Sperm Banks, Egg Facilities, and the Backfire Effect

The backfire effect refers to a psychological phenomenon in which presenting new or contradictory information to individuals with pre-existing beliefs leads them to dig in on their existing beliefs. This can also affect existing motives and policies. Here's how it may manifest in the donor conception business:

• Misinformation and belief reinforcement: When gamete sellers hold strong beliefs based on decades of selling anonymous gametes, and they encounter information that contradicts the ethics or validity of their modus operandi, they may react defensively. Instead of accepting new data or information, they may become more entrenched in the beliefs that have carried them and their profit for many decades: We've always done it this way and will continue to do so.
• Confirmation bias: People often filter out information that challenges them. When presented with research and anecdotal information that contradicts their beliefs or the way they run their business, they may dismiss it as wrong, biased, or unreliable, or attack the source, reinforcing their long-held views and practices.
• Cognitive dissonance: Individuals feel discomfort when their beliefs are challenged or when they hold conflicting beliefs. In response, some individuals may double down on their existing beliefs, despite data or evidence, to reduce this discomfort.

Challenges

Over the past few decades, sperm banks and egg facilities have faced various challenges regarding evolving donor family experiences and ideas. The potential for the backfire effect when it comes to information sharing and donor-family relationships is an unfortunate response and can manifest around the following conversations/policies:

• Anonymity: Since 2005, most donors can be easily found via a DNA test, even when they have not tested themselves. Yet, the gamete sellers continue to sell gametes as "anonymous" for a minimum of 18 years and have legally/financially threatened parents who test their child's DNA. They continue to focus on closing the barn door even though the horse got out a long time ago.
• Updating and sharing medical information: Sperm banks and egg clinics have long claimed to conduct regular/yearly medical updates with donors, but this is not the case for most donors. The majority of 2021 surveyed egg donors who tried to report new medical issues have felt "dismissed" by their clinic or agency. Ninety-four percent of those former egg donors had never been contacted by their clinic(s) for medical updates, while 24 percent felt they had medical/genetic issues that would be important to share with families.¹ Eighty-four percent of surveyed sperm donors had never been contacted by their clinic(s) for medical updates, while almost a quarter of them felt that they had medical/genetic issues that would be important to share with families.² Honesty and transparency are desperately needed.
• Changing perceptions of family: As society's understanding and definition of family continue to evolve, gamete banks can adapt to accommodate diverse family compositions and donor relationships. The old, DNA doesn't make a family has been replaced with DNA isn't the only way to make a family, but it certainly is one way. Thousands of donors and donor-conceived people have expanded their families to include an assortment of donor relatives, challenging the outdated model of gamete brokers working hard to keep these people from each other.

False Narrative

There is a false narrative and single argument that we hear from the reproductive medicine industry when responding to more progressive proposed policies/oversight/regulation that better serves the needs of donor-conceived people: Any oversight or regulation of the gamete donation industry will threaten the “reproductive rights” of parents. Parents are told, If there is oversight or regulation or oversight in our industry, you won’t be able to have the baby you so desperately desire! The accountability and policy updates that donor family members desire is not about challenging anyone's "reproductive rights." That is a different conversation. It is about running a more ethical and responsible gamete-selling industry.

Many in the industry know that the anecdotal and scientifically published information is accurate as they too hear from the families. But, they're stuck. Some people in the industry who are so invested in "helping families" find it difficult or even impossible for them to consider that their policies might actually be negatively affecting or hurting people.

Donor Money

Source: yupiramos'@123rf

What Is the Resistance?

What is the resistance to acknowledging new information about donor families? Money. If the industry acknowledged the decades of research and data, they would then need to honestly address and assess their outdated policies. This would most certainly affect their profit margins.

• Promising 18+ years of anonymity entices college-age students to donate. More donors = more money.
• Keeping and updating records costs money. Reporting births is voluntary, so sperm banks do not have accurate records of the children born from any one donor. They lose track of donors. One mom reports, If the sperm bank can't find the donor three years down the road when my sons were speech delayed or six years down the road when my son had cancer, why do they claim they can find him after 18 years?
• Keeping promises of limiting the number of offspring would be costly as selling fewer vials of a single donor would affect their net profit.
• Keeping promises of regular/yearly updating and sharing of medical information is costly and might also result in costly lawsuits. Updating medical information might reveal medical issues that can hinder selling more of a donor's genetic material.
• Properly educating and counseling all prospective parents and donors would also be costly. If donors understood that they could easily be found at any time via a DNA test and if they knew that they could end up with 100 to 200+ kids, many would never donate. That would take a big bite out of profit.

Assess, Accept, and Adapt

To address these challenges and evolving ideas about donor families, gamete banks can assess and accept decades of data and information that might challenge their modus operandi, and adapt.

• Foster open and honest communication between donors and families, right from pregnancy/birth. Messages, photos, and medical information can be shared directly with each other. While dozens of egg facilities facilitate this early connection on the Donor Sibling Registry, not a single sperm bank has indicated interest in exploring this option.
• There is no published research or any data showing that keeping a person from their close genetic relatives for the first 18 years of life is healthy or recommended by any medical professional. Develop honest, clear, and accurate policies regarding identity disclosure and the sharing of medical and genetic information.
• Educate all parties involved about the potential emotional and psychological implications of gamete donation and family relationships by offering 3rd-party pre-donation and pre-insemination counseling and support services to donors and recipients. Everyone deserves to make fully informed decisions that will affect them and their children for the rest of their lives.
• Be honest with prospective parents and donors about the fact that accurate record keeping doesn't exist on how many children are born for any one donor and that groups of 100 to 200+ half-siblings are common.

Genetics Essential Reads

Viral Infections May Change DNA and Promote Inherited Mental Illness

Left-Handedness and Genetics: New Scientific Insights

The Way Forward

As societal attitudes and legal frameworks surrounding donor families continue to evolve, gamete banks must adapt to meet the changing needs and expectations of all parties involved while being mindful of the potential for the backfire effect when discussing and setting policy on these sensitive issues. When setting policy, the ethical and empathetic way forward for the industry that is helping to create human life is by listening to, acknowledging, and considering the parents', donors', and most importantly the donor-conceived peoples' experiences in the years after the gametes are sold. Sperm bank and egg clinic employees have an opportunity to be part of the solution.