Assisted reproductive techniques are a reality in Spain. Single women, same-sex couples and heterosexuals with problems to impregnate can thanks to them obtain what they want so much: to have a child. In public health, any woman over 18 years of age can opt for this type of treatment, regardless of her marital status or sexual orientation. The age limit, although it depends on the treatment, is between 38 and 40 years old, and up to a maximum of three attempts are financed. Outside of these criteria, people can only go to a private center. The latest public data on assisted reproduction in Spain are those of the National Registry, in which 245 centers participate. According to their results, in 2018 a total of 149,337 in vitro fertilization (IVF) cycles were carried out, compared to 135,389 the previous year;an upward trend thanks to oocyte donation and frozen embryo cycles. Although the most widely used technique continues to be IVF, with 43,000 cycles compared to 16,000 for oocyte donation, the latter in turn experienced a 15% growth compared to the previous year. In any case, assisted reproduction treatments in Spain have increased by 28% in the last 5 years, as published by the Ministry of Health in October 2020.assisted reproduction treatments in Spain have increased by 28% in the last 5 years, as published by the Ministry of Health in October 2020.assisted reproduction treatments in Spain have increased by 28% in the last 5 years, as published by the Ministry of Health in October 2020.
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Assisted reproduction: more research and less billing
Spain, European leader in assisted reproduction
Once the pregnancy and a successful delivery have been achieved, there are many and many who consider whether or not to tell their children the truth of their origin.
Rocío Núñez Calonge, doctor in Biology, professor in the Reproduction Master of the Complutense University and the Spanish Fertility Society and specialist in Bioethics, has carried out a study, called
Patients Towards the Anonymity of Gamete Donation in Spain
[Patients and the anonymity of gamete donation in Spain, by its translation into Spanish],
in different clinics to learn about the situation of this issue in Spain. The report was carried out in 11 centers, through an anonymous survey of 66 patients undergoing gamete donation treatment, who provided their opinion regarding the anonymity of the donation. "Most heterosexual patients with a partner do not want to reveal their origin to their children, while in women alone or with a female partner, this proportion is reversed," Núñez emphasizes.
Although the survey has been given to the couple who come to make the donation, men have answered in a low percentage. “Perhaps because they think it is a woman's issue, or they are not as involved as they are. But all these are assumptions, because the results have been obtained after having all the surveys, and being anonymous, we do not know the reasons why there are hardly any men who responded ”, explains the expert.
As also scientific director of the UR International centers, Calonge has led this study that is carried out for the first time in Spain, in which the gynecologist Andrés Guijarro has also collaborated. This is a survey of people who are or have been in the process of treatment for the reception of donated gametes. The centers that have participated are in Alicante, Madrid, Oviedo, Murcia, Almería, Granada, Jerez de la Frontera, Malaga, Valencia, Zaragoza and Badajoz. The work has been presented at the 37th Annual International Congress of the ESHRE (Congress of Human Reproduction and Embryology).
The results reveal that homosexual or single women are more favorable to reveal their origin to their daughters and sons born by donating gametes in Assisted Reproduction processes. According to their results, “six out of 10 gamete recipients will not tell their daughters and sons about their origin and four out of 10 will not even comment on it with their closest circle or their family. Furthermore, only 21% of those surveyed would access Assisted Reproduction treatment by donating gametes if the donation was not anonymous in Spain ”. What do these results mean? In what situation is the Law of Anonymity? Do children have the right to know where they come from? These are some questions that we discuss with this expert in Bioethics.
Q.
How many women (single, gay and straight) use assisted reproductive techniques?
R
.
This data cannot be known with exactitude, since it is not asked in the National Registry of the SEF.
It depends on the centers, since there are many that have foreign patients in whose countries donation to single women is prohibited, while others will only have national patients.
It is known that the number of women without a partner or with a female partner is increasing, but the number is not known.
Q.
What does the Spanish law on Assisted Reproduction say about anonymity?
R
.
The Spanish Law of Assisted Reproduction (one of the first in the world) does not allow the identity of gamete donors to be revealed to patients, nor does it allow donors to know the identity of the recipients.
Only in the event of danger to the child's life, and by court order, can the donor be located.
P
.
In your opinion, what would happen if the donation was not anonymous?
Would more or less treatments be done?
R
.
If the donation was not anonymous, there would be far fewer treatments, drastically.
On the one hand, because the donors do not want to have anything to do or any responsibility with the offspring, which is logical.
On the other hand, because the patients do not want there to be an interference in the life of their family.
And in the end, in assisted reproduction clinics the number of donors would drop significantly.
P
.
Why are women alone or with a female partner the most predisposed to disclose this information?
R.
This is logical, since it is not a traditional family, they are more liberal and also, it is easier to tell the children why there is no male presence in the family.
Heterosexual couples who already have children are the most reluctant to explain their origin to them.
The reasons are not entirely clear, but in general, when a couple with donation children are asked why they do not want to explain it to them, they respond that this will not contribute anything, and prefer to remain anonymous.
P.
Leaving aside the law, in your opinion, do children have the right to know their origin?
A.
From an ethical point of view, it seems logical that children have the right to know their origin, but sometimes, considering the pros and cons, there are situations in which this disclosure is more harmful.
For example, in small places or where the use of these techniques is not “well regarded”, so that children may suffer some type of harassment.
In my opinion, children should be told, from a very young age, what their origin is, so that they incorporate it as something absolutely natural, but without the need to reveal the identity of the donor.
P
.
Would you like to add something to this respect?
R
.
Although the general opinion that is spreading in Europe is to suppress the anonymity of the donation, many factors must be taken into account, such as cultural ones (Anglo-Saxon culture is not the same as ours), and this decision cannot be made by lightly.
There is talk of the right to know the origin of children born by donation, but there are more values at stake that must be considered.
In the end, what is necessary is education and information on these techniques, so that parents consider it natural to tell their children about their conception.
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