Embryo donation and understanding of kinship: the impact of law and policy

Abstract

STUDY QUESTIONWhat is the impact of law and policy upon the experience of embryo donation for reproductive use?SUMMARY ANSWERAccess to, and experience of, embryo donation are influenced by a number of external factors including laws that impose embryo storage limits, those that frame counselling and approval requirements and allow for, or mandate, donor identity disclosure.WHAT IS KNOWN ALREADYTo date only three qualitative studies in Australia and New Zealand have been completed on the experience of embryo donation for reproductive purposes, each with a small cohort of interviewees and divergent findings.STUDY DESIGN, SIZE, DURATIONEmbryo donors, recipients, and would-be donors were interviewed between July 2010 and July 2012, with three additional interviews between September 2015 and September 2016, on their experiences of embryo donation. The sampling protocol had the advantage of addressing donation practices across multiple clinical sites under distinct legal frameworks.PARTICIPANTS/MATERIALS, SETTINGS, METHODSParticipants were recruited from five Australian jurisdictions and across 11 clinical sites. Twenty-six participants were interviewed, comprising: 11 people who had donated embryos for the reproductive use of others (nine individuals and one couple), six recipients of donated embryos (four individuals and one couple) and nine individuals who had attempted to donate, or had a strong desire to donate, but had been prevented from doing so. In total, participants reported on 15 completed donation experiences; of which nine had resulted in offspring to the knowledge of the donor.MAIN RESULTS AND THE ROLE OF CHANCEDonors positively desired donation and did not find the decision difficult. Neither donors nor recipients saw the donation process as akin to adoption . The process and practice of donation varied considerably across different jurisdictions and clinical sites.LIMITATIONS, REASONS FOR CAUTIONBecause the pool of donors and recipients is small, caution must be exercised over drawing general conclusions. Saturation was not reached on themes of counselling models and future contact.WIDER IMPLICATIONS OF THE FINDINGSThe differences between our findings and those of a previous study are attributable to varied legal and counselling regimes. Therefore, law and policy governing embryo storage limits, counselling protocols and identity disclosure shape the donation experience and how it is described.STUDY FUNDING/COMPETING INTEREST(S)This research was supported by Discovery Project Grants DP 0986213 and 15010157 from the Australian Research Council and additional funding from UTS: Law. There are no conflicts of interest to declare.TRIAL REGISTRATION NUMBERNot applicable.

Formal and informal support and counselling for embryo donation and receipt: An Australian qualitative study

“…By comparison, for some participants, there was a mismatch between counselling content and what participants required and/or expected. It was also apparent that the purpose and content of counselling varied across clinics and locations, as also noted by Millbank et al (2017) in their Australian study (and which differs even more widely internationally, Blyth, 2012). In addition, at least for some of the participants, counselling was experienced as a regulatory exercise, rather than one aimed at exploring their needs in depth.…”

“…Embryo donation first occurred in Australia in the 1980s (Kovacs, Breheny, & Dear, ; Millbank, Stuhmcke, & Karpin, ). While embryo donation has slowly increased in Australia, there are still only a relatively small number of babies born as a result of embryo donation.…”

“…The Australian National Health and Medical Research Council (NHMRC) recommends counselling for those involved in donation conception programmes (NHMRC, Section 4.4). Despite this recommendation, there are no laws in any state which make joint counselling with donors and recipients mandatory, and there are no mandatory requirements for the content of counselling (Millbank et al, ). Nonetheless, the Australian and New Zealand Infertility Counsellors Association (ANZICA) has guidelines on counselling in relation to infertility (, revised in 2018).…”

“…mandatory, and there are no mandatory requirements for the content of counselling (Millbank et al, 2017). Nonetheless, the Australian and New Zealand Infertility Counsellors Association (ANZICA) has guidelines on counselling in relation to infertility (2003, revised in 2018).…”

Receiving, or ‘Adopting’, Donated Embryos to Have Children: Parents Narrate and Draw Kinship Boundaries

“…In embryo donation neither the egg, nor the sperm that fertilized it, are the genetic gametes of the recipient parent or parents. Embryo donation may be seen as similar to adoption by those who donate or receive embryos (Goedeke et al 2015) or it may not (Millbank et al 2017). Most embryo donation appears to take place as a by-product of IVF when couples have produced more viable embryos than they want to implant and decide to donate the remaining embryos to another recipient family (Golombok 2015).…”