Over the past few days, there has been a veritable flood of articles in Canadian media about the practice of California IVF: Davis Fertility Center Inc. creating embryos to sell to clients to be used in IVF. See, for example, Wendy Leung's "Should IVF Patients be Allowed to Buy Embryos?", Sharon Kirkey's "For Sale: “Donor Embryos” Newest Addition to World of Artificial Procreation" and "Marni Soupcoff on the Sale of Fertilized Embryos: How much for that Blastocyst
in the Window?".  As a lawyer practicing in fertility law with my ear to the ground and an active embryo donation practice, California IVF's practice wasn't news to me.  In fact, over the past three weeks I have made as many presentations about embryo donation, all of which began with a statement about what embryo donation in Canada is not (being the practice in which California IVF is engaging).

In Canada, it is illegal to purchase (but not to sell) donor eggs or sperm (punishable by up to ten years in jail and/or a $500,000 fine), but it is legal to import donor eggs or sperm which were paid for abroad (see my earlier post here on this topic, or my Huffington Post article here).  It is also illegal to purchase or sell embryos in Canada (also punishable by up to ten years in jail and/or a $500,000 fine).  Although Bill C-38 (formerly known as the Omnibus Bill) introduced new legislation this past June that, when it takes effect, will regulate the importation of donor eggs into Canada (a practice which is currently unregulated), Bill C-38 and the Assisted Human Reproduction Act are curiously silent when it comes to regulating the importation of donor embryos into Canada.  Altruistic embryo donation, though, is legal and in my opinion, an excellent option worth consideration when a person has embryos left over from their own IVF cycle(s) (the other options being discarding the embryos, donating them to medical research or indefinite cryopreservation).

As a whole, the articles focus their collective outrage about California IV's practices on the aspect of purchasing donor embryos.  While this practice is strictly prohibited in Canada and certainly raises ethical concerns for some who argue that it is commodification of human life, I would argue that for many of us who practice in the fertility sphere, it's not the exchange of money that is so unconscionable.   In fact, I would make an educated guess that while practitioners in Canada respect the law, most are strongly opposed to the AHRA's prohibition on the sale of gametes and believe that it is bad policy (the same is not necessarilty true about the purchase and sale of embryos).  Based on my conversations with fertility lawyers and clinicians, the ethical concern and associated uproar isn't about the sale of embryos per se, but about clinicians creating embryos at their discretion without any particular parents in mind, using the characteristics that the clinicians determine are most likely in demand, which the clinicians then try to sell to potential intended parents.  Clinicians creating embryos out of donor eggs and donor sperm for an infertile individual or couple's use at the request of the parent(s)  - it happens all the time.  Clinicians creating embryos  with the hope that at some point a parent will show up and purchase the stockpiled embryos - this is what is so upsetting to so many. 

Legally, other than the commodification issue, there is nothing at odds with Canadian law about California IVF's practice, assuming both the sperm donors and the egg donors have provided proper consent.  Why is it, than, that this is so disturbing to so many of us, myself included? Dr. Laskin of LifeQuest IVF was quoted as saying that, that while many of his colleagues are uneasy with what’s happening in California, "[t]wo to five years from now, people may not even bat an eye at this."  This may be true, but for now, I agree with Francoise Bayliss that it is preferable (though not necessarily practical) to use one of the thousands of embryos cryopreserved in the clinics across Canada.  

Last night, I saw the play Hatched at the Toronto Free Gallery.  I had been waiting eagerly for the play to open, ever since first being contacted by the playwright, Claire Burns, reading a draft of the script, and then attending at and speaking at a fundraiser. 

Hatched is a play about egg donation.  It asks important questions: what makes a family? How important is biology? How much of a person is nature vs. nurture? Should parents tell a child born through the use of donor gametes about their conception, and if so, when? What role should a donor play in the life of the child conceived through the use of the donated gametes? Hatched goes a step further, though.  It asks questions about the emotional experience of the egg donor.  What does the experience mean to an egg donor? Is the donor curious about children born through the use of the donated ova? It explores the emotions of a woman who had donated her eggs in her youth and later ends up suffering from infertility; the only child with a biological link to her that will exist is the child who was conceived with the use of her donated eggs.

Because Hatched is a play and is therefore not required to be true to life, there are parts that are a little bit fanciful.  An intended parent being able to steal the medical records of an anonymous egg donor seems unlikely.  Even more unlikely is the egg donor being the guidance counsellor of the child conceived with the use of the donor eggs.  Regardless, I think it's important to explore the issues surrounding egg donation (and other third party reproductive technologies) from all perspectives, and theatre and art are excellent forums for this.  My one caveat, though, is that the audience must remember that this is a play, and not the actual experience of the donor. If we look back to Margaret Atwood's The Handmaids Tale, for example, when it comes to reproductive technologies, sometimes fiction has taken the place of reality in making policy which is a dangerous thing.

Hatched is playing through the 17th of November.  Tickets can be purchased here.

For me, PRIDE is a time of hope and celebration, and I think it is apropos that we recognize just how far we have come as a society in helping all people who want children build their families in various ways, including through assisted reproductive technologies (ARTs).

I often mention that, in my opinion, the Assisted Human Reproduction Act starts out with a bang that is truly something to be proud of (unfortunately it  
fizzles out from there).  Specifically, the Act states that,

s. 2      The Parliament
of Canada recognizes and declares that…

 (e) persons who seek to undergo assisted
reproduction procedures must not be discriminated against, including on the basis of their sexual orientation or marital status.

While ARTs are often lauded for their success in helping people with infertility, they are  just as useful, necessary and laudable for members of the LGBT community who do
not suffer from infertility.  Gay men in particular benefit from accessible ARTs with an emphasis on the T for
technology; donor insemination has long been a self-help remedy, but there is no corresponding self-help remedy for gestational surrogacy.  
   
Although there is much to celebrate (and there
really is – so many beautiful families would not have been possible without ARTS), it’s imperative that we learn how to make section 2(e) of the AHRA more than just an ideal but a reality.  To that end, I want to share with you the hands-down best presentation regarding ARTs that I have been to all year, which hopefully will obain the funding to be presented repeatedly throughout Ontario:

Reframing Assisted Human Reproduction: 

A forum theatre workshop about LGBTQ people’s
experiences with AHR services

The workshop is based on interviews conducted with 66 LGBTQ people across Ontario who have used, considered using, and/or avoided using AHR to have genetically related children.  Some of the worst experiences of
the interviewees are portrayed for the audience (the performance is candid that it is reflective of the worst-case scenarios and doesn’t reflect any of the positive experiences of the LGBTQ community accessing ART services in
Ontario).  I have to admit, I had my doubts about a performanced based workshop, but it was incredibly effective.  As far as we have come with people of the LGBTQ community having access to ARTs, the experiences as performed in the workshop were shocking, eye-opening and traumatic.  From the things that we can easily remedy to be more sensitive, such as offering genderless bathrooms, to the way consent forms are drafted making
assumptions as to gender and sexuality, this presentation highlighted practical ways in which we can make ART services truly accessible to the LGBTQ community.  

For more information, please contact Lesley Tarasoff

 Phone:
416-535-8501 x 7386

Email:
Lesley_Tarasoff@camh.net 

or see http://www.lgbtqhealth.ca/

A quick note about my earlier post regarding the legality of paying for imported banked frozen ova into Canada (read it here):
1. I'm proud to announce that a version of the post was published in the Huffington Post here, and
2. I heard through the grapevine that Health Canada confirmed that purchasing banked eggs and importing them into Canada is, in fact legal.  I am hoping to obain confirmation of that in writing shortly!

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?

On April 22, CBC’s The National aired a segment (Frozen Human Egg Trade) in which Kelly Crowe discussed how new technologies have progressed to enable human eggs to be retrieved, cryopreserved and banked in the US, and shipped to recipients in Canada.  Dr. Matt Gysler, a fertility specialist at ISIS Regional Fertility Centre in Mississauga, Ontario, openly stated that his patients frequently purchase and use these eggs for their reproductive purposes in Canada.  Dr. Gysler opined that just as it is legal to pay for frozen sperm imported from the US, so too, then, must it be legal to pay for eggs cryopreserved in the US and import those into Canada.  CBC interviewed Ms. Levitan, a fertility lawyer, who disagreed with Dr. Gysler’s analysis.  She stated that “it’s not a defence to say ‘but you said it was ok for sperm’…” and that she believed that people importing these eggs could face criminal prosecution.  Unsurprisingly, this program was followed in quick succession by a number of further stories on CBC and other media.  Suffice it to say that any Canadian suffering from infertility or looking to build a non-traditional family through the use of donor eggs likely absorbed the message that purchasing these banked eggs is illegal.

I respectfully disagree.

It is incomplete to state that the Assisted Human Reproduction Act (known as the “AHRA”) prohibits the purchase of ova or sperm; the AHRA only prohibits the purchase of ova or sperm from a donor or a person acting on behalf of a donor.  The World Egg Bank, depicted in The National segment, has a program whereby it purchases eggs from US donors and stores them until such time as they are purchased by an intended parent.  With recent technological advances, the eggs could conceivably be bought by an intended parent years after their retrieval.  The egg donor is paid, though, at the time of retrieval, regardless of when or whether an intended parent purchases the eggs from the Bank, much in the same way that sperm banks function.  Accordingly, the intended parent is purchasing eggs, but is not purchasing eggs from a donor, nor is the parent purchasing eggs from a person acting on behalf of a donor. 

As Dr. Gysler mentions, Assisted Human Reproduction Canada has condoned the practice of purchasing frozen sperm from the US and importing it into Canada.  To my mind, the reason that the purchase of sperm from a sperm bank is legal is not because of the Semen Regulations (yes, there is such a thing) with which all imported semen must comply, but because the sperm is not purchased from a donor or a person acting on behalf of a donor; the sperm bank (and now the egg bank) is not acting on behalf of the donor, but on its own behalf.  The issue, then, has little to do with whether a payment over the internet is found to be a payment made in Canada, as stated by Ms. Levitan.  In my opinion, even if the payment for a cryopreserved banked egg is made in Canada, such a payment is not prohibited by the AHRA and is therefore legal.

Two lawyers disagreeing over a legal analysis isn’t particularly interesting to anyone other than the lawyers themselves.  What is interesting, though, and the reason you ought to care about our differing legal analyses, rests precisely on the point where Ms. Levitan and I do, in fact, agree – despite the fact that I am confident in my legal analysis, I, too, continue to be concerned that potential clients who engage in such a transaction could open themselves up to an investigation or to criminal charges.  A strong argument that one has acted within the confines of the law is of limited comfort when faced with the risk of criminal charges, especially where the penalty for contravening the law is up to 10 years in jail and/or a fine of $500,000.   As fertility lawyers, neither I nor Ms. Levitan should be in a position where we must advise clients on a daily basis that the law regarding egg donation is so unclear that despite best efforts to work within the confines of the law, the potential for being investigated and even criminally charged remains.  Even more so, people struggling to build their families who must rely on third party reproductive technologies ought not be put in this untenable position.



Other offences and corresponding maximum imprisonment:

• ·         Advocating genocide – up to 5 years
• ·         Polygamy – up to 5 years
• ·         Public incitement of hatred – up to 2 years
• ·         Wilful promotion of hatred – up to 2 years
• ·         Assault (without a weapon) – up to 5 years
• ·         Assault (with a weapon) – up to 10 years
• ·         Forceable confinement – up to 10 years