I'm in the midst of attending a conference where it is clear that most of the participants feel very strongly against both commercialized egg and sperm donation, as well as against anonymous gamete donation.  These are not rare positions in Canadian circles, and are well-regarded in legal and other academic circles.  In its most basic terms, the argument against commercialization of human gametes is that it is morally repugnant to put a price on that which creates life.  The argument against anonymous gamete donation, at its most basic, is that it is not in the best interest of the children conceived from the use of these donor gametes who have the right to know their biological origins.  

For years now, ever since the Assisted Human Reproduction Act became law back in 2004 and prohibited the purchase of donor gametes from a donor or a person acting on behalf of a donor, most donor sperm used in Canada has been imported via the US or other countries.  Much of that sperm is paid for by the sperm bank in a jurisdiction where it is legal to pay for gametes.  The sperm is then purchased either by an importer of sperm from Canada or directly by Canadian parents.  Over the past couple of years, the same situation has become possible when it comes to donor eggs as the technology to vitrify and thaw the ova is now available so now there are not only sperm banks but egg banks too.

My best guess is that because of the restrictive and shockingly severe criminal sanctions in the AHRA (i.e up to 10 years in jail and/or $500,000 fine), more and more Canadian clinics and patients are going to turn to importing donor eggs as opposed to going through donor ova cycles here.  To make a long story short, whether or not this is legal is a nuanced answer where the devil is in the details but suffice it to say that I think it is possible to carefully work within the confines of the AHRA to import ova into Canada in a legal manner.  

The problem? Here it is:  At this point, most egg banks in the US offer only anonymously donated eggs (it seems to me that the push to use known or open-i.d. gametes is generally much stronger in Canada than the U.S.).  Further, my best guess is that all of the egg banks pay the donors for the eggs.  Accordingly, in a quest to prohibit commercialized gamete donation and anonymous donation, we have pushed Canadian clinics and parents toward what many will undoubtedly see as a legally preferable process than trying to negotiate the legislative minefield that is the AHRA (which fails to clarify what is an appropriate reimbursement with the potential penalty ranging from 5-10 years in jail and/or $250,000-$500,000 in fines) which will likely result in far increased use of ova which were paid for in the U.S. and provided on an anonymous basis.  Further, whereas when a donor in Canada goes through an egg donation cycle, we know she has publicly funded health care available to her, we can monitor the quality of her care, there are laws specifically targeted to ensure that she consents to the procedure, there is a legal system available to her if she were to suffer damages, there are resources (such as lawyers, psychologists, etc.) available to her, etc., We lose all such control over the process of egg donation and the resources available to a donor when the donation cycle happens outside of our borders.  So, while the criminal provisions of the AHRA may end up keeping our backyard clean, it is at the loss of being able to do a better job with a uniquely Canadian perspective and bent regarding assisted reproductive technologies at the expense of the donors and the children born through the use of donor gametes.   

This morning, the Supreme Court of Canada denied Olivia Pratten's application for leave to appeal to the Supreme Court of Canada. See the Vancouver Sun article here. 

Ms. Pratten is a Canadian woman who was conceived through the use of donor sperm in the early 1980s.  Ms. Pratten sued the Province of British Columbia (and others) for, among other things, discriminating against donor-conceived people as compared to adult adoptees by failing to take steps to ensure that identifying and medical information about the donor was available to donor-conceived people upon reaching the age of majority.  Ms. Pratten alleged that donor-conceived people suffered from various traumas as a result of not having access to such information, and this allegation was accepted by the lower court. Ms. Pratten was successful in the lower court, but the decision was overturned by the B.C. Court of Appeal.  For more information about the decisions, read this article here.

The fertility community - including parents, donor-conceived people, clinics, sperm banks, doctors, and lawyers - was waiting with baited breath for this decision.  Although the case was originally brought in B.C., if successful, it was widely believed that the implication would be a national ban on the use of anonymously donated sperm and eggs across Canada.  This would be the case for all donor sperm and eggs, despite the lack of known or open identification donors among various ethnic groups, the parents' preference, etc.

At this point in time, of all the donor sperm used in Canada that is not from a known donor (for the most part, such sperm being imported into Canada from the U.S. and Europe), about 60% is from open identity (open-i.d.) donors, meaning upon reaching the age of majority, the child already has access to information about the donor through the sperm bank (notably, though, this is a contractual relationship and the information provided is not through the state, province or territory).  The specifics of what information is available to the donor-conceived person varies from sperm bank to sperm bank.  The only remaining national Canadian sperm bank, Repromed, also offers donors and parents open-i.d. as an option.   Over the past decade or so, there has been a definite increase in Canadian parents' preference to use known or open-i.d. donors as compared to anonymous donors.  However, this preference isn't necessarily true for everyone, and isn't necessarily true of parents from every community.  For example, some fascinating research has been published about the British South Asian community which seems to suggest that this community is one that  would struggle with the idea of known gamete donation.

Is it acceptable that parents have a choice in deciding what is in the best interests of their child, taking into account many different factors, including the culture in which the family exists? Is it enough that through education and research, without imposing a complete ban, far more Canadian parents are choosing known or open-identity donors than are choosing anonymous donors? 


In my opinion, the best way to encourage known gamete donation across Canada is not to impose a ban on anonymity (which clearly isn't legally sound as per the B.C. Court of Appeal's decision), but for each province to draft legislation which clearly sets out the rights and obligations of sperm and egg donors, parents and children conceived through gamete donation, with respect to parental rights.  If parents were less concerned that a donor may have parental or other rights to their child, it seems logical that they would be less concerned about the issue of anonymity.  




 

Canada is finally lifting the almost 30-year lifetime ban on blood donation by gay men.  However, only men who have not had sex with another man within the past five years will be allowed to donate blood.  Canadian Blood Services hopes to have this new policy in place by mid-summer.  Although this is a marked improvement over the current ban which prohibits men who have had sex with another man even once since 1977 to ever donate blood, the change does not go far enough.  I hope that this is only a first step and that the ban will be further reduced to better balance the protection of those receiving the donated blood with respect for and inclusiveness of all people.  Canada can look to other jurisdictions that balance these
competing interests in a less extreme manner, and through the use of empirical evidence.  For example, Australia has a policy where blood donations are deferred for only twelve months.  A study shows that Australia did not see an increase in contaminated blood donations when it moved to this model.  However, as highlighted below, ideally the health of the donor should be determined based on a donor's behaviour and not on his sexual orientation.

This change may also reverberate to affect those who can be a sperm donor in Canada. Currently, the Semen Regulations under Canada's Food and Drug Act only allow specific men to donate sperm.  Restricted men include any man who has had sex with another man since 1977 (following from the ban on blood donation by gay males).  If a man who has had sex with another man even once since 1977 wants to donate sperm, special permission needs to be obtained unless the sperm is being used by the donor's sexual partner. The regulation points to an increased likelihood of such a donor being infected with HIV.

This policy is unnecessarily discriminatory.  It affects who can be a parent or a donor, and puts gay men at a disadvantage, regardless of the man's HIV status, whether he is in a monogamous relationship, and whether he even lives as a gay male or only engaged in sex with a man once back in 1980.  If the government's concern is the health of recipients of donor sperm, it should be looking for indications of the donor's health and behaviour, as opposed to his sexual orientation or gender.  For example, the current Semen Regulations (which I expect will fall by the wayside as soon as the federal government proclaims the new section 10 of the Assisted Human Reproduction Act and the regulations thereto to be in force), require that any donor sperm provided for the use of someone who is not the sexual partner of the donor be quarantined for six months in order to protect against HIV and other transmittable diseases.  If all donor sperm needs to be quarantined and tested anyways, why is that insufficient for gay males but sufficient for heterosexual males? Regardless, I'm hopeful that the change made to the restrictions on gay males donating blood will signify at least a similar change to the restrictions on gay males donating sperm (and that both policies will continue moving in the appropriate direction). 

NB: I admit that I do not have scientific training so if I am missing something here, feel free to school me.   As the policy stands, it seems to me like discrimination without the science or logic to back it up.

The Supreme Court of British Columbia released a landmark fertility law decision where, for the first time, sperm was held to constitute property at law.  You can find the J.C.M. v. A.N.A. decision here.

Briefly, here are the facts of the case:

A lesbian couple purchased sperm from a US sperm bank.  Using this sperm, they conceived two children at Genesis Fertility Centre.  The couple later broke up and divided up the assets of their relationship, but inadvertently failed to come to an agreement about the remaining sperm.  The applicant, J.C.M., later met a new partner and wanted to use the remaining frozen sperm to conceive a child who was biologically related to her previous children.  A.N.A. refused to allow the use and instead asked that the cryopreserved sperm be destroyed.  J.C.M. brought the application seeking a declaration that the sperm was her sole property.

The Honourable Madame Justice Russell ordered that the 13 remaining sperm straws be divided between the parties.

Here is what I had to say about the decision: watch the brief video here

Take home point: while an important decision, I doubt that the issue of whether gametes are property at law is resolved by this decision.  How would the judge have decided had the remaining donor gamete been a single cryopreserved egg that could not be divided? Would the decision have differed had the donor sperm not been purchased by the parties, thereby taking away any meaningful argument from the respondent that treating human gametes as property devalues and commercializes human tissue?