Tuesday, November 13, 2007

Shortage of Donors in Scotland

Donor crisis means IVF couples face 3-year wait


CHILDLESS couples are having to wait up to three years for a chance to conceive because of an unprecedented shortage of sperm and egg donors in Scotland, it was revealed yesterday.

Fertility experts say the crisis has been caused by new legislation, which ended the donors' right to anonymity, enabling children born after IVF treatment to make contact with their biological parents.

Dr David Farquharson, the clinical director, Women and Reproductive Services, at NHS Lothian, said: "We are looking at ways of reorganising the service so that we can offer first appointments for people more swiftly.

"An extra investment of £170,000 was made into the service and this resulted in a reduction of waiting times at one stage to 19 months. However, rather than have to disappoint patients, at present, we are saying to potential recipients of IVF treatment that there could be a wait of up to three years."

Launching a fresh appeal for donors, Dr Mark Hamilton, the lead consultant at the Aberdeen Fertility Clinic, said that before the right to anonymity was abolished, the clinic had never had a waiting list for sperm donations. But two years ago, after the regulations came into force, only two men came forward as volunteer donors for an area covering the whole of the north and North-east, as well as the Western and Northern Isles.

There is now a nine-month waiting list for sperm donations. Meanwhile, the number of egg donors has fallen from 17 to nine since 1998, with a waiting list of up to two years.

There are currently 29 couples waiting for an egg donor and 17 couples waiting for sperm donations in the area.

Dr Hamilton explained that every year about 20 couples were referred to the centre in Aberdeen for egg donation and 45 for sperm donation.

He said: "It doesn't sound like a lot of numbers, but if you are the ones who can't have a child it's a pretty ghastly situation."

The shortage of donors was, he said, a national problem and not unique to the Aberdeen clinic. He said: "It was always difficult to tempt people to be egg and sperm donors - and that is for understandable reasons.

"But the rules and regulations around egg and sperm donation have changed in recent years - principally around anonymity issues, and nowadays the legal situation is that donors have to be identified potentially by children conceived in this way.

"That identification will not happen until the offspring reach the age of 18, unless they get married before that time.

"Naturally, that might put some people off and so nationally there has been a trend in recent years of fewer donors coming forward. That has led to a bit of a shortage nationally and in the local situation it has been more of a struggle.

"We are leading a kind of hand-to-mouth existence in terms of getting sufficient donors to meet the need."

Dr Hamilton revealed: "The waiting times now for egg donation are approaching a couple of years. Previously, we didn't have a waiting list for sperm donation and now the waiting time is something like nine months."

The cut-off age for treatment is 45, which could mean that some couples are too old to undergo IVF by the time donor eggs or sperm become available.

'Sophie has made us complete'

MARIE and Gus MacRae, both 32 from Inverness, are among the lucky ones. Their daughter, Sophie, conceived after IVF treatment, will be six months old this week.

Mrs MacRae explained that she was 19 when she discovered she was incapable of producing eggs and that her only chance of becoming a mother would be through a volunteer egg donor.

"We were devastated, but we weren't thinking along the lines of a family at that stage," she said. "We decided to put things on hold until we were a bit more settled and I went to the clinic for the first time when I was 26."

The first two attempts at implanting a fertilised egg failed. But at the third she conceived.

Mrs MacRae, whose husband works as an offshore scaffolder, said: "You can't put into words what we feel about these people [the donors]. They are amazing.

"Gus and I have been together since we were 17, so we were quite happy the two of us, but there was always something missing. Sophie has made us complete.

"We had two failed attempts and the third one worked.

"In between we had treatments and tests and we were then on the waiting list for donors.

"We had to wait a year and a half to two years for our first treatment to start."

She added: "The first two attempts we had were under the old laws and we had waiting lists then. When we heard about the new laws we were concerned because we thought it was going to take longer to get a donor.

"We were told the waiting list was going to be two to three years at worst. We did an anonymous TV interview to help recruit donors so we were lucky - we got moved up the list quite quickly because of the recruitment drive."

NSW Government and Sperm Donor laws

NSW govt 'stalling on sperm donor laws

November 4, 2007 - 9:24AM

The NSW government has been accused of sitting on its hands over law reforms surrounding sperm donorship.
Opposition health spokeswoman Jillian Skinner said the changes outlined on Sunday in the Assisted Reproductive Technology (ART) bill were first proposed by the Iemma government in 2003.
"Proposed new laws to assist donor children to know who their fathers are have been a long time coming," Ms Skinner said.
"The state government introduced draft legislation to Parliament in 2003 but has ignored the pleas to move on it ever since."
The ART bill required sperm donors to add their names to a register enabling their children to make contact once they turn 18.
NSW Health Minister Reba Meagher says the changes will bring NSW into line with other states.
"I have had representations from people in the past who have argued that they should have been able to find out who their donor fathers were and I have always been sympathetic to that view," Ms Meagher said.
"The rights of children will now be enshrined in the legislation so that any child born through ART will, after they turn 18, be able to know the details of their biological parents."
Ms Meagher said the changes would also cover women who donate ova, while the bill would require ART service providers to offer counselling to ensure all donors "understand the implications of the procedure".
Donors would not be obliged to have contact with their offspring, she said.
"In fact, the bill will offer additional protection for donors by providing that donated sperm and ova may only be used in a manner that complies with the donor's wishes.
"For example, a donor from a distinct ethnic community may stipulate that their donation is only to be offered to members of that community."
Ms Meagher said it was not expected to lead to a drop in sperm or ova donations.

New Sperm storage for male cancer patients

Giving Male Cancer PatientsBetter Odds at Being a Dad
By KEVIN HELLIKERNovember 13, 2007;

Before David Goodack underwent cancer treatment at age 20, nobody suggested he preserve a sample of his sperm. Mr. Goodack himself didn't think of it, even though his physician warned that the necessary surgery could render him infertile -- as it did. "I was just thinking about surviving," says Mr. Goodack, a Kansas City, Mo., press foreman, now 44 and childless.

Since Mr. Goodack's surgery, hundreds of thousands of babies have been conceived with preserved samples of sperm. Yet a September article in the journal Cancer found that during the decade ended in 2005, only 18% of 821 young, male cancer patients had chosen to freeze samples of their sperm before undergoing treatment. Experts say the problem is that amid the terror of a cancer diagnosis, the only immediate concern too often is survival. At a time when survival is more the rule than the exception for young cancer patients, child-bearing options are an unnecessary casualty of treatment.

Now, two advocacy groups are teaming up with a for-profit sperm bank to make sperm-collection kits available across the country. The kits -- which will be distributed to oncology professionals nationwide starting this month -- contain the materials and instructions necessary for patients to produce a usable sperm sample at home or in the hospital. It includes a postage-paid package for fast delivery to Cryogenic Laboratories Inc., a Roseville, Minn., sperm bank, so no ice is needed for transport. Cryogenic Laboratories will charge $625 for processing and freezing the specimen for one year. The storage cost of each subsequent year -- frozen sperm can remain potent for decades -- is $280. In some cases, insurance will help defray that cost.
Of the 35,000 young men diagnosed with cancer each year, about 90% risk losing their fertility to chemotherapy, radiation or surgery. Cancer treatments sterilize men and women alike, but preserving the fertility of women is more complicated and expensive -- and more publicized.
The kit's arrival in oncology offices is designed to raise awareness. Major academic cancer centers are likely to offer fertility options. And men can on their own seek out one the many other storage facilities available -- particularly in big cities -- if they think of it. But about 80% of young men receiving cancer treatments do so in community hospitals, often in cities that lack sperm banks, says Lindsay Beck, founder of nonprofit Fertile Hope and the creator of the new kit. She adds that 20 states lack sperm banks altogether. In 2002, the Journal of Clinical Oncology published two surveys -- one showing that only 51% of 201 young, male cancer patients had been offered sperm banking, the other showing that 48% of 162 oncologists either never broached fertility with eligible male patients or did so less than 25% of the time.
"A lot of oncologists out there will see only a handful of adolescents or young adults a year, so they're not thinking about fertility," says Brandon Hayes-Lattin, an Oregon Health & Science University oncologist specializing in young-adult issues.

The kit, called Live:On, is also designed to eliminate a dilemma facing some men: whether to postpone treatment while pursuing sperm preservation. Gathering information about sperm preservation -- where and how to do it, how to ship off a specimen if no bank is nearby -- can take a few days. That could delay treatment of some fast-growing cancers. Armed with the kit soon to be available in oncologists' offices, however, a patient could preserve his child-bearing options in a matter of hours.

Cryogenic Laboratories will donate an unspecified percentage of its storage fees to its two partners in the effort, the Lance Armstrong Foundation and Fertile Hope, an organization dedicated to increasing fertility options for young cancer patients. Through Fertile Hope, financially strapped patients can apply for discounts.

Success rates for conceiving babies with preserved sperm vary according to technique. The September journal of Cancer article reported that of those young men who tried using their specimens for procreation, 36.4% succeeded with intrauterine insemination and 50% succeeded with two more-expensive techniques -- in-vitro fertilization and intracytoplasmic sperm injection. The Lance Armstrong Foundation says that its namesake, the world-renowned cyclist, owes his three children to sperm samples preserved before he underwent cancer treatment.
• Email: healthjournal@wsj.com

Thursday, November 1, 2007

Potential new regulations for surrogacy in India

New laws to rein in 'womb business'31 Oct 2007, 0057 hrs IST,Mahendra Kumar Singh,TNN


DELHI: Foreigners lining up to rent a womb in India will soon have to face legal regulations being planned by the ministry of women and child development (WCD). Surrogacy, an area unregulated till now, meant that childless couples from abroad as well as in the country could get away with renting a womb at terms often to the disadvantage of a needy women who stood the chance of being exploited. Women and child development minister Renuka Chaudhary said that the ministry was considering a law to regulate the business of surrogate motherhood and sperm banks on the lines of similar laws in other countries. Women's organisations have long been demanding a law on surrogate motherhood and hiring of wombs in India. "The sensitive issue of surrogacy in the absence of laws or regulations has become a free playing field for unscrupulous intermediaries who lure and push uneducated and poor women into surrogate motherhood," a WCD ministry official said, emphasising the need for the law. It is argued that there was every possibility of misuse of children born out of surrogacy for terrorism, prostitution or unethical genetic engineering research as the foreigners who pay for the child would not have any emotional bonding with the kid. India is emerging as a major destination for surrogacy as childless couples from US and Europe are lured by the prospect of a surrogate child for around Rs 100,000 ($2,250) to Rs 225,000 ($5,060) each pregnancy compared with some $40,000 or even more in the US. Many say the country can become a centre of "reproductive tourism". There is no law in India surrounding surrogacy. However, the Indian Council of Medical Reseach (ICMR) has framed national guidelines in 2005 to regulate surrogacy. The clinics that provide ART facilities take recourse to the guidelines that state that the surrogate mother has to sign a contract with the childless couple. But even then, it is not clear whether such a contract has any legal sanctity. "The rights of the surrogate mother over a baby she carries and issues like if mother dies during pregnancy remains unclear," said an official. And, the real problem arises after the birth of the baby. In the absence of any clear laws on the issue, foreigners are unable to get legal assistance when it comes to taking their child back to their home country.

Parents deceived in UK surrogacy

Judge warns agencies after surrogate mother dupes couples to keep babies· Judge rules that woman hands over boy to father· Compulsive desire to parent led to deception
Clare Dyer, legal editorWednesday October 31, 2007The Guardian
A high court judge has issued a stern warning to surrogacy agencies to carry out more stringent background checks after it emerged that a surrogate mother had deliberately duped two couples into believing she had miscarried their babies.
The woman, named only as Mrs P, entered into the surrogacy deals and conceived using sperm from the two fathers with the intention of keeping the two children for herself, the judge ruled. One of the children was nearly four years old when her father learned of her existence.

Mrs P already had three children of her own by different fathers but was motivated by "a compulsive desire to bear further children", Mr Justice Coleridge said. It was only when her own eldest daughter, 19, blew the whistle to the surrogacy agency, that the two couples learned the miscarriages had never happened.
The judge said surrogacy arrangements were now a feature of contemporary life. "When all goes according to plan they are a way of remedying the agony of childlessness. However, when the arrangements do not go according to plan the result, in human and legal terms is, putting it simply, a mess," the judge said.
He added: "As this case illustrates, women who put themselves forward for this role are very exceptional and may well have real unmet psychological needs of their own. When the arrangements go wrong the cost in terms of appalling emotional pain for the parties is huge.
"I would urge all agencies to ensure their checks into the background of all parties to these essentially artificial child birth arrangements are as thorough as they can be."
The elder of the two children born by surrogacy, a girl, was about to turn four when Mrs P's daughter told the agency that had set up the deal of her mother's deception.
Her true father , who had paid £850, and his wife decided not to apply to have her live with them but sought a court order for contact with her.
He later reached an agreement with Mrs P that the girl would be told at the appropriate time who her real father was and be allowed to see him.
The father of the second child, a boy, discovered just before his birth in December 2005 that there had been no miscarriage. He and his wife took the case to court, fighting Mrs P and her husband for the right to bring up the boy.
The judge said: "I make no secret of, or apology for, the fact that I have found this a particularly difficult case to decide." He ordered that the boy, by then 18 months old, should be handed over to his real father and his wife.
The ruling was handed down last July but the case was heard behind closed doors and the judgment was made public yesterday.
The judge said that the Ps had been good parents to the boy but had deliberately embarked on surrogacy with the object of having another child for their family and had never intended to hand the baby over. Mr P had had a vasectomy and the couple had investigated adoption and fertility treatment. All their actions were consonant with "a desperate desire to parent more children by fair means, or failing that, foul".
The question was which set of parents would be better for the boy's upbringing in the long term, and after a protracted legal battle, the judge chose the natural father, called J during the proceedings.
"When I confront that question and answer it I am driven to the conclusion, awful though it is from the Ps point of view, that he will thrive best in the Js' care," the judge said.
Mrs P and her husband, who were given the right to regular contact with the boy, launched an immediate appeal. But the appeal court upheld Mr Justice Coleridge's ruling and the Js took the boy to live with them in Leeds.
Mr Justice Coleridge said he had to resolve whether from the start the Ps had deceived the other two couples and never had any intention of honouring the surrogacy arrangements. This was important, he said, "because the children themselves are entitled to know in the future the factual background to their unusual conception".
He came to "the clear conclusion" that they "set out to deceive" both couples.
Surrogacy Child's best interests key in disputes
Surrogacy arrangements are legal in Britain and are regulated by the Surrogacy Arrangements Act 1985 and the Human Fertilisation and Embryology Act 1990. A surrogate mother may not be paid for the baby but may only be given "reasonable expenses" of undertaking the pregnancy and birth. The amount is not defined but is left to the surrogate and the commissioning couple to agree.
No surrogacy agreement is binding, so the mother may change her mind and decide she wants to keep the baby. If the commissioning couple disagrees, the case will have to go to court. In most cases the commissioning father and the surrogate mother will both be genetic parents, so they will have an equal claim. The courts will be reluctant to move a child who has bonded with the surrogate mother, but the decision will come down to where the child's best interests lie.