The American Society of Reproductive Medicine had their huge annual conference last week in Atlanta. Harkening back to my elementary school days, this blog will be my report on “What I Learned at the Conference”.
Sperm are cute, eggs are not, and the corollary axiom ~ sperm sell, eggs don’t. I have never been in a room with so many adorable sperm chotskies before. OK, truth be told, I had never seen a sperm chotsky before, much less been in a room with one, but still… I made it my mission to get one of everything sperm related and came home with a stuffed sperm plush toy, a sperm lapel pin, a sperm pen, and best of all, a sperm baseball hat. The possibilities for use and enjoyment of such treasures are simply endless. The first of such enjoyments came from the look on my children’s faces when they gathered around to see what I had brought them from the conference. Son #2 panics any time I mention the word sperm for fear that I’ll launch into another one of my “knowledge is power” talks (a.k.a. sex education), so you can imagine his discomfort when every other word out of my mouth was “sperm”. His little sister was enjoying his agony, until I handed her the lapel pin as her gift.
The gray areas of life draw me like a moth to a flame. I distrust easy answers to complex questions, and feel uneasy in the company of the black and whites of the world. When faced with someone who knows exactly what is right on an issue where right is not crystal clear, I feel compelled to formulate the other side in my head and play the “but what if” game. Not surprisingly, the sessions at the ASRM conference that I enjoyed most were the ones where very learned people discussed both sides of ethically confusing areas, and heaven only knows, infertility treatment is rife with these areas.
One such gray ethical area that deeply divides the infertility medicine community is gender selection. I attended a fascinating session on pre-implantation diagnosis/screening where several doctors and ethicists discussed the advisability of allowing couples to choose the gender of the embryos to be transferred during IVF. I so appreciated the depth of the discussion on this complex subject. Some doctors are opposed to gender selection in all situations other than to avoid gender specific diseases, others allow it to balance the gender of children in families, and some allow it for any reason at the sole discretion of the parents. Interestingly, it is not uncommon for there to be disagreement amongst doctors at the same clinic. What impressed me was how interested the profession as a whole is on “doing the right thing”, and they are just as confused as the rest of us on exactly what is right.
Another highly controversial session was on the advisability of a national registry for children conceived through donor egg or sperm. A registry would allow the flow of medical information between the donor and donor conceived person, and could prevent questions of consanguinity (accidentally marrying your half sibling). I don’t think anyone on the panel was seriously suggesting a government mandate requiring registration, but there was a good discussion about the advantages and disadvantages of a volunteer registry. Who would benefit, who should have access and under what circumstances, who would run it, and who would pay for it. I wonder if the whole idea of a volunteer registry is moot since the majority of parents using donor gametes aren’t telling their children. Although disclosure to children and registering them on a donor gamete registry are two separate issues, they are inexplicably connected since parents who do not tell their children that they were conceived by donor egg or sperm are not likely to voluntarily sign them up. Also, a registry is not necessary for those who use an identified donor. An interesting point I had never thought about was made by Dr. David Adamson, who will be our guest on the show this week on the totally different topic of how to pick a fertility specialist. He pointed out that a surprising number of people don’t know their paternity even when donor sperm are not used, so why should we suggest that those who used donor egg or sperm be the only ones to register.
And last, the session on whether clinics should be marketing egg freezing to woman wanting to postpone child bearing was thought provoking. The techniques for cryopreserving human eggs have advanced rapidly, but the ASRM still considers this procedure experimental. At what point should they end that classification and on what evidence? How do you do long term research on children conceived from frozen eggs without some form of registry. Actually, the same question could be asked about IVF kids in general. Should woman be encouraged to postpone conception at all? There are no easy answers, but I thoroughly enjoyed listening to smart people disagree on possible answers.
One of the best things about this conference for me was the chance to meet in person people I’ve worked with only over the phone or the internet or the radio show. Many of the speakers and attendees have been guests on the Creating a Family radio show, and I met others who will be on the show over the coming year to bring their expertise to you. I also met with non-doctor types that I’ve worked with through the years who have done so much for infertility patients. Here are a few I want to make sure you know.
- Mikki Morrisette is a single mom by choice and started Choice Moms to support others who have or are considering parenthood without a partner. Her site and book (Choosing Single Motherhood: The Thinking Woman’s Guide) are excellent resources, and Mikki is as nice and helpful in person as you would expect from her book and her appearance on our show. She continues to expand her services and support for woman choosing single parenthood, including a new radio show.
- Renee Whitley and Lee Collins are the force behind the National Advocacy Committee at Resolve, the infertility support organization. I would bet that few realize the debt we owe to the tireless work of these two women to make sure that infertility treatment remains available and legal. Throughout the year, legislation is introduced on the national and state level that affects the availability and affordability of infertility treatment. Some of these laws would result -either intentionally or unintentionally- in the severe restriction or prohibition of many types of infertility treatment. Lee and Renee stay on top of what is happening and provide information to the lawmakers on the consequences of the legislation to the infertile and support for advocates in each state. What impresses me most is that both of these women have finished building their families, so they won’t personally benefit from their efforts. They volunteer their time and talents just to make sure that the next generation of infertility patients has the option of building their family through infertility treatment. Check out some of their work at Resolve Take Action page. Hats off to you ladies and thank you!!
P.S. As to the fate of the pictured sperm hat: Daughter #1 wrested ownership of the hat from her dad. I must admit that he didn’t put up much of a fight. My daughter wearing a hat adorned with sperm wasn’t exactly the outcome I had imagined.
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The HFEA figures for egg donors are at the link. They’re broken down into altruistic and “egg-share” donors, but these are the raw figures:
Year All egg donors
2005 923 (donor anonymity ended April 2005)
Basically, the numbers dropped (though they were already dropping), but are now higher than before the rule changes. Interestingly, a much higher proportion are altruistic donors; there are now more altruistic egg donors than since 2001.
Thanks for the info Mark. What has happened with egg donation in the UK since anonymity has been abolished?
Thanks for sharing "What I Learned at the Conference”, Dawn. I really enjoyed reading it and learning about what is happening today in the field of reproductive medicine.
Nice summation of the conference, though I am disappointed I didn't get any sperm chotsky. Kudos to Barb, Lee and Renee for their efforts.
Well, I'm just saying that in all that huge exhibit hall I didn't see one egg chotsky, but plenty of sperm stuff. So apparently you are alone in your opinion. 🙂
How come eggs aren't cute? I think they are cuter than sperm!
I tried to find you as well. I showed up at the Rachel's Well booth a couple of times and kept missing you. Perhaps next time. Hey, add your comment to the blog itself and put in a plug for your Rachel's Well. (Do I have the name right?)
Thanks for the update Dawn. So sorry I missed you at the conference. You are right…Renee and Lee are fantastic and all their work is very much appreciated. Keep up the great work!
You crack me up! LOL. And for the record a registry of donor created kids is the stupidest idea I’ve ever heard.
ROFLMAO-You crack me up. Thanks for my daily laugh and also for sneaking in some education. You’re good at that. I now have a lot to think about that I’ve never even heard of before.
I started reading because of the title and first paragraph. Very very funny. I love the interaction you share with your kids. But once I started, I kept reading and was so glad that I did. I had no idea that people were passing laws that would affect whether my daughter could have been born or whether my future children to be could be born. We have 5 frozen possibilities and the thought that somewhere some fool could go off half cocked and make it illegal to transfer them and allow them life is scary. How did I not know this. I don’t know Renee and Lee, but I am so thankful for them and what they are doing. I will go to the Take action page and take action.
Let’s not forget that the primary stakeholders in donor conception are not the donors, or the parents, or the clinics, but the donor-conceived. They are overwhelmingly against secrecy and donor anonymity.
The UK has had a national registry of donors and donor-conceived people since 1991, and has also considered noting the fact that an egg or sperm donor was used on birth certificates to prevent parents from hiding that from their children. In one state in Australia, donor-conceived people are contacted at the age of 18 to inform them of their genetic origins.
Gamete donors in the UK can also no longer be anonymous, partly as a result of a case brought by two donor-conceived people to the European Court of Human Rights. Other countries that have ended donor anonymity include the Netherlands, Sweden, Norway, Iceland, Finland, Switzerland, Austria and New Zealand. The numbers of UK sperm donors have gone up three years in a row since the ending of anonymity btw.
Thanks so much for the update Dawn! You are so right…it was very exciting. Lots of fabulous people doing fabulous things. And thanks for highlighting Renee and Lee. They are simply awesome, and all that they do is greatly appreciated by everyone working in the fertility field. It was indeed a great meeting. Sorry I missed seeing you. Hopefully we can connect next year in Denver if not before.
Evelina W. Sterling, PhD, MPH, CHES
You make me crack up with your writing! I am done building my family, but having suffered infertility and adoption – I still find your stuff riveting and full of humor and it always gives me great ammunition, ideas and information to pass on to fellow friends and associates. Hats off to you! (No pun intended! LOL)
If Maury won’t have a “baby daddy” show on donor sperm/embryos, then I don’t think a national registry should happen either. Dr. Adamson made an excellent point. How many states still require a blood test before marriage? That might be a way of seeing if you’re related before you tie the knot.
Sounds like a great conference. Thanks for sharing.
I want a sperm lapel pin!!!
Very funny about the sperm hat. Love the pic. I can’t imagine how a registry of kids conceived by donor eggs would work, and I can’t imagine who would benefit. I can see the point you make about research. I thought of it when we conceived through frozen embryo and hoped like heck that the research was good. Sounds like an interesting conference. I saw what you said on Facebook about the goodies in the Exhibit Hall. So, did you gain weight???