Waiting lists and costs are growing as Britain experiences a critical shortage of sperm donors, and fertility experts are blaming the country's 2005 decision to ban anonymous donations.
About 4,000 women a year in Britain need donor sperm to become pregnant, but in 2006 only 307 donors registered.
Canada may be headed in a similar direction after a landmark ruling in British Columbia last month.
Olivia Pratten, the daughter of an anonymous sperm donor, filed a lawsuit against the province's attorney general and the College of Physicians and Surgeons of British Columbia claiming that the anonymity law discriminates against donor offspring.
Ms. Pratten wants the records of sperm, egg and embryo donors preserved permanently, and the province's Supreme Court has ordered doctors to retain their records until the suit, which may expand into a class action, proceeds.
While she admits that fewer men will donate without the promise of anonymity, Wendy Kramer argues that a ban is necessary, especially because the Internet has made it possible for children of donors to find their parents anyway.
"Is it fair to bring a child into the world who will have no chance of knowing the genetic, ancestral and medical background of their parent? It's a human rights issue," said Ms. Kramer, who helps donors' kids find their half-siblings through an online registry that she runs from Colorado.
"It's an ethical question. Whose needs trump whose?" Ms. Kramer said. "The one entity whose needs haven't been addressed are the donor-conceived people."
As in Canada, U.S. sperm donors are anonymous, but unlike in Canada, which outlawed payment for sperm and eggs with the exception of expenses in 2004, American fertility clinics woo young, anonymous donors with lucrative offers and advertising on university campuses.
A ban on anonymous donors would be tricky in Canada because Canadians mostly use the sperm and eggs of anonymous U.S. donors who can agree to disclose their identity if a child requests it at the age of 18, said Arthur Leader, an obstetrics, gynecology and medicine professor at the University of Ottawa who also works at the Ottawa Fertility Centre.
The bulk of the issue, Dr. Leader says, rests in family law: If individual provinces decide to protect sperm donors from paternity suits, a ban on anonymity could be possible.
"It's a question of legal and cultural frameworks that need to be developed," said Dr. Leader, adding that Sweden, which became the first country to ban anonymous donors in 1984, experienced a "precipitous" drop in donations and that it took a decade to recruit similar numbers again.
Still, some Canadian critics say that insemination must be treated as carefully as screening for adoption because the "babies" bred eventually grow up to be adults with identity issues.
Diane Allen, executive director of the Infertility Network, complained that many clinics do not provide counselling beforehand, and some offer just an hour.
"I think it's really important to get off the supply focus, which is where the doctors are stuck," she says.
"It is not going to fix infertility. This is much closer to an alternative form of family-building," and as such, deserves the same considerations as adoption, Ms. Allen says.
Ms. Pratten, now 26, has said that "farmers have kept better records on the artificial insemination of cattle than the physicians in B.C. have kept on people like myself."
She is also looking for the identity of her biological father: All she knows is he was a healthy Caucasian medical student with a stocky build, brown hair, blue eyes and type A blood.
While the records of biological parents of an adopted person are preserved, the records of a gamete donor are only required to be preserved for six years in British Columbia; in Ontario it is 10.
"The information in the donor records could one day be vital to Olivia's health," the court document says. "If the donor records are lost or destroyed, that information will be lost for all time and Olivia's health and safety could be compromised as a result."
Destroyed documents mean donor offspring also cannot learn their racial, cultural, religious and linguistic history, which may cause psychological distress, the legal action claims.
Yesterday, members of the British Fertility Society voiced their concern about the shortage in the British Medical Journal.
Mark Hamilton and Allan Pacey suggested better recruiting is crucial, and that donors should be allowed to create more babies. The current limit of 10 pregnancies per donor is designed to prevent siblings born from donation inadvertently having children together.
Zosia Bielski