Human Fertilisation and Embryology Authority Open Meeting
Organised by the Human Fertilisation and Embryology Authority
Glaziers Hall, 9 Montague Close, London Bridge, London SE1 9DD, UK
Wednesday 7 July 2010
The UK's Human Fertilisation and Embryology Authority (HFEA) held its open Authority meeting on Wednesday 7 July. The meeting discussed general advances in its work, received feedback from the Hampton Working Group and considered the data of compliance with multiple birth rate targets. The most pertinent and interesting presentation focused on feedback regarding the evaluation of the Donation Review.
At this interim point, four main points were raised for consideration by the Authority:
First, it was reported that the HFEA is prohibited under the Human Fertilisation and Embryology Act (HFE Act) 1990 (as amended) from disclosing donor codes to the parents of donor conceived children. Having consulted legal advisers, it is apparent that the release of donor codes is not permitted under the HFE Act. It is not clear whether individual clinics are similarly precluded and therefore it was decided that the HFEA should seek clarification on this point to ensure that correct advice is given to all clinics.
Second, the upper age limit for sperm donors was examined in an attempt to reconcile the discrepancies between HFEA Code of Practice, which recommends the upper age limit be placed at 45 years of age, and professional body guidance which places the cap at 40. On the advice of lawyers, the Authority is aware that age restrictions that are imposed in the absence of good medical reason potentially qualify as age discrimination. While it is apparent that sperm quality does decrease with age, there is no statistically significant cut-off point at which sperm quality is so low as to qualify as good medical reason and therefore a fine balancing act is required to avoid a discriminatory policy. The Science and Clinical Advancement Advisory Committee (SCAAC) have therefore recommended that this be addressed by affording flexibility of decision making to each clinic, provided all participants are fully informed of the risks that accompany older sperm donation.
Third up for consideration was the matter of conditional donation. It was suggested that the HFE Act appears to permit conditional donation, but this has the potential to be discriminatory under the Equality Act 2010. The subject promoted lively debate amongst Authority members as to which, if any conditions, would be 'positive' rather than 'conditional'. The biggest conundrum they discussed was whether donors of a particular faith would be able to restrict the use of their gametes to recipients of the same faith. Consultations with the Equality and Human Rights Commission are currently ongoing, although it is likely that the outcome will be determined by legal advice. As the Human Tissue Act prevents the conditional donation of organs after death, it looks likely that this may also be applied to gametes.
Finally, the notion of intra-family donation was raised with the intention of imminent review due to the lack of current guidance. Two types of intra-family donation were brought to the members' attention: 'replacement', which simply replaces an infertile gamete with that of a family member and 'mixing', which involves the amalgamation of gametes of two members of the same family (brother and sister, for example). Although it was quickly pointed out that there are no known cases of the latter, and considerations for the welfare of the potential child would stop this mixing from taking place, there is no explicit prohibition in the HFE Act. It was suggested that an explicit ban on certain types of mixing ought to be advocated. More broadly, the topic raised a plethora of ethical issues including social and genetic concerns, potential coercion of donor consent, and the psychological impact on children of these unconventional familial ties and therefore a heavy emphasis has been placed upon counselling within fertility clinics until final decisions are made.
The next stage of the review procedure will involve a public consultation which will now not take place until January and March next year to result in a decisive Authority statement in May. However, with 'austerity' being the word of the day and in the face of new budget cuts and recruitment freezes, timescales may go awry as the future of the HFEA, like many other quangos, is precarious.