It is often said that we cannot put a price
on happiness. However, for those who are medically or socially infertile,
happiness has a dollar value. For the first time in history adults can use
technology to create their babies, with the only restriction being their
ability to pay.

Accessing “donated” gametes has become
increasingly easy with websites such as SpermBank
California offering semen for US$300 to 500 per vial, while egg donation
services from providers such as Fertility Bridges range
from $3,500 to 35,000 or more. A child carried by an overseas surrogate can be
arranged for as little as $22,000 through companies such as Medical
Tourism Corporation. Many of these companies and clinics provide catalogues
of available donors whose profiles contain information about such factors as
academic and sporting prowess, in addition to photographs.

Are we, then, moving towards the acceptance
of eugenics as well as commercialism in the begetting of children, or does this
just continue the normal process of mate selection for procreation?

To answer this question we first have to
look behind the language of the baby industry.

Is it correct to speak of “donors”? To
donate is to give without expecting anything in return. In the reproductive
industry there are few truly altruistic donors; the vast majority are either
paid or reimbursed for “legitimate expenses”. In any case, a financial
transaction has taken place. “Reimbursement” is a weasel word.

Donating blood is more invasive and time
consuming than donating sperm, but no money changes hands. A better term than
“donor” is supplier.

It is difficult not to believe that the
main motive for donation and surrogacy is money. Research indicates that
financial gain motivates both egg donation and sperm
donation when it occurs in a commercial environment. While it may be nice
to think that poor surrogates can use the money to better their families’ lives,
at what point does a society accept or condemn the use of the human body to
construct a family for those who can afford it? Whenever money is involved,
there is always the potential for illegal and immoral exploitative treatment of
those less fortunate, as we saw in a Thailand
surrogacy ring earlier this year. Would any of these women have been so
altruistic if money were removed from the equation?

While the term “patient” is reassuring and
respectable, I prefer the word “customer”. After all, the father or mother’s
infertility remains uncured after the transaction.

Nor is the process without its physical
costs. Commercial conception and the need to provide good success rates lead to
multiple embryo implantation for IVF cycles which is now known to be causatively linked with an increase in morbidity and mortality of the foetus.

Egg donors can suffer ovarian
hyperstimulation syndrome which can lead to hospitalisation and, more
rarely, sterility and death.

Hidden costs

It is the emotional costs, however, that
are increasingly coming to light.

Everyone sympathises with the pain of
childlessness. But is commercial, artificial reproduction utilising “donated”
gametes or wombs the answer? Achieving happiness through artificial
reproduction soothes the customer’s immediate pain by deferring it, although
the pain can potentially be passed on to their children.

For recipient parents there is deferred
emotional cost. Typically, one parent will not be biologically related to the
child. Raising what can be viewed as another person’s child can undermine the
relationship between the non-biological parent and the child. It may create an
unequal balance of power between the raising parents. This may be why there are higher divorce rates among couples utilising donor gametes. For those maintaining secrecy the burden
of preserving the deception may also weigh heavily on their mind.

Donors suffer, too, sometimes for the rest
of their lives. What does their child look like? Why can’t they link up? This
may not happen at first, but frequently their attitudes change over time. The
same can happen for surrogates as reported
recently. Contending with the idea of selling your biological children or
your body to someone else is a difficult process to navigate once a person’s
thoughts turn to this different perception.

Then there are the costs to the families of
donors and surrogates. Relatives must grapple with the notion that they may
never meet or know their descendants or kin. This extends to not only the
parents of the donor, who are the child’s biological grandparents, but also the
child’s siblings, aunties, uncles and cousins. This family not only has to
assimilate the emotional and physical loss of what they may view as a family
member but that they may need to process concepts of that child being sold or
given away.

Then, most importantly, there are the costs
and pain suffered by the children. They are, according to the commissioning
parent(s), the most precious of all. Yet their rights and welfare have been
subordinated to adult desires and needs. The imbalance can cause lifelong
trauma for the child which may be passed on to future generations. With the
exception of same-sex couples, it is far too easy for the parent(s) to actively
and deliberately deceive the child about the truth of their origins. In fact, most parents
fail to inform their children. While some may argue, “what the child
doesn’t know won’t hurt them”, constructing a family on a lie instead of on
truth is clearly unethical.

The use of donated gametes deprives the child
of their biological father/mother and associated kin, their heritage and place
in the world, their identity, and a family medical health history which can be
vital for their physical
well-being. Not only does this provide ethical and moral concerns, it also
contravenes the United Nations Convention
on the Rights of the Child, which all countries except the US and Somalia
have signed.

While there is a trend in countries such as
the UK, Australia and New Zealand to use donors who are willing to be
identified, deception by recipient parents places their own desires above the
rights of the child. In any case, many countries, including the US, have
anonymous donation systems and run their industry as a laissez-faire market
place.

To know that one of the reasons you exist
is because your biological mother or father essentially sold you for cash,
thereby rejecting you and making you the equivalent of a piece of property is
degrading and dehumanising.

I am donor conceived and I know. Many
others of the Donated Generation have also expressed this view.

With increasing evidence that children born
through donated gametes want
to know their biological origins, that they are traumatised when they learn later in life that
they have been deceived about their origins, and that, like adopted
people, they have higher rates of mental, substance
and delinquency problems, we must start to ask, “Is the cost worth it?”

Damian Adams is a medical research
scientist at the Women’s and Children’s Health Research Institute. However, he
is writing here as a Donor Conceived person. Damian lobbies for the welfare of
children conceived through reproductive technologies as the paramount concern
and guiding principle for a paradigm shift toward a child-centric ethos.