Infertility
Fertility treatment using donor eggs, sperm or embryos
Sometimes a clinic will recommend treatment using donated sperm, eggs or embryos (also known as “gametes”) because conception would be unlikely to be successful for people using their own eggs or sperm. People may find out during initial investigations that they will need a donor, while others make the decision after having had some fertility treatment using their own gametes. Frances’s husband had had a vasectomy after having children in an earlier relationship; initially they hoped that it could be reversed through surgery.
Frances had not been expecting that she and her husband would have a family. When he suggested...
Frances had not been expecting that she and her husband would have a family. When he suggested...
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Well initially we weren’t going to have children because he had had a vasectomy. He had three grown up children from his first marriage and he didn’t particularly want children. And he was the one that changed his mind initially and said, actually he would like to see if there was some way we could have children.
Okay but once he had the vasectomy there was no way that he could produce sperm in other words is that right?
Ten years ago no. I mean what I don’t know with the improvements in technology since then whether they can now extract sperm directly. I am not sure if that is true any longer. I think perhaps now there would have been other alternatives.
But when you were going through it…?
But when we were going through it, it wasn’t being done. ICSI had just started at that stage was very experimental. And we weren’t really given many other options. It was sort of if you want to try and get pregnant you will need to get donor sperm. And that was when donor sperm was anonymous. Which it isn’t anymore. And one of the problems with people now who want donor sperm is there isn’t any. Because with the anonymity removed from the donor they are almost no donors. So it has sort of, the theory was just to solve one problem for the children, so that they could find out about their natural father later on. But of course, since then there are very few children being born. Which I think is a real shame.
Describe to me the process for you of changing your mind and deciding that you wanted children.
I think my husband brought it up first when we were on holiday. And it was sort of like Pandora’s box once he brought it up I absolutely decided that yes, that I did want children, having always known with him that I wouldn’t be able to have children. I had accepted that as part of the terms of the relationship. But it was like a Pandora’s Box the moment he said that he would like to consider the possibility. I was like right fine we are doing it [laugh]. Both guns blazing. Absolutely determined from that stage that if I could possibly get pregnant I was going to.
And how old were you at that point?
I was, I would have been just before I was 30. Because I was 30 when we married. So right about 30. And I was 35 when the children were born.
Okay. So it took five years?
It took five years, yes.
Right. So why did it take that long?
I think because after the vasectomy reversal I think my husband was determined that it was going to work and that the children would be his, and I don’t think at that point I had actually considered donor sperm as an option. I hadn’t really thought about if the surgery didn’t work, how we were going to try to have a child.
Because as I say it wasn’t until I was at the gynaecologist one day, and she said to me, “Well you could consider donor sperm because obviously the surgery hasn’t worked. Or it may be that you have a problem that you haven’t investigated.” Because at that point actually I hadn’t even though to have myself investigated to see if there was any reason that I couldn’t get pregnant.
Using donor sperm, eggs or embryos requires thinking about complex issues before starting treatment. People should be offered counselling before going ahead. In the UK, any child conceived from donated sperm, eggs or embryos is the legal child of the recipients. Once a child is 18 years old they can find out who the donor was (since April 2005 identifying information about donors is held on the Human Fertilisation & Embryology Authority (HFEA) Register). Payment for egg or sperm donation is currently illegal in the UK (although reasonable expenses are covered but set by the Human Fertilization and Embryology Authority (HFEA)). These regulations and other considerations mean that couples sometimes travel abroad for treatment to countries (e.g. Spain) where there is a more ready supply of donors.
(See HFEA, Donor Conception Network, Daisy Network, National Gamete Donation Trust).
Sally knew from the start that they would need to use donor sperm because her husband was infertile. Mike had colitis as a young man and had been on strong drugs affecting his sperm production. So when he married and wanted to start a family, he was not surprised that they needed to use donor sperm. Saskia and her partner, as a lesbian couple, knew they would need a donor and first tried with a gay couple they met through a network and then with a friend who already had his own family. (There are however possible dangers in using unscreened sperm - see Infertility Network UK and HFEA for more information).
Saskia and her lesbian partner tried an informal arrangement with a gay couple and then a friend....
Saskia and her lesbian partner tried an informal arrangement with a gay couple and then a friend....
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And we went to a course which was for any gay person thinking of co- parenting and we actually met a couple of men on that course. A gay couple. And we got friendly and we built up a friendship over a few months, and we said, “Well let’s do it together.”
So we tried with them for quite a few months. And it didn’t work. It didn’t work. And we fell out with them about a year into it. They, we found out about a health issue that the Father had. And we were upset, not really about the issue, but the fact that he hadn’t said anything about it. And it’s hereditary and it just created a bad feeling, and I think, I don’t know if it was waiting to happen this thing, but anyway, so we stopped that and thought. “Oh dear, let’s ask somebody we know. Let’s… We know some lovely men let’s ask.”
And so an old friend of mine said he’d help out and he’d got his own family and he wasn’t interested in being a Father, but he was really happy to be, you know, at a distance and meet the child, but just not, you know, the odd photo every now and again, but not more than that.
And so we tried with him. And it just didn’t work. And he lived quite far away so logistically it was… and so in the end. And there were a few other things. I think we started to go off the idea of having somebody else involved and started warming more to the idea of the anonymous donor.
And so we thought we needed to go to clinic. We needed to do it properly. And maybe there was something wrong, which is why it hasn’t happened.
So I think it was about 2003 that we went. So we’d sort of tried for three years, I mean not every month, because it just didn’t work like that because of the logistics. But for three years nothing had happened and it was, you know, quite emotionally draining and traumatic and all the rest of it.
And so I went to the clinic in 2003 and it was my understanding that I could only be treated as a single person at that time. I couldn’t, we weren’t going to be treated as a couple. And it was also my understanding that I wouldn’t necessarily get treatment. That we’d have to demonstrate certain things, that we had male role models and there’d be certain sort of judgements, you know, we’d have to say the right things and what have you. I didn’t think it was a sure thing that we’d be able to have it.
Sometimes people did not find out until they had had many cycles of failed treatment that they might need to consider a donor. Olivia and Walter used donor sperm to conceive their two children several decades ago, after tests showed that Walter was not able to produce any sperm. Naomi and Martin started to think about using donor eggs after several cycles of IVF. Doctors had concluded that Naomi was going into an early menopause.
Olivia and her husband took over nine months to decide to use donor sperm. They approached this ...
Olivia and her husband took over nine months to decide to use donor sperm. They approached this ...
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And I can’t remember if I actually raised it in the café with [husband] at the time. But pretty soon after that, I think I did. I mean it was very clear that the whole thing was too raw to proceed with at that point, for both of us, particularly, he needed time to think about it. To think whether that was something that we wanted to do.
And I suppose we spent the next nine months adjusting in our own ways, and I think in very different ways and I think that’s really an important thing for men and women to know that actually this is often what happens, is that men and women address and handle and manage all the feelings and issues round infertility often in very different ways.
[Husband], is I suppose, like many men, someone who feels things really quite deeply but rarely speaks about his feelings and in many ways doesn’t necessarily have a language for them. Whereas, I’m somebody who wears my emotions very much on the outside and I need to express my feelings and, and talk about them.
So there was a kind of mismatch there. But I don’t remember that being a huge problem for us. I just know that he quietly thought about it all, and I continued to research. And talk to other people. Because I think right from the start for us infertility and the possibility of donor conception was never shameful.
[Husband], gets his sense of who he is, as both a person and a man from other places. I think particularly through his work actually. And he was certainly very clear, that the infertility was just… oh I don’t know, just, you know, just something that had happened to him. It wasn’t his fault. And it certainly didn’t make him feel less of a man in any way.
So it was fine to talk with other people about it, and for me that was certainly a relief to be able to do so. I didn’t in fact tell closest family at that time, just a couple of close friends because we decided this was very… this was personal for us and we didn’t want to be being asked about it all the time, and you know, what we were doing about it.
But we did, once I had found a small private clinic that did donor conception and it’s quite interesting in that I had been somebody who would not have dreamt of going into the realms of private medicine, prior to that time. But the, there was a hospital that did donor conception on the NHS, but they had very long waiting list and I decided that we needed to take some control back here. It felt like control had been taken away from us about having a family. And the way of taking some control back, was by using a private clinic where we could decide when we were ready to have treatment, and they would then have donors available.
So that’s what we did. And in fact, before we’d made the decision to go ahead, we both went to that clinic and we had our photographs taken, which was going to be the way of matching us with a donor.
And we then went away and thought about it a bit longer. In fact, it took, about, about nine months, I mean an interesting kind of gestation period if you like of thinking about it before [husband] decided that that was okay, and that it was all right to go ahead with it.
Naomi and Martin had started to consider adoption. A break from treatment gave them the breathing...
Naomi and Martin had started to consider adoption. A break from treatment gave them the breathing...
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So we were still fighting that, but at the same time, we also thought well hang on a minute, it is a year and half ago now, treatment doesn’t seem to be, the pain of treatment wasn’t so fresh in our minds I suppose, and so a lot of people when I had been going for diagnosis tests about my early menopause, a lot of doctors had said to me, “Do you realise you have still got a really good chance, with egg donor, if you wanted to go that route.” And we had said no, but it was, well why did we say no. And we figured that we had really said no, because at the time we couldn’t face doing any more treatment. Now we had gone down the adoption route and actually could very much come to terms with the fact that we were going to have children that weren’t genetically related to us. Actually the idea of donor treatment didn’t seem so scary.
So we looked into doing it in this country and overseas and we eventually plumped for going overseas, because the waiting list were a lot shorter and the success rates are a lot, lot higher as well. And yes we went over to [city] for an initial visit.
There is several clinics out there. We sort of went out to meet one particular one that we had had personal recommendations from and really, really liked it. Very impressed with the facilities out there. The staff. The people. It was all really, really good. So we went out.
We went out there, that was August. We then got matched very quickly with an egg donor. Unfortunately that first cycle, our donor actually responded too well, and they had to cancel the cycle because she was producing too many eggs and it would have been dangerous to her. That was in November.
But we ended up going out there again in January this year, and we had a cycle and had two text book embryos put back in and I am now expecting twins.
Susan had donor egg treatment in the UK that failed and then decided to try abroad. Although she was very impressed with the treatment she received in Spain, it did not work either and she decided to stop.
Susan was in her 40s when she was trying to conceive her second child. She wished she had looked...
Susan was in her 40s when she was trying to conceive her second child. She wished she had looked...
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I could have actually you know, started some kind of treatment. Because we then started to think about egg donation. Which I had never considered and initially I would never have contemplated that kind of treatment. But once you actually know what the situation is you start to look at things in a different way. And people also change their views I think as well as time goes on.
So we then… yes, so it was actually said that if we were serious about wanting to conceive then the only way would be by egg donation, that IVF wasn’t… because by that time the eggs weren’t of sufficient quality any way. And you know, it looks as though the eggs are affected by endometriosis anyway, the quality of the eggs….
So… and so yes, we tried egg donation. I had to go somewhere else for that. I went to a few places…
In the UK or..?
Yes. I hadn’t actually looked at anywhere else then. I wish I had. And…
Why?
Because I think that they certainly have more experience with endometriosis and fertility and in a lot of centres in other European countries. Not all, in some European countries and the… and some countries have specialised in egg donation specifically. And others more on the IVF side. And they have huge data bases of you know the patients results and so on. So I think they are able to sort of make decisions on an individual basis, better.
And so anyway we went ahead and it was actually a long wait. I think it was, gosh, it was, let me think, we were told that it would be a few months but it was very much longer. A longer waiting list for, it must have been getting on for a year and a half and I had to also go to another part of the country where the donor was and… I didn’t know it at the time, but there were various things that they forgot to tell us to with you know the progesterone pessaries and so on to prepare the endometrium for implantation and I wasn’t very impressed. You know. And also we were only given information in little snippets, you know, a stage at a time, and when you are going through all that for the first time, you don’t know whether what they are telling you is the standard thing or you know, whether something has been overlooked or you know whether they have told you to do something incorrectly, and I had to actually follow up on quite a few things and I realised that there were certain things that they had forgotten to tell us and I was absolutely staggered.
And you are paying, you know a lot of money for that kind of treatment.
Naomi and Martin had initially planned that their treatment in Spain would be with donor eggs and Martin’s sperm. Although Naomi had come to terms with the idea of having children not genetically connected to her, she found it difficult accepting that their children would have her husband’s genetic heritage but not hers. When the clinic recommended they use donor sperm as well this came as a relief to them both.
Olivia and Walter completed their family with donor sperm treatment over twenty years ago. Their children are now grown up, so they were able to reflect on how they came to terms with using donor sperm and what it has meant for them as parents.
Walter was already a step-dad to his wife's son. They decided to use donor sperm to complete...
Walter was already a step-dad to his wife's son. They decided to use donor sperm to complete...
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And at that point we had to stop and think, well what do we do? Do we just make the decision not to have any more children? Do we think about adoption? Or, and it was a pretty obvious third choice was to think should we perhaps go for a family where [wife] could be inseminated by an anonymous donor, through a clinic, and we might have children that way.
And I suppose it made you stop and think a great deal about what was important. Important to yourself. Important to [wife]. What did we have to give as parents? As potential parents? I suppose we had already been in the parenting business. Found that not terrible [laughs]. And I suppose other the kind of recollections, the reflections I had were about the family that I’d come from, and I come from a family of farmers who, I can trace my father’s line back for, two or three hundred years, and just some feeling of wanting to continue not just the line, but I think the kind of values that I’ve inherited from my father and mother and the possibility of carrying those values on to another generation. And we were relatively well off, we were in a position to support a family, and all those things made me think, yes, I do want to go on. Childlessness or future childlessness, or just having [son], [wife]’s child. That wasn’t going to be fulfilling enough.
So then there’s the question of well what does one feel about this idea of having a child to whom I’m not going to be genetically related. And that’s a much deeper question and it’s a much more penetrating question I think for a lot of men to say, well am I going to love this child? What if, what is, “Most people have children that they are genetically connected to. And that creates the family bond.” Well I suppose I was quite well prepared by being a step-Dad and knowing that you can love a child that you’re not genetically related to. And feel that that child is part of your own family. So I suppose I had an advance in thinking on all that sort of thing.
But nevertheless, you still, I think, go through a period… of some bereavement, loss or grief over what is not to be. And that some period of thinking, is, can I cope with this? And…
Can I come to terms with this? And I think I probably resolved it in a rather simplistic sort of way, thinking well, if we go down this route at least we have a child whose, as opposed to adoption, this is a child who is going to be genetically connected to at least one of us, which seems sort of better than none. So a bit simple, kind of maths almost, and [wife] would go through the pregnancy, and we would go through that whole process together so I think I came to that conclusion relatively quickly, but not without some pain and grief and feeling that this was going to be rather significant in my life. Little did I know how significant it was going to be in my life at the time.
Walter considers some of the big philosophical questions that donor conception raised for him...
Walter considers some of the big philosophical questions that donor conception raised for him...
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What is a family? What are genetics? What is the nature, nurture issue here? And what does it really mean? One of the big questions that nobody knows the answer to. How much of our personality and style and success or failure in life, is attributable to the, genes we’ve inherited, and how much of it is attributable the upbringing that we’ve, that we’ve given our children or that we’ve received.
And nobody knows the answers to these questions. So almost every aspect of social science if you like that is engaged in the question of donor, donor conception. As I say, there’s genetics, there’s medicine if you like, there’s anthropology. What is a family? How does, what value’s placed on genetic relationships in this particular culture? At this particular time? In Western society, in UK society, in London society which is totally different I suspect from what it would have been two hundred years ago, in this particular country and probably very different from what it would be 6,000 miles away in Africa in some communities or in South America in some communities. So anthropologists will have a field day with all of this. It’s a subject of potential, enormous study I suspect. Sociology, how do we, how do families relate to each other, and what’s going on in the culture of societies, more generally, in the movement to accept this as a more natural thing. Or is it? Philosophy. What are we valuing here? Why are we valuing it? What engages us to value it? Law - what are the legal implications of non-genetic parenting? We have been so used to the inheritance of land, names, legal parenting, titles. That’s genetically in the law, in family law, in property law, and so almost every…Psychology what’s our understanding of ourself and our understanding of identity? What do we, how do we identify ourselves? What do we see as the key issues in our identity make up? Do we think of ourselves as, do you think of yourself as a researcher? Or do you think of yourself as the daughter of your parents? And how much of each? So that is only a glimpse of the profundity that there is that you’re led to think about in this area intellectually. So... But it’s not just of course an intellectual game, or an intellectual pursuit. It’s about real people. It’s about our family. And so I do find it , rightly absorbing of my, some of my energy, both intellectual and emotional. As one ought to have for one’s children. But I guess most people don’t have the necessity to think as deeply as we do and as I’ve had the opportunity to do, about these questions because parenthood just happens and it happens through sort of peer pressure. People live together, other people seem to be having kids, oh we better have kids. And that’s the way most people slip in, slide in to parenthood. We’ve had to think about parenthood and why we want children. Why do we want children? What is this driver that rather simplistically says that either if other people around are having children then we think we’ll look a bit odd if we don’t. Or, and/or a real urgent need to have children. Where does that come from? And yes, we must know that the human race wouldn’t continue if there wasn’t something of a [primal], primordial drive. And we know it’s not just sex, it is a need to have children. And how enormously painful and distressing it can be for people who have, who are unable to have children. Not everybody of course, but for some people who cannot have children of their own, or can’t have children at all, the immense grief and loss that they feel about being confronted with that situation. So there is something pretty deep, and yet none of us really know what it is or where it comes from. So I have had through the opportunity to talk to other people and hear from, other people’s storie
Using donor sperm or eggs is not something that everyone feels they can, or would want to, do. Janine and Steve had a couple of cycles of fertility treatment with donor eggs, but decided to stop and went on to adopt two boys. Sarah was concerned that it might be, “Storing up trouble or just weirdness” to accept an offer of egg donation from a friend. George did not think he could look at a pregnancy the same way if it was, “Some other chap’s sperm”. Sandra thought she might have considered it if she had been younger but did not want to start down this route in her early 40s. Talking to children about donor conception is discussed in ‘Impact on parenting and talking to children’.
Mitochondrial donation treatment
The Human Fertilisation and Embryology Authority (HFEA) have approved the use of donated mitochondrial in fertility treatment. The UK is the first country in the world to regulate mitochondrial donation. Only people who are at a very high risk of passing a serious mitochondrial disease onto their children are eligible for treatment. Every case of mitochondrial donation treatment needs to have HFEA approval and only a small number of clinics will provide the treatment.
The Human Fertilisation and Embryology Authority (HFEA) have approved the use of donated mitochondrial in fertility treatment. The UK is the first country in the world to regulate mitochondrial donation. Only people who are at a very high risk of passing a serious mitochondrial disease onto their children are eligible for treatment. Every case of mitochondrial donation treatment needs to have HFEA approval and only a small number of clinics will provide the treatment.
The treatment involves transferring nuclear genetic material from the mother’s eggs or embryos into the eggs or embryos of a donor with healthy mitochondria. Any children would still be the mother’s and father’s biologically but without the mitochondria that cause the disease. For more information see the HFEA’s website.
Last reviewed July 2017.
Last updated July 2017.
Last reviewed July 2017.
Last updated July 2017.
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