The Assisted Human Reproduction Act--New Hope for Infertile Couples

Due to the ethical dimensions of the issue, the first order of business for the new law is protecting the identities of donors, recipients, and artificially conceived children.

In the future, couples seeking to receive sperm or eggs will be provided information about the donor's race, skin color, and blood type by health professionals in order to determine its acceptability. Other information such as the donor's occupation will be kept private.

Hitherto there has been no set of clear guidelines or infrastructure by which donors and recipients can interact legally. The two sides come into contact privately, creating a high likelihood for disputes. For example, an artificially conceived child might, upon reaching adulthood, learn that his or her biological parent became very wealthy. In such a case, the child would currently have a legal right to learn that parent's identity and would have a claim toward inheriting the parent's property. Such cases have caused controversy.

For this reason, the new law protects the identities of both donor and recipient equally. But in order to quell fears of unwitting incest, hospitals will request copies of the families' household records from household registration offices to make sure donor and recipient are not closely related. When the child reaches adulthood and is to marry, the child will also be able to request that the Bureau of Health Promotion (BHP) check the records against the proposed spouse to make sure the couple are not close relatives.

Ethical dilemmas

Additionally, the new law takes steps toward establishing a fee to be paid to donors. In principle, donating eggs or sperm is seen as comparable to donating blood and to be done on a purely volunteer basis. However, men will be permitted a "health maintenance fee" of NT$4-8,000. Due to the complicated and painful procedure of extracting eggs and taking into account that women must go under anesthetic and be available at the right time in their monthly cycles, the new law allows egg donors to receive NT$50-100,000.

In order to keep people from turning into "professional donors," hospitals must contact the BHP after processing a donation and inform it of the donor's identity. To ensure that an individual's eggs or sperm are only used once, hospitals must destroy what is left over after successful delivery of a child conceived of that individual's donation. However, this means that couples wishing to have multiple children have to find another donor, creating even more bloodlines within the family and complicating things further.

To prevent controversies such as the recent one surrounding sperm harvested from Army Captain Sun Chi-hsiang, who died in the course of duty, couples using assisted reproduction must sign an agreement beforehand stating that should one die or if they divorce, the eggs or sperm collected will be destroyed. This will help to ensure that the children conceived through assisted reproduction will grow up in a two-parent home environment.

Due to the complex ethical issues in cases where a woman's womb cannot bear the heavy burden of nine months of pregnancy due to illness and she must use a surrogate mother, these questions were not dealt with in this law. They are left for a future law to determine, disappointing women involved in such situations.

Reproductive rights

The Assisted Human Reproduction Act applies to couples of which one member is infertile or has a severe genetic disorder. There must be either healthy sperm from the male or healthy eggs from the female--couples cannot use both donated eggs and donated sperm. As people are marrying later these days, and one in seven couples of child-bearing age cannot reproduce, this law gives new hope to many people.

But on the other hand, as the law specifically excludes single people, homosexuals, and non-traditional arrangements, it has been attacked as overly conservative and a violation of the reproductive rights of such groups.

Dr. Li Mao-sheng, who harvested sperm from Sun Chi-hsiang after his death to give his fiancee Li Hsin-yu a chance to bear his child, has stated his unequivocal opposition to limiting unmarried women's access to assisted reproduction. More and more women are remaining single by choice or otherwise, and artificial insemination represents their hope of having a child. There are also many couples who choose to live together without marrying and hope to have children together--should they have trouble conceiving, they might seek assistance too. The strict new law virtually quashes the rights of these groups to reproduce, adding insult to injury.

As homosexuals lack legal channels for adoption or artificial insemination, lesbians who want to have children obtain sperm and inject it themselves or even seek out a man willing to "marry" them to fulfill their dream. These illegal methods are not only expensive, but also present problems for the children as they will lack knowledge of their biological fathers' identities and medical histories.

For that reason, legislator Huang Shu-ying believes that Taiwanese society still shows prejudice toward single parents, unwed mothers, and homosexuals, but it has also taken a step forward as the new law takes into account other ethical questions and the rights of the children. Though for now the laws are not liberalized, in the future they will follow social trends and become more inclusive.

A first step

After more than a decade of struggle, the law has been passed. It might not go far enough, but expectations are high.

According to statistics, more than 20,000 babies have been conceived artificially in Taiwan since 1998. Of those the majority are conceived through in vitro fertilization from the couple's own egg and sperm, but more than 10% are conceived with sperm or an egg from a third party. That means that in Taiwan one out of every 10,000 people belong to that latter category, and that is before considering those who use illegal channels or travel abroad to obain eggs or sperm. Considering social trends this figure is destined only to get larger. It is a phenomenon that should not be ignored.

Though the law didn't please everyone, at least it will solve some dilemmas. However, experts caution that assisted reproduction is not a cure-all and that mothers-to-be should still try to conceive at an age when they are biologically capable. Also, with more and more young women seeking abortions or abandoning their babies, adoption is another avenue that should be considered in addition to assisted reproduction.