This policy document is the fourth part of a response submitted by the Progress Educational Trust (PET) to the Human Fertilisation and Embryology Authority's Consultation Donating Sperm and Eggs: Have Your Say.
1. Which of the following approaches do you think we should take towards mixing sperm and eggs between family members?
|✔||No further regulatory control|
|Prohibit the mixing of gametes between close relatives who are either genetically related or unrelated|
|Prohibit the mixing of gametes between close relatives who are genetically related|
It is already the case that there is a de facto prohibition on mixing sperm and eggs belonging to close relatives. In the background information provided by the HFEA to people responding to this consultation, it is noted that 'clinic staff have been dealing with family donation for several years with no reported problem and no mixing between close relatives (for example, brother and sister or father and daughter) is known to have occurred'. In light of this fact, there is no need for any new measures to discourage or prevent the mixing of gametes between family members.
2. Which of the following approaches do you think we should take towards donation between family members?
|✔||No further regulatory control|
|Issue guidance to clinics on handling donation between family members|
|Invite the counselling profession to produce guidance for clinics on handling donation between family members|
|Require clinics to have a strategy in place to deal with cases of donation between family members|
It is already the case that there is a de facto prohibition on mixing sperm and eggs belonging to close relatives. It is also already the case that if sperm and eggs between more distant relatives (for example, cousins) are to be mixed, and if there is a family or ethnic history of genetically transmissible disease whose risk is exacerbated by consanguinity, then genetic counselling through regional genetic services is recommended.
These existing safeguards are quite sufficient to address problems arising from donation - whether intergenerational or intragenerational - between family members. Beyond this, different families will have different attitudes towards donation between their members. Some families will not wish to countenance it, some families will wish to avail themselves of counselling while they consider it, and some families will feel perfectly comfortable with it from the outset.
In the background information provided by the HFEA to people responding to this consultation, it is claimed that donation between family members can result in 'confusing genetic/social relationships for children'. But there is no reason to assume that children in these scenarios will find their genetic and/or social relationships confusing. If any such confusion arises, then adults can help to address it, as already occurs with the many aspects of life that children require help to understand.
Any broader discomfort that exists in society, about the fact that gamete donation between family members is not traditional, should have no bearing on whether and how it is regulated.
3. Do you think any of the family donation options would have a disproportionate effect on any groups of people on the basis of their age, disability, ethnicity or race, religion, gender or sexual orientation?
Further regulation of donation between family members would have a disproportionate effect upon people who can only conceive using donor gametes, if those people wish to have children who are genetically related to them. For example, a key characteristic of Turner syndrome is infertility, and people with this condition require IVF with egg donation in order to have children. Some women store their eggs if their daughters have Turner syndrome, so as to give their daughters the option of having genetically related children upon reaching adulthood.
Furthermore, any attempt to further regulate donation between family members, when existing safeguards are quite sufficient to address any problems which might arise, risks adding to the stigma and misinformation already experienced by ethnic groups in which consanguineous marriage is common.