The donation of sperm or eggs is a very laudable social service and demand in the UK is increasing[1], albeit, sperm is in short supply for artificial insemination (AI). The service can be carried out by one of the many reputable licenced clinics recommended by the HFEA which regulates their activities and gives a great deal of clarity about consent and responsibilities towards children created from the donor sperm[2].
There are, however, shocking and indeed harrowing stories about sperm donors who have fathered multiple children and we would like to explore some of the issues. The cause of disquiet is the very real possibility of inbreeding (a genetic abnormality arising from inadvertent half-sibling reproduction as the result of a common father – the genetic term is consanguinity), incest and psycho-social/emotional issues in donor children. Consent, if it has been given, is often far from informed.
A recent case involves a musician in the Netherlands who has been accused of fathering more than 550 children from his “donations” which were offered via social media and to a significant number of clinics, of which 11 were in the Netherlands. The court in The Hague has recently found against him in a case brought by one of the mothers and the charity DonorKind.eu, on the basis that he lied to the clinic/mothers about his history and activities; had they known, they would not have chosen him as a donor. This judgement of preliminary relief will deter him from making further donations[3]. These mothers are now faced with an extraordinary extended network of half-siblings.
There have been many other circumstances of sperm donors fathering multiple offspring, both consensual[4] and adversarial[5]. In the latter instance there have been multiple cases of doctor-donor conceived children in the US, with fertility fraud being documented on websites such as donordeceived.org and even Netflix[6].
Many people feel it is important to know their origins, as it gives them both identity and helps them make sense of their being. The UK took a giant step in this direction on 1st April 2005 when individuals became able to identify their sperm donor, upon reaching the age of 18 (from this year, 2023). This was a result of studies which acknowledged the need for individuals to know the identity of their biological parents and which followed up the International Convention on the Rights of the Child, adopted by the UN General assembly in 1990. This shift from anonymous to open identity sperm donors has been replicated in other countries, nearly always with limits placed on the number of times a particular donor sperm can be used. In the UK, this is 10. In the Netherlands, this is 25[7]. For the genuine sperm donor and child relationship open identity is seen as a very positive circumstance. Donors are on a registry that can be accessed by the child via the HFEA, if wanted, and many people find surety in knowing their biological as well as their social father. More difficulty arises in cases of fertility fraud, where a quest to find the biological parent has often resulted in the discovery of many half-siblings. The psychological and social effects on the individual are rarely taken into proper consideration and indeed, as these situations evolve, are probably not yet fully understood. There is in fact no evidence for the choice of this number relating to how many times a donor can be used and the number chosen by each country is arbitrary[8]. The primary concern seems to be the possibility of genetic disorder, which though significant is in fact less than that of a first cousin mating (taboo in many countries but not the UK or indeed to Charles Darwin himself) but in our view, more concerning is the psycho-social impact of such a large number of siblings on the individual, which after all, is unprecedented in any human society.
DNA testing technology using broad brush ancestry services (Direct to Consumer) has enabled half- siblings to discover not only anonymous biological fathers, but possible other half-siblings – the use of a precision DNA test to determine the true family relationship (always recommended) enables this to be confirmed with a reliable statistical probability[9]. Data indicates that from use of these tests, the discovery of non-parent expected (NPE) events (that one or more parent is not biological) ranges from 4-12 %. Whilst there are of course other explanations, one of these is that social parents have not discussed with the child the circumstances of their conception. The evidence suggests[10] that donor conceived children often have difficulty (often seeking help) coming to terms with; a) the nature of their conception, b) the efforts to find a biological parent and c) their reaction upon hearing about it. This is particularly acute if they discover that the father has sired many children.
Regarding consent, then the DNA testing technology that is now available for tracing biological relatives was not available when many of the donor conceived children were actually conceived. As we know it now, informed consent would have been impossible at that time and many of the issues since raised are very new to science, society and law. Genetic technology is changing fast and information is coming to light so quickly, that it is impossible to give informed consent in the present (informed consent has only even been relevant in the precise time window it is given, and can only be based on the state of knowledge at that precise time). By sequencing individual human genomes, we can reveal information relating to genetic disease that was unknown; sometimes these are late onset disorders and/or could not be known or predicted at the time of conception. Other times, we (or more specifically the direct-to-consumer client) will have the genetic information and either not know or be in a position to know how it relates to disease or the prediction of characteristics. The fact is of course, that we are all genetically pre-disposed to something, as much as we can be genetically protected from the very same things.
Donor conception is a delight to many – but the emergence of fertility fraud has raised several important questions, for which there are simply not enough informed counsellors. Maybe, given the vast data sources, artificial intelligence (AI), has a role to play in AI after all.
[1] https://www.hfea.gov.uk/about-us/publications/research-and-data/trends-in-egg-sperm-and-embryo-donation-2020/
[2] https://www.hfea.gov.uk/choose-a-clinic/consent-to-treatment-and-storage/
[3] https://nltimes.nl/2023/04/28/court-orders-sperm-donor-550-kids-stop
[4] https://www.theguardian.com/science/2018/nov/24/sperm-donor-man-who-fathered-200-children
[5] https://www.nbcbayarea.com/investigations/doctor-sperm-donor-cases-fertility/3148093/
[6] https://www.netflix.com/gb/title/81227735; https://donordeceived.org/
[7] https://doi.org/10.1016/j.fertnstert.2007.06.020
[8] https://academic.oup.com/humrep/article/25/5/1089/639772
[9] https://dadchecksilver.com/sibling-tests/
[10] https://bioethics.hms.harvard.edu/journal/donor-technology
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