Tuesday, June 29, 2010

Sperm banks at center of discussion about emotional effects on children

Published: Tuesday, June 29, 2010, 6:00 AM
Angela Townsend, The [Cleveland] Plain Dealer

A report with a title "My Daddy's Name Is Donor: A New Study of Young Adults Conceived Through Sperm Donation" is a sure attention-grabber.

The Commission on Parenthood's Future, a New York-based think tank, released the report in May. 

Equally eye-catching: the headline on the press release, issued by theInstitute for American Values, or IAV: "Pathbreaking Study Finds Adults Conceived Through Sperm Donation Suffer Substantial Harm." Data was culled from an online survey of 1,687 people, roughly one-third of whom said they either knew that they were sperm-donor offspring or suspected as much.

The report talks -- mostly anecdotally -- about the emotional and psychological effects of being a donor offspring: feelings of loss, anger and confused identity.

Unless you've used one, donated to one or were conceived with the help of one, you probably haven't thought much about sperm banks. I'll leave it up to you to form your own impressions about the 140-page report, filled with news accounts and first-person observations. But I'll admit the report got me thinking a lot about a topic that, until a few weeks ago, was not at the forefront of my mind.

And that, says Elizabeth Marquardt, lead co-investigator of the report, is the point.

"Our aim is to reframe the national discussion," says Marquardt, director of the IAV's Center for Marriage and Families. It's not just about making babies, but "making people. [Donor offspring] have just as much of a right, if not more of a right, to be leaders in this conversation."

One recommendation in the report is for an end to anonymity. While some sperm banks have open or identity-release donors (men who consent to contact from their offspring once the child turns 18), the vast majority do not.

The report also calls for mandatory counseling for donors, would-be donors and parents.

"We're in this Wild West -- there are so little regulations," Marquardt says. "Some [fertility centers] do a very good job. Others do a very poor job. It's pretty much at the clinic's and doctor's discretion in how to proceed."

The Cleveland Clinic and University Hospitals Case Medical Center both operate fertility clinics, but neither has a sperm bank. In fact, none exists in Ohio. The hospitals recommend banks that they have used in the past to patients who decide to go that route.
The Clinic encourages their in vitro fertilization patients and sperm- and egg-donation recipients to speak with a psychiatrist for needed counseling. At UH, everyone considering using donor egg or sperm is required to meet with a psychologist for evaluation.

"It can be a psychological burden for the couple or child, that's why we insist on [the evaluation], says Dr. William Hurd, chief of reproductive endocrinology and infertility at UH.

"My Daddy's Name Is Donor" cites the statistic that between 30,000 to 60,000 children in the United States are conceived each year through donor sperm.

That may have been the case 20 years ago, but there are not nearly as many today, says Dr. James Goldfarb, president of the Society for Assisted Reproductive Technology, or SART.
"Now with [continued advances in] in vitro fertilization, many of the men with very low sperm counts in the past can easily conceive a child," says Goldfarb, director of Infertility Services at the Clinic.

For example, intracytoplasmic sperm injection, or ICSI, conducted in a lab, makes it possible for an egg to be fertilized with just one sperm, instead of needing an entire semen sample -- a boon for men with low sperm count.

The cost for one IVF cycle with ICSI can be more than $10,000 while the cost for the services of a sperm bank is several hundred dollars. For those who don't want that expense, or single women and lesbian couples who don't have the benefit of getting sperm from a friend, the bank is the only other option.

The number of sperm banks in the United States has gone down in the years since the Food and Drug Administration began enforcing more stringently the guidelines for testing and incubating sperm.
"In years past, sperm donation was done everywhere and very casually," Hurd said. "Then people became aware of infectious diseases."

The FDA requires vigorous testing for HIV, hepatitis and other sexually transmitted diseases. Many sperm banks also have begun genetic testing.

SART guidelines for fertility clinics and their use of sperm banks -- aside from using banks that comply with FDA rules -- state that all participants should have informed consent and be offered psychological screening.

"These couples, in my opinion, have the best service if they go to a clinic where they're experienced in doing this," Goldfarb says. "The procedure is low-tech. The real skill is in [dealing with] people."

Even before the "My Daddy's Name Is Donor" report, extensive research has been conducted on the welfare of children from donor sperm and, to lesser extent, donor eggs.

"The vast majority suggest that it's very safe psychologically," Hurd says. Even so, "We need to continue to try and to study the psychological and medical well-being of all our patients who undergo assisted reproductive technology. We don't necessarily know the long-term implications."

The Donor Sibling Registry was founded in 2000 to help egg, sperm and embryo donor offspring and their biological parents get in contact with each other. Since then it has conducted research, some of which has been presented at conferences and published in peer-reviewed journals.

Not everything about donor conception is bad, says registry co-founder Wendy Kramer.

"I know a lot of donor-conceived people who are very happy, healthy and well-adjusted," says Kramer, whose son was 2 years old when she told him he was conceived with donor sperm.
"My own son wanted to know who his biological father was," she says. "But being curious and wanting to know doesn't always imply devastation and destruction."

A graduate of Kent State University who holds a master's degree in library science, Lindsay Greenawalt of Canton writes the blog "Confessions of a Cryokid." On it, she openly states her desire to be reunited with "Xytex sperm donor 2035," her biological father who donated to a sperm bank in Georgia.

"Offspring have varying degrees of how they feel," says Greenawalt, 25. "I'm past the anger thing, I'm more directed at the big picture. I want to make change."

Make that a revolution, the word Greenawalt uses when talking about the possibility of what could happen when more people start to demand many of the same changes that have shaped the way adoption looks like today.

"I think that in time, donor conception will be seen like adoption is now," she says. "Adoption used to be parent-centric but that's changed."

As for the commission's report, in which she is mentioned, she says, "I think [the report] has already elevated the conversation. A lot of [the response] is negative, but I think we're kind of to the point that people are listening."


Mark Diebel said...

"Even before the "My Daddy's Name Is Donor" report, extensive research has been conducted on the welfare of children from donor sperm and, to lesser extent, donor eggs."

Thank you as always for your work that brings statements like this to light! Am almost amused at the "extensive research" comment. What do you think?

Mark Diebel said...

"Even before the "My Daddy's Name Is Donor" report, extensive research has been conducted on the welfare of children from donor sperm and, to lesser extent, donor eggs."

Thank you as always for your work that brings statements like this to light! Am almost amused at the "extensive research" comment. What do you think?

Lindsay said...

Well said Mark!

But as always, laypeople get things wrong. There has been other research (mainly through the DSR), but NONE as extensive, and none have focused on the welfare of ADULT offspring. She was unknown to the issues in DC before reading MDNID, and put the article together fairly quickly....she interviewed me only 2 weeks go!

However, I think Angela did a good job at providing various opinions and did not discount the research or overly endorse it....she kept to the facts. Besides that comment, everything else was quite true.

What amuses me has been the comments made - people are either just truly ignorant or simply stupid!