The demand for fertility treatment involving egg or sperm donation has been growing, as people are putting off having children until later in life. But fertility tourism, where patients go abroad in order to seek treatment, has also been growing. Because of differences in legislation across the EU, many intended parents are effectively able to choose whether they want their donor to be anonymous or not. In this article we’ll look at the pros and cons of both kinds of donation.

What differences are there between countries? 

The non-anonymous system, in which identifying data is made available to donor-assisted children, is established in some countries such as the Netherlands, Sweden, Finland or the United Kingdom. It’s one of the reasons patients from these countries tend to look abroad for treatment.

Portugal was the last to join them in 2018, and since then all those who donate gametes know that their personal data including their name and surname, will be available to their offspring.

Other countries such as Russia, Georgia, Romania, Denmark and Ireland use a mixed system: donors can opt for anonymity or choose to make their data available to potential offspring. Those undergoing treatment are able to choose what level of anonymity they are comfortable with. 

In the majority of the countries (at least within the EU), anonymous donation is the norm. Notably, egg donation is not legal in Germany, Switzerland and Norway. In Bosnia, gamete donation (whether egg or sperm) is directly prohibited. 

Spain and anonymous donation

Spain is one of the countries with the most complete and clear legislation, which makes it a perfect destination for those who opt to go abroad for fertility treatment. Gamete donation is regulated by the Assisted Reproduction Law, making it anonymous. It also establishes that "...donation will never be lucrative or commercial" effectively, limiting the economic compensation that donors can receive. 

However, this may be set to change soon. The European Council, as well as the bioethics committee that forms part of the Ministry of Health, both advocate for the ending of anonymity. In Spain, adopted children do have the right to know who their biological parents are. However, when it comes to donor-assisted children, many doctors believe that sharing personal information of donors would mean placing too much importance on DNA. The argument is that donor-assisted children know who their parents are: they are the people that have raised them from birth. A donor is nothing more than a person who has provided a gamete for donation. 

The Spanish Fertility Society (SEF) has publicly positioned itself against eliminating anonymity in a document published in October 2019.

Among the arguments for anonymity pointed out in this text, ranging from the philosophical, epigenetic, and legal, there is also a practical concern that cannot be overlooked: if anonymity was no longer protected as a donor’s right, the number of donations is likely to drop by a huge number. 

Around 20% of all fertility cycles performed in Spain correspond to patients from other countries. Most of the patients who come to Spain do so from the United Kingdom, Germany, France and Portugal. Some of these countries have a ban on egg donation (Germany) and in others non-anonymous donation, which leads to a shortage of donors (United Kingdom and Portugal). 

Eliminating anonymity could lead to a very large drop in the number of potential donors. The donation in Spain is, in practice, altruistic because clinics are only able to provide “compensation for the inconvenience” effectively limiting what donors can be paid. Spain is a generous country, and a leader in terms of organ donation as well as gamete donation. But usually their commitment does not want to go beyond helping a patient to start their own family. Potential donors may feel put off by concerns surrounding their anonymity. Potential parents may share these concerns. They are generally very grateful to donors; but do not want further involvement with the donor. Furthermore, in Spain, donor’s personal information is stored on a national database, and details can be revealed in the case of life-or-death situations. 

Some families think that by having the information that appears in a carrier test, they know everything they need to know. Others, however, do not have a problem with the identity of the donor being made available to the children when they are of legal age. In general, the biggest concern is the potential decrease in the number of altruistic donations.

Regarding children, some do wish to know the identity of their biological parents, a concept that is much more restricted than in the case of adopted children. At the end of the day, they have not had contact with them in any case and the only influence it can have on their life is purely genetic. For others, however, it is completely irrelevant data. Although there are few studies on the topic, it seems that finding out you are a donor assisted child is easier when you are younger. Adults may find it distressing, whereas children who are naturally informed when they are younger have less need to know the donor.  

In any case it is not a simple question and there is still much to debate. We will see where the laws evolve and if anonymity does not exist or not.