The changing landscape of donation
Consultation closed
The 'Donating sperm and eggs: have your say' consultation closed on 8 April 2011. The information on this page is presented as it was during the consultation period and releates to the landscape of donation at the time.
See the consultation findings, and the current policies around sperm and egg donation in the UK:
The wider donation context:
The ethics of sperm and egg donation capture the public imagination.
The issues are rarely out of the press which is unsurprising given what donation involves: making children who will not be genetically related to their parent(s).
As the fertility watchdog, it is our job to regulate sperm and egg donation and treatment. We last looked at our rules in 2005, but even in this short time the landscape of donation has changed and we want to make sure our rules are up-to-date.
Many aspects of donation are beyond our remit but they impact on the areas we do regulate – namely compensation for donors, the family limit and donation within families.
Social and technological changes
The changing age of fertility treatment patients
The average age of women having fertility treatment in UK clinics with donated sperm, eggs or embryos has increased: from 31.9 years in 1991 to 35.1 years in 2007.
This mirrors the average age of mothers giving birth, which has been gradually increasing since the mid 1970s: from 26.5 years in 1975 to 29.4 years in 2009.
In the last decade the number of women giving birth at age 35 or older has increased by a third: from 15% in 1999 to 20% in 2009.
Who is having fertility treatment?
The structure of the family is changing and so too are patterns of personal behaviour. The percentage of births outside marriage has risen dramatically in the last 30 years: 11% in 1979, 39% in 1999 and 46% in 2009.
Same sex couples and single women are increasingly seeking treatment with donor sperm. Up to 30% of clients at London Women’s Clinic – a major donation clinic in London - are lesbian couples, representing an increase of about 10% from 10 years ago.
Since 2009 it has been possible for two women to register as the parents of a child and the law no longer requires clinics to consider the ‘need for a father’ before offering treatment. It is also now possible for two women or two men to become parents following surrogacy.
New technologies in fertility treatment
Today IVF is commonplace; it has proved itself to be a safe and mainstream clinical technique. Many additional treatments and techniques have been developed since 1991, such as ICSI (intracytoplasmic sperm injection) and egg freezing.
These techniques open up a number of fertility options for people who a generation ago would not have had the choice.
Shortages of egg and sperm donors
Demand for donor treatment in the UK is greater than the supply of donors. Although this has been an issue since we were established in 1991, it is often argued that the shortage was exacerbated by the removal of anonymity by parliament in 2005.
As the regulator, it is not our role to ensure the supply of donors: that is for fertility clinics. However, this shortage impacts on aspects of donation where we do have some control: donor compensation, the family limit and family donation.
What are the consequences of donor shortages?
The shortage of donors results in long waiting times for treatment: there are reports of waiting times of three to five years for donor eggs in the UK.
Long waiting times for suitable donors is one of the main reasons people give for going abroad, where it can be easier to access donor treatment. Rules on donation differ across Europe. It is possible, for example, to travel within the EU to access sperm from an anonymous donor, which is illegal in the UK.
However, people conceived in clinics abroad will not be able to benefit from the safeguards which exist in the UK, including the right to information about their donor and siblings.
Rising number of online donation sites
There has been an emergence of web-based matching services where donors advertise their willingness to donate to potential recipients.
We are concerned about the safety of patients and the quality of care if donation does not take place within a licensed clinic. There are real risks that:
- the sperm sample received is not safe
- the donor is not who they say they are
- women in a vulnerable situation are exploited
- the safeguards that the law offers to parents, to donors and to those who are born do not apply.
There have also been media reports of donors being paid directly by the recipient for their donation.
Fertility treatment and donation trends
Infertility affects around one in six UK couples – approximately 3.5 million people. Whilst the world’s first IVF baby was born in 1978, it is likely that sperm donor insemination has been going on for centuries.
As well as being a treatment for couples where the male partner has fertility problems, donor insemination is also used for single women, same sex couples and those who want to avoid passing on genetic disorders.
...keep reading about fertility treatment and donation trends
Possible solutions to the donor shortage
One way to increase donor numbers is to increase awareness of donation. The National Gamete Donation Trust (NGDT), a government-funded charity, works to achieve this, though it is a small charity with limited funds.
Improving the current system
Many people make initial enquiries about donation, but they don’t go on to become donors. This may be because they change their mind after finding out about what donation involves (eg, lack of anonymity, the screening process, the time involved and lack of payment) or they are not accepted because of medical reasons.
Our discussions with donor and patient organisations so far suggest that donors are sometimes lost because of inadequate customer service.
Some clinics fail to return donors’ phone calls or to let them know if they have been accepted as donors following screening.
More donors could be retained through better customer service and improved information.
Clinics have told us that the current system for compensation is a burden to administer and may leave some donors out of pocket. Making the process for claiming expenses easier (eg, not being required to submit receipts) may increase donor numbers.
Access to sperm donor treatment might be increased by raising the number of families an individual donor can donate to - this limit is currently set at 10.
Putting systems in place to make it easy for clinics to monitor the maximum family limit set by donors could also improve access to treatment.
"Many people make initial enquiries about donation, but they don’t go on to become donors."
The ethical principles and concerns of donation
There is a greater demand for donor treatment in licensed clinics than the supply of donors, yet there is a perception that unlicensed donor/recipient matching websites are on the increase.
This suggests that there are people who are willing to donate, but do not do so through licensed clinics.
These issues force us to consider our values and principles regarding the nature of giving, the value of life, how life should come about and the proper place of regulation.
There is not a clear ‘right’ answer; there are competing principles and concerns.
These are the principles we think are relevant to the issues surrounding donation.
- Welfare of the future child - not doing anything which could result in serious harm to any child born as a result of assisted reproduction with donor eggs or sperm.
- Safety of donors, patients and donor conceived people – safety of all those affected by donation is paramount, for example, donors are carefully screened for transmittable diseases.
- Respect for family life – concerns the intrinsic value of forming a family. For some, donated sperm, eggs or embryos represents the only chance, other than adoption, of forming a family. In order for such people to form a family, there needs to be an adequate supply of donated gametes; posing unjustifiable barriers to donation may be seen to impinge some people’s ability to form a family.
- Altruism – is acting in the interests of others, rather than through self interest. Anything that would benefit the donor directly – such as a financial reward – might be seen to undermine altruistic motivation.
- Fairness – relates to treating people equally and not benefiting one party over another. It may be perceived as unfair for donors to be out of pocket as a result of donation, especially if clinics benefit financially from their donation.
- Informed consent – in order to consent to treatment or donation, full information about the procedure, risks and any consequences must be provided in an accessible and easy to understand way.
- Free choice – family pressure, or financial incentive, to donate may impinge an individual’s ability to make a free choice.
- Importance of counselling – patients and donors must, by law, be offered counselling to discuss their donation/treatment, before it takes place. This helps ensure consent is fully informed, free and properly thought through.
- Pragmatism – any change in policy should be easy for clinics to implement and pose minimum burden on donors, patients and clinics.
- Openness – it is believed to be in the best interests of the donor conceived to have information about their origins; clinics must, by law, give patients information about how to inform their children of their donor conception.
- Special status of the human embryo – human embryos have special moral status (although not full human status) and should be afforded legal protection; in part, it is the role of the regulator to ensure this protection is provided.
Factsheet - key points and summary
This factsheet provides a summary of ‘the changing landscape of donation’ section of this consultation. It is intended to aid discussion of the issues. It is not a substitute for reading and responding to the consultation.
Page last updated: 20 January 2011
This factsheet provides a summary of ‘the changing landscape of donation’ section of this consultation. 
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Should the number of families created with sperm or eggs from one donor should be capped?