they should be added to a list of approved conditions. I don’t believe dyslexia, or Asperger’s syndrome should be on that list, and sperm banks should not be able to ban donors with these conditions.</p><img src="https://counter.theconversation.com/content/61927/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Christopher Gyngell receives funding from the European Union's Horizon 2020 framework programme</span></em></p>Why can we choose some things and not others?Christopher Gyngell, Research fellow, University of OxfordLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/519062015-12-08T23:37:05Z2015-12-08T23:37:05ZAs Victoria opens sperm donor records, the key question is: do contact vetoes work?<p>Victoria’s parliament is on Wednesday debating the controversial <a href="http://www.parliament.vic.gov.au/static/www.legislation.vic.gov.au-bills.html">Assisted Reproductive Treatment Amendment Bill</a>. The government <a href="http://hansard.parliament.vic.gov.au/search/?LDMS=Y&IW_FIELD_ADVANCE_PHRASE=be+now+read+a+second+time&IW_FIELD_IN_SpeechTitle=Assisted+Reproductive+Treatment+Amendment+Bill+2015&IW_FIELD_IN_HOUSENAME=ASSEMBLY&IW_FIELD_IN_ACTIVITYTYPE=Second+Reading&IW_FIELD_IN_SittingYear=2015&IW_DATABASE=*">intends</a> that its legislation, if passed, will retrospectively open Victoria’s sperm donor records so all donor-conceived people can obtain the name and date of birth of their donor, regardless of the donor’s consent. Victoria will become the first jurisdiction in the world to take such drastic action on such a large scale.</p>
<p>In recent weeks, donors have <a href="http://www.theage.com.au/victoria/wealthy-sperm-donor-fears-contact-from-more-than-two-dozen-offspring-20150903-gjefke.html">expressed anger</a> about the <a href="http://www.theage.com.au/good-weekend/when-spermdonor-children-come-calling-20150902-gjd76r.html">implications</a> of the legislation, arguing that it is an <a href="http://www.theage.com.au/victoria/andrews-to-overhaul-laws-guaranteeing-sperm-donor-anonymity-20151120-gl4h0l.html">invasion of their privacy</a>. </p>
<p>In response to such concerns, the bill includes the option of lodging a “contact preference”. This will enable a donor or donor-conceived person to veto contact or prescribe the type of contact with which they are comfortable. But do contact vetoes work?</p>
<h2>What will the new law do?</h2>
<p>The proposed law eliminates the existing requirement that someone who donated sperm prior to 1998, when anonymity was still permitted, must give his consent before his identifying information can be released. Any concerns about the privacy rights of donors created by the removal of consent are to be managed through the use of contact preferences.</p>
<p>A donor or donor-conceived person will have four months after an application is made to decide whether or not to lodge a contact preference. If a preference is lodged, the applicant will be required to sign an undertaking that they will comply with its conditions. If an applicant refuses to sign, information will not be provided. </p>
<p>Breaches of a contact preference will be a criminal offence. The penalty will be a a fine of up to 50 penalty units (about A$7583).</p>
<p>If a donor cannot be located within three months of an application being filed, the applicant will be given the donor’s identifying information. However, the applicant must sign an undertaking that if the donor is located, contact will not be made.</p>
<h2>Do contact vetoes work?</h2>
<p>Whether contact vetoes can protect the privacy rights of donors and donor-conceived people can be assessed by looking to the adoption context. Several Australian states and <a href="https://www.ipc.on.ca/images/Resources/adoption.pdf">overseas jurisdictions</a> have introduced laws over the past 20 years retrospectively opening adoption records. Many of those laws include the <a href="https://www.ipc.on.ca/english/Resources/Reports-and-Submissions/Reports-and-Submissions-Summary/?id=214">option of contact vetoes</a>.</p>
<p><a href="http://www.tandfonline.com/doi/full/10.1080/10926750802163188">Research</a> from Australia, the UK and the US on the use of contact vetoes in adoption law indicates that they are rarely breached. For example, a review of the first 12 months of the NSW adoption disclosure system found that compliance with contact vetoes was “remarkably high”, with <a href="http://www.lawreform.justice.nsw.gov.au/Documents/report_69.pdf">only one breach</a> reported. Concerns about parties breaching contact vetoes are thus largely unfounded.</p>
<p>While contact vetoes are typically respected, the NSW review indicated that breaches were not the only criterion by which participants judged the success of the system. The process of lodging the veto was also important.</p>
<p>For example, it was reported that department officials administering the veto system made some adoptees and birth parents feel uncomfortable about lodging a veto. Officials were described as critical of those who sought to put a veto in place. They were also accused of pressuring applicants to attach a message or photo to the veto.</p>
<p>Those who lodged vetoes also objected to having to do so in person. They felt this gave department officials an opportunity to pressure them to not lodge the veto. Others noted that ill-health or lack of mobility made it difficult to lodge a veto in person.</p>
<h2>How should the contact veto system work?</h2>
<p>While concerns that contact vetoes will be breached appear to be largely unfounded, the system must be administered neutrally if the privacy interests of donors and donor-conceived people are to be fully protected. This can be achieved in a number of ways.</p>
<p>First, the counselling that both donors and offspring have to attend if they are the subject of an application must be neutral on the question of contact vetoes. Counselling cannot be used as an opportunity to dissuade participants from lodging vetoes.</p>
<p>Second, those administering the system must refrain from discussing applicants’ decisions with them. Any suggestion that an applicant should change his or her mind or provide photos or other information should be understood as wholly inappropriate.</p>
<p>Finally, it should be possible to lodge a contact veto online or via mail, and the process should be free.</p>
<p>The privacy concerns of donors and donor-conceived people can likely be met by the Assisted Reproduction Treatment Amendment Bill provided the contact veto system is adequately managed. The process must be simple and free of coercion. </p>
<p>A system that lacks these attributes runs the risk of intruding on the privacy of donors and donor-conceived people who do not wish to participate in the new regime.</p><img src="https://counter.theconversation.com/content/51906/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>In a world first, Victoria plans to retrospectively open the records of formerly anonymous sperm donors to all donor-conceived people. A system of contact vetoes aims to manage the privacy concerns.Fiona Kelly, Associate Professor, Law School, La Trobe UniversityDeborah Dempsey, Senior Lecturer in Sociology, Swinburne University of TechnologyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/463992015-08-23T19:52:27Z2015-08-23T19:52:27ZWhy we should consider whether it’s time to allow sex selection in IVF: NHMRC<figure><img src="https://images.theconversation.com/files/92678/original/image-20150821-8374-61dbeh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Should parents be allowed to select the sex of their child through IVF when there's no compelling medical reason to do so?</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/marcus_hansson/7758937784/in/photolist-cPCzTo-5oyxeG-KKWAX-55m4QT-aKFaHn-51gVns-6TyRFP-8YWkeN-622Jk-tmB1Y-aizoR9-oFRmGv-uT8huE-7DsjCB-6TCTFW-6vWn3c-pjxzdF-qvsN4Q-6u52om-8RkMcC-6c4oU4-9yewju-5U3D2W-tmAZE-dEGUtx-5KbN5k-xnxwV-s1RsA-5BvDj7-aKhJYz-ourHzZ-fPfypm-7gB3Vt-tmARJ-ch3U2q-2EDxGa-k4Y9Dg-7vQYh-7tsiXY-gBTUGg-jiUs23-6TyRxT-n7kbU8-b732Da-dWoL9g-c7MTZQ-j3dweT-9RmQvK-vUj8L-pRFZyx">Marcus Hansson/Fkickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p><em>Read <a href="http://theconversation.com/choosing-childrens-sex-is-an-exercise-in-sexism-45836">an argument against allowing sex selection</a> for IVF.</em></p>
<hr>
<p>As part of a periodic review, the National Health and Medical Research Council (NHMRC) is <a href="http://consultations.nhmrc.gov.au/public_consultations/assisted-reproductive-tech">calling for public submissions</a> on its <a href="http://consultations.nhmrc.gov.au/files/consultations/drafts/artdraftethicalguidelines150722.pdf">draft guidelines on the use of assisted reproductive technology in clinical practice and research</a>. This, in lay terms, is the practice of in vitro fertilisation (IVF).</p>
<p>Producing guidelines to advise the community on ethical issues relating to health is one of the NHMRC’s many tasks. Revisions aim to reflect changes in technology and social attitudes and are based on advice from the Australian Health Ethics Committee (AHEC), which I chair.</p>
<p>The suggested change to the ethical guidelines that’s getting most attention is the question of whether parents should be able to select the sex of their child when there’s no compelling medical reason for doing so.</p>
<h2>A changing world</h2>
<p>When the NHMRC first introduced the ethical guidelines for assisted reproductive technology in 1996, the technology was new and community attitudes were still developing. Not only has technology changed considerably since, IVF is now routine practice, and the public is much more aware of related issues.</p>
<p>Since the last revision of the guidelines in 2007, for instance, technology has allowed for eggs to be frozen and defrosted for use, as sperm and embryos could already be. This has raised the possibility of having egg banks, akin to sperm banks, and the draft guidelines are also seeking comment on whether women should be compensated for the invasive procedure of donating their eggs.</p>
<p>The <a href="http://consultations.nhmrc.gov.au/public_consultations/assisted_reproductive">initial public consultation</a> on existing guidelines in 2014, which sought, among other things, to identify gaps in the guidance, received mixed comments relating to sex selection. Some supported allowing sex selection for non-medical reasons while others wished to maintain the current guidance. </p>
<p>The committee is aware that some Australians are pursuing sex selection in overseas clinics. And because not all international clinics have the same standard of care that exists in Australia, this could be risky for both the woman and her child.</p>
<p>Although fertility and reproduction are often seen as personal matters, they have wider implications. Many issues around IVF have social and political implications, such as relationships within families where parents aren’t the biological parents and priorities for health-care resources, in addition to ethical considerations.</p>
<h2>A slippery slope?</h2>
<p>It’s important to note that no decision about allowing sex selection in IVF has been made yet. <a href="https://consultations.nhmrc.gov.au/home">We’re seeking community input</a>, which we’ll take into account, along with ethical and practical considerations, before any changes are made.</p>
<p>This is not a simple all-or-nothing decision, as selecting the sex of your child is already allowed for certain sex-specific medical conditions. It’s allowed for haemophilia, for instance, where the son of an unaffected woman has a 50% chance of inheriting the illness (it’s very rare for girls to inherit haemophilia).</p>
<p>It’s now a matter of determining whether non-medical reasons for selecting the sex of your child are considered acceptable and, if so, where the line should be drawn. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/92682/original/image-20150821-8344-hbwnwv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/92682/original/image-20150821-8344-hbwnwv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/92682/original/image-20150821-8344-hbwnwv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/92682/original/image-20150821-8344-hbwnwv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/92682/original/image-20150821-8344-hbwnwv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/92682/original/image-20150821-8344-hbwnwv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/92682/original/image-20150821-8344-hbwnwv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">One common reason for wanting to choose the sex of a child is ‘family balancing’.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/plushoff/2575864684/">Jacki Gallagher/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span>
</figcaption>
</figure>
<p>One argument against allowing sex selection for non-medical reasons is that it may be the thin edge of the wedge towards being able to select for other characteristics, such as height or intelligence. </p>
<p>Aside from such choices not yet being medically possible, the slippery slope argument may falter because there’s no natural progression between approving non-medical sex selection and approving being able to select other characteristics. Sex selection is a discrete choice around which a definite boundary can be drawn.</p>
<h2>Food for thought</h2>
<p>The committee has provided case studies to help the community explore the complexities of the issue. One common reason for wanting to choose the sex of a child, for instance, is “family balancing”. Parents who have several children of the same sex may want to choose the opposite sex for their next child. </p>
<p>Although this is often presented as a choice of parents, the child’s interests also have to be considered. Will they meet their parent’s gender expectations, and should they have to? Similar questions arise when parents seek to “replace” children who have died.</p>
<p>Other case studies explore whether cultural reasons for wanting to select the sex of a child are appropriate. And whether we should allow medical reasons for sex selection where a disease is not sex-specific but there’s a slight prevalence imbalance between the sexes. Couples who have an autistic child, for instance, somewhat reduce their chances of having a second autistic offspring by having a girl because the condition is less common in that sex. </p>
<p>Another case explores whether there could be adverse psychological consequences for a child who is told that her parents selected her sex. Australia has quite strict requirements about allowing donor-conceived children to discover who their unknown parent is, but countries that allow non-medical sex selection don’t necessarily have similar regulations.</p>
<p>And if sex selection is eventually allowed, where should we draw the boundary? In Israel, for instance, couples can apply to the government to be considered for sex selection after having four children of the same sex. Would two or three kids of the same sex be thought enough in Australia?</p>
<h2>International norms</h2>
<p>Although IVF providers cannot practise without national accreditation, which depends on their agreement to follow NHMRC guidelines, state and territory-based legislation also governs what they’re allowed to do. </p>
<p>Sex selection for non-medical reasons, such as gender balancing, is prohibited by law in New South Wales, Victoria, South Australia and Western Australia. And it would still be disallowed if the guidelines were changed, unless local laws are amended. </p>
<p>Although Australians travel to countries where sex selection is allowed, Australia’s current position is by no means out of step internationally. Sex selection for non-medical purposes is illegal in four states of America, in Europe, New Zealand and in parts of Asia. </p>
<p>Finally, there’s the question of whether sex selection for non-medical purposes is a good use of medical resources. With all the other demands on the medical system to treat disease and restore wellness, we need to decide as a community what priority should be given to funding the ability of couples to choose the sex of their children when there’s no compelling medical reason to do so.</p>
<p><em>Read <a href="http://theconversation.com/choosing-childrens-sex-is-an-exercise-in-sexism-45836">an argument against allowing sex selection</a> for IVF.</em></p><img src="https://counter.theconversation.com/content/46399/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Ian Olver does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The National Health and Medical Research Council call for public submissions on whether sex selection should be allowed without a medical reason recognises changing social attitudes.Ian Olver, Director, Sansom Institute for Health Research; Chair of Translational Cancer Research, University of South AustraliaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/440152015-07-02T20:13:30Z2015-07-02T20:13:30ZSecrets and lies: why donor-conceived children need to know their origins<figure><img src="https://images.theconversation.com/files/87075/original/image-20150702-27138-1e9jb8l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Many children are raised by and form strong parental attachments with adults they're not genetically related to.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/michaeljzealot/14061621968/">MjZ Photography/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span></figcaption></figure><p>In all Australian states and territories, laws are now in place to ensure that when children born via donor conception turn 18, they have a <a href="http://www.healthlawcentral.com/assistedreproduction/donorconception/access-information/">right to access information</a> about the identity of their donor. However, research suggests that <a href="https://aifs.gov.au/publications/families-policy-and-law/9-secrecy-family-relationships-and-welfare-children-born">most heterosexual parents</a> who conceive via donor conception never tell their children. </p>
<p>Donor insemination became widely available in the 1980s with the emergence of sperm freezing technology. However, in these early days few jurisdictions had clear <a href="http://www.abc.net.au/austory/specials/howimetyourfather/donconceptionlegislationvic.pdf">regulatory frameworks</a> around donor conception and record keeping was often inconsistent. </p>
<p>The lack of regulation allowed for, and was facilitated by, a culture of shame and secrecy around infertility and donor insemination. It was common for medical practitioners to <a href="http://www.abc.net.au/austory/specials/howimetyourfather/vartahowtotellchildren.pdf">advise parents</a> not to tell their children they were donor conceived. The prevailing wisdom was that anonymity and secrecy was better for children, families and donors. </p>
<p>Victoria was one of the first jurisdictions in the world to <a href="https://www.varta.org.au/regulation/history-victorian-art-regulation">introduce laws</a> banning anonymous gamete (sperm, eggs and embryos) donation and requiring donors to consent to the release of identifying information to donor recipients aged 18 or over. These laws <a href="https://www.varta.org.au/sites/default/files/ART%20further%20amendment%20legislative%20changes.pdf">came into effect</a> in 1998*. </p>
<p>By 2005, anonymous donation <a href="https://theconversation.com/donor-conception-secrecy-and-the-search-for-information-44000">was prohibited</a> nationwide. However, many donor-conceived children still struggle to access information about their donor, due to laws not being retrospective in many states, or because records have been destroyed.</p>
<p>When Victorian donor-conceived children <a href="https://www.varta.org.au/sites/default/files/ART%20further%20amendment%20legislative%20changes.pdf">born after the introduction of the first laws regulating donor conception</a> were due to turn 18, the Victorian Infertility Treatment Authority in 2006 ran a campaign entitled “<a href="http://www.abc.net.au/austory/specials/howimetyourfather/donconceptionlegislationvic.pdf">Time to Tell</a>”. This encouraged families to talk to their children about being donor conceived. </p>
<p>As the use of new reproductive technologies had become more common, stigma around this had decreased. This brought concerns about the rights of donor-conceived children to the forefront. The <a href="https://www.varta.org.au/regulation/regulation-art-victoria/legislation-about-right-information-about-donors">new laws</a> supported the rights of children to access information about their donor, but this did not necessarily support parents to tell their children they were donor-conceived. </p>
<p>However, studies had begun to reveal potential problems that arose from not telling children. While in general, people who are donor-conceived are not disadvantaged in terms of <a href="http://humrep.oxfordjournals.org/content/28/2/375.short">well-being or connectedness</a> to their family, problems can occur when they <a href="http://www.ncbi.nlm.nih.gov/pubmed/19398766">learn of the circumstances</a> of their conception later in life.</p>
<p>When this happens, people may feel betrayed by their parents, leading to resentment, confusion and distress. This may be particularly destructive if a person inadvertently discovers they are donor-conceived, rather than being told by their parents. </p>
<p>Alongside this, there is an emerging body of <a href="https://www.varta.org.au/resources/publications/age-when-learning-about-mode-conception-and-well-being-among-young-adults">research</a> which shows that telling children they are donor conceived does not damage their well-being, particularly if they then have the option to learn more about their donor. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/87081/original/image-20150702-27111-18ic0gy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/87081/original/image-20150702-27111-18ic0gy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/87081/original/image-20150702-27111-18ic0gy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/87081/original/image-20150702-27111-18ic0gy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/87081/original/image-20150702-27111-18ic0gy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/87081/original/image-20150702-27111-18ic0gy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/87081/original/image-20150702-27111-18ic0gy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Donor-conceived children aren’t disadvantaged, as long as they’re told about their circumstances.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/littlemonkeybutt/3702390721/">KatLevPhoto/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span>
</figcaption>
</figure>
<p>These days, <a href="https://www.asrm.org/uploadedFiles/ASRM_Content/News_and_Publications/Ethics_Committee_Reports_and_Statements/informing_offspring_donation.pdf">clinical guidelines</a> generally suggest doctors and counsellors encourage parents to tell children about their donor conception. </p>
<p>Despite this, most heterosexual couples who conceive children using donor sperm do not tell their children. In <a href="https://aifs.gov.au/publications/families-policy-and-law/9-secrecy-family-relationships-and-welfare-children-born">Australian studies</a>, fewer than 35% of couples surveyed had told their children they were donor conceived. This is consistent with <a href="http://www.ncbi.nlm.nih.gov/pubmed/21398181">overseas research</a>, which suggests the majority of parents never tell their children. </p>
<p>There are multiple <a href="http://www.slate.com/blogs/xx_factor/2013/12/13/donor_conceived_children_deserve_to_know_the_truth_about_their_origins.html">reasons why parents choose not to tell</a> their children they were donor conceived. Some are concerned their child will feel different or “not normal”. For others, the pain of infertility is raw and avoiding the issue is emotionally easier. </p>
<p>Some parents intend to tell but never find the right time or words to do this. But a common concern is that children will no longer see their “non-genetic” parent as their real parent.</p>
<p>Biological relatedness is central to <a href="https://aifs.gov.au/publications/families-policy-and-law/3-ancestry-identity-and-meaning-importance-biological-ties">idealised Western notions of family and kinship</a>, even though the reality of contemporary family life is much more complex than this. Step and blended families, families created through adoption or fostering, same-sex parented families and networks of close friends all involve non-biological family relationships. Many children are raised by, and form strong parental attachments with, adults to whom they are not genetically related. </p>
<p>This is not to say that biology is irrelevant. Many people’s sense of place in the world is connected to their biological heritage. Donor-conceived people often feel that <a href="http://www.news.com.au/lifestyle/parenting/donor-conceived-kids-fight-for-their-rights/story-fnet08ui-1227299910083">knowing about their donor</a> is an important part of forming and understanding their identity. But biology in itself does not create family relationships. </p>
<p>The problem with secrecy around donor conception is that it contributes to the notion that biology is more important than lived family ties. It implies that a child having a genetic link to someone else undermines the importance of those parents who have raised that child. </p>
<p>By contrast, <a href="https://www.varta.org.au/sites/default/files/Telling%20about%20donor%20assisted%20conception.pdf">openness about donor-conception</a> allows parents to emphasise the strength of their family connection and includes their children in the creation of the family narrative. </p>
<p>Laws that ensure donor-conceived people have access to identifying information about donors encourages greater openness around donor conception; although <a href="https://aifs.gov.au/publications/families-policy-and-law/9-secrecy-family-relationships-and-welfare-children-born">some people argue</a> the laws need to go further, mandating parents to tell their children. </p>
<p>The complexity of this issue points to a continued need for resources to support families to talk to their children about donor conception. </p>
<p><em>* An earlier version of this article said anonymous donation was prohibited in Victoria in 1988. This has now been updated to 1998.</em></p><img src="https://counter.theconversation.com/content/44015/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jennifer Power has previously received funding from the Australian Research Council, Relationships Australia, VicHealth and ACON. She currently works on a project funded by the Commonwealth Government. </span></em></p>Most heterosexual parents who conceive via donor conception never tell their children.Jennifer Power, Research Fellow at Australian Research Centre in Sex, Health and Society, La Trobe UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/440002015-07-01T04:33:14Z2015-07-01T04:33:14ZDonor conception, secrecy and the search for information<figure><img src="https://images.theconversation.com/files/86938/original/image-20150701-25044-1pd2yot.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">If proposed Victorian laws are enacted, they will be a world-first for donor-conception.</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-207364195/stock-photo-closeup-of-woman-legs-waiting-at-pedestrian-crossing.html?src=HK8we_CVd5dYG8ksXNny9w-1-28">Vlad Teodor/Shutterstock</a></span></figcaption></figure><p>Over the past 50 years, assisted reproduction using donor sperm (and more recently, eggs and embryos) has been both celebrated – for enabling people to have children – and derided for religious, moral and social reasons.</p>
<p>In the 1960s and 1970s couples often felt ashamed about their infertility. They faced allegations that using donated sperm was akin to adultery and questions about whether the process was a “medical treatment” at all. They also worried about legal parentage, and rights and responsibilities for the child. </p>
<p>Donors were told it was best they were anonymous, while recipients were told it was best not to tell their child. </p>
<p>There was little consideration about the impact such secrecy and anonymity may have on donor-conceived people as they grew. In the 1990s and into the 2000s, many searched for information about their donors and siblings, but often to no avail. </p>
<p>Donors also <a href="http://www.theage.com.au/victoria/father-figures-20111112-1ncxt.html">wondered about the children</a> they helped create, and recipient parents wanted information to share with their children, but were denied.</p>
<h2>Laws prohibiting anyonymity</h2>
<p>Over time, many jurisdictions (including all states and territories of Australia) passed laws to clarify the rights and responsibilities of parents and donors, and the legal status of children. Assisted reproduction became increasingly widespread and accepted. </p>
<p>In the 1990s and 2000s, there was growing recognition that children were entitled to know about the method of their conception, and to have access to information about their donor(s) and genetic siblings. In some jurisdictions, laws were passed to prohibit anonymous donation. </p>
<p>Several countries facilitated the recording and release of identifying and non-identifying information about donors to donor-conceived people. This included <a href="http://www.smer.se/news/the-genetic-integrity-act-2006351/">Sweden</a> (1984), <a href="https://www.ris.bka.gv.at/GeltendeFassung.wxe?Abfrage=Bundesnormen&Gesetzesnummer=10003046">Austria</a> (1998), <a href="https://www.admin.ch/opc/en/classified-compilation/20001938/index.html">Switzerland</a> (2001), <a href="http://wetten.overheid.nl/BWBR0013642/geldigheidsdatum_30-06-2015">The Netherlands</a> (2002), <a href="https://www.regjeringen.no/globalassets/upload/kilde/hod/red/2005/0081/ddd/pdfv/242718-biotechnology_act_master.pdf">Norway</a> (2003), <a href="http://www.legislation.gov.uk/ukpga/2008/22/contents">the UK</a> (2004), <a href="https://www.finlex.fi/en/laki/kaannokset/2006/en20061237">Finland</a> (2006) and <a href="http://www.legislation.govt.nz/act/public/2004/0092/latest/DLM319241.html?search=ad_act__assisted+reproductive____25_ac%40bn%40rn%40dn%40apub%40aloc%40apri%40apro%40aimp%40bgov%40bloc%40bpri%40bmem%40rpub%40rimp_ac%40ainf%40anif%40bcur%40rinf%40rnif_h_aw_se&p=1">New Zealand</a> (2004), and <a href="http://www.healthlawcentral.com/assistedreproduction/donorconception/access-information-australia/">some Australian jurisdictions</a> (Victoria in 1998, Western Australia in 2004, New South Wales in 2010, and South Australia in 2010). </p>
<p>However, even in these jurisdictions, such provision did not guarantee information. Many people do not know they are donor-conceived, while others do not have the legal right to access information <a href="http://www.news.com.au/lifestyle/parenting/donor-conceived-kids-fight-for-their-rights/story-fnet08ui-1227299910083">because they were born before</a> the laws were enacted. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/86947/original/image-20150701-25041-jnxpw4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/86947/original/image-20150701-25041-jnxpw4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/86947/original/image-20150701-25041-jnxpw4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/86947/original/image-20150701-25041-jnxpw4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/86947/original/image-20150701-25041-jnxpw4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/86947/original/image-20150701-25041-jnxpw4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/86947/original/image-20150701-25041-jnxpw4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Many people conceived after laws were enacted still don’t have access to information about their donor.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/cat.mhtml?lang=en&language=en&ref_site=photo&search_source=search_form&version=llv1&anyorall=all&safesearch=1&use_local_boost=1&autocomplete_id=14357191112454370000&searchterm=medical%20files&show_color_wheel=1&orient=&commercial_ok=&media_type=images&search_cat=&searchtermx=&photographer_name=&people_gender=&people_age=&people_ethnicity=&people_number=&color=&page=1&inline=225336085">val lawless/Shutterstock</a></span>
</figcaption>
</figure>
<p>In Australia, people conceived with sperm donated before laws prohibiting anonymity had access only if the donor consented (Victoria 1988-1998), or had to place their name on voluntary registers (Victoria pre-1988/98; WA pre-2004; NSW pre-2010), hoping their donor would do the same. They, and anyone conceived in Tasmania, Queensland, the Northern Territory, and the ACT (where there are no laws), may ask clinics for information. </p>
<p>However, this often proves fruitless. This is despite the <a href="http://www.nhmrc.gov.au/guidelines-publications/e78">National Health and Medical Research Council Guidelines</a> recognising the entitlement to know about a person’s genetic heritage, prohibiting anonymous donation nationwide since 2005, and requiring clinics to engage in forums to encourage people to share information.</p>
<h2>Toward access for all</h2>
<p>Some jurisdictions, however, <em>did</em> include provisions for access to information by offspring conceived both prospectively and retrospectively. </p>
<p>In Switzerland, laws passed in 2001 setting up a register of donor information for all future children also included a retrospective provision for children born before that date, <em>requiring</em> clinics to release information about donors to donor-conceived people upon request. (The difficulty, however, is that many records pre-2001 were destroyed.)</p>
<p>In the Netherlands, laws allowing for access to information for offspring conceived after 2004 required that all donors who donated prior to that date be <em>asked to consent</em> to the release of information. Where consent was given, information may also be released.</p>
<p>Laws introduced in 2005 in the United Kingdom banning anonymity allowed for people who donated between 1991 and 2005 to “re-register” to consent to the release of information.</p>
<h2>What about Australia?</h2>
<p>Some Australian states have also made provisions for greater openness.</p>
<p>In 2008, Victoria enacted the only laws in the world that provide for an <a href="http://www.austlii.edu.au/au/legis/vic/num_act/arta200876o2008406/s153.html">addendum to the birth certificate</a> of donor-conceived people born after January 1, 2010, notifying them of further information held on the Registry of Births, Deaths and Marriages. The information is their donor-conceived status. The law intends to encourage parents to disclose early. </p>
<p>Further, following <a href="http://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Legal_and_Constitutional_Affairs/Completed_inquiries/2010-13/donorconception/report/index">national</a>, <a href="http://www.parliament.vic.gov.au/57th-parliament/lawreform/article/1465">Victorian</a> and <a href="http://www.parliament.nsw.gov.au/prod/parlment/committee.nsf/0/EE71C90F0F8B8713CA257ABC001A28AA">NSW</a> inquiries into donor conception practices, Victoria and NSW have moved towards laws that will increase access to information for some donor-conceived people.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/86944/original/image-20150701-25059-10bzxqg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/86944/original/image-20150701-25059-10bzxqg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/86944/original/image-20150701-25059-10bzxqg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/86944/original/image-20150701-25059-10bzxqg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/86944/original/image-20150701-25059-10bzxqg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/86944/original/image-20150701-25059-10bzxqg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/86944/original/image-20150701-25059-10bzxqg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Both donors and recipients want more access to information.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-153022880/stock-photo-two-people-sitting-on-the-bench-in-the-park.html?src=_CXOlMXj4PTCQccU7pJh4w-1-76">D. Kucharski K. Kucharska/Shutterstock</a></span>
</figcaption>
</figure>
<p>On June 29, 2015, Victoria introduced laws giving all donor-conceived people born prior to 1998 the right to seek access to information about their donors, <em>subject to consent</em> of the donor (donors are also able to seek their offspring). This right had only existed for those born between 1988 and 1998 before. </p>
<p>In NSW, work is ongoing to see similar changes put into effect for pre-2010 offspring.</p>
<p>However, if consent is not forthcoming, information will continue to be denied.</p>
<h2>The future</h2>
<p><a href="http://www.parliament.vic.gov.au/57th-parliament/lawreform/article/1469">Many</a> have <a href="http://www.bionews.org.uk/page_104517.asp">argued for the full release</a> of information to all donor-conceived people. This would allow the information to be released, while permitting donors to protect their privacy by placing a “contact veto”. In 2012, the Victoria Law Reform Committee accepted this suggestion, and <a href="http://www.parliament.vic.gov.au/57th-parliament/lawreform/article/1468">made unanimous recommendations</a> to change the law. </p>
<p>Further changes are now afoot in Victoria. While the then-Liberal government took the step to introduce the laws permitting information release <em>subject to the donor’s consent</em>, the new Labor government <a href="http://health.vic.gov.au/art/info-donors.htm">has pledged</a> to follow through on the Law Reform Committee’s recommendations. </p>
<p>A discussion paper released on the same day the “consent first” laws came into effect, outlines the Victorian government’s intention to provide information subject to the donor being able to express their “contact preference” (email, telephone, letter, or none). </p>
<p>Failure to respect the contact preference may result in fines up to A$9,000. Balancing the rights and interests of all is key.</p>
<p>Many donor-conceived people <a href="http://www.areyoudonorconceived.org/">continue to fight for openness and information</a>. Donors and recipients also want to share information. </p>
<p>Their voices are making a difference. If proposed Victorian laws are enacted, they will be a world-first for donor-conception, giving access to information regardless of when a person was conceived, while allowing contact preferences to be expressed. They will mirror rights long since given to other disenfranchised people seeking information about their biological heritage, such as adoptees. </p>
<p>Further debate will surely follow, and such laws may prompt other jurisdictions to ensure donor-conceived people have access to donor information.</p><img src="https://counter.theconversation.com/content/44000/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sonia Allan received a grant from the AMP Foundation (2014) to create the web-based health-law resource she links to in this article (Health Law Central); and a grant from the Churchill Trust (2011/12) to conduct research on the release of information to donor-conceived people around the world from which some information in the article is drawn. </span></em></p>Historically, donors were told it was best they were anonymous, while recipients were told it was best not to tell their child.Sonia Allan, Senior Lecturer, Law, Macquarie UniversityLicensed as Creative Commons – attribution, no derivatives.