Sperm donation in Australia was once shrouded in secrecy and donors were forced to be anonymous, even if they did not want to. After learning some of the lessons from adoption, as well as listening to the voices of the donor conceived, practice and policy regarding donor conception began to change.
No longer would donors be allowed to be anonymous but rather they would have to agree to the release of identifying information to their biological child once the child reached 18 and requested the information. First Victoria banned anonymity completely in 1998 through legislation, and then the rest of Australia followed suit in 2004 with the introduction of National Health and Medical Research Council’s (NH&MRC) guidelines. These 2004 guidelines meant that any donations from 2005 onwards would need to meet the changes in policy and the donors would have to be willing to release their identity.
According to reports in the media from interviews with clinicians working in the fertility industry, the number of sperm donors in Australia had dropped since the introduction of the NH&MRC guidelines. There was however, no data available to support these assertions at the time that they were published. In the March 2016 edition of the Journal of Law and Medicine, we published our findings of a survey we conducted investigating the numbers of sperm donors in Australia prior to and after the introduction of the NH&MRC guidelines. This manuscript is titled “Does the removal of anonymity reduce sperm donors in Australia?”
We sent out surveys to all fertility clinics in Australia. We received data from over 62% of the major clinics in Australia and over 47% of the smaller clinics (which is the satellite clinics of the major parent companies). This data included the number of donors per year for each of the clinics responding from the years 2000-2012 inclusive. This covered a period of 5 years leading up to the introduction of the NH&MRC guidelines and 8 years post introduction. As Victoria had already removed anonymity prior to the study period and prior to the guidelines, Victoria was able to act as a control group that would be unaffected by the policy change that the guidelines introduced.
If the reports in the media were correct, then we would expect to see a drop in donor numbers from 2005 onwards. What we observed from the numbers received was that the numbers in 2005 were actually higher than those of 2004. In fact 42% higher in the states affected by this change. While there was some up and down variation year to year over the entire period, the trend was for higher numbers of donors over time.
During the post NH&MRC guideline period there were some years with a small decline, but these were matched with larger declines in the Victorian data-set suggesting that other factors may be involved in those isolated declines than the alteration to policy and practice. Recruitment of donors was not an area that we investigated, however, the recruitment strategies of clinics may change over time, as has public opinion of donor conception potentially in line with increased coverage of stories in the media. Data from Victoria in the post guideline period showed a significant increase in donor numbers, highlighting an increase in the willingness to donate from 2005 onwards irrespective of any changes to anonymity.
Interestingly, in the United Kingdom, they also underwent a change in policy and practice in the same year. In their situation, they too have had an increase in the numbers of sperm donors after anonymity was banned. Their increase however was on a smaller scale than that seen in the Australian context, but an increase nonetheless.
It may be possible that some clinics who chose not to participate in the survey may have had a reduction in their donor numbers post change, however, we saw very little evidence for this occurring in our data. From the data that we did obtain, the results paint a more accurate picture of what was occurring in the states of Victoria, South Australia, Western Australia, Northern Territory and Tasmania, while the states of New South Wales, Queensland and the Australian Capital Territory were poorly represented.
This study shows that from the available evidence that the removal of the ability for a sperm donor to remain anonymous did not result in reduced numbers in Australia as was being reported in the media. While numbers on the contrary went up, this does not mean that the removal of anonymity caused this change. Rather there can be numerous factors which may contribute to the rise of number of sperm donors in Australia. This study also did not analyse the question of whether the number of donors is enough to meet current demand, only whether removing a donors anonymity results in lower donor numbers.
Data is a good means for informing policy and debate. The data we obtained is vital to show that donations were not adversely affected by changes to policy. However, the study also highlighted other areas of policy and practice that needs improving.
Rather than trying to survey clinics for the number of donors, a national database of donors should be introduced that not only keeps accurate statistics on donations and birth outcomes, but one which can be used to track donors and be a source of information.
Currently clinics do not communicate between each other to determine if a donor is donating at multiple clinics. Some states having legislated limits on the number of families that can be assisted by the one donor to try and prevent the occurrence of related offspring unwittingly forming romantic relationships as the majority do not know they are donor conceived. This is clearly a problem as after meeting the limits at one clinic, the donor could move on to another clinic, or even donate simultaneously at multiple clinics. A national database could also assist in the dissemination of identifying information and help build redundancy into a system which has seen all too often in the past, evidence of where records have been destroyed or redacted.