For the first time in the United States, babies who are conceived with help from donor eggs or sperm could soon have the right to learn their biological history when they become young adults. A bill just passed in Colorado says secrecy about family formation can be hard on children and hurt family relationships.

So starting in 2025, people who are conceived through egg or sperm donation in Colorado will be able, as adults, to learn the donor’s name and medical history and even form a personal relationship with the donor, if both are amenable.

The bill, which is awaiting Gov. Jared Polis’ signature, would make Colorado the first state to end anonymous sperm or egg donation. Senate Bill 224, which passed late Tuesday night, would also:

  • Require someone who donates sperm or eggs to be at least 21.
  • Limit the number of families a sperm donor can help to 25.
  • Limit a woman’s egg donation retrieval to six cycles at most, depending on medical risks.
  • Require sperm and egg banks to track births involving each donor.
  • Require sperm banks, egg banks and fertility clinics to be licensed starting in 2025.
  • Require clinics to maintain updated contact information and medical history of all reproductive tissue donors — or at least make a good-faith effort to update medical records and the donor’s address every three years.

If signed, children donor-conceived in 2025 could learn the identity of the person who aided their conception when they turn 18 in 2043. The law is not retroactive.

The Colorado law would also apply to out-of-state banks that provide the reproductive tissue, called gametes, to Colorado recipients. Both eggs and sperm are gametes.

The popularity of commercial DNA technology made clear how badly such a law is needed, the bill sponsors said. Individuals were sometimes learning by accident that a parent was not their biological parent or that a stranger was when they took a DNA test through companies like Ancestry or 23andMe. Some of those sites also connected donor-conceived people with an improbably high number of half-siblings.

Wendy Kramer, who with her son Ryan, 31, co-founded the Donor Sibling Registry, said he has nearly two dozen half-siblings who were also donor-conceived. And some prolific sperm donors have said the children to whom they contributed their gametes number into the hundreds.

Family and industry challenges

The first artificial insemination in a U.S. hospital reportedly took place in 1884 in Philadelphia, according to a Donor Sibling Registry blog. The first successful egg donation occurred in 1983 at UCLA.

Kramer remembers how desperately she wanted a baby when she and her husband sought reproductive help. But she didn’t understand some of the challenges that would emerge over time, like her son’s overwhelming curiosity. “Just give me the baby. I will figure everything else out later. But somebody should have counseled us anyway,” she said.

Ryan started asking questions about his donor when he was very young. And he managed to find him eventually through a DNA database.

They now know the man who contributed gametes to her son, which has given them another view into the industry. He said he was promised there would be no more than 10 kids born from his donation. He knows about more than 20, Kramer said, and the number may grow.

What’s been a boon for many parents who wanted but could not conceive children without help has been, to a large degree, unregulated and even uncounted. No one mandates reporting of live births following fertility treatments. So “counts” of how many children are donor-conceived — a description used for anyone who is deliberately conceived using donated sperm or egg or both — amount to a maybe-good guess.

Naomi Cahn, a law professor at University of Virginia who has written extensively on family law topics, including reproductive technology and donor-conceived children, said half a million is an imprecise, but often-used estimate.

Cahn and Sonia Suter, a law professor at George Washington University, wrote about issues impacting donor-conceived children in The Conversation and noted they support the Colorado legislation.

The two said that 12% of U.S. women have used some type of infertility medical care, which could include medicines, intrauterine insemination, in vitro fertilization or donor sperm, eggs or embryos. As many as 10%-20% of heterosexual people have trouble conceiving, they said — and that doesn’t include same-sex couples or single individuals who want to have a child.

The Centers for Disease Control and Prevention estimated in 2019 that close to 78,000 live births came about from fertility treatments, which includes egg donation. No one knows how many children are born through sperm donation because no one’s counting that.

Stopping fraud, lies and too much giving

The Gazette in Colorado reported that the bill’s sponsors said the “current anonymity of the assisted reproduction industry promotes fraud, encouraging donors to lie on their applications and allowing nefarious actors to take advantage of blind donations.”

Those sponsors also told Colorado Public Radio that they received thousands of letters supporting the legislation prior to its passage.

One need run only a simple Google search to see what sparked concerns: a startling number of stories about fertility doctors who — unbeknownst to their patients — used their own sperm to help women get pregnant. Or donors who say they’ve provided sperm to multiple clinics and individuals, sometimes all over the world, to help women conceive.

A student in one of Cahn’s college classes told her that he’d found he had 102 half-siblings — something some donor-conceived individuals find dehumanizing, she said. There’s even a remote chance that two people, conceived with gametes from the same donor, could meet and fall in love, she added.

While the bill would enable it, it would not require donor-conceived people to learn their gamete donor’s identity, said Cahn. “But many who know they are donor-conceived are or might be interested in information about their donors,” she told the Deseret News.

New York Times reporter Jacqueline Mroz took a deep look at “serial” sperm donors, including some who are biological fathers to hundreds — if not more — children. The list included a Dutch musician who acknowledges having helped with the conception of around 200 children and maybe more.

Kramer’s research — she’s been published in more than two dozen peer-reviewed academic journals, she said — suggests that about one-quarter of sperm donors donate to more than one facility.

“It’s not uncommon to randomly meet someone who was donor-conceived. We joke about it. ‘If you get serious, you’ve got to find out her donor number.’ We joke about making an app where you can tap phones to see if you’re half-siblings,” Kramer said.

Actual deception is also sometimes a challenge. The New York Times chronicled a Georgia clinic that reportedly marketed sperm as “belonging to a neuroscientist with a genius-level IQ who turned out to be a schizophrenic felon and who has fathered at least 36 children.”

In search of solutions

Officials, advocacy groups and the reproductive-assistance industry itself have taken piecemeal steps to solve some of the problems.

“Some sperm banks already have adopted systems in which adult offspring can learn the identity of donors if both parties agree,” according to Medscape, “However, a survey by the U.S. Donor Conceived Council, an advocacy group, found ‘significant problems’ with some of those policies, such as requirements that donor-conceived offspring sign nondisclosure agreements or banks refusing to release information if a donor-conceived person’s parents never registered the child’s birth with the bank.”

Cahn and Suter said some states — the number is growing — have provisions for fertility fraud, as when a fertility doctor uses his own sperm without telling the parent.

Washington in 2011 allowed disclosure of donor identifying information and medical history to children at 18 and some other states including California have followed, but a donor can opt out. There would be no opt-out in Colorado.

A bill being considered in New York would require fertility clinics to collect and verify the medical histories of donors during the donor screening process and let those who are donor-conceived see the information. Donors would have to sign releases allowing the reproductive tissue bank to obtain the needed information, including medical records. And, if it passes, outside agencies would have to comply with the law in order for the gametes to be used in New York.

Regulations are spotty worldwide.

Sweden and the U.K. ban donor anonymity. Spain mandates it. Germany allows 15 children to be conceived from a donor’s gametes, while the United Kingdom allows 10 families of however many children. The Netherlands doesn’t allow anonymous donations and bars payment for sperm. Its nonbinding guidelines say clinics must limit donors to contributing to the birth of 25 kids and donations should be made through only one clinic, though that’s very hard to police. The American Society for Reproductive Medicine guidance says no more than 25 children per donor in a population of 800,000.

Will changes stick?

While some critics of the Colorado bill said it would strip away the identity protection of donors, the bill’s sponsors point out that DNA technology already did that.

Opponents also worry that such a law would discourage would-be donors, something the bill’s supporters say there’s little evidence of. A 2016 study published in the Journal of Law and the Biosciences found some would-be donors were discouraged by the loss of anonymity, but two-thirds stayed in when they were paid a bit more.

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According to the Cahn and Suter article in The Conversation, “In Australia, where payment for sperm donation is prohibited beyond expense reimbursement, the number of sperm donors actually increased after anonymity was removed. Similarly, a 2020 survey of 148 egg donors in South Africa, where donor anonymity is allowed, found that 79% would have still donated their eggs even if their identity were released.”

A number of groups backed the Colorado legislation, including the U.S. Donor Conceived Council, We Are Egg Donors, GSMoms and Advocate Genetics, according to The Gazette.

Ask Kramer if she thinks the bill will help solve challenges in the industry and she says simply, “I don’t know.” She’s skeptical because she believes industry regulation is inadequate and that the record-keeping would have to greatly improve to accomplish the bill’s aims.

But she knows change is possible. The Donor Sibling Registry already has a strong relationship with dozens of egg clinics, which include information about the registry in the parent-donor agreement, alleviating some of the problems, she said. “They get to define relationships with each other and what kind of information they share. If they want to meet, they can, from the beginning. They share medical information.”

Sperm banks, she said, have historically spent a lot of time and money keeping those people apart.

But even without the laws, she adds, parents have been given very basic medical information when they selected a donor. Unless sperm and eggs banks keep great records and are diligent in updating, donor-conceived children and their parents may not get much more than that.

Medical histories tend to be incomplete for a number of reasons, Kramer said, including that donors are typically young — often college students looking to make extra money — and don’t yet know how their medical stories will unfold. Besides that, she said, nothing has forced them to tell the truth about where they donate gametes or how often.

Solving that would require a national or even international system to keep track.

“Who’s going to police this?” asked Kramer, who lives in Nederland, Colorado, and has written books on the issue, including “Donor Family Matters: My Story of Raising a Profoundly Gifted Donor-Conceived Child, Redefining Family, and Building the Donor Sibling Registry.

Until there are accurate records, she said, mandating other things is very difficult. “You would have to do an overhaul to make reporting mandatory.”

Since Colorado’s law mandates some specific record-keeping, won’t it be different? “I don’t know,” Kramer said. “What I know is that so far, no law has made one iota of difference.”

She said the Donor Sibling Registry has about 80,000 people who are involved in some way with donor conception, including donor-conceived children, their parents and people who donated gametes. As of last week, they’d matched nearly 23,000 donor-conceived individuals to half-siblings or the donors. Some of those connecting on their registry are as old as 80, she said, conceived when fertility procedures were “very hush-hush in a doctor’s office.”

Correction: A previous version said Wendy Kramer and her son co-founded the Donor Support Network. They co-founded the Donor Sibling Registry. The bill being considered in New York no longer asks for verification of education history, though an earlier version did. The story has been updated.