Donor and surrogacy: processes and legislation

Donor and surrogacy process and legislation

At Repromed we understand that a family can be made up of one parent and one child or several parents and a number of children. Family does not always include genetic lineage but is created through love, social connections and the contribution of others. 

Children may live in different families but be genetically connected. Parents may form life-long relationships with the people who assisted them to become parents. 

We know family building is a journey and it’s helpful to have a map to follow so here we’re providing some information on the process around gamete donation arrangements and surrogacy, including some of the more technical requirements to be aware of.

In this article, Repromed Counsellor Helen Nicholson looks at some frequently asked questions about processes and legislation for donor and surrogacy.

 

What are my options?

Gamete donors 

When we talk about gamete donation, this includes egg, sperm and embryo donation and egg and sperm donation in combination with each other. Gamete donation can include either a ‘known’ or ‘clinic donor’.

    A known donor is someone who donates their eggs or sperm to a recipient, where both parties are known to each other. This could either be where there has been an existing relationship eg a friend/family member or where the recipient has recruited the donor though advertising or an exchange of personal information on social media. 

    A clinic donor is someone who donates their eggs or sperm to a recipient, where both parties are not known to each other. This is facilitated by the fertility clinic where the donor is allocated a unique donor code, undergoes extensive counselling and health screening, gamete collection and is subsequently chosen by the recipients after viewing a selection of non-identifying information from the donor. 

    Although the clinic donor cycle is managed in an anonymous manner throughout the treatment process, it is important to know that the donor is required and has given consent to be identifiable to a donor conceived child upon their 18th birthday. 

    Clinics are required to send the donor and offspring identifying information through to the Department of Internal affairs where a database of this information is kept with Births, Deaths and Marriages.

    (Fertility treatment with a known donor or clinic donor at a fertility clinic means your potential child is protected. The known or clinic donor has no legal or financial responsibilities for any resulting donor conceived people, and your potential child is entitled to request their donor’s identity when they turn 18 years old.)

    Embryo donors 

    Embryo donors are unique in that they have the opportunity to choose a profile of embryo recipients. Profiles are shared and once donors have indicated the recipients they might want to donate to, then we share the donor profiles with the recipients. 

    The recipients can then start to look at if it’s a good match for them. Information on the embryos is also shared. Once both parties are comfortable with their choice, the embryo donation arrangements require and Ethics Application (See below for further information on ECART).

    Surrogacy

    Surrogacy may include egg donation, sperm donation, egg and sperm donation in combination or embryo donation. Because of the complexity of these arrangements, this option requires the addition of legal advice and an Ethics Committee application (ECART). 

     

    How long does it take?

    The length of time it takes for a recipient or intended parents to get to the point of starting their treatment for insemination, egg collection or embryo transfer, depends on many factors, most importantly on the availability of a suitable donor and/or surrogate. As a general rule it takes longer than most people anticipate.  

    Known egg or sperm donor

    The quickest option is where the recipient comes to the clinic with their own known egg or sperm donor that fits the recommended age criteria and does not require any ethics approval according to the HART Act. In these cases it may take four to six months of donor and recipient preparation before treatment begins. 

    During this time all parties undergo health screening, counselling and a three month quarantine period. 

    For sperm donors several suitable samples are frozen and stored to enable at least three rounds of inseminations. Egg donors require a round of hormone stimulation and egg collection with subsequent IVF and embryo freezing which can take up to six months to complete.

    Clinic donor

    As the demand for clinic donors grows, so does the pressure on clinics to deliver a continuous supply of recruited high calibre donors. The wait time for clinic donors in New Zealand fluctuates between 20 and 24 months depending on the ethnicity and other characteristics required. Checking a clinic’s website or phoning their Donor Coordinator is the best way to find out the current wait time. 

    The option of importing donor sperm from overseas is highly restricted by the requirements of our New Zealand HART and not routinely recommended.

    Embryo donation

    Embryos available for donation are not particularly abundant, so it is not possible to predict how long that process will take. It is helpful to anticipate that it may often require the embryos to be transported from one clinic to another with all parties required to supply consent for this, which may take three to six months. Again, all parties require to undergo health screening and counselling, often taking up to six months to complete. 

    Surrogacy

    Surrogacy arrangements are inherently more complex and because they require ethics approval and counselling/screening and treatment of multiple parties, it is not uncommon for this process to take between six and 12 months.

     

    What information is included in a clinic donor’s profile?

    Profiles include information which the donor has decided they are willing to share. There is therefore some variation in what is included, but generally the information provided includes:

      • Physical characteristics such as their height, hair and eye colour, whether they are left or right handed, or have any allergies.
      • Family medical history.
      • Education and career information (what they have done or might want to do for a job)
      • Talents, hobbies and skills they might have
      • Their motivation to donate – this helps us get a sense of their values. 
      • We also ask them to give an indication on their openness for future contact with a donor-conceived child.

       

      How do I find a surrogate?

      The first thing to know is that Aotearoa has an altruistic surrogacy model. The Human Assisted Reproductive Technology Act HART Act prohibits certain commercial transactions relating to human reproduction. That means that surrogates cannot be paid or compensated in their role for carrying pregnancy.

      However it is possible for intended parents to pay for pregnancy related expenses. Your legal adviser can discuss the parameters of that with you once you have found a surrogate.

      Surrogacy legislation also prohibits intended/non-birthing parents from advertising for a surrogate. Clinics can’t facilitate matching intended parents with surrogates and vice versa. We are however happy to speak with intended parents about how they might start the process of finding a surrogate.

      Once intended parents are ready to start an ECART application, we will arrange a doctor’s appointment for the intended parent and/or the surrogate, we set up counselling appointments and provide information on where to get legal advice. 

      We also direct you to contact the adoptions team at Oranga Tamariki. In New Zealand, all intended parents are required to make a formal application for adoption in order to become the legal parent. Oranga Tamariki social workers will work with you to complete their requirements for adoption, as will your lawyer.

       

      What is the ECART application? 

      In New Zealand, the HART legislation provides the framework for third party arrangements (donor and surrogacy) and also provides regulation around fertility treatment including the requirement for the Ethics Committee on Assisted Reproductive Technology (ECART) oversight on arrangements that are considered complex. 

      Complex arrangements include embryo donation, surrogacy, donated egg and donated sperm treatment in conjunction with each other, or in combination, and also some situations where eggs or sperm are being donated between family members such as in an intergenerational arrangement. 

      In those instances the clinic goes through the process of working through an ECART application. As an example for surrogacy, it includes reports from medical specialists for the intended/or non-birthing parent, a medical report for the birthing parent/or the surrogate, counselling summaries for both parties, legal advice (not required for embryo donation or egg and sperm donation in combination) from independent lawyers.

      There might be other documentation such as other letters from medical specialists, people involved in the application can put in a letter themselves; or letters from family members or significant others can also be included.

      Reports are submitted in non-identifying form (people are not identified by name) to ECART. The Committee is made up of a range of people from the medical and health sectors, scientific and legal, as well as policy specialists and advocates. They act independently from fertility clinics and review applications under ECART guidelines. It can take several months to meet all the requirements to submit an application. 

      The fertility clinic will submit on your behalf. Each clinic will charge to put the application together. There is no public funding available for an ECART application, even if the treatment is funded. The cost of an application is about $3,500.  

       

      How can I get more information?

      You can learn more about our growing your family through donor services and surrogacy here. 

      To learn more about our becoming a donor, click here.

      If you would like to speak with our Donor Team (confidentially), you can reach us on 0800 483 105 or email

      Megan Black

      Nurse Manager

      DipNurs

      Megan leads the nursing team through the continually changing face of IVF. She works in a multidisciplinary team, providing the essential organization between the doctors and laboratory and ensuring communication between all departments.

      Megan started her IVF nursing career in the United Kingdom, working in two large London clinic’s before returning to New Zealand. She is also the Secretary of Fertility Nurses of Australasia.

      I love working with people and see nursing as a vocation, not a job. I usually spend my downtime absorbed in a good book and planning my next travel adventure.