Fatal Attraction? On the Risk of Incest for Children of IVF

[From Physicians For Life]: 

As the month of love rolls in, we are inundated with stories of romance on television, in the news, and even in forwarded e-mails.

Among the stranger stories are those like the December report of British twins who unwittingly married each other. Such stories have been the basis of ancient literature as in the legends of King Arthur, or in the current cultural icon of the soap opera.

While this story is based on a single reference lacking in detail, its introduction in a debate in the British House of Lords was raised to point out the current risk of sibling marriage among children conceived through anonymous donor sperm or donor eggs.

But is there a risk of incest among children of in-vitro fertilization (IVF)?

Regulation of assisted reproductive technology (ART) in the United Kingdom is through the Human Fertilisation and Embryology Authority which was created by legislation in 1990.

In the United States there is no such comparative authority regulating ART. Because of the American legal tradition of limited government and a deferral to the authority of medicine, after nearly thirty years of practice, ART in the United States is governed by very few laws.

The Fertility Clinic Success Rate and Certification Act of 1992 requires reporting of fertility cycles and their success rates to the Centers for Disease Control, but does not require fertility centers to comply.

A few states have enacted embryo protection laws in regard to fertility treatments and parental rights and responsibilities. But so far, there is no regulation on collecting information for donors of gametes.

Internal standards of regulation have been made by the American Society for Reproductive Medicine (ASRM) and the Society for Assisted Reproductive Technology (SART).

Practice guidelines for gamete donors suggests that directed (or known) donation is better than anonymous donation, but no standards exist for management of the donor information.

Large sperm donation centers, such as California Cryobank, insist on the anonymity of their donors, and keep no means to track donors once they are finished.

ASRM and SART have recently acknowledged this failure and say they will meet in March to begin discussions for the creation of a registry which would track gamete donors. But as with their other standards, such a registry would have the status of voluntary participation only

With so little external or internal regulation and increased numbers of children being born from donor gametes, the means for adult children of ART to discover their genetic inheritance is limited.

So has the risk of fatal sibling attraction increased? 

Let's do the math:  if one person's gametes have resulted in multiple births (from two to several hundred, as in the case of sperm donation) over a limited time period, and in a given geographical zone, the possibilities are unknown, but are definitely NOT zero... 
  [February 2008  www.tennesseecbc.org, Melanie Unruh, The Tennessee Center for Bioethics & Culture]


Back at home...

It must be remembered not all infertile couples are successful with IVF, so what happens to the sibling-situation if a child is adopted? 

Is the incest rate higher because the terms "family" and "genetically-related" are more broad and wide-spread , leaving more room for sexual opportunity?  When discussing the sexual taboo subject with members of the adoption community, I was assured screening for pedophiles is done.  Of course, I doubt that screening gets done with older siblings.

It only makes sense to me that the poorly placed child could very well be exposed to two separate yet very different experiences with incest -- one that is "home-based", and one that can be genetically traced.  

In a survey of 796 undergraduates at six New England colleges and universities, 15% of the females and 10% of the males reported some type of sexual experience involving a sibling. Fondling and touching of the genitals were the most common activities in all age categories. One-fourth of the experiences could be described as exploitative either because force was used or because there was a large age disparity between the partners. Reactions to the experiences were equally divided among those who considered them positive and those who considered them negative. Females were more likely than males to have been exploited and feel badly about it. Few participants of either sex ever told anyone. The research finds evidence that such experience may have long-term effects on sexual development. Females who report sibling sexual experiences, both positive and negative, have substantially higher levels of current sexual activity. Their level of sexual self-esteem may also have been affected, but more selectively. Those with positive sibling experiences after age 9 have more sexual self-esteem. However, experiences with much older siblings taking place before age 9 are associated with generally lower levels of self-esteem and no increase in current sexual activity.  http://www.springerlink.com/content/qg7tu631r7503228/

So, who should be held responsible for the sexual safety of a child, when that child comes from a different family-name?  Parents? 

During the past 20 to 30 years, professionals have given increased attention to intrafamilial incest, primarily addressing father-daughter incest. More recently, sibling incest, a type of intrafamilial incest, has received notice from mental health professionals; how-ever, many professionals still do not recognize the seriousness of the problem. Some professionals have asserted that sibling incest is as common as, and possibly more common than, parental incest. The prevalence of sibling incest can only be estimated because sex between siblings as a phenomenon has been poorly researched. http://tfj.sagepub.com/cgi/content/abstract/10/2/195

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