The HFEA (Human Fertilisation and Embryology Authority) govern and regulate all fertility treatments that take place in licensed fertility centres throughout the UK. The code of practice has recently been updated and we are awaiting the official issue of the 9th edition so that we can implement this into our clinical practice. There are a few updates that are applicable to surrogacy arrangements and may mean that there is a slight change to your treatment plan if you are currently going through treatment at this moment or are planning your treatment for the very near future.
The updates that may affect you are as follows:
● The HFEA Guidance notes 11 – Donor recruitment, assessment and screening and Guidance note 20 – Donor assisted conception showed thatpreviously if a centre offered NATS (Nucleic Acid Amplification Technique) testing, there was no specified quarantine periods for donor sperm or embryos created using donor sperm outlined by the authority. This meant that clinics were able use the sperm from the intended fathers (if applicable) to create embryos and perform NATS testing for HIV, Hepatitis B and Hepatitis C on the day of the egg collection of the egg donor or female intended parent and that those embryos could be used by the intended parents for an embryo transfer with their host surrogate immediately.
● The change to the above license condition now means that even if centres are able to offer NATS testing for their sperm donors and male intended parents as above (in addition to standard serology), then the embryos or sperm will need to be quarantined for 3 months before those embryos or sperm can be used. This can add a significant delay to the surrogacy treatment and in most cases, will mean that all embryo transfers for surrogacy will be frozen embryo transfer cycles unless the sperm is quarantined first and then embryos are created once the sperm has been released from quarantine.
● If the treatment centre or clinic does not offer NATS testing, then the original quarantine periods of 180 days outlined by the authority will be applicable to you.
● Centres should screen all egg donors by NAT testing in addition to serology.
These changes have been made on recommendation from the relevant professional bodies and the advisory committee on the Safety of Blood, Tissues and Organs (SaBTO). These recommendations will be published and the new HFEA code of practice will make reference to these recommendations.
Other code of practice updates include the following:
The HFEA have provided clearer guidance on surrogacy arrangements for licensed centres (guidance note 14 – Surrogacy) Reference is made to the Department of Health guidance published earlier this year and the law reform on Surrogacy. The highlighted changes are below:
● Surrogates and their partners (if applicable) should attend implications counselling. The Intended parents should also attend an implications session and a further joint session should take place for all involved. This can be accepted if it has taken place elsewhere.
● Legal advice should routinely be recommended
● Further advice from the GP should be sought to support the surrogacy arrangement
● All clinics should have an SOP (Standard Operating Procedure) in place to outline their surrogacy process and pathway.
Further information can be found via the links below:
Francesca Steyn is the Head of Nursing at the CRGH (Centre for Reproductive and Genetic Health) based in London and has a specialist interest in gamete donation and surrogacy.
She is a steering committee member for the Royal College of Nursing (RCN) Fertility Nurses Forum and is also an active member of the Senior Infertility Nurses Group (SING).
Francesca has co-authored national guidance and publications on surrogacy, fertility education and fertility preservation and has presented both nationally and internationally on Fertility nursing care and best practice.