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When a couple is ready to have children but there is an infertility issue with the father-to-be that prevents normal conception, in this day and age they have a number of options to consider. Artificial insemination from an anonymous donor is one route to take, as is as adoption. Or here’s another approach–if you’re the mother, how about getting pregnant through in vitro fertilization with a sperm donation from your husband’s father? 

For this article, we’ll be taking a slightly more serious tone than usual as we explore that very issue and the current controversy surrounding it. It’s become the topic of intense debate in Japan over the past few days after new details about the practice emerged from a maternity clinic in Nagano Prefecture. Join us as we introduce the facts and examine some of the ethics involved through reader opinions.

Let’s take a moment to think back to our high school biology class days and the unit on reproduction. To jog your memory, in vitro fertilization is a form of assisted reproductive technology in which eggs are removed from a woman’s ovaries and fertilized in a test tube or dish (or “in vitro”), and then implanted back into the woman’s uterus. Depending on the specific situation, the sperm used to fertilize them is taken from either the woman’s partner or from a donor, whether anonymous or not. In the case we’re about to discuss, it’s taken not just from a friend, but the woman’s actual father-in-law. In other words, the child’s grandfather suddenly becomes his biological father.

The Suwa Maternity Clinic in Nagano Prefecture made waves through the Japanese media last week when they announced that from 1996 through last year, 79 couples at the clinic have collectively had 118 children using the woman’s father-in-law’s sperm via in vitro fertilization procedures. This isn’t the first time the clinic has been at the center of intense public scrutiny, either–in the past, they made headlines after performing selective abortions to fetuses with abnormalities (you can read an article on the topic in English here).

▼The Suwa Maternity Clinic in Nagano Prefecture, Japan

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As for this newest debate related to sperm donations at the clinic, here’s the breakdown of the numbers: 

Between 1996-2013… 

146 couples received sperm from close relatives:
110 couples from the husband’s father
28 couples from the husband’s brother
Eight couples from anonymous sources

Out of the 110 couples who received sperm donations from the husband’s father, 79 couples became pregnant and a total of 118 children were born. Out of those same 79 couples, 19 of them went on to have two or more children using the same method.

As far as the causes of male infertility were concerned:
81 of the husbands–the cause was unknown
12 had a chromosomal abnormality
Five were undergoing cancer treatments
Two were related to spinal cord injuries

Lastly, the men who donated sperm (in other words, the mothers’ fathers-in-law) ranged significantly in age:
20 of them were in their 50s
73 were in their 60s
17 were in their 70s

According to Asahi Shimbun, this practice of using a close relative’s sperm could violate guidelines regarding infertility treatments already set in place in Japan. A report published by a health ministry council in 2003 decreed that in vitro fertilization should only be performed using eggs or sperm from an anonymous third-party donor. Similarly, the Japan Society of Obstetrics and Gynecology “limits in vitro fertilization to gametes of couples in legal or common-law marriages.”

Suwa Maternity Clinic Director Yahiro Netsu defended his clinic’s practices at a conference of the Japan Society of Fertilization and Implantation in Tokyo on July 31, stating that pregnancy rates after utilizing in vitro fertilization with the father-in-law’s sperm have been significantly higher (38.2%) than the rates resulting from other kinds of infertility treatments. In addition, many couples he works with actively seek to use the sperm of a close family member to secure a blood connection and inherit genes from the father’s side of the family. He stressed that such couples undergo extensive counseling beforehand, including how to clearly define family roles if a child is born so relations won’t become too complicated.

Here are two short news clips, in Japanese, which touch on the Suwa Clinic and Dr. Netsu’s appearance at the conference:

As you can imagine, this topic has provoked some strong reactions from Japanese citizens concerning ethical issues. The majority were critical of the practice, posing questions such as “Will the children really be able to accept the fact that their grandfather is really their dad?”, while others seemed a bit more understanding of those couples who wish to create a stronger biological connection using the grandfather’s sperm. Finally, there were those who didn’t seem to favor one stance strongly either way, but felt that each individual couple should be allowed to make the decision based on their own values.

We’ve compiled the thoughts of several Japanese Twitter users below. Take some time to think about the different perspectives out there:

“Taking into account existing laws and the current state of society, I don’t know which thought is more ‘correct’–when there are children who are born from the sperm of the husband’s father or when couples just have children without much thought. The natural way to reproduce, like animals, and a process which involves human choice…aren’t they both correct?”

“I heard the news about using sperm from your husband’s father or brother to have children. I wish the people on TV would stop saying, “Isn’t it nice that there are many kinds of families?” so carelessly. Is that really OK? I was actually shocked.”

“It means they want to preserve the bloodline, right?”

“‘Receiving sperm from your father-in-law.’ As a woman I’m not opposed (on the contrary, I feel like having a blood connection would be good), but my husband said ‘I’d probably get confused whether the child is my sibling or my kid.’ Questions of feelings are hard.”

“I wasn’t easily blessed with children and was troubled, but this would be impossible for me, emotionally speaking.”

“It’s talking about conceiving a child with your father-in-law, right? Impossible. Pregnancy rate? 38%? Nope, no way~ It would be your father-in-law’s child and your husband’s sibling from a different mother… And what must it feel like from your mother-in-law’s point of view? Just thinking about it gives me the shivers.”

“Using in vitro fertilization with either the infertile husband’s own father’s or brother’s sperm…hmm, it’s a tough call. Many parents might relax knowing that the child is genetically related. That means from a genetic standpoint, consanguineous marriages may become necessary. Cousins should probably be told before they hit puberty.”

“Infertility treatment using a sperm donation from the husband’s father. I guess I think along the lines of ‘there will be a blood connection with the husband,’ ‘the kid (should) inherit traits from the family,’ and ‘no one else’s bloodline will be involved’.”

“It’s sick using sperm from your father-in-law (in my personal opinion). That would mean raising your husband’s sibling…what would the children think if they knew? It brings up some ethical questions, and I feel like it would all mostly be for the parents’ self-satisfaction.”

“In the middle of infertility treatments, I also thought about it. [Retweet] Suwa Maternity Clinic…does that means they don’t consider adoption as a viable alternative? I think the process of raising a child is more important than genes (the parents who raise you over your biological parents).”

We don’t want to overwhelm you with too many voices, so we’ll leave you now to form your own opinions about the issue. Please feel free to share your thoughts in the comments section below!

Sources: Naver Matome, Jiji Press, Nippon News Network 1, 2, Nikkan Jiji NewsYomiuri Online, Asahi Shimbun
Feature/inset screenshots: FNNnewsCH 1, 2