About
two weeks ago, I had read an article by an American woman who had, seven years
after her divorce, decided that she was ready to have children. Because of the
(infamous?) biological clock that women yet to have their own children are
never allowed to forget, the woman at 37, decided to take the plunge into
motherhood. This is normal enough. However, while it is also becoming quite
normal for some women to decide that they do not want to get married (again for
those who had married before, or at all for those who have not) and would
rather be single mothers, what I thought is not yet quite that prevalent but
which some research has proved otherwise (at least in Western countries), is
the decision for a woman to decide to approach sperm banks to get her eggs
fertilized and go the whole motherhood route without at least some man in the
background if not by her side.
The
woman in the article I read, did it and now has two children she is raising
alone and without a father figure in those children’s lives.
Later
on last week as well, Wendy Williams during the Hot Topics segment of her Show,
mentioned the story of 25-year old unmarried Matteo[1],
a Bachelorette contestant who, while a management consultant, also appeared to
have chosen being a sperm donor as a vocation. This guy, at 25, claimed that
his sperm has been used to produce 114 children! There doesn’t seem to be any
information yet on whether all these children were born to women resident in
the USA.
A
number of countries particularly in Europe, have enacted laws with regards to
Assisted Reproductive Technology (ART). In Africa, South Africa seems to be at
the forefront in the enactment of a Law on ART. Kenya had a 2014 Bill on In-vitro Fertilzation (IVF) which
appeared not to have been passed[2].
While
there are a number of aspects like surrogacy, IVF etc to ART, the main focus of
this write-up is the issue of how many offspring or live births a single
donor’s sperm[3]
should be used to produce and how to effectively regulate same especially in
view of ART tourism by persons who for one reason or the other, including, but
of course, not limited to cost and restrictive laws in their own countries, go
outside their countries of residence to get sperms (or eggs, as the case may
be).
In
the UK, the maximum number of families a single donor can endow is 10[4];
six families in Spain and 12 families in Denmark, in the Netherlands one donor
can contribute to 25 families while Taiwan allows just one[5].
Though there is no law at present governing ART in Kenya, it’s been reported
that a donor can only be allowed to donate 3 times[6],
in South Africa, sperm from a donor can only be used for 6 live births[7].
Whereas
a number of countries in Europe as already mentioned, have laws limiting the
number of families sperm from a single donor should be allowed to assist in
producing children, the United States of America has no such law. At best, what
the USA has is a voluntary guideline issued by the American Society for
Reproductive Medicine (ASRM), of no more than 25 births per sperm donor in a
population of 800,000 people. As has been mentioned however, this guideline is
voluntary and in the absence of strict laws to ensure compliance, sperm banks
can use a donor’s sperm to produce as many live births as they are able to[8].
In
Nigeria, in spite of calls for regulation by medical practitioners and the
Association for Fertility and Reproductive Health (AFRH), there is as yet no
law to regulate ART. The closest to what may be regarded as some kind of
regulation is the provision of Part VI
of the National Health Act of 2014
which prohibits the procurement of human blood or tissue or any organ of a
living being for money except reimbursement of reasonable costs incurred[9]
and mandates the giving of consent by donors[10].
ART
is however becoming quite popular in Nigeria and recruitment of sperm donors
are reportedly being done in our higher Institutions, meaning the majority of
sperm donors if reports available are correct, are undergraduates. And where
sperm donors are prohibited from receiving payment for their donations, they
are said to receive what is called Inconvenience allowance which, as at
the writing of an article in the Guardian in January of 2017[11],
was between N10,000 to N25,000 per visit depending on the donor’s
personality, academic qualifications, physical attributes among other things. An
undergraduate interviewed in the Saturday Magazine of the Guardian Nigeria
article just mentioned, was in fact quoted to have claimed he was making up to
about N200,000 to N250,000 a month just from donating his sperm. How true this claim
is can only be wondered at.
Whether the claim
is true or not, is however not the focus here. The real focus is, and rightly should be, as is being
expressed all over the world where the practice of ART particularly around
sperm (and egg) donations are concerned, how to regulate the number of live
births a donor’s sperm or egg should be allowed to produce in view of the very
real danger of incest an absence of regulation can cause. Besides the very real
danger of incest among siblings is the issue of genetic diseases that may be
passed on from the donors to the children especially in places where absence of
laws or regulations make genetic testing optional.
In
the United States and other Western countries, there already is a big outcry
over the huge number of children some popular donors are fathering. And except
for countries like Sweden, Australia, and the Netherlands which do not permit
anonymous donations, tracking donor-conceived children and ensuring they do not
meet and ignorantly have sexual relations with each other can be real
difficult. The need to track donor-conceived children is one of the reasons
some countries including the UK and Sweden prohibited anonymous donation.
But
while the laws prohibiting anonymous donations may work to a limited extent to
limit the number of children conceived by a single donor in those countries,
they reportedly also had the effect of reducing the numbers of donors willing
to come forward to donate. The laws also created fertility tourism with those
who can afford it, taking trips to countries with more liberal or no laws, to
purchase sperms and eggs. It was reported for instance that the Danish sperm
Bank, Cryos, claims to have 1,400 active and real donors in Europe,
about 200 in the US and that it sells sperms to over 100 countries worldwide[12].
Denmark
is said to be about the most popular destination for ART tourism and Cryos
mentioned earlier, is reported to have the largest bank of sperm in the world.
Indeed, research has indicated that about 90% of Danish sperm goes to other EU
countries. This is perhaps the reason Denmark in addition to pegging the number
of families one donor’s sperm can be used for to 12, also went further to limit
the number of conceptions such a donor’s sperm can be used to achieve
internationally. And so in addition to the 12 families in Denmark, a donor’s
sperm can only be used for 6 couples in Sweden and eight couples in Switzerland[13].
Just
as important as regulating the number of donor-conceived children per donor is,
so is creating a strong process of ensuring that donor-conceived children are
aware they were conceived through the assistance of donors, and that they have
means of knowing and identifying their half siblings and other members of their
biological fathers (or mothers as the case may be)’ families. Indeed, under the
United Nations (UN) Convention on the
Rights of the Child (CRC), the right of a child to know his parents was
given the status of a Fundamental Human Right.
In
some countries, donor conceived children are entitled to information on their
donor-fathers upon reaching the age of 18. In New Zealand for instance, a
Registry for the purpose of access to information by both donors and donor-conceived
children was established under the Human
Assisted Reproductive Technology Act of 2004. A donor-conceived child can
thus get access to information at the age of 18 or by Court Order at the age of
16[14].
Whereas
the countries that have laws and binding regulations restricting the number of
children that a single donor’s sperm should be allowed to produce can be said
to have taken some steps, albeit inadequate, to address the issue of the danger
of siblings ignorantly engaging in sexual relations, the major problem is with
countries with no law or regulations and virtually all the countries on the
African Continent because of the culture of stigma (or shame) surrounding the
issue of infertility will be guilty here. This may be the reason a country like
South Africa absolutely prohibits disclosure of both the donor and the
recipient’s identities in spite of the fact that donors are required to
register with the National Health Directorate and may choose to be informed
when their donation produces a pregnancy[15].
In
a country like Nigeria where data gathering in most aspects of our national
lives is still a very big challenge, preventing incest among donor-conceived
children especially where there is an absence of regulation and or monitoring
will be impossible. Nigeria’s case will especially be difficult for a number of
reasons besides the absence of a law to regulate. Nigeria generally has a
history of regulatory agencies that focus more on revenue generation as opposed
to their primary tasks of regulation and monitoring. Most important however is
the stigma or shame around infertility which would mean that most couples will
keep not only the fact of the donor assistance from their donor-conceived
children, to forestall the possibility of the children ever finding out; they
will also keep it from their close relatives and friends.
Obviously, a lot of work will need to be done
in Africa generally, and Nigeria in particular, to remove the shame and feeling
that a woman or a man who for one reason or the other, is unable to have
children, is less than whole. This should be done by our religious
organizations and bodies who have a lot of influence on their followers. It may
be time to start using religion for purpose other than dividing the populace.
While
it at first appeared that Matteo’s boastful claim of having fathered 114
children through sperm donation, was far-fetched, some research on the subject
soon showed that his claim may well be true. The story of Cynthia Daly who in a
bid to connect her donor-conceived son to his half-siblings through a web-based
registry but found that her donor as at 2011 had fathered 149 other children is
a popular one[16].
There are reports also of other donors each of whom have been found to be
biological fathers of hundreds of donor-conceived people. Some donors were reportedly
shocked to have learnt that their sperms were used to conceive so many children[17]
and one donor has an excel spreadsheet file to keep track of his offspring.
The
lack of regulation in many countries have made it difficult to track exactly
how many people globally were conceived using ART and more particularly, the Intracytoplasmic Sperm Injection (ICSI).
While sperm banks ask recipients to report births of donor-conceived children,
only about 40% of births are for instance, reported in the US[18].
Countries with laws regulating ART while able to monitor births internally will
be missing figures of those who travel outside to get sperms or eggs.
This
writer’s recommendations for keeping near accurate track of births of
donor-conceived children to avoid accidental incest are first; as is already
the practice in most countries, each donor should be given a unique number through
which donor-conceived people can identify themselves as offspring of the same
donor. This should work even for countries like South Africa which prohibits
disclosure of both donors and recipients identities.
There
should also be a central registry much like the Donor Sibling Registry which
was founded in 2000 by Wendy Kramer while trying to look for her 10-year old
son’s half siblings. As at the 22nd of May 2019, DSR claims to have
64,186 members inclusive of donors, donor-conceived people and parents of
donor-conceived people. According to the figure on its website, the Registry
has also successfully connected more than 17,060 offspring with their half
siblings and or their donors.
While
DSR has done very well in facilitating these connections, it is obvious that a
Registry that will be supported by, if not all countries of the world, but
majority of the countries will be required especially in view of tourism
engaged in by persons either looking to evade their countries’ strict laws or
just looking for sperm banks in a country with better donor testing. And for
the Registry to work effectively, countries should have laws which compel
parents/recipients to disclose to their donor-conceived children their status
as having been so conceived. This is most important with respect to African
countries whose people seem to have a culture of shaming people with fertility
issues. And Sperm Banks will have to be regulated and mandated to keep records
of both donors and recipients and to monitor the results after purchases.
The
Registry can still work very effectively with the identities of Donors
undisclosed for countries which are still uncomfortable with disclosure of
identities of the donors. Other information except the names of the donor can
be put in the registry. With his/her unique number, a donor can also track the
number of births that have been produced with his/her sperm or eggs. It should
then be the choice of the donor to reveal or keep undisclosed, his/her
identity.
With
well over 5 million donor-conceived people[19]
in the world today and with social media and technology shrinking the distance
between humans, the danger of accidental incest between half siblings cannot be
more real and the need for laws mandating Sperm Banks to drastically reduce the
number of conception a single donor’s sperm is used to achieve cannot be
over-emphasised.
An
interesting point to close this write-up is the fact that single women like the
woman in the first paragraph of this article, and gay couples make up a
considerable percentage of recipients of ART (at least in the more developed
countries even though countries like France does not allow donation to single
women and gay couples and hence ART tourism).
[1] After getting
initial information which did not include the name and occupation of the
Bachelorette contestant on the Wendy Williams Show, further
information in the course of research into this topic was obtained in an
article by Sarah Zhang published on May 13, 2019 in the The Atlantic. The article is titled The Trouble With Fathering 114
Kids.
[2]
The 2014 Bill
was apparently not passed and there’s a report that a similar Bill was
reintroduced into the Kenyan Parliament in 2018. The fate of the re-introduced
Bill is not known.
[3]
It should be
noted that there are couples and singles who received donations from people
they know. These people are called known donors, and in some countries with
laws governing ART, such known donors can be sued for child maintenance.
Conversely, known donors can also sue recipients to allow them have access to
the donor-conceived child. Though, there may have been written agreements
between the known donor and the recipients, Courts, particularly in the US will
usually disregard such agreements with respect to the paternity of a child.
This piece is however not focused on known donors but really on donors who
donate through sperm banks mostly anonymously, whether for pecuniary gains or
for altruistic purposes.
[4] Human Fertilsation
and Embryology Act, 1990.
[5]
A lack of Regulation has
created enormous genetic families. Now they are searching for one another by Ariana Eunjung Cha
published in the washingtonpost.com on 12th September 2018.
[6]
The number of
times a donor is allowed to donate does not however take care of the number of
live births the donated sperm can or will be used for. Since each sample
donated can still be divided and put into several vials, it means many live
births can be achieved even from a single donation.
[7]
See: The
Rising Debate – Anonymity of Gamete Donation in South Africa. www.aevitasfertilityclinic.co.za published on August 16,
2017. See also provisions of the National
Health Act of South Africa.
[8] The American Fertility
Society (AFS)’s Guidelines also recommends 10 pregnancies per donor or under 10
if recipients are members of an isolated subgroups of the population:
www.scholarship.law.duke.edu
[9] Section 53(1) of the National Health
Act 2014.
[10]
Section 48(1)(a), National Health Act 2014.
[11]
Sperm Donor’s Nightmare:
Have I fathered 500 Children Already? Written by Franca Osakwe in www.guardian.ng
on 7th January 2017.
[12]
See the article published in theguardian.com/science/2018 titled America’s
hottest export? Sperm, written by Soo
Youn on August 15, 2018.
[13] Ibid
[14] Regulated
Sperm Donation: Why requiring exposed donation is not the answer by
Vanessa L. Pi. Published on March 8, 2009.
[15] The
Rising Debate – Anonymity of Gamete Donation in South Africa. Supra.
[16]
See publication in www.nytimes.com One
Sperm Donor, 150 Offspring written by Jacqueline Mroz published on September 5, 2011. By the article
earlier cited and titled The Trouble with Fathering 114 Kids,
Cynthia Daly’s donor’s children had risen to 189!
[17] One
Sperm Donor, 150 Offspring. Jacqueline Mroz (Supra)
[18] Regulating
Sperm Donation: Why requiring exposed donation is not the answer. Vanessa
L. Pi.
[19] ART
in Europe: Usage and Regulation in the context of Cross-Border Reproductive
Care by Patrick Praig &
Melinda C. Mills published on 13th January 2017. https://www.link.springer.com.
