Information for Recipients of Donated Sperm

Information for recipients of donated sperm

Fertility treatments involving donor sperm can help many patients achieve their dream of having a baby. The decision to go ahead with donor treatment is sometimes difficult, and there are many medical, ethical and legal aspects to consider. As a recipient, you will be encouraged to see our counsellor before embarking on any treatment. The counsellor will discuss with you the implications of donor treatment with respect to you and your family. This aim of this information sheet is to:

 Help prepare you for treatment with donor sperm  Provide information about the law with respect to donation and how it affects you  Answer your questions about donors and donor treatments  Encourage you to think about the issues you may face

Who are the sperm donors?

Donors recruited by the Fertility Centre

The Fertility Centre selects donors very carefully. They are recruited primarily from the local community using advertising material displayed in the Whittington Hospital itself, local newspapers, blood donation centres, GP surgeries, businesses and higher education establishments. Some people motivated to donate will also find our website through internet searches and social media campaigns. All Fertility Centre sperm donors are men aged between 18 and 45, however in practice, few men under age 25 apply, and the majority tend to be in their 30s at the time of their donation. Since April 2005 anyone donating sperm does so as an identifiable donor. This means that at the age of 18, any person conceived via donation will be able to obtain certain identifiable information about their donor from a register held by the Human Fertilisation and Embryology Authority (HFEA). Donor-conceived people over 18 may also be able to find out identifiable information about any donor-conceived half-siblings they have, on the basis of mutual consent. Individuals accepted onto our donor programme must produce high quality semen samples which we judge to have a good chance of being capable of initiating a pregnancy. We thoroughly assess the medical and family history of potential donors in order to minimise the risk of heritable disorders being passed on to your child. We also screen donors for a range of transmissible viral and bacterial diseases in order to prevent you from becoming infected via treatment. All potential donors are specifically tested for: • The viral infections HIV, Hepatitis B, Hepatitis C and Hepatitis A • The bacterial infections syphilis and chlamydia • The genetic disease(s) most common in people belonging to the donor’s specific ethic background, for example cystic fibrosis, thalassaemia or sickle cell disease

Donors who have travelled to countries in which there is a greater risk of exposure to other infectious diseases will also undergo additional screening. All semen samples are frozen in liquid nitrogen and stored in our sperm bank. Samples are only released for treatment after the donor has undergone a final round of testing that excludes the possibility of new infections having been acquired during the donation period. Although our testing procedures are rigorous, it is impossible to completely rule out the possibility of transmission of an infection or a genetic condition. Known donors It is possible that you may already know someone who is willing to act as a ‘known’ sperm donor for you / you and your partner. If you have someone who wishes to donate in order for you to undergo insemination treatment then please contact us to obtain more information about using his sperm on a known-donation basis. We can register this man as a donor who is willing to donate only to one family (i.e. yours). HFEA-licenced clinics have a responsibility to assess and screen all sperm donors in exactly the same way; even if the intended recipient would be willing to be more relaxed about the screening process because they know the donor personally. As such, recipients of known-donor sperm must cover the costs of the donor’s viral and bacterial screening, counselling, medical appointment, sperm freezing and sperm storage themselves. If you use donor sperm in an HFEA-licenced clinic like the Fertility Centre, then the legal aspects relating to treatment are the same regardless of whether you use a known or an ‘anonymous’ donor. For example, if you have treatment in our centre then you (or you and your partner) will hold all legal rights and responsibilities towards your donor-conceived child (see later on for further information about donation and UK law). This is not the case if you use your known donor’s sperm in a private arrangement. Who may wish to use donated sperm?

Donated sperm is needed by a broad group of patients. These range from heterosexual couples (where the male partner does not produce sperm, has very poor quality sperm or carries a genetic abnormality which could be transmitted to his children) to same-sex female couples and single women. Donated sperm is used to try and fertilise eggs, either using artificial insemination or IVF treatment; both of which take place within a fertility clinic. How will I/we be matched with a sperm donor?

A list of current Fertility Centre donors will be given to you, and you may select which donor you would like to use from this list. This list contains information about the donors’ ethnic background and their physical characteristics such as eye colour, hair colour, height and build. We hope to be able to offer you a wide range of donors to choose from; however you may sometimes have a more limited choice at the time of your treatment. In order to help you select a donor from our bank we can also offer you access to non-identifying information that the donor has supplied. This information may include his reasons for donating, a ‘pen-portrait’ in which he describes himself and a ‘goodwill’ message designed to be read by your child once she or he is 16 or older.

If we do not have any donors who would be suitable for you, then we will attempt to help you find a donor at another clinic. We currently accept sperm from two other UK donor banks, namely: Brighton Fertility Associates: https://www.brightonfertility.co.uk/ Semovo: https://www.buysperm.co.uk/ What traits/characteristics could a child inherit from their donor?

It is very difficult to say what characteristics a child might inherit from their donor. It is likely that your child will bear some physical resemblance to their donor; however genetics is very complicated and most traits are the result of a sophisticated interplay between many different genes. Eye colour is one characteristic which follows a more predictable inheritance pattern, as there are fewer genes involved. For example if you and your male partner both have blue eyes, you would naturally only be able to conceive a blue-eyed child. Therefore a blue-eyed donor would offer an ideal match for you. However, if either or both of you have brown eyes, a naturally conceived child may still have blue-eyes. This is particularly true if your parents, siblings or grandparents had blue eyes. In this case, a blue or a brown-eyed donor could be a good match for you. As for personality traits and interests, these are far more a product of nurture than nature. For example, if a donor describes themselves as sporty it doesn’t mean a child would automatically be sporty too; it would depend on the environment he or she had been brought up in. The same applies to intelligence, which is strongly related to the opportunities and education a child or person receives rather than genetics alone. In any case, it is important to remember that you will be encouraged to tell your child (at a reasonable time) how they were conceived. Evidence from studies involving donor-conceived and adopted children shows that it is best to tell donor-conceived children about their origins in childhood, as finding out later in life can be emotionally damaging to them and their family. If donation has been part of the family story for as long as your child can remember, their genetic origins needn’t be an issue. Opting not to tell them at all would be highly risky and is strongly discouraged. We will give you information about a number of excellent support groups that can help guide you through approaching this subject (these are listed at the end of this document). Your counsellor will also be able to discuss these types of things with you before you embark on any treatment. What types of donor sperm treatment are available?

Donated sperm is used to fertilise eggs, either by artificial insemination or in vitro fertilisation. Intrauterine insemination with donor sperm Intrauterine insemination (IUI) is a treatment in which the sperm are inseminated directly into the uterus at or around the time of ovulation. The high concentration of sperm and the precise timing of the procedure help to enhance the chances of pregnancy. The treatment can be done in a natural menstrual cycle or in a stimulated cycle using low doses of hormones. For more information about IUI treatment please ask us for the Fertility Centre’s IUI information sheet.

In vitro fertilisation with donor sperm In vitro fertilisation (IVF) with donor sperm is a more advanced form of fertility treatment. It involves hormonal stimulation which typically results in the growth of many more follicles than would be produced during stimulation for IUI. At the appropriate time, eggs are then retrieved from these follicles during a minor operation, and inseminated with donor sperm in the laboratory. In some cases, intracytoplasmic sperm injection may be used in conjunction with IVF, in order to optimise the chances of achieving a good rate of fertilisation. At present, the Fertility Centre at Whittington Health does not offer IVF treatment. However, if you have had unsuccessful IUI treatment with us, and would like to keep using the same donor for your IVF, we may be able to transfer donor sperm to another clinic for you. Please ask us for further details regarding this process. How much sperm can I reserve for my treatment?

At any one time you may have enough sperm reserved for up to three rounds of treatment. All reserved sperm must be purchased in advance. If you are lucky enough to become pregnant on your first cycle of treatment, but have paid for sperm for three cycles, we will keep the extra sperm for you in case you wish to use it to try for a sibling at a later date. If you pay for one cycle at a time and become pregnant, we can then reserve sibling sperm for you; provided you are willing to pay for this upfront. If you do not have sperm samples specifically reserved for you then we cannot guarantee that we will have enough sperm left for you to continue having treatment using the same donor (even if you have already had a child using sperm from this donor). Please contact us if you would like further clarification regarding our policies on sperm reservation and sibling treatment. What are the chances of success? This depends on a wide variety of factors, including the type of treatment you are having, your age, and the results of a variety of tests that are designed to assess how fertile you are likely to be (you will receive thorough investigations before you begin treatment in order for us to help select the most appropriate treatment for you and to give you a more accurate indication of your individual chance of success). Success rates nationally (broken down by age group) can be found on the HFEA website (see below).

What advice and support will I receive? As a recipient of donor sperm, you will be supported at medical and nurse consultations by professionals who are experienced in performing donor treatment. You will also be referred for pre-treatment implications counselling with our psychologist. If you are in a relationship, then both partners should be present for consultations and implications counselling. It is crucial that you both understand the medical, emotional and legal implications of treatment involving donor sperm. Implications counselling is a confidential session routinely provided for anyone considering treatment using donor sperm. The session gives you an opportunity to explore the short and long term implications of creating a family in this way. There may be implications not only for you and your partner (if you have one), but also for any existing children you may have or for your wider family.

Up to two sessions of counselling are included in the price of your first donor insemination cycle at the Fertility Centre. If you wish to undergo further counselling then our counsellor will be happy to see you privately. Our counsellor offers both face-to-face and online counselling sessions.

Donation and UK law Is sperm donation anonymous? It is in the sense that you will not be given identifying information about your donor and you will not know who your donor is. However, as of 2005, donor-conceived people have the right to apply for identifying information about their donor once they reach the age of 18. Not all donor-conceived people will want to apply for this information. However, you may want to think about how you would feel if your child or children did. You should also consider how this could affect others who are close to you. What can the donor decide about the use of his sperm? Although by law a donor can place conditions on who can receive his sperm, in practice, donors are unlikely to be accepted by the Fertility Centre if they wish to impose restrictive conditions (apart from in the case of known donors who are specifically donating to one named person). The Fertility Centre also has a duty to provide equality of opportunity with regards to our donation programme and we need to ensure that any conditions imposed do not unfairly discriminate against a person or group of people. A donor can also consent to the freezing of embryos created with his sperm, and specify the duration of the storage period for those embryos. We do not accept donors who are unwilling to allow their sperm to be used to create embryos which can be stored for 10 years, as this would limit our recipients in terms of treatment type and treatment timing.

How many children could be born using the sperm from a single donor? According to UK law, a single donor can only be used to create a maximum of 10 families. A family could mean one baby, twins, or siblings later on. The donor may also have his own children at the time of donation, and/or he may go on to have children in the future.

What if the donor changes his mind? Sperm donors consent in writing to their sperm being donated and used for the treatment of others. Donors can change or withdraw their consent up to the point at which sperm, or embryos created using their sperm, are placed into the recipient’s womb. Given that fertility treatment is costly, time-consuming and emotionally and physically stressful, we ensure that all our donors understand how important it is to be certain about donating before they proceed. It is extremely rare for a donor to withdraw consent.

Who will be the donor conceived child’s legal parents? Any woman who gives birth to a baby is its legal parent under UK law. If you are having treatment as a single woman, then you will be your child’s only legal parent. If you are undertaking treatment as part of a heterosexual couple or a same-sex female couple, then both you and your partner can be the child’s legal parents.

The Human Fertilisation and Embryology Act of 2008 stipulates that any man who is married to a woman undergoing donor sperm treatment will automatically be the legal father of any child she has as a result. For same-sex women in a civil partnership or marriage, the female partner who is not herself undergoing treatment will also automatically become the second legal parent. The only exception to this rule is if a woman undertakes donor sperm treatment without her husband, wife or civil partner’s knowledge or consent. Even though it is not a legal requirement, the Fertility Centre will ask all married couples and those in civil partnerships to complete the HFEA’s WP and PP forms, just as evidence that there is no objection. An unmarried man whose partner is having donor sperm treatment will be the legal father if both he and his partner consent to this in writing before conception. This also applies to same-sex female couples who are not in a relationship that has been legally formalised. The Fertility Centre will ensure that such couples complete the HFEA’s WP and PP legal parenthood consent forms for this purpose. Consent to legal parenthood forms must be completed before treatment is carried out. You have the option to withdraw your consent to be the legal parent of your partner’s child, or for your partner to be the legal parent of your child, but only if you do this in writing before treatment begins. Children born through donor sperm treatment are issued with a normal birth certificate. Nationals or residents of other countries should be aware that the law in other countries may be different from that in the UK, and should seek their own legal advice regarding this. For more information, please see the HFEA’s leaflet entitled ‘Becoming the legal parents of your child’, which can be found here: http://www.hfea.gov.uk/docs/HFEA_Legal_parenthood_leaflet_AW(2).pdf

What does being the legal parent of a child actually mean?

A person recognised as the legal parent of a child may not automatically have parental responsibility. Legal parenthood gives a lifelong connection between a parent and a child, and affects things like nationality, inheritance and financial responsibility. A person with parental responsibility has the authority to decide about the care of a child while the latter is young, for example in terms of medical treatment or education.

A child’s legal mother automatically has parental responsibility. The position of the father or other parent depends on factors including marital status, what is recorded on the birth certificate and whether or not the family court has made a specific order. Whenever there is uncertainty about legal parenthood or parental responsibility (for example in particularly complex cases), we advise that independent legal advice is sought. We can help you to find an appropriate lawyer, if necessary.

Does the donor have any responsibilities towards a child created using his sperm? When treatment takes place within a licensed fertility unit, the donor has no legal rights or responsibilities (including financial responsibilities) towards any person created through his donation.

The responsibility that donors do have is to provide comprehensive and accurate information about their health, and the health of their family members, to the clinic at which they donate. If it can be demonstrated that a donor intentionally told lies or withheld information regarding these subjects, then a donor-conceived person whose health has been affected as a result may be able to sue the donor for damages. All of our Fertility Centre donors are informed of this fact from the outset.

Can the donor receive any information about a child created using his sperm? Legally, a donor can make an application to the Fertility Centre or to the HFEA to find out the number, gender and year of birth of children created from his sperm. In practice, if a donor asks us, we can let him know if a recipient of his donation has a confirmed pregnancy. By law, we cannot tell donors the names of the children or provide any identifying information about them or you. Most donors are delighted to hear that their donation has been able to help another person or couple.

What information can a donor-conceived child get about their donor? Licensed clinics are required by law to pass information about donors and donation cycles on to the HFEA. Parents and/or donor conceived offspring may apply to the HFEA or to the Fertility Centre for information about their donor. The following non-identifying information about a donor is potentially available to parents of donor- conceived children at any time, and to donor-conceived children themselves from the age of 16:

 Physical description (height, weight, eye colour, hair colour and skin colour)  Year and country of birth  Ethnic group  Whether or not the donor had any biological children at the time of donation, and the number and sex of those children  Non-identifying information about any donor-conceived genetic siblings (number, sex, year of birth)  Other details the donor may have chosen to supply (e.g., occupation, religion and interests)  The ethnic group(s) of the donor’s parents  Whether or not the donor was adopted or donor-conceived (if the donor himself was aware of this)  Marital status (at the time of donation)  Details of any screening tests and medical history  Skills  Reasons for donating  A goodwill message  A description of themselves as a person (pen portrait) From the age of 18, donor-conceived adults (conceived after April 2005) also have the right to access the following information about their donor:

 Full name (and any previous names)  Date of birth  Town or district of birth  Last known postal address (or address at the time of registration) 8

When a donor-conceived adult applies for identifying information about their donor, the HFEA will contact the donor to let them know that an application has been made. The HFEA will not tell them the name of the donor-conceived person, or any of their identifying details. Other information that is available to donor-conceived people on application to the HFEA includes:

 Information about the possibility of being related to the person they intend to enter into an intimate physical relationship with (from the age of 16)  Information about the possibility of being related to the person they intend to marry or enter into a civil partnership with (at any age)  Identifying information about donor-conceived genetic siblings, with mutual consent (from the age of 18)

You must also take into account the advances in technology which mean that genetic relationships can be uncovered (accidentally or otherwise) via DNA sequencing and sharing websites such as 23andMe. Thinking ahead, your child is likely to have very easy access to services like this by the time he or she reaches the age of 18. Bear in mind that even if the donor himself does not submit his DNA to one of these services, any of his close biological relatives would still appear as ‘linked’ to your child if both parties agreed to this level of information sharing.

Does the donor get paid for donating? No. UK law prohibits payment for sperm donation. However, clinics can offer donors a compensation fee of up to £35 per donation appointment. We are careful to ensure that our donors’ motives for donation are altruistic and that they have a genuine desire to help childless people realise their dreams.

What responsibilities do I have as a recipient of donor sperm? Your primary responsibility after having undergone donor insemination cycle is to inform the Fertility Centre of both the initial outcome (i.e. whether or not you had a positive or negative pregnancy test, and then whether or not the pregnancy is deemed to be ongoing at the time of your ultrasound scans) and the eventual outcome (whether or not you were fortunate enough to have a live birth). If you call us to report a birth we will also ask you some details about the child, including its name, weight, where it was born and whether or not any abnormalities were apparent at birth.

Where can I find out more information?

Human Fertilisation & Embryology Authority (HFEA) – the authority that regulates and monitors all licensed fertility treatments. www.hfea.gov.uk

Donor Conception Network - a national support group for people who have conceived through donation and those who are considering becoming a donor. www.dcnetwork.org

British Infertility Counselling Association (BICA) - The professional association for infertility counsellors and counselling in the UK. The website includes a list of counsellors providing services and a downloadable leaflet on choosing a counsellor. www.bica.net

Infertility Network UK (INUK) - The largest network in the UK offering information and advice by phone and face-to-face. It has groups throughout the country and also produces a range of publications on infertility. www.infertilitynetworkuk.com

Fertility Friends - an active self-help community for people experiencing the pain of infertility. This is a useful site featuring message boards and live chat rooms. We recommend, however, that you do not view Fertility Friends as a reliable source from which to glean information regarding any medical or scientific issues relating to fertility treatment! www.fertilityfriends.co.uk

Leaflet Author: Erica Foster. First issue date May 2016

The Fertility Centre at Whittington Health NHS Trust

(HFEA Centre 0258, HFEA 9th Code of Practice)

Tel.: 020 7288 3776

Email: [email protected]

Patient advice and liaison service (PALS) If you have a compliment, complaint or concern please contact our PALS team on 020 7288 5551 or [email protected]

If you need a large print, audio or translated copy of this leaflet please contact us on 020 7288 3182. We will try our best to meet your needs.

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Whittington Health NHS Trust Magdala Avenue London N19 5NF Phone: 020 7272 3070 www.whittington.nhs.uk

Date published: 11/02/2021 Review date: 11/02/2023 Ref: ACW/FertCent/IRDS/02