From Edition 14 – October 2008
In our very own brave new world, assisted fertility is an everyday miracle. But for many people on the receiving end of this miracle there is someone at the other end providing the means to make the dream come true. Philippa Macken delves into the world of egg, sperm and embryo donation and the complex realm of surrogacy.

Liz Lonsdale was 34 years old when her doctor told her she had gone into early menopause. Liz felt her world come crashing down as she realised she would never be pregnant. “We had been trying to conceive for about 18 months when I found out there was no hope,” says Liz. “It was a horrible feeling, to be told I would never bear children, never be a mother.”  For Liz, the story has a happy ending. Her daughter, now five, was conceived through the gift of a stranger’s egg and her husband’s sperm.

Thanks to the wonders of in vitro fertilisation (IVF), women with fertility issues are no longer necessarily condemned to a life without children. However, the donation of eggs, sperm and embryos, and the concept of surrogacy is a minefield of ethical, legal and emotional issues for which there are no easy solutions.

“After much discussion, we came up with a couple of rules for any potential donors,” says Liz. “Firstly, we wanted the donor to already have her own children. Also, we had a preference for women in their early thirties because we hoped this would indicate a higher level of emotional maturity. Obviously, our concern was that the donor could become possessive of our child after the birth.”

So began a rollercoaster ride that lasted two years. The first potential egg donor backed out after the mandatory counselling process because she didn’t think she could go through with the heavy hormonal treatments required to harvest the eggs.  It was several months before Liz had another response to her advertisement in the local newspaper.

“Gillian was ideal,” said Liz. “She was 33, already had three children and a very stable family life. It was the second time she had donated her eggs and her reasons for doing so were entirely altruistic.” It took two rounds of IVF for Liz to successfully become pregnant, but the end result could not be better. “It’s a miracle beyond my wildest expectations,” said Liz. “We have Molly, our beautiful daughter. Gillian keeps in touch, mostly via email. We can never thank her enough.”

Gillian felt incredibly fortunate to be able to help Liz and her husband start a family. “I’ve always thought that not being able to conceive would be the worst kind of torture,” said Gillian. “Being so naturally fertile myself, it seemed like something I could easily help with. Molly is adorable, but I don’t think of her as my child. I didn’t carry her for nine months, I didn’t give birth and breastfeed her. She is Liz’s daughter and I merely provided a tiny genetic component that Liz needed to conceive.”

The laws regarding egg donation differ from state to state.(see box) In most states anonymous donors are available through IVF clinics but the wait list is very long. The identification of anonymous donors is possible once the child reaches a certain age. Payment for eggs is illegal throughout Australia and New Zealand, although all medical costs are covered by the recipient couple.

“Donating my eggs was not something I undertook lightly,” said Gillian. “By law, I needed my husband’s consent and we discussed it at length with our children. I felt strongly about helping women with fertility problems, and ultimately my family understood and supported that.”
Helping others to create a family is not restricted to the donation of eggs. Families are as unique as the individuals that form them and when fertility issues are being addressed, no two cases are exactly the same. Jason O’Reilly is a 34 year-old homosexual who plans to donate his sperm to a close friend who is in a lesbian relationship. “I have been friends with Cassie for more than a decade,” says Jason. “When she and her partner decided to try their best to become parents, it was important to them that they knew the sperm donor well.”
As a ‘known donor’, Jason must still undergo the same legal process as any other sperm donor. Firstly, a semen analysis is carried out, followed by compulsory counselling of both the donor and recipient. Donors must provide a medical history, lifestyle details and undergo screening tests for blood group, Hep B, Hep C, cystic fibrosis, syphilis, Chlamydia, chromosome analysis and HIV status. The sperm is then stored for six months before again being tested for infectious diseases. Once given the all clear, the sample may finally be used.

“We live in different cities so I won’t be in the child’s life on a daily basis but I certainly do not intend to be a stranger,” says Jason. “I will probably be referred to as ‘Uncle Jase’ and the child will be aware of our genetic bond. However, the parenting will be left up to the child’s two mothers. I won’t be a father figure but I would like to be a positive adult influence in the child’s life. Young people can never have too many of those.”

The three have undergone counselling and have asked all the hard questions, including who would look after the child if Cassie and her partner died. “In that situation, the child would go to Cassie’s brother and his wife,” said Jason. “They already have two children and the financial means to look after a third. I feel really honoured to be able to help Cassie create her family but the reality is I am not set up to look after a child and it’s not something I personally desire in my life.”

While many people rely on the generosity of others to help in the creation of their babies, others are praying for cures to the many terminal illnesses that affect young children. The use of embryos for research into treatments for these conditions is a topic which usually provokes heated debate in the community.What one person regards as assisting medical progress is ‘playing God’ to another.
Many couples who successfully complete an IVF program have healthy embryos left over. They must decide whether to destroy these embryos, donate them to an infertile couple or donate them for scientific studies and/or stem cell research. Eva Kougellis and her husband Michael were faced with this decision following the birth of their third child.“We conceived twin boys via IVF,” said Eva. “When the twins were just over one, I became pregnant naturally. We were so surprised – and utterly thrilled.”

Eva and Michael knew their family was complete and they made the decision to donate the left over embryos for stem cell research. Stem cell research aims to develop treatments for many types of diseases, including cancer, by generating healthy cells to replace damaged ones. In 2002 legislation was passed in Australia to ban human cloning and regulate the use of spare human embryos from IVF clinics. 
“The thought of disposing them was heartbreaking because those embryos were potentially the beginning of life for our future babies. Storage was costing us $350.00 per year so the best option was to donate them.  Knowing that they will help towards a better future for IVF and stem cell research was reassuring to us.”

Possibly even more controversial than the donation of genetic material to infertile couples is the issue of surrogacy. In Australia, the laws surrounding surrogacy differ from state to state. In New South Wales surrogacy is legal, however the recipient couple must apply to the Family Court for full parenting rights.  Due to the legal complications in Australia many couples struggling to create a family find that surrogacy is simply not a viable option. Those who can afford it may travel to America where agencies provide commercial surrogacy services, albeit at great cost.

The process of surrogacy presents a unique set of complications not found in other forms of assisted reproductive methods because the surrogate mother must experience all the emotional, mental and physical feelings of pregnancy. On the one hand, it may be argued that people should be free to make surrogacy arrangements as consenting adults. On the other, the list of possible negative consequences is long. What happens in the case of multiple births? What if the surrogate mother or recipient couple changes their mind? What if the child has serious disabilities? Uniform surrogacy laws may one day help clear up these issues and make surrogacy a more feasible possibility for couples requiring reproductive assistance in Australia.

In the meantime, women like Liz Lonsdale will never take for granted something that is considered a female birth right – the ability to bear children – and her daughter Molly is a permanent reminder of Gillian’s selfless offering. “The donation of Gillian’s eggs restored my faith in the human race,” said Liz. “She gave a complete stranger the chance to be a mother and without her Molly would not exist. To me, there can be no greater gift.”

The Facts of Life
What the law says:
• It is illegal in Australia to buy or sell human sperm, eggs and embryos.
• In NSW, a child born from a donated egg or sperm is deemed to be the child of the birth mother.
• Donors are under no legal or financial obligation to the child.
• Sperm from one donor is currently able to create a maximum of 10 families.
• IVF Australia aims to provide enough sperm from one donor for a family so if siblings are desired they have the same biological father.
Visit www.ivf.com.au

Thinking about donating eggs?
• ‘Known’ egg donors are a friend or family member of the recipient, while anonymous donors have no knowledge of who receives their eggs.
• With anonymous donations, recipients are given only basic information about the donors, such as height, build, eye and hair colour.
• True identification is kept on file to be provided to any conceived people, upon request, when they reach a certain age (laws differ in each state).
• As egg donors in Australia are scarce, recipients cannot make requests for particular physical features.
• Women aged 35 years and under can be anonymous donors, while women aged 38 and under may be known donors.
• Most clinics prefer donors to have at least one child of their own and each donor is tested for genetic conditions.
• If you are married, your partner must have a blood test, attend a counselling session and sign a consent form.
• As a donor, the eggs are legally yours until the time of fertilisation. After this point, it becomes the legal property of the recipient couple. By law, you will be told if there is a successful birth.
Visit www.aussieeggdonors.com