Giving - The Sperm and Egg Donor Perspective

The simple answer is to make money. But why come to the UK? Because in the UK there is a shortage of sperm and egg donors, or at least a perceived shortage, that's why. Whether or not there is a shortage depends who you speak to. Some British clinics have invested in advertising campaigns and the infrastructure to deal with the enquiries they generate and so have an excellent track record in recruiting donors. Other clinics appear to have given up and would rather refer patients to clinics overseas than to their colleagues (and competitors) down the street. So your impression of the situation depends very much on who you speak to at the Fertility Show. But what is the picture outside the microcosm of a wet weekend at Kensington Olympia? No one seems to know and this may be a stumbling block to finding a solution to this so-called shortage. The National Gamete Donation Strategy Group (NGDSG), a group set up by the Human Fertilisation and Embryology Authority (HFEA), aims to find new approaches to raising awareness of donation and improving the care of donors in the UK. The Group needs to understand what the shortage is to assess the scale of the problem. I was honoured to be invited to join the NGDSG and am fully committed to its core objectives to: 1. increase awareness of donation and the information that donors receive 2. improve the 'customer service' that donors receive when they contact clinics 3. help donors provide better information about themselves for future families The NGDSG has only had one meeting (1), so it hasn't got all the answers yet, but if the enthusiasm and determination around the table at the first meeting are anything to go by I wouldn't rule it out. Other messages you hear about gamete donation at the exhibition stands at the Fertility Show are far from clear at best and downright misleading at their worst. There are clinics offering 'educated' donors, 'attractive' donors and 'caring' donors. While these attributes are something we may look for in a partner and we may desire for our children – who judges whether the donors meet these criteria and what difference does it make to the resulting child? For example, just considering the 'educated' description. What does this mean? According to the dictionary 'educated ' means 'having undergone education' or 'characterised by or displaying qualities of culture and learning'. Is being 'educated' therefore something children can inherit from a gamete donor? It is the old nature or nurture question all over again and to me it sounds more like nurture than nature. If you accept that it is nurture and you are using an anonymous donor from overseas that your child will never meet, what is the relevance of the 'educated' descriptor? If your child has the option of meeting the donor at 18 is it more important to you that the donor was educated? And if so, why? These questions are some of many which we will be addressing in our project 'When It Takes More Than Two'. The aim of the project is to clarify public and professional understanding of issues relating to donor conception, particularly in relation to identity and genetics. Donors are frequently sought and marketed on the basis of characteristics like being 'educated' whose heritability is complex or disputed at best, and non-existent at worst. The heritability of such personal predispositions is far more complex and contentious than the marketing materials would suggest. But even with more basic physical attributes – such as height (tallness is an almost universally preferred donor characteristic), hair and eye colour, which contain an element of Mendelian inheritance – observations show that strict Mendelian patterns of inheritance are not followed down the generations. The first event in a series of three is 'GIVING: THE GAMETE DONOR PERSPECTIVE'. A panel of speakers will address issues including what motivates people to donate, the criteria used to screen donors for their physiological and psychological health, and the placing of conditions upon the use of sperm or eggs one has donated. The latter is a controversial area where the HFEA has recently issued new policy, and where different parts of UK law are potentially in conflict. For example, a sperm donor may want to prevent his sperm from being used by a lesbian. The event it will take place on 12 December, for more details of this free event and others in the series please see the Progress Educational Trust's forthcoming events.

Egg donor shortage in UK forces people to fertility clinics abroad

With a shortage of donors in the UK, foreign fertility clinics are proving big business for British women trying to get pregnant. However, says Claire Higney, success isn’t guaranteed I'll never forget turning to my husband Andy and saying, ‘If we can’t have children, I’ll never put my body through fertility treatment.’ I was 30 and couldn’t understand that desperation to have a baby I’d seen in some women. Of course, I was speaking with the arrogance of someone who had never faced infertility. Those words would come back to haunt me. Fast forward ten years, and I was sitting on a hotel bed in Spain with tears rolling down my face because I’d just been told by my Spanish fertility clinic that our two embryos ‘weren’t doing well’. It was likely that they’d have to cancel the cycle before I had what’s known as ‘the transfer’ to my womb. ‘We’ll only charge half the fee, though,’ the nurse said, as if that would suddenly make everything OK. I felt devastated. We’d decided to travel to Spain for egg donation after four miscarriages and two failed IVF attempts. By this point I understood the despair that women feel when they can’t have children. Egg donation was our last shot. I’d given up a job I loved on a national newspaper to focus on having a baby and we’d found another £10,000 – on top of more than £30,000 we’d already spent on investigations and treatment – to pay for it. Meanwhile, my friends were reproducing for England and I felt almost embarrassed that my body couldn’t do what it was meant to. While they were all cutting back on luxuries to afford nursery fees, I consoled myself with handbags: a Marc Jacobs tote here, a Mulberry clutch there. I’d just started ticking the ‘age: 40 to 42’ box on the medical forms, and according to figures from the Human Fertilisation and Embryology Authority, I now had just a 12.7 per cent chance of success using my own eggs. A donor egg carries an average 33.4 per cent success rate (I chose to ignore the fact that for my age group it was nearer 20 per cent). We’d have preferred to find an egg donor in the UK, but since the government removed anonymity from donors in 2005 there has been a shortage. And according to the latest figures, the average waiting time for donor eggs is two and a half years. Waiting times are much shorter in Spain, which tends to use younger donors and anonymity is guaranteed. It’s estimated that thousands of British women choose to go abroad for this reason every year, with Spain, Russia and the US being the most popular destinations. What kind of donor had they given me? Was she a heavy drinker or smoker? Could she have been over 35?’ After doing some research online, we opted for a clinic in Spain that promised 18- to 35-year-old donors who had been screened for genetic conditions and sexually transmitted diseases. We gave the clinic a photo of Andy and me so that they could try to find a donor who matched our characteristics. The staff spoke English and informed me I’d be able to have the preparatory hormone treatment in London and would need to go to Spain only for the embryo transfer. I was otherwise fit and healthy and Andy had no fertility issues, so surely our chances were good if we used the egg of a super-fertile 20-something? What’s more, the clinic said it had an impressive 55 per cent pregnancy rate with embryo transfer. Andy and I had discussed all the issues: would it be weird to have someone else’s DNA inside me? How would I feel about giving birth to another woman’s child? But friends reminded me that, unlike surrogacy, I’d get to carry the baby and it would share my blood supply, plus biologically it would be 50 per cent Andy’s genes. Also, my name would be on the birth certificate as the mother. We had the obligatory tests for HIV and hepatitis; Andy flew out to Spain to have a sperm sample frozen, and I was given an injection to shut down my menstrual cycle and began taking progesterone to prepare my womb lining, aspirin and heparin injections to thin my blood and improve the chances of implantation, plus steroids to help reduce risk of miscarriage. A few weeks later, the donor was ready for egg retrieval. Then the clinic called to say fertilisation had gone well and we had nine good embryos. We sped off to the airport with a good-luck stork charm from my sister-in-law and €500 from my parents so I didn’t ‘have to worry about finding a cashpoint’. When we arrived in Spain the clinic rang to say that the embryos were doing so well that they could go to the next stage and grow them a further two days to day five, which would give us a better chance of success. We headed off to a tapas bar that night feeling excited. The clinic had said they would contact us the next morning to tell us when to come in for the transfer, but by lunchtime there was no news. When I rang them all I got was voicemail. Then at 6pm I finally got a call from one of the nurses. ‘I’m sorry, Claire, but your embryos aren’t doing well,’ she said. ‘There are two left and they’re not looking good. It’s unlikely that we’ll be able to continue with the cycle. This is very unusual.’ So why was it happening to me? The heartache was so overwhelming it felt like physical pain – and I was angry, too. My own eggs had fared far better during IVF – at least I’d produced good-quality embryos that could be transferred. What kind of donor had they given me? Was she a drinker or a smoker? Could she have been over 35? We’d chosen an anonymous donor to make things less complicated in the future, but maybe the US system of choosing a donor based on detailed profiles, including family medical history and lifestyle checks, would have been more sensible. I felt naive for not having prepared myself for this scenario. Maybe I was blinded by hope; maybe I should have done more research. We went to bed that night resigned to the fact that we would be leaving with nothing to show for all those weeks of preparation, tests and treatment. The next morning was spent at the pool, trying to relax before flying home. At about midday my mobile rang. It was the clinic. Our two embryos were suddenly doing much better and I’d be able to have the transfer after all. We were surprised, but jumped in our hire car and raced to the clinic. The transfer went well and I was given a photo of my two embryos. In the run-up to the pregnancy test two weeks later I kept checking the picture, willing the embryos to stick. But they didn’t. After a blood test at our London clinic, I was told I wasn’t pregnant. I’d faced this disappointment many times before, but it was harder to accept this time, maybe because it felt like our last chance. The Spanish clinic rang me and suggested trying again. ‘Could I request a donor who’s had children herself or produced a successful pregnancy through donation?’ I enquired. ‘Yes, you can,’ she said. I was shocked. Why hadn’t anyone told me that previously? I had been led to believe that I had no influence over the choice of donor. Maybe it’s cynical, but after being told my embryos ‘weren’t looking good’, I couldn’t help wondering if they were substandard but had been implanted anyway so I could be charged the price of a full cycle. It was the end of the road for me. You need to know when to walk away. Somehow I knew I wouldn’t be one of those women who finally got her ‘miracle baby’ after 15 IVF attempts. Fertility treatment is wonderful when it gives you the child you’ve always dreamt of, but all we were left with was a file, three inches thick, cataloguing all our failures, test results and invoices adding up to nearly £50,000. Egg donation is no magic bullet. On average the chances of success are 33.4 per cent across the age groups, but when you break those figures down it’s just 20.8 per cent for women aged 40 to 42. My advice would be to give yourself a cutoff point and do your homework (see box). While sperm is easy to test for quality, eggs cannot be tested before they’re donated, so it’s wise to request a donor with a proven history of fertility. Fertility treatment can cause rifts even in the strongest of couples, but if anything the experience brought Andy and me closer. However, I wasn’t prepared to keep putting us through the stress of fertility treatment when the odds were so bad. Once we’d made the decision not to have more treatment, it was a huge relief. Andy and I are now in the adoption process. My attitude has changed, too – it’s not about having a baby, it’s about having a family to share our lives with and giving someone else the chance of a good life. The assessment period has been a positive experience and we’ve just been approved. Adopting a child is kind of like being pregnant – the months of preparation, wondering if it’ll be a boy or a girl and trying to imagine what this new person will look like. And, if the child turns out to be a girl, she’ll inherit some very cool handbags. Egg donation abroad: the facts Pip Morris of the National Gamete Donation Trust (NGDT), a charity trying to tackle the UK’s shortage of egg and sperm donors, has this advice… ● Look at the clinic’s success rate in your age group; the age of its donors (ideally 18-35); its genetic and medical screening for donors; its country’s law regarding anonymity; whether the clinic does many such procedures, and if it’s linked with UK clinics so you can have some of the treatments here. ● Read the small print: I’ve heard about a donor who was named on a birth certificate, which had huge implications for her and the couple who had wanted an anonymous donor. In the UK, donors must be prepared to be identified and traced when the child reaches 18. ● Many people go to foreign clinics because of shorter waiting lists, but you still need to consider the implications of carrying another woman’s egg. ● It’s important to trust the clinic; find out how it is monitored and if it has ever been inspected for irregularities. ● UK donors are typically older — aged 30 to 35 — but have usually had their own children and so have proven fertility. However, waiting lists are long — typically two and a half years unless you find your own donor — which is why NGDT is trying to raise awareness. ● Finally, remember, even with egg donation, overall there’s still only a 33.4 per cent success rate. Article: 2nd December 2012 www.dailymail.co.uk

Fertility forced abroad as NHS cuts back on IVF treatment

Nicosia looks nice. The clinic website shows pictures of boats bobbing on blue-green Cypriot waters. Spain feels more familiar, but the Ukraine is cheaper. Or what about Mexico, where you can choose whether to have a boy or a girl?
The fertility business is global and booming. As the NHS cuts back on free treatment for the childless, lumping IVF with tattoo removal as an act of kindness rather than treatment for a disease, the competitive prices of private clinics overseas compared with their UK rivals will look ever more tempting. This weekend a number of them will be touting for business at the Fertility Show, now in its second year, at London's Olympia.

Their websites are in English, their blandishments are soothing and the success rates they advertise are eye-popping to those unversed in the complexities of such data. You can get an instant email quote (in sterling) – I was offered IVF using donor eggs (difficult to obtain in the UK) in Kiev for £5,277, in Nicosia for £3,945 (including six days in a hotel and airport transfer) and in Mexico for £4,316 – or £5,091 if I wanted to choose the sex of my child. The UK has some of the best and safest IVF clinics in the world. It is the home of the pioneers – Bob Edwards, responsible for the world's first IVF baby, Louise Brown, recently won a Nobel prize, putting reproductive medicine firmly in the category of humane treatments that have advanced us as a species. But the government's yearning towards the free market and its dislike of red tape are threatening the quango which keeps standards high and clinics safe. The Human Fertilisation and Embryology Authority (HFEA), this week celebrating the 20th anniversary of the Act that set it up, is down for abolition. Its various roles are to be picked apart and handed to other bodies.

These are rocky times for the unhappy childless. North Yorkshire and York, Bury, South West Essex and West Kent have already cut back or suspended NHS fertility treatment. IVF, in a cash-strapped health service, is one of the first things to go. Funders know that desperate people will do it anyway. Houses will be re-mortgaged.

"Couples know they can't wait for the recession to be over," says Clare Lewis-Jones, chief executive of Infertility Network. "There won't be as much NHS IVF, but patients will find the money at least for one cycle. They have had to in the past and they will do it again."

To read more go to http://bit.ly/dtrGLy

Egg donors could get up to £800 in payments

Currently the Human Fertility and Embryology Authority (HFEA) imposes a £250 cap on payments so as to avoid commercialising the procedure.
But the low payment is thought to be behind a shortage in egg and sperm donation which is driving infertile women and men to overseas – often unregulated – clinics, according to research.

Now the HFEA is considering adopting the Spanish system which would see the payment cap lifted to £800.

"We want to review egg donation," Professor Lisa Jardine, the chair of the HFEA told the Sunday Times.

"We are suggesting moving closer to the Spanish system. But there is no suggestion of adopting the US model where a good-looking girl with a degree can get $30,000 (£19,000) for her eggs."

A report will go to the HFEA's executive next month, setting out the proposed higher payments.

It will then be put out to public consultation.

Fertility clinics are barred from offering straight payments for egg or sperm donation.

Even though egg donors can face invasive procedures and some health risks, they are entitled to a maximum "compensation"of only £250 for loss of earnings, plus expenses.

To read more go to http://bit.ly/dmDUNQ

I couldn't be a mother.... until I went to Spain

As more and more hopeful parents are forced abroad to seek donor eggs, Victoria Macdonald recalls the agony and joy of her IVF quest
In a coffee shop the other day, a woman came over to tell me, at some length, just how cute my baby daughter is. Of course, I was hardly likely to disagree, but after a while the woman straightened up, looked long and hard at me and said: “So, does she take after her father, then?”

Later that week I was telling a friend just how determined Gabriella was becoming. My friend laughed and said: “Well, we know who she gets that from.”

There was an awkward pause. Because Gabriella does not get that from me. And, yes, she does look a lot like her father and not one bit like me. She has brown hair with a hint of red, chubby little cheeks, a perky nose and elegant long fingers. I do not.

But then it is not surprising we are so different in appearance. Although I carried her through 36 weeks of pregnancy and gave birth this time last year, there is no genetic link between us at all since Gabriella was conceived after we travelled to Spain for a donated egg.

To read more go to http://bit.ly/9nuW07

What's driving UK fertility tourism? First study published

Expensive UK fertility treatment and long waiting times related to a shortage of egg and sperm donors are the major reasons people seek fertility treatment abroad, according to the first academic study into cross-border reproductive care.
Researchers from De Montfort University (DMU), in collaboration with the universities of Sheffield, Huddersfield and Swansea, interviewed 51 people. They found that 71 per cent of those interviewed went abroad to seek treatment using donor gametes. Out of those, 46 per cent of couples were having treatment using donor eggs, 12 per cent using donor sperm and 10 per cent using donor egg and sperm.

The high cost of treatment in the UK was cited as another reason couples seek treatment abroad; most IVF (in vitro fertilisation) is not funded by the NHS and can cost a minimum of £4,500. The participants were also interviewed about their experiences abroad. The majority of couples were very positive and reported high standards of care.

Lead researcher Professor Lorraine Culley from De Montfort University said the research has: 'helped to dispel some of the myths commonly associated with having fertility treatment abroad'.

To read more go to http://bit.ly/cwdyDS