Dr Anupa Nandi
BFS study day - Creating modern families - learning points
Today I attended a very informative session at the British Fertility Society study day, Creating Modern Families.
A brief summary of some important learning points:
1. Should children be informed that they were born through gamete donation or surrogacy?
Though patients are always advised to inform their children about their gamete conception, there is a hesitation among patients in doing so.
It was very nice to hear about the 20-year longitudinal study organised by Centre for Family Research, on children born from donated gametes and surrogacy.
It started in 2000, when children born through gamete donation and surrogacy were followed till 2019. Families were interviewed at their home after delivery. Their interaction and bonding with the child at age 1 and then 4 years were assessed using various gadgets of interactive play.
The child was separately interviewed at age 7 and again at 14 years regarding their knowledge and attitude towards their gamete conception. The child's development was also assessed by interviewing their school teacher.
It was very reassuring to know that there are a positive psychological adjustment and positive family relationship and higher global functioning among children who were being disclosed about their donor conception.
Children who learn about their donor conception before the age of 7 years had a better relationship with their parents than who were unaware and most adolescents felt indifferent about it by the age of 14.
This information would definitely help me to counsel couples seeking fertility treatment with donated gametes.
2. Fertility tourism - what facts should the patients be aware of?
Fertility tourism is on the rise.
There was a very nice talk about the cross border fertility treatment by Rachel Cutting, Principal Embryologist at Jessop Fertility at Sheffield Teaching Hospitals NHS Foundation Trust.
While in the UK HFEA provides a framework which allows us to work ethically and sensibly, fertility treatment is not so quite well regulated in other parts of the world. It was worrying to know that in many countries embryology laboratories were not included in the surveillance and in very few countries there is a requirement for licensing for the laboratory.
In addition to this, there is no limit to the number of embryo transfers to transfer in many countries, leading to a high rate of multiple pregnancies.
Surrogacy is not regulated in many countries leading to maltreatment of surrogates.
Our patients going abroad for treatment would need to be extremely careful in choosing the fertility clinic.
3. What is the importance of ongoing counselling in patients having treatment with donated gametes?
While it is absolutely essential to have implication counselling before treatment with donated gametes, it is certainly not enough.
We heard the stories of couples who resorted to terminating pregnancies conceived through donated eggs or sperm as they couldn't cope with the pregnancy.
This shows the importance of ongoing counselling throughout the treatment and also after the birth of the child.
4. Is there any upper age limit for adoption in the UK?
It was nice to know details about the adoption in the UK and the process patients have to go through.
It was reassuring to know that families were assessed thoroughly before being accepted as an adopter.
There is no upper age limit for adoption and the child will be age-matched with the couple.
5. What important points are to remember while treating transgender patients?
Another nice talk was on Gender Incongruence.
It was good to know that gender reassignment surgery is funded by the NHS.
It is very important that patients are referred to the Gender Identity clinic before considering fertility preservation for them.
A fingerprint might be better proof of identity for returning patients after gender reassignment.