Under UK legislation, children reaching adulthood will, by the end of the decade, be able to ask the Human Fertilisation and Embryology Authority if they were born through donor conception or are related to someone they intend to marry. The legislation also allows for new regulations that would give these young adults more information about donors, including information that would identify them. Department of Health officials are preparing an options paper on the issue for ministers, which could form the basis of a public consultation.
One in six couples suffer infertility problems, and fertility treatment, despite having a success rate of only between 10 and 20 per cent, has led to a huge rise in the number of babies conceived with artificial help over the past ten years. Between 1985 and 1998, the number of babies born in the United Kingdom through in vitro fertilisation rose from 444 to 7,397, while the number born between 1991 and 1998 from donor insemination almost doubled - from 882 to 1,321.
But the pace of medical advance has outstripped investigations into the consequences. What impact does it have on a child to be told that one of their biological parents is an anonymous donor? How does a family live with such knowledge?
Susan Golombok, professor of psychology at City University, London, uses standard scientific methodology to study the psychological development of children born by artificial reproductive technology. She conducts interviews with the mothers and gathers standardised information from the fathers, the children and the children's teachers, backed by ratings from child psychiatrists.
Such a formally scientific approach is, however, eschewed by Alexina McWhinnie, senior research fellow in Dundee University's social work department. She has interviewed both mothers and fathers, usually in their homes, asking them what they feel is important about their experience, without directing the discussion.
"It's a different way of exploring things," she says. "People tell you what is important, what is hurtful, what is manageable. If you go in with a questionnaire, you've decided what's relevant."
Both academics found that couples who had successfully used reproductive technology had very strong partnerships. McWhinnie found that almost every infertile partner had urged the other to leave and find someone else, and that the couple had therefore made a positive decision to stay together. But she nonetheless found tensions among 39 per cent of donor insemination (DI) parents.
When the City researchers assessed children aged between four and eight, they found not only that they were well-adjusted and much loved, but that they had better relationships with their parents than naturally conceived children. "The lack of a genetic link didn't seem to make a difference. What made the difference was just wanting to have a child so much," says Golombok.
McWhinnie found that most of the children she studied were consistently loved and cared for by both parents, although the IVF parents were more likely to see themselves as protective or over-protective.
But both researchers found the parents' joy in their children was not matched by openness. Golombok discovered that none of the 111 DI children in her survey and only one of the 21 egg-donation children had been told of their genetic origins by the age of six. "There's concern that the child will love the (non-genetic) mother or father less, concern that they haven't anything to tell the child about the donor, and that they don't know how to tell, or what to tell," she says.
Golombok's team has found that the genetic link seems less important to a good family life than a strong commitment to parenthood. She would like to do a follow-up study of the children when they reach late adolescence, but is not sure whether this will be possible. "The problem is that if the parents have kept the secret, they might not be very keen for us to speak to the children," she says. "With adopted children who know they are adopted, it's usually after the age of 11 that they start becoming interested in their birth parents, although often trying to contact them doesn't happen until well into adulthood."
Some parents wish they had already told the child, but believe they have left it too late. "The worry is always that it will come out at the worst possible time, or come out through someone else," Golombok says.
McWhinnie clearly fears the impact of continuing secrecy. She says it used to be thought best not to tell adopted children about their origins, but many people who later discovered they were adopted found the secret profoundly distressing. What distressed them was not so much the secret itself, but that the adoptive parents had not been honest with them.
McWhinnie thinks that secrecy is more likely in cases where eggs or sperm have been donated. She believes her interviews have been one of the few opportunities for men to talk about their experience and found the reactions of those who discovered they could not father a child ranged "from devastation to blind rage". "The reality is that for families who are still traumatised about one or other of them not being able to be the biological mother or father, the temptation not to tell is enormous. The wife is pregnant in the community for nine months, there is a natural birth, you have a beautiful baby and it is assumed that you are the biological parents. In surrogacy and adoption, you can't do that."
McWhinnie says secrets about a child's origins are different from other family secrets. She has interviewed three DI adults, and studied the reported views of another 80 to 90, finding a range of reactions. One man, who had believed the differences between himself and his father meant his mother had had an affair, was relieved. Others were hurt and resentful, having been told during a row or marital break-up.
Children's questions are unavoidable, she says. At school, they may want information for family trees, or learn about the inheritance of eye colour. Parents have to decide how they will respond. "Most of the parents I interviewed were not going to tell, which meant they had to lie to all the relatives. When the paternal grandmother gazes fondly at the new baby, how do you cope with her saying: 'She doesn't look like you, Dave'?" "By the very nature of how the parents got these children they take on another task - how to live with it. This isn't about being a 'parent-plus', but being a parent who can manage this constructively. And really, I don't think anybody is doing them a service by not helping them look at that before they start," says McWhinnie.
There are fears that donor numbers will fall if identification is compulsory, which has lead to suggestions of a twin-track system. Donors could choose whether or not to be identified, with parents choosing a donor on this basis. But McWhinnie argues that it would be unfair on the children for some to have access to information while others do not.
She says that the debate must now shift its focus from the interests of the parents to those of the conceived and the Department of Health must make sure it hears the views of DI adults. "They have a legitimate locus in this debate. To date, their views have not been heard, but growing numbers are voicing their concern and anger at aspects of how they were created."
Human Fertilisation and Embryology Authority: www.hfea.gov.uk/