Third-party reproduction

Written by Dr Sue Winspear
22 Jul

Five things you need to know about using donor sperm, eggs and embryos

If you’re in a same sex relationship, or in a heterosexual relationship but dealing with complex fertility issues, sperm, egg or embryo donation may provide your only chance to start a family. Or, if you’re a single woman and longing to have a baby, you may be thinking about using a sperm donor.

There’s no doubt today’s assisted reproductive science is an incredible gift if you’re in any of these situations. But what should you consider first? And what about the potential impact in the future – for you and your family?

Using donor sperm, eggs or embryos involves a relatively straightforward medical procedure, but the legal, emotional and psychological issues can be much more complex. Here are five key facts to consider.

Donor-conceived families are just as happy

A 2012 study1, the largest and most comprehensive examination of donor conceived families in Australia, found that these families are just as ‘psychologically happy’ as families with children conceived naturally.

The study looked at the health of the couple’s relationship, their relationship with their children, and the communication and support within the family. On average, mothers of children conceived with donor sperm had lower levels of psychological distress. Fathers recorded higher nurturing scores and less conflict with their children. And overall there was no difference in the quality of relationships.

Counselling is a vital part of the process

In Victoria, the Assisted Reproductive Treatment Act 2008 regulates all donor procedures. This includes you and your partner meeting with a counsellor at least two times to discuss the psychological and legal implications of using a donor to create your family. For NSW and QLD based clinics, all individuals and couples are required to meet with a counsellor at least once, but are encouraged to have at least two before going ahead with a treatment involving donor sperm, eggs or embryos.

You cannot pay a donor for sperm, eggs or embryos

In Australia, it is illegal to receive or make payment for any human tissue, however a donor can be reimbursed for travel costs and reasonable medical expenses.

Your fertility clinic can recruit a sperm donor for you, and keeps a waiting list for embryo donation, but if you need to use donor eggs to conceive you will need to find your own egg donor. This could be a sister or friend, or you can also advertise for one.

A surrogate is encouraged not to use her own eggs

If pregnancy is too risky for you or your baby, or if carrying a pregnancy is medically impossible, surrogacy may be your only hope of having a child. This is a highly complex journey, and you can find out more about the legal requirements in your area via the links at the end of this article. Our clinics only offer gestational surrogacy which means your baby is conceived using your own (or donor) egg and sperm. Traditional surrogacy where the surrogate uses her own eggs and carries the pregnancy, is legal in most states except Victoria, however is not recommended or offered in our clinics.

When your child turns 18, they can request information on their donor

To tell, or not to tell? Interestingly, the Australian Institute of Family Studies' study1 we mentioned above found most donor children were not told they were conceived with donor sperm.

However, many specialists in this field2 believe it is important to explain to children where they come from.

There are practical considerations – they have a legal right to find their donor once they turn 18, there is the possibility they could form a relationship with someone they are related to, and they may need to know more about their medical history later on.

This is a very personal decision, but it is best if your child hears this information from you, and that you make their story a positive part of their life.

In Victoria, the birth certificate will state that there is additional information available upon request to the person named, which implies that the majority of Donor conceived individuals will be curious and request the information if they are not aware of it already.

Read more:
Donor Program in Melbourne , Donor Program in Queensland , Donor Program in Sydney, Donor Program in Newcastle

1http://www.theage.com.au/national/donor-sperm-families-just-as-happy-20…
2http://www.parentlink.act.gov.au/parenting-resources/parenting-guides/a…

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Related Articles

Conceiving in your 40s, what are the chances?

I was recently asked to comment in a Sun Herald article on 26th August (also published online here: Sydney Morning Herald) on Collette Dinnigan, who pregnant at the age of 46, has called on women not to leave it too long to try for a baby.

It is always news when a high profile personality such as Ms Dinnigan, has a child, particularly when the personality in question is a bit older.  The difficulty is that these occasions, while very happy for the people involved, give a misleading picture of the actual likelihood of conception in these circumstances.  Remember that high profile personalities such as Ms Dinnigan, are human beings who quite rightly value their privacy and so very rarely (quite understandably) talk to the press when things aren’t going so well.  It was therefore, a particularly courageous action of Ms Dinnigan, while celebrating her own happiness, to so publicly, point out the difficulties that may face other women, seeking the same fulfilment.

What then, are the issues for women in their forties who are planning to have a child?

The main difficulty is that conceiving is simply harder at that age and, even once a woman does conceive, the risk of miscarriage is higher.  Surprisingly, although we have very good data about the effects of age on IVF conception (more shortly), we don’t have very good statistics about the effects of age on conceiving naturally. The limited available data about natural conception comes from old population studies or studies of unique populations, such as the Hutterites of North America, who do not use contraception.  Interestingly these data, such as they are, seem to be entirely consistent with the more modern and abundant IVF data.  Generally, in one year of trying, 75% of women under 30 years and 66% of 35-year-old women but only 44% of 40-year-old women will achieve a live baby naturally.

The main explanation for this, is that women are born with a finite number of eggs, and from that moment onwards, the number of eggs is declining all the time, until women go through their menopause at around 50-51.  Nonetheless, women in their 40s do still ovulate each month.  What is it about their eggs that cause all these problems?

A common misunderstanding with some women is that the fact she looks and feels young, and leads a healthy lifestyle, means that her eggs will be healthier. I regularly see women who have taken enormous care with their fitness and their health.  The rest of their body is in great shape, completely fit and ready to carry that longed-for pregnancy.  Sadly, despite this, the eggs still can’t do it.  The effects of time are remorseless and, sadly, there is no wonder drug to fix it.

Scientists have shown that eggs from older women are more likely to have an abnormal makeup making pregnancy less likely, miscarriage more common and increasing the risk of Down Syndrome, a condition where a child is born with an extra chromosome number 21.

Nor is IVF a cure for this problem. For women, in their early 40s, IVF is still a good thing to try and gives significantly higher success rates than trying naturally.    However, IVF success rates fall sharply after the age of 40 and by the time a woman is 45 are close to zero.

So, what’s the good news?  Well despite all of the above, many women do conceive in their forties, either by IVF, or naturally, and have very happy healthy families.  It is obviously better to have your family earlier, if you can, but all hope is not lost, just because you’re past 40.  Conception and early miscarriage are the big problems but, if you do conceive and get past the first few weeks, by far the most likely outcome will be a healthy child.  While the risk of Down Syndrome is increased, most of the other problems that affect young children are not increased by being conceived a later maternal age.

Finally, many women worry that by having their children later, their long term health and emotional development may be affected.  On the contrary, we now know that the children of older mums grow up to be as healthy and bright as any other child.

Snapshot of Fertility in Australia

There have been a number of happy and high profile stories in the press recently about older celebrities giving birth to healthy children. Stories like this used to be extraordinary, but they certainly seem to be on the increase. While this trend is supported by data that shows the fertility rate and numbers of births are increasing for women over 30 and especially for women in their early 40s, women and couples should understand the risks associated with having children later in life.  IVF Australia, Melbourne IVF and Queensland Fertility Group, have teamed up to create their latest infographic - “Fertility and Age in Australia” which explores some of these issues.
 Fertility in Australia infographic

Paternity, Maternity, Equality

Conceiving a baby in a same sex relationship

IVFAustralia, and its partner clinics Melbourne IVF, Queensland Fertility Group and TasIVF, are proud supporters of ‘rainbow families’. IVFAustralia were an Official Supporter of Sydney’s Gay and Lesbian Mardi Gras this year, and we’ve seen the number of same sex couples accessing our donor program double in the last year.
 
In 2011, a survey of 3,835 LGBT people found 33% of women and 11% of men had children1 - but close to 40% reported wanting to have children or have more children. This so-called ‘gayby’ boom is thanks to changes in community attitudes and laws, including better access to Assisted Reproductive Treatments for lesbian and single women.
 
So, if you’re hoping to experience the joy of starting a family within a gay or lesbian relationship, what do you need to consider?

How long will it take to conceive?

Generally speaking, we’d expect a healthy woman with no fertility issues to fall pregnant through IVF or Artificial Insemination within six months. You can prepare for pregnancy by improving your diet, doing regular exercise and other lifestyle factors.
 
When you access the donor program there are a few extra decisions you need to make.
 
Do you choose a known donor, or an anonymous donor? In a lesbian relationship, do you want to implant an embryo with eggs from one mother into the other? Should you store some sperm from the same donor for later, in case you’d like a related sibling? For two dads, the process of finding a surrogate can also be complex.

How do we choose a donor?

Our fertility clinics offer access to both Australian and US* donor sperm. The access fee for US donor sperm is higher, but the waiting list is also shorter as there is a shortage of local donors (gay men, we’d love to hear from you!)
 
When you’re using donor sperm or eggs, there are a few legal, emotional and ethical factors to consider and a counsellor will help you work through these concerns so you can make the best decisions for your family’s future.

Are there any legal issues?

Each state has different laws about parental recognition and access, so it’s worth seeking specialist advice before you start.
 
For example, in Victoria, the Victorian Assisted Reproductive Treatment Act (2008) removed discrimination against lesbian and single women with regard to fertility treatment, recognised parenting status for non-birth mothers and also effectively legalised ‘altruistic’ surrogacy. It also recognises lesbian couples as equal parents of their child or children as long as they were in a de facto relationship.

What else should we be prepared for?

30 years of research2 has shown that the children of same-sex parented families do just as well as the children of heterosexual parents socially, educationally, physically and emotionally.

The issues your children will face as they get older are just the same as the issues facing any children conceived using donor sperm or eggs: Where did I come from? Should I contact my donor? You need to be prepared for these questions at some point.
 
In the meantime, we hope we can help you fulfil your dream of having a baby, and that you will experience the joys of pregnancy, birth and parenthood.

What should be my next steps?

If you would like to learn more about the fertility treatments available for same-sex couples in your regions, visit one of our websites. 


 * IVFAustralia and Queensland Fertility Group patients only.

1 Leonard et al. (2012) Private Lives 2: The Second National Survey of the Health and Wellbeing of GLBT Australians, The Australian Research Centre in Sex, Health and Society, Melbourne
2Rainbow Families Council of Victoria (2010) Rainbow Families and the Law, RFC, Melbourne, http://www.rainbowfamilies.org 

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