November 30, 2022

expert reaction to HFEA report on Trends in Egg, Sperm & Embryo Donation

A report by the Human Fertilisation and Embryology Authority (HFEA) looks at trends in egg, sperm, and embryo donation.

Dr Alison Campbell, Chief Scientific Officer, CARE Fertility Group, said:

“Educational campaigns and improved public awareness of fertility issues and donation may have contributed to the increase in donations of eggs and sperm in the UK. The motivation to donate varies and many donors have observed the fertility challenges of family or friends. The decision to donation can be complex and is an act of great kindness and compassion.

“Donation in the UK is highly regulated, so treatment within UK licensed clinics is the safest option for people requiring eggs, sperm or embryos, whether they have been imported, or not.

“The cost of living increases could cause challenges for people needing donation, as well as those considering donating. Donors are compensated for their time and expenses but the amount has not been increased for many years, and we have been lobbying the HFEA to review this.

“Many UK fertility clinics don’t have the expertise or resources to find donors to meet patient needs, and are reliant on the import of donor eggs and sperm from abroad. However, some UK clinics have their own donor banks to meet the increasing demand and offer patients a good choice of donor characteristics and profiles. At Care Fertility we have seen a 15% increase in treatments using our donated eggs, from our own UK bank, in the last year.

“A shift in IVF laboratory practice, over time, has enabled us to offer frozen donor eggs, as well as fresh, which has improved availability, removed waiting lists and provided much more choice for recipients; although ethnically diverse donors remain particularly challenging to find, as highlighted in the HFEA report.”

Prof Alastair Sutcliffe, Professor of General Paediatrics, UCL, said:

“Use of ART (assisted reproductive technologies) rises year on year. A boon to those who can’t conceive naturally for whatever reason. So this report is welcomed.

“The HFEA report reflects an improvement in the availability of donor gametes. There are multiple reasons why this is happening.

“First egg cryopreservation is still a relatively new technology and thus is more widely known about. Second, after a dip in the donor gamete rates after it became possible for some basic characteristics of the donor being legally obtainable by the conceived individual some years back, there has been some recovery in rates of e.g. sperm donation, as the seemingly off putting nature of that change has had less of an effect than feared by those who wanted to be truly anonymous.

“There is increasing acceptance of this way of conceiving over time, and thus what may have been said in hushed voices privately is now a little more in the open.

“The majority of women who have their eggs frozen do not return for them, thus are perhaps tempted to offer them to less fertile individuals. This may be also true for those couples who have cryopreserved embryos.

“Furthermore there have been little in the way of safety concerns about these technologies for the children born thereof over time.”

Prof Allan Pacey, Professor of Andrology at the University of Sheffield

“This is an interesting report which describes trends in sperm and egg donation in the UK over the past 32 years since the HFEA was established. There is a lot that has changed in the UK social and political landscape over that time, as well as advances in reproductive technologies.

“First, I recall when the technique of Intra-Cytoplasmic Sperm Injection (ICSI) was originally developed in the early 1990’s to treat male factor infertility, many people predicted that this would quickly abolish the need for donor sperm in reproductive medicine in all but a few rare cases. However, the report shows that this was not the case. The welcome liberalisation of social attitudes about who could become a parent using donor sperm has meant that we are more reliant than ever, with single women and women in same sex partnerships now being the major users.

“Second, over the past 30 years we have systematically struggled to maintain a robust national infrastructure to recruit sperm donors at a rate the country needs. This is in spite of several national recruitment campaigns and initiatives designed to increase the supply of UK donors. It is not surprising to see in this report that we are now using more donor sperm that has been imported into the UK from donors in other countries (typically Denmark and the USA) than we have been able to recruit from within the UK. I struggle to comprehend why this is the case and think we need to take a long hard look at our donor recruitment infrastructure to try and make it easier or more convenient for UK men to donate if they want to.

“The third interesting aspect of the report in my opinion is the reminder that in 2023 we will reach the date that a significant number of donor conceived people can now find out identifiable information about their donor if they choose to ask. Overall I think this is a good move (although I admit that I was not always of this opinion), but I worry about whether we have the right support mechanisms in place to make sure this take place in a safe and supportive environment for all concerned. I remember worrying about this when the law changed in 2005 (and I said so in the press many times) but I am still not convinced that we have properly thought this through. It is not as if we haven’t had long enough to think about it!”

Sarah Norcross, Director of the Progress Educational Trust (PET), said:

“It is striking that so much donor sperm is now being imported into the UK from the USA and Denmark, suggesting that there is a shortage of UK donors. However, research commissioned by PET this year – conducted by Ipsos – shows that more than 50% of UK men would consider donating sperm to help others have children (1). Seen in this context, the HFEA’s data seems to indicate that UK clinics are failing to capitalise on existing goodwill. Clinics need to find ways to make it simple and straightforward for men who are willing to donate sperm to do so.”

(1) See https://www.progress.org.uk/wpcontent/uploads/2022/06/pet_fertilitygenomicsembryoresearch.pdf

– ‘Fertility, Genomics and Embryo Research: Public Attitudes and Understanding’, Progress Educational Trust, June 2022, p12. Ipsos interviewed a sample of 2,233 adults aged 16-75 in UK using its online i:omnibus between 24 and 27 March 2022. Data has been weighted to the known offline population proportions for age, working status and social grade within gender and Government office region.

‘Trends in Egg, Sperm & Embryo’ was published by the Human Fertilisation and Embryology Authority (HFEA) at 00.01 UK time on Wednesday 30 November 2022.

Declared interests

Dr Alison Campbell: “Dr Alison Campbell is an employee of CARE Fertility, a private company providing fertility services.”

Prof Alastair Sutcliffe: “Professor Sutcliffe and his team are using Anonymised HFEA data to study the health of men women and children who are subfertile or conceived thereof.”

Prof Allan Pacey: “Editor in Chief of Human Fertility, the Chairman of the Steering Committee for the UK National External Quality Assurance Scheme for Reproductive Sciences, a trustee of the Progress Educational Trust (Charity Number 1139856), and a Temporary Advisor to the World Health Organisation Guideline Development Group for global guidelines on the prevention, diagnosis and treatment of infertility (all unpaid). In addition, Allan is: (i) Chair of the Cryos International Scientific Advisory Board; (ii) a member of the Exceed Health Scientific Advisory Board; and (iiI) a member of the Cytoswim Ltd Scientific Advisory Board. But all fees associated with these are paid to the University of Sheffield and used to support teaching and research.”

Sarah Norcross: “PET is a charity which improves choices for people affected by infertility and genetic conditions.”