Dan Reisel
Senior Research Associate, Institute for Women's Health (UCL). Coordinator of the ethics teaching on the Institute's MSc courses, researcher in preventive medicine and bioethics in Women's Health
Location London
Activity
-
Dan Reisel made a comment
Welcome to the course! Look forward to learning with you and from you in the weeks ahead. Any questions please feel free to ask, and of course add your comments and views. Everyone benefits from a vibrant and wide-ranging conversation about all of these issues.
-
Dan Reisel replied to Adriana Contreras
Agree that it would be great to add these perspectives, both from international and more local surrogacy arrangements. And perhaps include a family that have chosen to stay in touch with their surrogate.
-
Thanks for sharing, well worth watching.
-
I tend to agree with you that we're already there and that we're unlikely to see this change. The challenge is to maintain respect for individuals affected by such convictions at the same time, and continue to make society more inclusive and supportive. And that's not an easy challenge!
-
Dan Reisel replied to Chloe Findlay
I suppose a follow-up questions would be, how can we maintain respect for the dignity of people living with disabilities at the same time as we, as a society, work towards limiting the prevalence of certain conditions.
-
Dan Reisel replied to Maria Apelt
You might find step 5.13 this week interesting, as it deals with the case of late onset disorders (BRCA-related inherited cancer) and PGD. Some feel this is beyond the pale, yet many carriers, who have gone through radical surgery or even had cancer, are desperate to eradicate the deleterious mutation from their family.
-
Dan Reisel replied to Naomi-Beth Carter
Termination of pregnancy based on fetal sex is not legal in the UK. That of course does not stop individuals having the a test in the private sector and then procuring an abortion. How widespread this is, no one knows.
-
Dan Reisel replied to Irene Croly
Thanks Irene. Do you know if there is public support in Ireland for a law change?
-
Wonderful. Thank you for sharing, Carole.
-
Dan Reisel replied to Beth Atkinson
Thanks for sharing.
-
Dan Reisel replied to Melissa Burke
Think it would be terrific to add this in future course runs.
-
If you feel like that, then you're already at an advanced stage of understanding!
-
Dan Reisel replied to ALISON LINNEMANN
How interesting, thank you for sharing.
-
Dan Reisel replied to Linda May
Thank you for sharing, Linda.
-
Dan Reisel replied to Sian Forster
Thank you for sharing that, Sian.
-
Dan Reisel replied to Liz Jenkins
Thank you for sharing that, Liz. We touch on this in step 5.13 in two week's time. Would be interested to hear your thoughts then.
-
Dan Reisel replied to keith miles
Good point, which is why co-parenting is increasing as a real option for many people, enabling contact with the donor from as early as is desired. The age of 18 has to do with it being the end of the period when the child is eligible for monetary support. If the donor was identified earlier than the child's coming of age, there was a concern on behalf of...
-
Dan Reisel replied to keith miles
The law is not retrospective, so anyone who donated gametes anonymously in the IK prior to 1 April 2005 are still considered anonymous donors. They can, however, voluntarily sign up to a register, so that donor-conceived children aware of their status, can potentially contact them.
-
Dan Reisel replied to Phillippa Delaney
Fascinating perspective. Thank you.
-
Dan Reisel replied to Natalie Wren
Thank you for sharing! See you next week! :)
-
Dan Reisel made a comment
Apologies for the link not working! Futurelearn is on the case!
-
Thank you for sharing this and for your insightful comments, Rebecca.
-
The WHO actually classifies infertility as a disability: http://www.who.int/reproductivehealth/topics/infertility/definitions/en/
-
Dan Reisel replied to David Marples
Correct about NICE, David. Very interesting points!
-
How interesting! I assume this is for heterosexual couples only? And when you say subsidy, does that mean it's free? How many cycles? Tell us more!
-
Quite. And that is why the definition of infertility matters: http://europe.newsweek.com/single-people-who-struggle-find-sexual-partner-considered-infertile-512404?rm=eu
-
Dan Reisel replied to René Munro
This is a key question. It also goes to the heart of what infertility means. More on this later this week.
-
There are important cultural variations around these issues. So important to understand what people think at various stages of gestation. Thank you for your contributions.
-
These stats are for women who have had collection and implantation below the age of 35. There is a reason that clinics quote this rather than the success rate at 45...
-
This will be covered later on in the course - stay tuned!
-
I don't believe this is a material factor.
-
Everything is relative, i suppose! Thank you for your comment.
-
Dan Reisel replied to René Munro
Note that this success rate is for women under the age of 35. Agree with your final point!
-
Dan Reisel replied to Katya Smith
Thank you for your valuable comments.
-
Dan Reisel replied to Alison C
Thanks both - fascinating!
-
This particular clinic state that they have live brith rates of 60% in under 35s, which is very high compared to others. They also state that they don't have a material difference between frozen and fresh embryos.
-
Dan Reisel replied to Tatiana Olesova
Usually patients are given a general anaesthetic (asleep) for the procedure. This does involve risks. And some eggs will not survive thawing, which is why usually several cycles are required.
-
Dan Reisel replied to Anna Pearse
Given the funding pressures on the NHS in the UK at present, I can't see that we will get there in terms of social egg freezing but your point still stands - it's unfair that only those with a large disposable income can afford these technologies. Perhaps an insurance-based model could work?
-
The effects of the hormonal treatment is probably not completely understood I imagine.
-
Dan Reisel replied to Erica Ackers
Wish we could have included more in this interview, but there is just so much to cover!
-
More about this later! Thank you.
-
Dan Reisel replied to Rebecca Howitt
I wonder how this differs in different countries. I believe there is a generally agreed cut-off in the UK (mid-fifties). But each clinic will have their own parameters.
-
Dan Reisel replied to Habiba Paracha
Good point!
-
Dan Reisel replied to René Munro
There might be a decline in oocyte quality but I believe the answer is essentially no, there isn't a limit as such.
-
My own take would be that although the placenta to a large extent doesn't age and hormones can be replaced, there is a higher incidence of complications. But that is the risk a person takes when embarking on this. In many cases, the benefits of having a family of their own, outweighs the risks. Thanks everyone for insightful and interesting comments!
-
Impressive - thank you for sharing!
-
Dan Reisel replied to Natalie Wren
Thank you Natalie for your perspective.
-
Dan Reisel replied to David Marples
Helen O'Neill speaks to this issue later in the week's learning. Thank you!
-
Dan Reisel replied to Margaret Fox
Well at a price... :)
-
I like your analogy lol, but there is some evidence to the contrary: http://www.medicaldaily.com/frozen-embryos-produce-more-sociable-children-fresh-ones-some-reason-307713
-
Dan Reisel replied to Anne Cooper
In many cases, it's not only finding Mr Right but actually finding Mr Ready -- the man who is mature enough to settle down and have a family, with all the support and sharing of chores that it involves.
-
Dan Reisel replied to Samina H
Guess the question is whether this increases or decreases their reproductive autonomy! If it only adds to the stress and the expectations on women (to perform at work whilst at the same time successfully planning a family etc), then perhaps not...
-
In the UK, this is covered by the NHS in many, though not all, cases.
-
Interesting - though bear in mind that she is the Deputy Head of Embryology at a premier IVF clinic in London. So she knows all about the conception rates etc. But your point still stands!
-
Dan Reisel replied to Jun Jie Ong
Hi Jun, do you know why social egg freezing is currently not legal in Singapore? What reasons do the authorities give? And do you think there would be a market for it of it were legal?
-
Dan Reisel replied to joan appleton
Hope you will find that some of the interviews this week will address those issues of access and structural inequality.
-
Dan Reisel replied to Cemre Canbazer
A bargain! Thanks for sharing!
-
A sign of the times, perhaps! Thanks for sharing.
-
Dan Reisel replied to Heather H
Good point Heather!
-
Dan Reisel replied to Fatimat Amoke Rabiu
Very interesting. Thank you for sharing.
-
Dan Reisel made a comment
I have let Futurelearn know about the link not working - and they will correct it today. Apologies!
-
Dan Reisel replied to Susan W
Thanks for your comment - will see what I can do for future runs of the course.
-
Thank you Madison for your contribution.
-
This is indeed something that people are increasingly advocating for... Thanks for your comment, Keith.
-
Thank you for your perspective, Takaki. Fascinating!
-
We have just submitted an article about this practice, especially looking at the ethics and the legal side, and I will put a link up as soon as it is published.
-
Here is a link to the TED talk mentioned above: https://www.ted.com/talks/veerle_provoost_do_kids_think_of_sperm_donors_as_family
-
Dear Natalie,
Thank you for sharing your personal experience. Very powerful testimony.
Wishing you every luck in your endeavour to create a family in the way that you have chosen to do so.
-
Dan Reisel made a comment
Welcome to the course! Hope you will enjoy the video interviews with scientists and academics, and especially the personal stories that start off each of the topics. As you go through each step, please consider sharing your thoughts, questions and comments with others - it really enriches everyone's experience, not least your own!
-
Always happy to chat with anyone interested in the course. Email me and we can talk further (d.reisel@ucl.ac.uk).
-
Sure, let's talk. Would be great to be able to continue to make use of your expertise.
-
Step has now been updated. Thank you for all your insightful comments Lyndsay.
-
Dan Reisel made a comment
Link now working. Apologies!
-
Dan Reisel replied to Sisan Alokwe
Dear Sisan, thank you for your comment. You highlight an important issue, the fact that a large part of infertility (possibility as high as 40%) and a large portion of genetic abnormalities in the offspring are due to errors in the father's DNA. PGD is a test of the embryo, so it would potentially pick up a genetic error from either parent. There is also...
-
Dan Reisel replied to Ellie Burnett
Thanks for highlighting this. Very valuable feedback!
-
This has now been corrected. Many thanks.
-
Dan Reisel replied to Hafsa Jalisi
Thank you for your comments, Hafsa. The opening story in Week 3 is Lyn's story, of being donor-conceived and finding out at the age of twenty that her family narrative was different than what she had thought.
-
Dan Reisel replied to [Learner left FutureLearn]
Hi Eleanor. Your point is well made. I think the notion of parenthood is evolving, it's in flux, and so to a certain extent it might be that this is a question of semantics. Parenthood can mean so many different things to different people, and it changes depending on context. Thank you for your valuable input.
-
The questions for this week picks up on the last point that Paul Serhal makes, which is about if a health condition (in his example HLA typing for kidney disease) somehow makes the genetic relationship with the donor relevant in way that it otherwise wouldn't have been. Fascinating to hear about your own experience and that of your daughter, thank you for...
-
The quoted percentage refers to pregnancy rate, not live birth. An empirical paper has been submitted by the team, and I will be adding as a link in the future.
-
I have clarified this with the clinic, and the correct figure is a pregnancy rate of 60% from frozen eggs in women under the age of 35, as the first video stated.
-
Dan Reisel replied to Maire Hewitt
See here for a recent paper on motivations of sperm donors. High up on the list is the desire to help others (and to procreate, though not necessarily to parent).
http://humrep.oxfordjournals.org/content/early/2016/07/13/humrep.dew166.full.pdf+html
-
Thanks for sharing.
-
That's true, although not in the unregulated sector of course, where all bets are off.
-
Hi Staci-Jill. The difference between panel testing like you mention, and home genomic testing is that direct-to-consumer DNA tests like 23andMe also include information about ancestry. This means that a donor-conceived individual would likely be provided with information that wouldn't fit with their family story. The uptake of these tests are growing faster...
-
Dan Reisel replied to Jen Mason
Hi Jen. Thanks for your detailed comments. Fascinating that you brought up mitochondrial donation, what is sometimes referred to as three-parent embryos. I agree, with an expanded notion of what it means to be a parent, this too is relevant.
-
Dan Reisel replied to Staci-Jill Burnley
I agree that every case is unique. There isn't good data on this but let's for the sake of argument assume that only a minority of donor-conceived adults feel the way Lyn feels. But even if the practice only harmed 40% of offspring, or even 20%, wouldn't that still be an argument for doing that which would cause least harm? Given the fact that we cannot know...
-
Dan Reisel replied to Hans Suter
As part of step 3.8 later on in this week's learning, there is a link to a recent paper about this very topic. Have a read if you want to delve into this fascinating, if somewhat unsettling, development. Link here: https://www.futurelearn.com/courses/making-babies/1/steps/107691)
-
Dan Reisel replied to Maire Hewitt
Thank you both for your comments. Very vital insights. We will be covering the epigenetics of gestation as part of the section on surrogacy next week. So please stay tuned.
-
Thanks Andrew. I appreciate your feedback and acknowledge that even in the UK, prices do vary a lot. One example (chosen at random) might be this pricelist: http://www.completefertility.co.uk/price_list/complete-fertility-price-list.pdf which with one cycle and 5 years of storage come to a total of approximately £7,700. Of course there might be a need for more...
-
Hi Andrew. The costing we made includes the thawing and IVF. Hope this makes more sense now.
-
Dan Reisel replied to Laura O’Boyle
Dear Laura, I agree, that would be sensible, as they have completely different expectations.
-
What's fascinating to consider, I think, is that the unregulated sector might be larger than the regulated one.
-
Hi Olivia. You are correct in your assumption: according to UK law, the donor is considered the legal parent only if the recipient is not married or civilly partnered at the time of conception.
-
We all are! Thanks for your honesty!
-
Dan Reisel replied to Nicola J
Thanks Nicola, though as Emily Jackson points out, the sperm donor is considered the father in the eyes of the law only when the recipient is not married or in a civil partnership.
-
Thanks Nicola. Really appreciate your taking the time to share this resource with others!
-
Agree 100%. The child's point of view will be covered in more detail in Week 3, when we'll look at donor anonymity and parental disclosure.
-
Hi Rochana. It doesn't prevent it, but reduces the likelihood that they'll meet. In the UK, the regulations state that a door can donate to unto 10 families, but they can be the donor for more than one child in each family. Most donors have fewer offspring than that.
-
Dan Reisel replied to Robin Hadley
This is, I agree, a key question, Robin. We will have to continue to keep that at the forefront of our minds.
