Sperm donors need limits, says a European fertility group
Sperm donors need limits, says a European fertility group
欧洲生殖组织：精子捐献者需设定上限
EXECUTIVE SUMMARY Ties van der Meer doesn’t know how many siblings he has. The 47-year-old was conceived at a private fertility clinic in the Netherlands using sperm provided by an anonymous donor. After the Netherlands banned anonymous donation in 2004, the doctor who ran the clinic destroyed records that might have identified those donors, he says. He describes the situation as “problematic.” Children have a right to know their biological parents, he says. While he did ultimately track down one sibling, who helped him identify his father along with other genetic relatives, he may have others he’ll never find.
执行摘要 Ties van der Meer 不知道自己有多少个兄弟姐妹。这位 47 岁的人是在荷兰一家私人诊所通过匿名捐赠者的精子受孕的。他说，在荷兰于 2004 年禁止匿名捐赠后，该诊所的医生销毁了可能识别出捐赠者身份的记录。他形容这种情况“很有问题”。他认为，孩子有权知道自己的亲生父母。虽然他最终追踪到了一位兄弟姐妹，并帮助他确认了父亲和其他遗传亲属，但他可能还有其他永远无法找到的亲属。
Other donor-conceived people who have been able to track down siblings have found they have tens or even hundreds of them. One donor-conceived woman who found 25 half-siblings over the course of seven years told the Guardian, “It does make you feel a bit mass-produced.” We need international limits on the number of children a single donor can contribute to, a European fertility organization argued yesterday. At a conference in London, members laid out plans to start with a Europe-wide limit.
其他通过捐赠受孕并成功追踪到兄弟姐妹的人发现，他们有几十甚至上百个兄弟姐妹。一位在七年间找到了 25 个同父异母兄弟姐妹的女性告诉《卫报》：“这确实让人感觉自己像是被批量生产出来的。”昨天，一家欧洲生殖组织提出，我们需要对单一捐赠者所能贡献的后代数量设定国际限制。在伦敦举行的一次会议上，成员们制定了从欧洲范围内的限制开始的计划。
Today many countries, including the UK, have banned anonymous egg and sperm donation. But anonymity can’t be guaranteed even in places where it is technically allowed. Genetic tests offered by companies like Ancestry and 23andMe, along with genetic registries, have made it much easier for donor-conceived people to find parents and siblings who share their genes. And because sperm can be frozen and stored for years before it is eventually used, the current set-up can result in situations where donor-conceived people discover the identity of a genetic parent only after the person’s death.
如今，包括英国在内的许多国家已经禁止了匿名卵子和精子捐赠。但即使在法律上允许匿名的地方，匿名性也无法得到保证。Ancestry 和 23andMe 等公司提供的基因检测，加上基因登记库，使得通过捐赠受孕的人更容易找到与自己有基因联系的父母和兄弟姐妹。而且，由于精子可以在最终使用前冷冻储存多年，当前的机制可能导致通过捐赠受孕的人在捐赠者去世后才发现其遗传学父母的身份。
They might also find that they have siblings of very different ages, all around the world. Some people are finding hundreds of siblings. Sperm from Jonathan Meijer, a Dutch man who began donating in 2007, was used to conceive between 550 and 600 children. (Stichting Donorkind, a foundation and advocacy group for donor-conceived people that’s chaired by van der Meer, took him to court, and he was ordered to stop donating in 2023.)
他们还可能发现自己拥有遍布世界各地、年龄差异巨大的兄弟姐妹。有些人甚至找到了数百个兄弟姐妹。荷兰男子 Jonathan Meijer 自 2007 年开始捐精，其精子被用于孕育了 550 到 600 名儿童。（由 van der Meer 主席领导的捐赠受孕者权益组织 Stichting Donorkind 将他告上法庭，他于 2023 年被勒令停止捐赠。）
Stories like these can be distressing for donor-conceived people. And there are other reasons why limits are considered important. The offspring of a prolific donor might be at risk of unknowingly forming romantic or sexual relationships, for instance. And some people are concerned that a donor with a harmful genetic mutation might pass that down to many children. This is unlikely, given the level of screening that most donors undergo. But it has happened. A man who donated his sperm to a sperm bank in Denmark was found to have a genetic mutation that significantly increased the risk of multiple cancers. But his sperm had already been used to conceive at least 197 children across Europe. Some of those children developed cancer. Some died.
这类故事可能会让通过捐赠受孕的人感到痛苦。此外，设定限制还有其他重要原因。例如，多产捐赠者的后代可能面临在不知情的情况下建立恋爱或性关系的风险。还有人担心，携带有害基因突变的捐赠者可能会将其遗传给许多孩子。考虑到大多数捐赠者所接受的筛查水平，这种情况不太可能发生，但确实发生过。一名向丹麦精子库捐精的男子被发现携带一种显著增加多种癌症风险的基因突变，但他的精子已被用于在欧洲孕育了至少 197 名儿童。其中一些孩子患上了癌症，甚至有人因此死亡。
Many countries already have legal limits for donors. In Malta and Cyprus, for example, both egg and sperm donors are allowed to contribute to the birth of just a single child, according to data presented at the European Society of Human Reproduction and Embryology (ESHRE) meeting in London on July 8. Other countries set limits based on the number of families a single donor can contribute to, allowing recipients to have children who share a genetic link. In the UK, that limit is set at 10 families per donor.
许多国家已经对捐赠者设定了法律限制。例如，根据 7 月 8 日在伦敦举行的欧洲人类生殖与胚胎学会 (ESHRE) 会议上公布的数据，在马耳他和塞浦路斯，卵子和精子捐赠者仅被允许贡献孕育一个孩子。其他国家则根据单一捐赠者可贡献的家庭数量设定限制，允许接受者拥有具有遗传联系的孩子。在英国，这一限制设定为每位捐赠者最多可贡献 10 个家庭。
But these limits are difficult to enforce, partly because donated gametes don’t necessarily stay in their original country. In Denmark, the national limit is set at 12 families. But the country is a major exporter of sperm. In the UK, for example, more than half of sperm donations in 2020 were imported—with most of those coming from either Denmark or the US.
但这些限制很难执行，部分原因是捐赠的配子并不一定留在原产国。在丹麦，国家限制为 12 个家庭，但该国是主要的精子出口国。例如，在英国，2020 年超过一半的精子捐赠是进口的，其中大部分来自丹麦或美国。
“The only thing that really makes sense is a transnational limit,” Jackson Kirkman-Brown, a professor of reproductive biology at the University of Birmingham, said at the meeting. Kirkman-Brown and his colleagues have spent months putting together a document that represents ESHRE’s position on these limits. After consulting with fertility specialists, clinics, sperm and egg banks, donors, and donor-conceived people, the team has developed a plan to start with a Europe-wide limit on sperm and egg donations.
伯明翰大学生殖生物学教授 Jackson Kirkman-Brown 在会上表示：“唯一真正有意义的是跨国限制。”Kirkman-Brown 和他的同事们花了几个月时间起草了一份文件，代表 ESHRE 对这些限制的立场。在咨询了生殖专家、诊所、精子和卵子库、捐赠者以及通过捐赠受孕的人士后，该团队制定了一项计划，旨在从欧洲范围内的精子和卵子捐赠限制开始。
ESHRE is calling on sperm and egg banks, as well as fertility clinics, to respect an initial limit of 50 families per donor. That’s still very high, according to a handful of people I spoke to at the meeting. But at least it’s a start. Europe should move toward setting limits at 15 families per donor, Kirkman-Brown said. “We may find that 15 is also too high,” says Vasanti Jadva, who studies the psychological well-being of people conceived using donated eggs, sperm, and embryos at City St George’s in London. “We still don’t know what the right number is.”
ESHRE 呼吁精子和卵子库以及生殖诊所遵守每位捐赠者 50 个家庭的初步限制。我在会上交谈过的几个人认为，这个数字仍然太高，但至少是一个开始。Kirkman-Brown 表示，欧洲应该朝着每位捐赠者 15 个家庭的限制迈进。伦敦城市圣乔治大学研究捐赠卵子、精子和胚胎受孕者心理健康的 Vasanti Jadva 说：“我们可能会发现 15 个家庭也太高了。我们仍然不知道正确的数字是多少。”
It will be difficult to enforce these limits, too. And if they end up limiting the supply of donor sperm, there’s a chance that some people will turn to unregulated sperm donations from people who do not undergo health screening. Unregulated donations can lead to other problems for prospective parents, including the possibility that donors will seek parental rights over the children conceived using their sperm. And it will be even harder to establish international limits.
执行这些限制也将非常困难。如果它们最终限制了捐赠精子的供应，有些人可能会转向未经健康筛查的非正规精子捐赠。非正规捐赠可能会给准父母带来其他问题，包括捐赠者可能寻求对其精子所孕育子女的亲权。此外，建立国际限制将更加困难。
When I asked the American Society of Reproductive Medicine for its thoughts on ESHRE’s proposed limits, a representative directed me to a guidance document saying “it has been suggested” that for a population of 800,000, single donors should be limited to “no more than 25 births” in order to avoid the risk that relatives will have children together. (Considering the US has a population of over 340 million, the total figure could be pretty high, but many sperm banks opt to limit the number of families contributed to by a single donor at around 25.) Van der Meer thinks that even a limit of five families from a single donor would be high.
当我询问美国生殖医学会关于 ESHRE 提议的限制的看法时，一位代表向我指引了一份指导文件，称“有人建议”对于 80 万人口的群体，单一捐赠者应限制在“不超过 25 次出生”，以避免亲属间生育后代的风险。（考虑到美国有超过 3.4 亿人口，总数可能相当高，但许多精子库选择将单一捐赠者贡献的家庭数量限制在 25 个左右。）Van der Meer 认为，即使是每位捐赠者 5 个家庭的限制也太高了。