When Supply Doesn’t Meet Demand
The recent media interest in IVF and embryo donation (60 minutes, The Morning Show and TodayTonight) has given me pause to think about why this quite radical form of philanthropy is becoming more and more important to a greater number of Australians.
The number of people undertaking IVF increases every year, with one in six couples currently experiencing difficulty conceiving. When traditional IVF doesn't produce results for them, a portion will move forward onto other forms of Assisted Reproductive Technology (ART) which include using donated sperm, eggs, embryos and engaging surrogates. The need for ART increases, yet Australian supplies of donated eggs and sperm in particular and our number of willing surrogates are some of the lowest in the privileged Western world.
When I began my own journey into seeking egg and sperm donors, I was genuinely shocked at how difficult it was to source donor eggs and sperm without going offshore. Since the media coverage and the release of my book, ‘Lexie’s Village – A New Kind of Family’, I’ve received a flood of feedback from people who are also taken aback by how limited Australian supplies still are. My story of sourcing both donor eggs and sperm overseas may sound extreme until you understand that it was really my only viable option.
So why is the egg and sperm supply in Australia so low?
When I first approached my Sydney IVF clinic about ‘going it alone’, my first surprisingly huge hurdle was sourcing donor sperm. I wasn’t prepared for the news that I had to go on a 6 month minimum waiting list to access Australian sperm. This was largely due to my single status: the waiting list for couples was around 3 months. It was a rude and frustrating awakening: I’d finally built up the gumption and fortitude to create my family alone but the unwillingness of Australian men to donate was letting me down.
Why? What was stopping them?
Sperm donation although not invasive: no drugs or hormones injections are required but, as I discovered, it’s certainly not simple or straightforward. It requires at least a 6-12 month commitment, beginning with extensive health tests and continuing with regular deposit visits to gather the required semen levels.
The required commitment is compounded by two major barriers. The first revolves around Australian laws in regards to donor issues. These laws differ slightly from state to state but are uniform on remuneration policy: we are not legally allowed to remunerate donors beyond the cost of medical and travel expenses. This leaves no incentive to donate beyond pure altruism.
Despite egg donation being a far more invasive and complicated set of procedures, no remuneration is permitted for donors in Australia either. In addition to the health risks and painful discomforts, the egg collection procedure requires a serious time commitment. Women need to undergo an only slightly‑modified IVF cycle to have their eggs harvested for donation. This involves a plethora of hormonal drugs, medications, blood tests and ultrasounds over an intense, month-long process. It is physically and emotionally arduous. The cycle ends with the uncomfortable medical procedure required to collect the egg cells (oocytes). It is a special woman indeed who would undergo all this just to help a complete stranger.
Secondly, there are specific laws in Australia put in place to protect rightly so, donor children but they currently impact potential donors and their willingness to donate. According to the Canberra Times, Australian men are shying away from donating their sperm due to fears about dwindling anonymity. Melbourne Law School Professor, Loane Skene, has identified that the legal right for Australian donor children to identify and locate their genetic parents once they have reached the age of 18 has undoubtedly reduced the number of sperm donors in Australia. Thus, Australian women are turning to the US, the superpower of exported sperm, which in turn serves to minimise awareness about Australian sperm supplies. Dr Chris Copeland, the scientific director at the Canberra Fertility Centre, estimates that 95% of donated sperm used in his clinic at Deakin is sourced overseas, the vast majority being from the United States.
Dr Copeland believes that Australian men remain hesitant to donate sperm because they do not want to be identified by their potential offspring. When the ACT introduced these legal requirements, the number of donors at his clinic fell, a trend he attributes to a misunderstanding of what the requirement means for them. “Donor children are often not interested in meeting their fathers but want to know that their genetic father is a person and not just a number," he said. “The law is extremely clear about separating parenting rights from donor rights."
The reality is, ART and the need for donors is not going away. There were “More than 14,000 documented ART babies were born in 2014 — 12,875 in Australia, an increase of 21 per cent from 2010.” I believe it’s in everyone’s best interest if Australians can locate donors without having to go overseas. By doing so, it allows the government to fully capture the necessary data in order to get the full picture of the number of people utilising ART and the specific type of ART (Sperm, egg, embryo, surrogacy). It will also alleviate financial burdens on people traveling overseas and it will reduce their high risk exposure from a health and potentially legal perspective. The other positive byproduct of keeping Australian's in Australia to undertake ART is that it will boost the Australian economy.
To combat the barriers to Australians becoming more willing to donate and thus address the current problem of lack of ‘supply’ in our country, I believe the following steps should be considered:
Awareness – in the recent 60 Minutes story, it was quoted that there were only 77 registered births attributed to embryo donation last year. But this statistic only includes Australian IVF recorded embryo donor births and doesn’t reflect cross-border embryo donor births, such as my daughter Lexie’s brother Sam and sister Adeline. Additionally, my daughter Lexie is not included in the ART birth records in Australia, even though she was born here. We are not capturing the full picture of the total number of Australians undertaking ART and without the corret statistics to illustrate the full picture, we will never quite know just how large the demand is.
There is one small light of hope though, ‘Regulation Relations’ is a team at the University of Technology, Sydney, who are currently undertaking the first Cross Border Reproduction Research Project. It’s a study designed to combat this informational void. If you have undertaken ART overseas, I urge you to sign up and help the team capture this much needed data. We need stats: with stats we can create a clear voice that we can use to build awareness for our plight.
- Education – the optimal time for egg and sperm donors to donate is usually in their early to mid twenties. It's a critical time when they're still sorting out who they are themselves. The uncertainty of their future and the idea of potential offspring approaching them in 18 years time is therefore a daunting prospect for many. We need to develop an educational program that addresses their concerns and fears. By sharing success stories, humanising the people in need, alleviating anxieties about what an open donor status entails would go along way to help young, healthy people feel more comfortable donating.
Remuneration – remuneration has been proven to be effective overseas in a number of countries. I paid my egg donor USD$10K that went towards her Masters tuition fees. If we can model off successful remuneration structures and ensure that structured laws surrounding the practice were in place to protect any susceptible parties from exploitation, we would provide both incentive and safety to potential donors.
- Legislative change - The ART field has evolved quickly but some of the laws that currently manage it are out of date and/or impacting specific parties. Major overhauls are required, on both a state and federal level, if it's to meet the needs of all parties: donors, recipients and donor children.
Natalie Lovett is the author of the recently published book 'Lexie's Village - A New Kind of Family' and is actively championing ART and embryo donation rights and awareness. She has appeared in numerous TV shows (The Project, Australian Story, Today Tonight and The Morning Show), to tell her own deeply moving story of one woman’s extraordinary journey to motherhood and her idea that expands everything we believe about families.
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