The Human Fertilisation and Embryology Act 2008 is the British assisted reproduction law, which covers all aspects related to human assisted reproduction, third-party reproduction, tissue cryopreservation, and funding of fertility treatments.
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The role of the British HFEA
The Human Fertilisation and Embryology Authority (HFEA) is the UK's regulator overseeing the use of gametes and embryos in fertility treatments as well as research.
The HFEA (hereinafter, "Authority") is responsible for licensing fertility clinics carrying out in vitro fertilization (IVF) or any other assisted conception procedures.
The HFEA describes the term "donation" as the gifting of sperm, eggs or embryos either for reproductive or research purposes. In short, by donating you can give others the opportunity to create a family through third-party reproduction.
Pregnancy through donor conception
In the United Kingdom, signing a third-party agreement is required before starting an infertility treatment with donated gametes or embryos. The HFE Act states that it should be done in writing.
Also, the Authority bets on elective single embryo transfers (eSET), especially when the embryos have been created with donor eggs and/or sperm, due to their high quality.
Donor eggs can be used for mitochondrial donation as well, a novel technique allowed in the UK for the prevention of mitochondrial diseases being passed on from mother to child. Thanks to it, children can be born with three identifiable genetic parents. The following are the basic steps involved in mitochondrial transfers or three-parent IVF:
- The patient’s nuclear material is removed from the egg and transferred into donated eggs.
- The eggs now containing the intended mother’s nuclear material and the donor’s healthy mitochondria are fertilized with donor or partner-donated sperm.
- The resulting embryos are transferred into the patient’s womb
Freezing and storing unused embryos after IVF or ICSI is a common option after finishing the treatment cycle. You can also choose to donate them for reproductive purposes, research purposes or training. Written consent of the patient and, if applicable, her partner is necessary before storing the embryos.
Also, it is possible to access funding to have fertility treatment on the NHS as long as you are referred from your GP. Should you be eligible for NHS funding, you should take into account that you may have to wait for treatment.
Compensation policies
When a man or woman decides to donate their gametes, they are expected to follow principles such as altruism, fairness and pragmatism.
As for the compensation policies, the law prohibits payment of donors, but they can be given a compensation for expenses and the inconveniences derived from the donation. Such compensation includes:
- Reasonable expenses, such as travel costs
- Loss of earnings (up to £61.28 for each full day)
Egg sharing is allowed, as well as sperm sharing and freeze sharing schemes. So you get an idea, egg sharing may suppose a significant reduction in the cost of the treatment—half or the full cost, which is about £5,000 per cycle.
Sperm sharing schemes are offered by some clinics and consist in a reduction in the treatment costs or being moved up the waiting list in return for the male partner donating his sperm cells.
In the case of freeze sharing programs, it is currently available at a reduced number of clinics. Thanks to this option, women who are about to freeze some of their retrieved eggs can do so for about 5 years at no cost in exchange for donating some eggs.
Knowing the identity of the donor
Anonymity of egg and sperm donors is not compulsory anymore since 1 April 2005. Donors who donated before that date can now choose to “re-register” and become known to any children born as a result of their donation.
Donors who decide to re-register as identifiable should know that the fact that they meet or are in contact with the donor-conceived child or children does not mean they have financial responsibilities or legal obligations to them.
Donor-conceived individuals, either through donor eggs or sperm, born after 1 April 2005 are able to consult the HFEA's register and find out about their donor and their genetic origins once they turn 18.
The first step to get started with the donation process in the UK is that the donor completes an application form. Then, she has ultrasound and Anti-Müllerian hormone test to check whether she is healthy to become an egg donor. If screening results are okay, the treatment plan is scheduled and the donor prepares goodwill message and personal description.
The process for prospective sperm donors is simular, yet longer, as they have to undergo full quarantine, that is, a re-screening six months after the last donation to rule out the presence of infectious and/or viral diseases.
Legal parenthood and parental responsibility
For married couples, including lesbian civil partners, the law states that the husband will be automatically recognized as the legal father of the donor-conceived child. The HFEA does not recommend to home inseminate because the parenthood will be conferred on the partner if sperm insemination does not occur at a licensed clinic.
Patients who turn to sperm or embryo donation at a UK clinic and are not married or in a civil partnership should keep in mind that it is crucial to give consent from both the patient and her/his partner so that he/she becomes the legal parent of the child.
Also, a person who has been recognized as the legal parent may not automatically have parental responsibility. The following is the difference between both concepts as explained by the HFEA:
- Legal parenthood: It affects aspects such as inheritance, financial responsibility and nationality, and gives a lifelong connection between parent and child.
- Parental responsibility: It gives a person the authority to decide about care of the child (e.g. medical treatment, education, etc.).
The woman who gives birth to the child is automatically considered to be the legal parent of the child, but her partner will not unless consent has been given before the treatment starts. This applies even in the case of lesbian couples and co-paternity.
Couples who decide to do so can withdraw their consent before treatment begins. In cases where the patients decides to go ahead and give birth, she will be the legal parent, but her partner will not. Talking to your clinic as soon as possible is crucial in any case.
In the case of gay couples who are in a female civil relationship, both partners will be the legal parents of any child unless the woman not giving birth states that she did not consent to the treatment.
Why do British patients seek IVF abroad?
The reasons why UK patients seek or end up seeking IVF abroad are varied and often interrelated. According to a survey conducted by the HFEA, the main motivations are related to:
- Shorter waiting times
- Higher success rates
- Lower cost of treatment
- Availability of donor eggs and sperm
- Opportunity to have more embryos replaced
- Standards in overseas clinics
Women who need donor eggs to get pregnant, especially because of their age, tend to seek donor-egg IVF abroad in order to avoid six-month or over waiting lists due to the shortage of donors in the UK. Also, having the opportunity to choose an anonymous donor is a key motivation.
Many patients in need of a gestational carrier have no alternative but to travel abroad because they see their legal parenthood compromised once the baby is born. According to the parenthood law, the woman who gives birth is considered the legal mother.
The surrogate will be considered the legal mother of the child and her spouse or civil partner, if any, recognized as the legal parent. For the surrogate's spouse or partner to waive this right, he/she has to prove to the court that there is a factual reason behind.
Couples who undergo treatment with donor sperm or embryos at a clinic outside the UK should bear in mind that the parenthood law applies to married couples. If you are unmarried or in a civil relationship, your partner would have to adopt the child to be the father or second parent.
FAQs from users
Do sperm donors have legal rights or obligations in the UK?
No, donors have no rights to the child born as a result of their donation. The donor is not the legal parent, has no legal obligation to the child or children, will not be named on the birth certificate and will not have to pay financial support to the child.
Conversely, when fresh donor sperm is used outside of an HFEA licensed clinic, the donor will be considered by law the child's legal father, with all the rights, responsibilities and obligations it involves.
How does the Donor Sibling Link (DSL) work?
The DSL is a platform designed by the HFEA so that donor-conceived people can get in touch with their genetic siblings. Those conceived after 1 August 1991 are eligible to join. By signing up, you can share and/or receive contact details of your potential genetic siblings.
What are the average success rates for licensed fertility clinics?
The HFEA has created "league tables" where the national average between registered clinics can be compared. Nonetheless, the libe birth rate per treatment cycle with fresh embryos from donor eggs is 30-54% if patients of all ages are grouped together.
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And what about the Spanish legislation for the donation of gametes? I read that any woman over 18 years old who is in full capacity to act can use donor eggs to get pregnant through ART. I find it quite attractive, since in other countries the recommended age is 21 years old. But I don’t agree with the Spanish legislation in one aspect, i.e. she needs her husband’s consent to become an egg donor, but why? I mean, every woman should be free to make this decision, her husband’s word shouldn’t be decisive at all…