Nameless relations: anonymity, Melanesia and reproductive gift exchange between British ova donors and recipients 9781845450403, 9781571816474

Table of contents :
Frontmatter
List of Figures (page ix)
Preface (page xi)
PART I: THE SECRETS IN THE GIFT
1. What is Concealed Inside an Anonymously Donated Gamete? (page 3)
2. Anonymity and the Way of Juxtaposition (page 34)
PART II: IN THE NAME OF THE UN-NAMED
3. Donors I (page 57)
4. Donors II (page 84)
5. Donors III (page 111)
6. Recipients I (page 132)
7. Recipients II (page 161)
8. Recipients III (page 186)
PART III: APPLICATIONS
9. Unconcealing Extensional Transilience (page 207)
10. Unconcealing Regenerative Transilience (page 219)
11. Conclusion: Relations of Non-relations (page 238)
Appendix I: Donor Biographical Profiles (page 245)
Appendix II: Recipient Biographical Profiles (page 250)
Appendix III: Treatment Protocol (page 253)
Bibliography (page 259)
Index (page 275)

Citation preview

NAMELESS RELATIONS

Fertility, Reproduction and Sexuality GENERAL EDITORS:

David Parkin, Director of the Institute of Social and Cultural Anthropology, University of Oxford

Soraya Tremayne, Co-ordinating Director of the Fertility and Reproduction Studies Group and Research Associate at the Institute of Social and Cultural Anthropology, University of Oxford, and a Vice-President of the Royal Anthropological Institute

Volume 1

Managing Reproductive Life: Cross-Cultural Themes in Fertility and Sexuality Edited by Soraya Tremayne Volume 2

Modern Babylon? Prostituting Children in Thailand Heather Montgomery Volume 3

Reproductive Agency, Medicine and the State: Cultural Transformations in Childbearing Edited by Maya Unnithan-Kumar Volume 4

A New Look at Thai AIDS: Perspectives from the Margin Graham Fordham Volume 5

Breast Feeding and Sexuality: Behaviour, Beliefs and Taboos among the Gogo Mothers in Tanzania Mara Mabilia Volume 6

Ageing without Children: European and Asian Perspectives on Elderly Access to Support Networks Philip Kreager and Elisabeth Schroder-Butterfill Volume 7

Nameless Relations: Anonymity, Melanesia and Reproductive Gift Exchange between British Ova Donors and Recipients Monica Konrad

NAMELESS RELATIONS Anonymity, Melanesia and Reproductive Gift Exchange between British Ova Donors and Recipients

Monica Konrad

Berghahn Books New York * Oxford

First published in 2005 by

Berghahn Books www.BerghahnBooks.com ©2005 Monica Konrad First paperback edition printed in 2006 All rights reserved. Except for the quotation of short passages for the purposes of criticism and review, no part of this book may be reproduced in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system now known or to be invented, without written permission of the publisher.

Library of Congress Cataloging-in-Publication Data Konrad, Monica. Nameless relations : anonymity, Melanesia, and reproductive gift exchange between British ova donors and recipients / Monica Konrad. p. cm. -- (Fertility, reproduction, and sexuality ; v. 7) Includes bibliographical references and index. ISBN 1-57181-647-X (hardback : alk. paper) 1. Artificial insemination, Human--Social aspects. 2. Artificial

insemination, Human--Great Britain. 3. Kula exchange. I. Title. II. Series. HQ761.K65 2005

304.6'32’0941--dc22 2004055426 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library

Printed in the United States on acid-free paper ISBN 1-57181-647-X hardback ISBN 1-84545-040-X paperback

In memory of my father Frigyes Konrad (1923-1995)

Blank Page

CONTENTS

List of Figures ix Preface Xx} PartI THE SECRETS IN THE GIFT

1. What is Concealed Inside an Anonymously Donated Gamete? 3 Incoexistence - Inside Out — ART, Exteriorisation and Forms of Facelessness — Future Feminisms — ‘Cosmic Egg’ Revisited — Ova

Donors and Recipients — Finding Method in the Oblique — Implicit Links and Multiple Audiences

2. Anonymity and the Way of Juxtaposition 34 Anonymity/taboo — Anonymity/openness — Anonymity/reciprocity — Anonymity/partibility - Anonymity/transilience

3. Donors I 57 4. Donors II 84 Part IT IN THE NAME OF THE UN-NAMED

Come Superovulate! — Free Gift Emerging —... ‘Not a Hardship at _ All’ — Testimonies of Assistance — Intimately Impersonal —... And Free Gift Receding ... - Becoming Special — Prestige and ‘Fame’ — ‘It’s Something I Must Do!’ —- Summary Link

Categories of De-identification and Degrees of Anonymisation — Strong, Indeterminate and Weak Anonymity — Knowledge Outcomes and the Form of the Return Gift — Neither Inalienable nor Forgettable - Remote Parenting? — Negotiated Maternity and the Ambiguous Progenetrix

5. Donors III 11] Donating Agency, Extension and Intersubjective Spacetime — Reproducibility and Relations of Non-relations — Odelle: Genes by Proxy — Policy Link — Penny: Relations as Ripple Effects — Policy Link — Rita: Donating Adoption — Policy Link — Meena: Receiving Pardon — Summary Link — Dispossession, Effraction and Non-

traceability - What Goes Round Comes Around — What Goes around Comes around (Again)

vill Contents 6. Recipients I = 132 Gift Elasticity and the Infertility Industry — Egg-sharing, Egg-giving and Egg Donation — Anonymity, Kinship Distance and ‘Poison’ in the Gift — ‘Like with Like’ and the Equivalence of Matching — Degrees of Information and Informational Gaps — The Idea of ‘Donor-release’ — Mismatching — ‘You See What You Want to See’ — Blood Food Lines — Summary Link

7. Recipients I 161 Accountability and Blood Manipulations — Revealing-while-keeping the Secret (Ella’s Effacement) - Whatever Happened to You? — Money Manipulations and Ova Pathways — Taming Contingency (I): Ova Pathways and Directing Flow — Taming Contingency (II): Ranking between Recipients - How Ova and Embryo Pathways

8. Recipients III 186 Make Half-siblings — Policy Link —- Summary Link

Hyper-kinship within a Remaindered World — Eliciting Hyperembryo — Re-donation, Refusal and ‘Disowning Decisions’ — Sacrificial Keeping-while-giving and Donation to Research — Obviating a Compounded Life — Liquidating the Third Party — Re-donation as Continuous Gifting — Summary Link

Part WI APPLICATIONS

9. Unconcealing Extensional Transilience 207 Hyper-embryo into Infinite Partibility and the Sourcing of Embryonic Stem Cells — Policy Link — Transilient Kinship and Embryo Donor-conceived Children — Summary Link

10. Unconcealing Regenerative Transilience 219 Spotlight on the Final Frontier — Envisioning the Problem of Ovarian Tissue and the Lite-giving Death — Reconstituted Persons and the Extensional Imaginary — How it is Imagined Breath Circulates between Persons — How it is Imagined the Unborn Sibling Blood-donor Child Will Make New Life — Discussion

11. Conclusion: Relations of Non-relations 238 Appendix I: Donor Biographical Profiles 245 Appendix II: Recipient Biographical Profiles 250

Index 275

Appendix II: Treatment Protocol 253

Bibliography 259

LIST OF FIGURES

1 Ban lifted on use of frozen eggs to delay conception. 13

23 Egg donors aged just 12. 16 Donor information form. 93 4.1 For the giving and receiving of the potential for life. 136

4.2 Your most natural gift for childless couples. 136

5 Alternative ova pathways. 175

6 Form for consent to storage and use of eggs and embryos. 188

transilience. 215

7 Anonymous sociality characterised by field of extensional

8 ‘You never know where they get their IVF eggs these days!’ 223

Blank Page

PREFACE

Since the birth of the first IVF baby in 1978, more than 68,000 children have been born in the U.K. through novel assisted-conception methods. Figures compiled in 2003 by the Human Fertilisation and Embryology Authority (HFEA) indicate that over 25,000 such IVF children have been born as a result of donated sperm, eggs or embryos since the early 1990s,

and that for the most part these donations have been by anonymous donors. In setting out to explore such issues, this book undertakes its own experimental turn: it may be read as the attempt to bring together the interests of social anthropologists and non-anthropologists to illuminate con-

temporary practice in this field. Why seek to write for such a mixed audience? For one thing, it is significant that fertility experts, research scientists and policy advisors often see little reason to integrate anthropological materials into mainstream public debate on biomedicine and the human reproductive technologies. Accordingly an important body of anthropological research on kinship and family relationships continues to remain eso-

teric to government officials and regulatory watchdogs; our analytic commitment to the comparative exercise apparently of little obvious value to the fashionable remit of Public Consultation agendas and such like. If one aim then of this book is to begin to export anthropological knowledge in a particular direction, outwards as it were, so at the same time I have wanted to defend a method of internal comparison that can give analytic consistency to our project ‘within’ anthropology. By juxtaposing in this way a number of literatures and ideas ordinarily kept separate, what follows is hardly conventional ethnography, even if one of my main inspirational sources could be taken for anthropological convention itself. My inspiration goes back to the long seafaring journeys of the Massim region whose circular motion brought men from otherwise remote islands into contact with each other. What has become known to generations of social anthropologists as the ceremonial exchange of the kula ring, is also the history of how certain valuables have moved around a giant circle of

communities, around a ‘ring’ of islands east of mainland Papua New Guinea. Across the seas, kula participants —- many of them male local lead-

ers or ‘big-men’ — would sail forth in canoes, voyaging around the ring with a view to exchanging gifts of special renown, their continuous debt

xii Preface

partnerships forming part of a valued network of person-to-person relationships that often endured for life. Moving from one island or area to another, men would gain considerable prestige, their names travelling ‘high’.! Argonauts of the Western Pacific, Bronislaw Malinowski’s original descrip-

tion of the kula, was published in 1922. It exercised a profound influence on the subsequent development of anthropological theory and practice, and remains today a standard set text on undergraduate reading lists. Like most students faced for the first time with its bulky form, I can remember removing a copy from the library shelf, its dog-eared and pencil-anno-

tated pages a visible sign just how many hands the book already had passed through. Drawn over the years to subsequent re-readings, my interest in Argonauts has lasted beyond first notes and the mandatory student essay. Some may see this as an excessive romanticism on my part, especially for an institution that — if not already obsolescent in certain parts of the kula region — continues to undergo major political and eco-

nomic transformation, to say nothing of early mission influence and ‘modernisation programmes’. I recognise the time-shift but remain captivated by a system that was originally organised as the incessant ‘opposite flow’ circulation of clockwise-moving and anti-clockwise moving neck-

lace and arm shell valuables. Captivated by a system in which shells, standing metonymically for particular persons and relations, could be said to ‘marry’, ‘divorce’, and ‘give birth’ once they are put into social circulation, the one valuable/person for the other. Argonauts happens to be striking for other reasons. It is the first time that an anthropologist mentions the phenomenon of ‘free gift’. And very nearly the last time too. Malinowski famously retracted the notion a few

years later in a subsequent work, partly in response to comments from Marcel Mauss; a retreat that was perhaps another defining moment for the future course of theoretical anthropology. Or should one say course manqué? It may then seem like one is pulling the proverbial white rabbit from out oi the hat to suggest that contemporary developments in assisted reproductive technology may help us to glimpse the trace of reproductive gilts ‘freely’ given. The extra-corporeal gifts of reproductive ova put into

social circulation by women donors follow no literal circle or ‘ring’ as such and they defy moreover the norm of delayed exchange returns. Anonymity, it may seem counter-intuitive to think, is a ‘valuable’ block to reciprocity. With the kula as background stimulus, what I believe we can set out to trace today are the incredible range of flows of ‘journeying’ substance between female donor and recipient anonymised ‘transactors’ as well as their intermediaries. And how it is one’s name may go low, very low, both within and across the generations. This is the first anthropological study to follow in detail the trajectories of anonymised ova donors and recipients within the ‘high tech’ assisted conception context. Its publication comes in the midst of two major policy reviews conducted recently? in the U.K. by the Human Fertilisation and Embryology Authority and the House of Commons Science and Tech-

Preface Xili nology Committee. The HFEA review on sperm, egg and embryo donation (‘SEED Review’) undertaken throughout the course of 2004 is intended to

advise the Department of Health on future possible changes in the law regarding donor identification. The review may well lead to a distinctive change: there is the possibility that from 1 April 2005 children born from donated eggs, sperm or embryos will have the legal right at eighteen years of age (i.e. from 2023 onwards) to trace their donor genetic parent. The second review process initiated by the Science and Technology Committee takes the form of an open ‘e-consultation’ on ‘Human Reproductive Technologies and the Law’ that ran as an online debate forum between January and March 2004. Designed to elicit submissions from the public and interested parties, it is the first open forum of its kind undertaken by a British government Select Committee.* Now against the backdrop of such busy policy activity, the easy task for the field researcher would have been to jump aboard one or other of the public bandwagons about donor anonymity and the provision (or non-provision) of personal information to various interested parties: to donors, recipients and sets of offspring. Let me say that J empathise with the real-life predicaments of the different

‘sides’: those ‘pro-openness’ activists who wish to have information revealed about genetic kin, and indeed claim this to be their right, as against those who prefer the protections afforded by secrecy and non-disclosure. Indeed I hope one of the possible gains to be had in reading this book will be a more nuanced understanding of different sides of the donation complex. How it is, for instance, that the respective partners in the donation experience have various stories to tell that may sometimes ‘mirror’ those of the other side. But I must also dispel any illusions from the outset and say clearly that this book is not about ‘taking’ any such sides. If I arrive at a final particular position, one that may double up indeed as

recognisable advocacy, this is because my endeavours lie elsewhere. I have always wanted to say that the discourse of anonymity is multiple, complex, challenging, elusive and that, much like Marshall Sahlins’s interpretation of the spirit of the gift (kau), anonymity may yield its own productivity through its strange, paradoxical surprises. What I hope is that

this book may facilitate an appreciation of some of the more unspoken aspects of the anonymisation of persons, since this is something that has not to date found its way into mainstream public debate, nor, indeed, has the theme been of especial interest to anthropologists. Think of the illumination, if you will, as the unfinished product of conceptual origami: what we, the readers, see happening is the unfolding of multihedral planes whose intersections can fold back into shape to create the illusion of a portable object, cross-transferability. First point of cross-transferability: historically, the value of rationalism

in Western societies has been premised on classificatory denomination systems and the conferring of a name as an essential mark of personhood. Individuality is seen to lie in one’s name such that naming — the act of being given a name — equates not only with the individual’s induction into

an order of linguistic exchange but with the power to signify and effect

Xiv Preface

culture. Thus the name as patronym not only bears the law, it also institutes it. This is the psychoanalytic reading offered by Jacques Lacan, and the conceptual basis of feminist critique by post-Foucauldian philosopher and rhetorician Judith Butler. As Butler points out, the patronymic power to signify was originally divinely sanctioned with the naming that God the father performs on Adam, timelessly perpetuated ever since through acts of baptism (Butler 1993:208). Concepts of bodily integrity may also support the function of nomenclature. For their part, anthropologists have recorded the world over how the incest of kinship systems can only be structured on prohibited sexual access to those named as family. Systems of teknonymy can also rule out relatedness through the avoidance of specific names: persons being known or addressed primarily in terms of their parental status and in relation to named offspring. This book is not foremost an anthropological exploration of the productive limits of psychoanalysis, although there is an implied inversion of Lacan’s symbolic imaginary (‘In the Name-of-the-Father’). What the main analysis seeks to hold up rather is the paradox of anonymity as a ‘labour

of the negative’ to borrow Michael Taussig’s words — a paradox that undoes, literally defaces and effaces some of these naming conventions. My concern is not simply with what cannot be named and is therefore nameless, but with the form of the unnameable itself: the instantiation of anonymous sociality through a kinship of irrelationality. It is a paradoxi-

cal feature of the present argument that the productive tensions of anonymity are ones that will always be made explicit by virtue of the ‘rev-

elation’ of persons as unknown and unknowable relations. In setting out to work through forms of facelessness I am guided also by Melanesianist James Weiner’s plea for anthropology to work through the negative, to chisel out and communicate itself as the work of the unconventional. ‘If we see our task as anthropologists as only to describe and codify the conventional, we work against the task of interpretation, for conventionality by itself short-circuits meaning. What resists convention, what surfaces as perceptions of the uncanniness and strangeness of social life, is as much a part of that life and its constitution, even though their effects seem to originate beyond it’ (Weiner 2001: 64). I should mention that part of my early life in the field was spent both inside and outside of various assisted conception units (ACUs) in London between 1992-94. In fact it was with the assistance of a few supportive clinicians who agreed to open certain doors that I was able to begin at all what turned into an ethnographic study of donor anonymity conceptions.

Exploring the experiences of non-IVF volunteer ‘altruistic’ donors, namely, healthy woman who were not undergoing fertility treatment for their own benefit but all the same wanted to donate their eggs to help infertile others, the book tells in turn the experiences of ova recipients, the intended beneficiaries of these gestures. To everyone who made me so welcome upon my visits to their homes, to those who shared their experiences, and sometimes articulated private thoughts they had not voiced before, I learnt more than I could have hoped and thank you all.4 A num-

Preface XV

ber of fertility specialists, trained counsellors and staff at patient organisations and user groups have listened patiently to my plans during the formative stages of the research, and again more recently during the course of updating certain material and renewing contacts. Many persons have offered much sound advice and J am especially grateful to Claire Brown, John Dickson, Tanya Patmore, Dr Sue Jennings, Alison Bagshawe, the Reverend Dr Tim Appleton, Dr Avril Crollick, Hilary Everett. My sincere thanks also to Sam Abdalla, Mary Power, Lena Korea, Dr Susan Smith, Dr

Rajat Goswamy, Virginia Bolton, John Parsons, Ruth Curzon, Kate Brown, Annie Harris, Prue Bakpa, Peter Brinsden, Dr Robert Forman. For kind help with research queries and ongoing consultation I extend thanks

to staff at the Human Fertilisation and Embryology Authority, the National Gamete Donation Trust, the British Medical Association, the British Fertility Society, British Infertility Counselling Association, Women’s Health, the Daisy Premature Menopause Support Group Network, the Progress Education Trust, and the Wellcome Trust. My intellectual debts are many. A grant from the Economic and Social Research Council (RO0429134168) enabled the main period of fieldwork. I would like to thank the AL Charitable Trust for an award in 1994 and The Reeves Foundation at the London School of Economics and Political Science for financial assistance during 1994-95. To Professors Henrietta Moore (my Ph.D. supervisor), Jonathan Parry, the late Alfred Gell, Joanna Overing, Howard Glennerster, Jane Lewis and Martin Bulmer I extend my sincere appreciation for pre-field and post-field discussions. I thank Pat

Caplan for introducing me in 2000 to the Institute of Commonwealth Studies at the School of Advanced Study, University of London, and am grateful to Denise Elliott and Christie Goodall for administrative support as J wrote up the final manuscript. I thank also Samuelle Carlson for help

with illustration work. Within the world of reproductive science and assisted reproductive technology (ART), I have benefited enormously over

the years from the brave scholarship of numerous feminist theorists and ethnographers. I would like to thank especially Sarah Franklin for her intellectual companionship. While it is not possible to be all-inclusive here I would like to acknowledge the inspiring visions of Gay Becker, Monica

Casper, Charis Cussins, Joe Dumit, Barbara Duden, Jeanette Edwards, Sarah Franklin, Val Hartouni, David Horn, Signe Howell, Susan Kahn, Margaret Lock, Emily Martin, Marit Melhuus, Rayna Rapp, Pat Spallone. Their contributions to evolving debates around technological innovation show just how forward social science scholarship can be, putting rest to the popular myth — largely promoted by research scientists — that the humanities and other exploratory discourses necessarily lag behind the

logos of the natural sciences. This critical body of ethnographically informed work is not running to catch up; it is setting enticing agendas — novel interventions — of its own.

My other intellectual debts come from the brilliant insights and sustained fieldwork of a number of Melanesian scholars. IJ cannot name everyone whose work has illuminated with such subtlety various ele-

Xvi Preface ments of the Melanesian lifeworld, nor can I possibly hope to do justice to the whole of ‘Melanesia’ in these pages, given of course the immense cultural and linguistic diversity of the region. For their direct stimulus how-

ever, especially for enlivening my imagination and engrafting ideas, I would like to acknowledge the work of the following scholars. Debbora Battaglia, James Carrier, Alfred Gell, Gillian Gillison, Maurice Godelier,

Simon Harrison, Gilbert Herdt, Lisette Josephides, Bernard Juillerat, Andrew Lattas, Thomas Maschio, Mark Mosko, Nancy Munn, Andrew

Strathern, Marilyn Strathern, Roy Wagner, Annette Weiner, James Weiner. I hope my analysis does not commit the worst kind of objectification as I identify and elaborate here, necessarily with some selectivity, a number of thematic linkages. This comparative exercise is not undertaken for the sake of delivering any kind of synthetic ‘meta-analysis’. It is undertaken rather out of concern for the preservation of those life forms that may be said to exist in the experimental nooks and crannies that are the little ridge of possibility for conceptual transplantation. In crossing these apparently disparate worlds, in straddling across ART and Melanesia, Iam obliged most of all to Marilyn Strathern, the original pioneer of cross-fertilisation between Melanesian and Western forms of reproducibility. Without The Gender of the Gift (1988) it would not have been possible to begin

to see how the non-links I describe could fall into place. For this and much more, I am most grateful. Of course the usual disclaimer applies: may all be acquitted of any guilt by association. MK

Budapest September 2003

Notes 1. I borrow an expression made in the context of Hagen ceremonial exchange (mainland New Guinea). Building upon Malinowski’s observations, Andrew Strathern comments that the link between social prestige and the social circulation of certain valuables (e.g., pigs, shells, stone axes, salt packs) creates the possibility ‘one’s name goes on high’ (Strathern 1971: 13). 2. Still underway as this book goes to press — incompleteness of the [written] account being a marker of our day and not simply a condition and effect of the ethnographic rendition. Technology may move us forward, but the illusion is that we can never be forward enough. 3. In its entirety, this particular consultative exercise was designed to feed into a wider critical inquiry on the updating of reproductive legislation. Via its accom-

panying web-based literature, the Committee thus stressed how those forwarding online submissions may be seen as helping to shape future revisions to the original legal framework provided by the Human Fertilisation and Embryology Act (1990). See .

Preface XVii

4. Inthe process of writing this book I have included the views of a greater number of donors from the original sample recruited during my doctoral research, sixty-two women altogether, as well as some additional recipients. This group includes a handful of non-anonymous donors whom [ also include in certain sections of this book. Certain constraints mean that the total sample size of the

recipient group remains smaller than I had hoped, twenty-four women to date. In some cases I have been able to meet ova recipients’ partners, some of whom feature in parts of the narrative storylines presented here. In keeping with the climate of confidentiality and donor anonymity, all persons and treatment centres have pseudonyms. More recent follow-up work with ova recipient families belongs to an ongoing project whose findings are not reported here.

Blank Page

PART I THE SECRETS IN THE GIFT

Blank Page

CHAPTER 1

WHAT IS CONCEALED INSIDE AN ANONYMOUSLY DONATED GAMETE?

Wee Ioften first set staff there would askfoot withinaassisted mixtureconception of surpriseclinics, and interest: ‘What’s an anthropologist doing researching egg donation? I thought you anthropologists study bones and the remains of dead people!’ I was quick to learn that my survival in the field, both inside and outside of medical settings, would depend on more than the presentational display of the home-based researcher. What mattered was how one continued to justify one’s presence and how the anthropologist’s mode of self-materialisation already implicates one’s craft as perceived relation. If one was required to reach out to others through continuous acts of explanation and interpretation,

these ‘extensions’ revealed an otherwise hidden core. As much as my person, what was on show was the discipline I carried inside of me. If others’ perceptions of social anthropology matter, it matters too how these visions come to be animated as processes of intellectual exchange. This depends on a certain externalisation — a making visible of hitherto eclipsed or latent knowledge as more explicit, more readily knowable, more digestible knowledge. Knowledge that is brought into the direct field of vision — and hence made to be unconcealed — may be ‘digestible’ because it will have to be palatable and consumable: it will have to be capable of re-internalisation, of being [made] evident to others by being ‘taken away’. Others’ attempted understandings of the wider anthropological vision and my ability (or lack thereof) in the field to try to communicate something of our theoretical discourse could thus be seen as instantiating a certain impetus for ‘give and take’. At first I couldn’t always counter the ‘skulls and bones’ preconception with a quick enough response. ‘Yes’, I would say, ‘some forensic and biological anthropologists do study human remains and this might be quite dilferent from the approach taken by cultural anthropologists who may study entire societies and their cultural organisation in terms of funerary relations

4 Nameless Relations or mortuary exchange processes’. People would smile politely or shufile impatiently. I could see the next gesture required was the potted account. ‘The way certain groups of people believe they make social relations with and through the deceased’ I would continue. ‘Which is interesting because ...” ‘Yes, okay. But what are you doing?’ came the return query. ‘What are you doing right now with your project?’

Surviving the process of fieldwork within complex institutions often depends on ‘packaging anthropology’. One must learn both to play and resist the game by adopting a flexible style of presentational shorthand. The skill lies in double operations: as one packages, so one commits an un-packaging, drawing in one’s audience — and returning ‘home’ as it were — by re-introducing the terms of one’s craft. But these dual movements must always be seen to ‘fit’ within the presiding institutional ethos, must always be capable of speaking to multiple audiences at once. In this sense the work the anthropologist ‘does’ may appear surreptitious: nothing she touches is guaranteed to seem obvious to others — to be rendered as explicit effect — within the frame of the present. (‘What are you doing right now?’) Moreover double operations create the rim of an opening, a fresh space for conceptual re-exploration, through discretionary withholding (the ethnographer’s secrets). One may hope to offer this is as the magical ‘technique’ of the practising anthropologist. Within the world of assisted conception, presentational shorthand abounds in the form of various ‘familiar’ acronyms. Medical experts feel comfortable using everyday terms such as GIFT (gamete intrafallopian transfer), ZIFT (zygote intrafal-

lopian transfer) or TET (tubal embryo transfer) when they talk between themselves and explain particular clinical procedures to their patients (see Appendix IIT). J had no pre-packaged acronyms of my own with which to trade, but worked instead through the predominant medical shorthand in order to make the case for my seemingly more cumbersome anthropological longhand.

What I would like to convey in this chapter is something of the way such anthropological longhand can write itself into ‘foreign’ worlds when, for instance, it seeks to re-engage with medical orthodoxy as ongoing discursive inter-articulation. When anthropology goes public and is seen to ‘talk to’ experts outside its own customary range of interaction, anthropology needs to know why it can offer itself up (to others) as knowledge

of genuine relevance. The catch is that genuine anthropology, like the classic return gift, may only make its presence felt as deferred effect. xkx«**

What is concealed inside an anonymously donated gamete? Intrigue and paradox, avoidance and fear, protocols and profit, persons and relations, the past and the future — these are perhaps just some of the constituent parts that go to make up the reproductive substance modern biology calls ‘gametes’. But there is a sense too in which what may be taken as concealed is yet more encompassing. There is a sense in which all of ‘society’,

What is Concealed Inside an Anonymously Donated Gamete? 5 so to speak, is contained within the gametes (the tiny egg and sperm cells)

anonymous donors give to other anonymous recipients in the highly charged contexts that characterise this form of reproductive gift exchange. Rather than present simply an enumerative breakdown, a nice tidy list of component elements — as some readers might expect — I would like to invite the female generated gamete to introduce herself through a format

certain anthropologists would recognise as the work of ‘elicitation’.' Drawing forth the problem of anonymity comes as the first revelation here, as the focal and inspirational moment of a speculative unturling within this particular ethos of containment. Of course this will not be an approach familiar to the medical profession. It will not be straightforwardly meaningful to the busy clinicians I observed whose sights are set foremost on quantifiable results and performance indicators; the number of patients they treat each year, the number of children born as ‘live births’ through assisted conception and so forth. But perhaps the unexpected obliqueness, the approach through nameless relations, will prompt

another recognition: the surprise of relevant revelations. Maybe even approaching matters through the oblique will produce its own effects by drawing in what would otherwise have remained as unexposed reaction. Let me begin by noting that the concept of anonymity has been virtually absent from scholarly study, being deemed neither sufficiently interesting nor worthy a topic for critically sustained empirical or theoretical analysis. In those remote instances where the term has appeared almost by accident, it has denoted negative social trends or characteristics such as a-historicity, alienation, and passivity. Insofar as it pertains to certain features, practices or modes of representation in complex society, the phenomenon of anonymity is ascribed most typically to forms of a-sociality. Upholding conventional social meanings, it is seen as the ultimate symbol of incoexistence.* Describing how ‘social warmth can only thrive where

the Other is recognised and accepted in his otherness ... where he is known as a person’, one anthropological theorist draws together the mutually exclusive nature of anonymised persons with the production of social relationships. ‘Social warmth is not possible’, Jan van Baal (1975: 69) suggests, ‘in a society in which the individual is but an anonymous case’. This view derives in part from the Durkheimian legacy of person-toperson relationships constituted from the ‘presence-availability’ of persons whose embodiment imputes valued networks of social solidarity.* Nameless Relations asks whether we can see the obverse: can the social be thought through the anonymous? In short, the book sets out to challenge the essentially negative connotations accorded to the concept of anonymity in mainstream social science literature and the longstanding academic neglect of the subject as intellectual topic.

6 Nameless Relations Incoexistence — Inside Out The attribution to anonymised persons of unnameable and unknown [non-] identity in western industrial society stems in large part from a Marxist conception of concealment and alienation as the commodity form of social relations (Godelier 1977). Such a view sees ‘anonymous’ persons

primarily as depersonalised on account of the impersonal character of commodity exchange. Raymond Firth (1951: 137), for instance, equated the individual of industrial society with ‘a high degree of anonymity, of impersonality in the economic situation’ such that it is ‘his specific industrial characteristics, not his total social characteristics, that matter’. Maurice Bloch and Jonathan Parry (1989: 6) can be seen as following much the same line with the claim that money ‘lends itself to the impersonal and inconsequential relationships characteristic of the market place and even to a complete anonymity in exchange’. This connection between anonymity and forms of alienation is also intimated in a foreword commentary to Marcel Mauss’s locus classicus on the gift. Referring to Titmuss’s seminal study on blood donation, Mary Douglas (1990) remarks that there can be no such thing as ‘anonymous relationship[s]’. Douglas intimates that a gift that is anonymous cannot in fact be conceptualised, not only because it cannot be ‘free’ (Douglas’s

reading of Titmuss), but because it involves a logical contradiction in terms. In Douglas’s formulation a social relation of anonymity could only

be advanced in the remote realm of hypotheticals. ‘He [Mauss] would have said “Nonsense!” just as heartily to Titmuss’s idea that the archetypical pure-gift relationship is the anonymous gift of blood, as if there could be an anonymous relationship’ (Douglas 1990: vili, emphasis added).

As if there could be such a thing as an anonymous relationship! The exclamation is mine since I wish to ask about the rather persistent insensibility, on the part of Western anthropologists and indeed others, to recognise the creativity of non-linkage. Douglas’s objection to the existence of the free gift is of a different order to the Derridean claim (1992: 24) of the actual impossibility of the gift itself as ideational construct. Where Derrida, the deconstructionist philosopher, suggests that the gift cannot be thought, Douglas, the social anthropologist, cannot yet conceive of a particular kind of social relation: for her, relatedness founded upon anonymisation is the impossible. Anonymous relations would remain inconceivable, beyond the realm of the social. But it is not simply that free gifts would be impossible offerings; they would, she asserts, be quite wrong. Ultima ratio, Douglas’s objection happens to reside within the

preserve of the normative. ‘... the whole idea of a free gift is based on a misunderstanding. There should not be any free gifts’ (ibid., vii). What is it that governs this reluctance on the part of so many anthropologists to re-think the basis of the social when what is unknown or invisible cannot be equated most readily with the mystical, supernatural and religious? Why does the assumption persist that anonymity is homologous to forms of a-sociality and experiences of alienation? Why should

What is Concealed Inside an Anonymously Donated Gamete? 7 strangeness only make itself apparent to us within the framework of familiarity?

The occasion for this thought experiment is neither abstract nor inconsequential. The current kinship experiments arising from another contemporary gift context — the technological agendas attached to forms of ‘third-party’ procreation, the assisted reproductive technologies (ARTs), prove to be enticing agents of provocation. This book takes as its focus the anonymity surrounding practices of donor-assisted conception. From various angles and intersecting planes, it enquires into the value we think we

attach to forms of cultural effacement in these particular reproductive contexts.

ART, Exteriorisation and Forms of Facelessness Ova donation is a much more recent phenomenon than its procedural counterpart. Up until the development of intracytoplasmic sperm injection (ICSI)° in the early 1990s, sperm donation had been a non-technical and relatively straightforward affair, albeit one shrouded in secrecy and social stigma (Daniels and Haimes 1998, Snowden and Mitchell 1981). In 1950s Britain, the euphemism ‘artificial insemination by donor’ (AID) stood for a quasi-illegal practice, one condemned by the Church of EngJand and much maligned by the medical establishment. Only a few physician-gynaecologists were prepared to offer help to couples presenting with involuntary childlessness, and to this end went about recruiting a limited donor pool, usually young medical students, as anonymous semen substitutes for their infertile or sub-fertile male patients. But things were kept discreet: to talk openly about male infertility was not a popular conversational subject in the immediate post-war years. Donor insemination (DI)

as it has since come to be known was associated then with the moral seediness of ‘back-street’ abortions: clandestine corporeal acts nobody much cared to talk about, least of all the prospective social father. Anec-

dotal evidence suggests there may have been cases where one sperm donor alone, in exchange for nothing more than trifling ‘beer money’, was recruited to ‘seed bottles’ on multiple occasions (Lorbach 2003: 79). Thus began the legend of the ‘champion donor’ — the person whose substitutive efforts could have been equivalent to the potential conception of hundreds of genetically related offspring from one biological father.® Ova donation, by contrast, only came into its own in the mid-1980s with the first reported case of a donor-egg-conceived birth in Australia.’ This time lag comes with its own interesting story. The entire process of medical assistance whereby one fertile woman (the ova donor) may stand in as procreative replacement for another woman (the ova recipient) is always far more complex than is the case with the procedure of sperm donation. Indeed for a woman to donate her eggs is nothing less than a

technological feat. The crucial point is that human eggs cannot be extracted from the woman donor’s body in quite the same way that a

8 Nameless Relations male donor is expected to provide his self-activated ‘ejaculate’ sample. (At

the assisted conception clinic, small bottles for the samples and ‘recreational’ magazines, euphemism for soft porn, are provided as a matter of course in the men’s private room.) Purely on the technical front alone, it took reproductive scientists years of experimental research to perfect socalled ‘egg harvesting’ and maturation techniques with a view to making the female-assisted donation process viable as a possible infertility ‘treatment’.® This is one reason why the advent of assisted procreative techniques is deemed ‘new’ — it is part of the evolving armoury of facilitation that members of the biomedical community (fertility specialists, gynaecologists, obstetricians, embryologists, nurses) have defined as the subspeciality of ART (Franklin 1997; Lock et al. 2000). But novelty, it must be stressed, found its way into the inner recesses of women’s bodies as precise methods of bio-cultivation (ovulation induction) and extraction (egg

retrieval). In more ways than one, human eggs are thought to become bona fide scientific property only when they are brought beyond the bodily surface, rendered tangible as transferable objects. ‘Grasped’ as an exvivo resource when drawn from out of the body, elicitation here appears very literal. It is about visible exteriorisation. Nonetheless egg extraction from live donors cannot be undertaken without a subject’s prior consent, without explicit agreement to the procedures. Every woman who elects to

act aS an ova donor agrees to undergo extensive drug preparation and invasive medical procedures as part of a lengthy and risk-laden clinical protocol (see Appendix III).? Just how these medical hazards come to be recognised as part of the very gesture of the anonymised ‘gift’, and indeed with what consequences, will form the analysis of later chapters. For these reasons ova that are exteriorised by female donors as extra-

corporeal, ‘ex- vivo’ body parts assume the status of rare and precious ‘valuables’: they are entities that are not readily available, whether for therapeutic donation or experimental research purposes. A key defining difference then between female and male-assisted donor conceptions is the global shortage of donor eggs. Nowhere is there a plentiful enough supply of human eggs to treat all those who would wish to be assisted, a lament shared by medical practitioners and prospective infertility consumers alike. In many fertility treatment centres in western states, as well as the new ‘satellite’ clinics and independent units in less developed countries, egg-freezing facilities are not routinely available. And without egg freezing the natural life span of a medically extracted pre-fertilised human ovum is considerably shortened. As we will see in subsequent chapters, it

is this scarcity that makes the human egg simultaneously valuable as a commodity and gift entity. Human eggs have a complex ‘biographical career’, in the words of Igor Kopytoff (1986), as they co-traverse the transactional worlds of anonymous sociality.

But there is another fundamental difference between egg and sperm donation. Whereas the DI-assisted male has no biological tie to his resulting offspring, the female assisted ova recipient most certainly does. She gestates and gives birth to the child her female donor helped her conceive.

What is Concealed Inside an Anonymously Donated Gamete? 9 Whilst neither can be said to be the genetic parent of any donor-conceived child, the ova recipient has a biological connection to the child. In other words, egg donation enables each rearing or social parent to have a

biological connection with donor-conceived offspring (in contrast to sperm donation, traditional maternal surrogacy and adoption). In kinship terms, the substitutive replacement of egg donor for recipient raises distinctive differences to sperm donation and, as we shall see, egg donation is all the more complex a cultural phenomenon by this count. It is therefore highly dubious to model egg donation on the older, more established practice of sperm donation, after the manner of current British fertility legislation.!°

With the expansion of infertility treatment since the late 1970s, there has been a significant increase in the numbers of donor conceived children worldwide. During 2000/2001 alone, the Human Fertilisation and Embryology Authority (2002a: 13) is able to account for the births of 465 donor egg-and/or donor embryo-conceived children, and some 25,000

children have been born since the early 1990s by treatments using donated gametes or embryos. As these figures refer only to the compilation of clinic-based data based on centralised records set up by the HFEA since its inauguration in 1991, this is by the Authority’s own admission an incomplete reflection of past donation events. Left out of the picture are data relating to so-called ‘transitional donors’ (Human Fertilisation and Embryology Authority 2002b: 2) — those persons who donated prior to the establishment of the HFEA register. According to the Department of Health, some 12,000 children were conceived with donor sperm or eggs before this time, however this, too, is only an estimate.'! Truly we do not know just how many persons have come forward to volunteer as reproductive gamete donors. If this is one missing link, it is compounded by yet another form of ‘lost’ knowledge. The vast majority of these assisted births will have occurred as anonymous donations (see Chapter 2). The ova donor will not know to whom she donates and the ova recipient will not know from whom she receives. (The same principle of anonymity applies for sperm donor.) In turn, donor-conceived children will not know the identity of their genetic parent. In itself we can see how such non-knowledge already makes relations: it clearly divides people. Anonymity divides activist-campaigners

who press for the ‘right to know’ one’s genetic parentage from those donor or recipient populations who, in far less muted ways, support or are otherwise indifferent to secrecy and concealment. In Britain, a govern-

ment-initiated consultation led by the Department of Health has been deliberating changes to the law with regard to donor information provision policy (see Chapters 2, 3, 6). If approved, a greater flow of identifying information would be opened up to interested parties. ‘Donor-release’ is the favoured term (see Chapter 6, Recipients I). It is a counter to the facelessness of anonymity — the nameless relations — that makes kinship with

strangers at once so strangely intimate and distant.

10 Nameless Relations ‘Kinship with strangers’ is social anthropologist Judith Modell’s (1994) term for the cultures of secrecy surrounding ‘closed’ adoption practices in contemporary North America.'* Adoption of course involves the transfer in law of parental rights from one set of parents to another. The child or minor person passes, via third-party mediation, from the birth parents to its adop-

tive parents. There is nothing technological about these kinds of anonymised transfers. Instead, the moment of cultural erasure is enshrined in law with the issuing of the adoptee’s new birth certificate. As the names of the birthparents are written out, so the names of the adopting parents are written in. Legally an adopted child will appear ‘as-if-begotten’ (Modell 2002: 5): as though the child [always] had been born to the adoptive parents. As for the transfer itself, no visible public traces will be left.

There are certain parallels but also important differences between ‘stranger’ adoptions and anonymous donor-assisted conception by IVF technology. I have already mentioned, in the case of egg donation, the social mother’s biological tie to the child through the process of maternal gestation and birth. Assisted conception by sperm donor ensures again the same biological tie through the maternal line, though in these cases the bio-

logical mother’s own genetic link to the child will be evident. Thus, the ‘non-blood’ relationship that characterises the tie between adoptee and adoptive parents cannot be transposed straightforwardly onto the context of donor-conceived children. However, in both instances, the range of meanings ascribed to kinship are likely to perforate traditional symbols of relatedness, the ‘blood tie’, on account of the establishment of a virtual relational triangle. This ‘triangle’ is a kinship formation whose sides can never link up to make a clear or completed impression of itself. Between the triadic formation of birth parents, adoptive parents, adoptee child on the one hand, and that of the ova donor, ova recipient, donor-conceived child on the other, the different triadic sides cannot interlock as ‘one’. If dis-

connexion appears as though it were a fundamental attribute of such anonymous relatedness, we miss the point if we do not enquire further into what it is that gives anonymous sociality its paradoxical cultural referents. When anthropologists first began to speculate how applications of the new reproductive technologies may bear upon forms of relatedness, their

enquiries built upon previous cross-cultural work on procreation and birth symbolism, idioms of fertility, and the interplay of notions of substance with constructs of personhood.'? Cross-cultural comparison, as an end in itself was not however an explicit focus of this particular early technological turn, with the notable exception of Marilyn Strathern’s (1992a) pioneering Reproducing the Future. Prompted by the impetus to identify the nature and basis of changing conceptions of Euro-American kinship, the preponderant analytic focus has been with Western perceptions and values. The anthropological engagement to date thus appears confined to a number of publics in parts of Britain, Europe and North America (Abrahams 1992; Edwards et al. 1999; Fox 1993; Franklin 1997;

Hauser-Schaublin et al. 2001; Ragoné 1994; Rapp 1995; Strathern 1992b).'* In addition, this anthropological literature may be characterised

What is Concealed Inside an Anonymously Donated Gamete? 1] by its analytic preoccupation with named kin as identifiable partners or consumers of the new technology. Much of the scholarly material documents the views of various individuals in their capacity as known relations.

Whether surmising relations within a given family, or extrapolating the nature of different kin relations with divergent interests, researchers in the field have worked amongst identifiable persons and have sought to elicit the views of specific individuals. It is important to see that there is

nothing particularly surprising about this. Indeed, it is quite to be expected. Certainly for Euro-Americans the idea that individuals reside within identifiable persons simply confirms the most obvious view from the ground; it is a view expressed forcefully in several commonplace contexts, amongst them people’s folk explanations of their own procreative origins. In presenting some prevalent beliefs shared by town inhabitants from the northwest of England, Jeanette Edwards (2000) for instance analyses how her informants articulated the not altogether unfamiliar kinship belief that ‘gametes need names’. Edwards illustrates how people strive to accommodate relationality in terms of a particular repertoire of kinship thinking. The English, she suggests, tend to imagine they best relate to one another when persons become visible as individuals who believe themselves to be ‘rooted’ to each other through relations and places (see also Strathern 1992a and 1992b). Indeed the conceptual legacy of Euro-American kinship as diffuse and enduring forms of relatedness, a view that entered the anthropological canon with David Schneider’s cultural critique (1968) has always rested on the presumption of kin identifiability. We are faced therefore with an intrigue and anomaly. How does the figure of the donor — as extra-conjugal provisioner of sex cell gametes — come to be incorporated as a figure of

kinship at all? Parts II and II will explore the web of contradictions that follow when we recognise that people need not always be recruited into kinship as exclusively named, known and knowable persons. We will see, in other words, how adept Euro-Americans can be at doing relationality in several rather different ways.

Future Feminisms Ova donation is probably one of the foremost feminist issues of our time. Consider for instance the fact that ova donation technology dramatically

alters human reproductive potential and, in theory at least, enables women of any age to become pregnant. The world’s oldest mother is thought to be Satyabhama Mahapatra, the wife of a retired headmaster from Nayagarh in eastern Orissa in India. She gave birth in 2003 at the age of 65 and thereby ousted previous recordholders.'? Rosanna della Corte from Italy was 62 when she gave birth in 1994; Arceli Keh from California was 63 when she delivered a baby in 1997. That same year, Elizabeth Buttle, a 60-year-old Welsh hill farmer broke news headlines when she became the oldest mother in Britain.!®

12 Nameless Relations Extending treatment beyond the medical cause of primary infertility opens up the possibility of expanding age boundaries for reproduction beyond the female menopause. Were it ever to be recognised as a legitimate method of delayed age childbearing, postmenopausal mothering would offer women the possibility to start second or even third families with different partners — much in the way men are already free to do! In fact this eventuality is already gaining quiet momentum. Recent reports suggest that the reversal of the female menopause through ovary graft techniques may soon become a safer, more effective alternative to hormone replacement therapy. Moreover scientists predict such graft techniques would actually have a restorative function: ostensibly, a woman would be given ‘back’ her powers of fertility. Medical researchers are already envisioning the establishment of so-called ‘ovary banks’ compris-

ing either the woman’s own pre-banked ovarian tissue or tissue from cadaver donors or aborted foetuses!’ (see Chapter 10). Of course such developments are revolutionary as much for their profound cultural impacts as for the science. Just as postmenopausal mother-

ing unsettles conventional norms for the classification of age-related parenthood, scientific experimentation redefines the very ground of ‘nature’ itself. When a donor-conceived child born to a post-menopausal mother reaches her teenage years, the social mother is fast approaching an octogenarian. The expectation parenthood should involve the rearing of a child to adulthood has led critics to express concern over the welfare of the child. The problem is perceived au fond as a disjunction: as though it were simply a matter of one ‘nature’ based claim against another ‘culture’ based claim. In a reversal of the expected downward allocation of parental rights and responsibilities, the child welfare argument holds that it is unpalatable to think the child might have to tend to his or her parents, or worse still that she may be abandoned as an ‘orphan child’.!® Across many cultures,

however, it may be seen as a matter of respect for junior kin to honour their elders through forms of ritual ‘care’, and it is not unusual in extended

households for parenting to be bestowed upon grandmothers. Countercritics from the West argue meanwhile that a woman of mature years may prove a better mother than someone of a younger age who conceived naturally.’? Of course anyone’s mother can die at any stage in one’s life and in any case we do not currently restrict parenting rights to those with sound health or expected longevity. Let us not forget that in the coming age of genetic prognostication and predictive genetic testing technology, subtle eugenics is not a remote prospect but one that can creep insidiously into arguments in various guises (Konrad 2005). Simply in technical terms it is, of course, already possible for daughters to donate eggs to mothers who thereby give birth to their own ‘childrengrandchildren’ and their daughters’ siblings-children. Such practices radically transform our notions of intergenerational relations and challenge basic kinship categories (see Part III). Whether or not such practices are allowed to take place is another question, and will be determined, in part, by cultural attitudes, ethical mores and regulatory systems. At the present

What ts Concealed Inside an Anonymously Donated Gamete? 13 time, many privately run assisted conception clinics in North America accommodate the wishes of daughter-as-donor to mother-as-recipient intending couples, whereas in Britain health ethics committees have declined approval for such treatment.?° ‘Egg freezing may come to be seen as the ultimate kind of family planning’.?’ Possibilities for delayed childrearing through egg freezing technology, whereby the mother-to-be places her own ova in an ‘egg bank’ for future use, may also change the future pattern of women’s professional work lives.*? Already it is possible for a young woman in her twenties who

wishes to pursue a career until her late forties or beyond to have her eggs ‘frozen down’ while they are in ‘peak’ condition (see below ‘“Cosmic Egg” Revisited’). Once she and her future partner are ready to start a family, the eggs are ‘de-thawed’ and fertilised ex-vivo. This is known as pro-

creation by ‘ice baby’. But if egg banking offers one way to shatter the ‘glass ceiling’ phenomenon, does this new form of biological capital simply reinvent the wheel through a form of backdoor biological essentialism? ° WOMEN ARE to be offered the By JEREMY LAURANCE

an ] Ee on option of postponing Editor , hood by motherup toa-Health decade by

freez_

a ing their eggs for later use after nique it will be a major break-

use of frozenA the Human Fertilisation and . through treatEmbryology Authority gavethe ment, Butfor weinfertility must always be . -e ol go-ahead yesterdayforthetech- very cautious about these de-

ot 4 ) nique, which had previously velopments,” she said. |

e S O eC. ay been banned for safetyreasons.... The HFEA is also to allow the

; | The HFEA, the regulatory donation of frozen eggs to

— : body, said it would allow the women who cannot produce

concep 10n. “carefully controlled of treatment, their own. But MswasDenton _— oo frozen eggs foruse” fertility the method unlikelysaid to apwhich is expected to be used pealtowomenasameans ofhav chiefly by cancer patients atrisk ing a family except those who had of becoming infertile because of ne other choice,.because of the

surgery orchemotherapy. risks associated with collecting However, the authority is the eggs and the low chance of not ruling out use of the tech- a live birth of between 1 and 10 nique for social.reasons, by per cent. “Women would have to women who wish to delay child- be inforrned and in that context bearing while they build upaca-_ itis unlikely they would chicose

reer. By freezing their eggs that option. Also, clinicians would while young and storing them have to consider the welfare of in liquid nitrogen, they would potential children born by the

know they would haveasupply method,” she said. :

available to start afamilylater. . The decision to lift the ban The decision not to exclude _ was prompted by the conclusocial reasons angered family sions of an independent report rights campaigners. Josephine commissioned from fertility exQuintavalle, director of Com- pert Dr Sharon Paynter, a Jec-

ment on Reproductive Ethics, turer at the department of gid: [tn-vitro fertilisa-- .the obstetrics andof gynaecology at . ion]“IVF is.offered as asolutionto University Wales College the problems of infertility but of Medicine, Cardiff. She said not wanting a child atapartic- that while the technique was

ular time is not an infertility not without risk, the results

problem. Whenever you do that . were “very encouraging”.

you are putting the childsecond: Scientists have long used to your career and the welfare frozen embryos in fertility treat-

of the child has to come first.” ment but freezing eggs has Jane Denton, deputy chair- proved more technically diffiwoman ofthe HFEA, defended cult. Advances in the past three the decision on the basis that years have led to at least 28 live the technique offered hope to births worldwide from frozen survivors of childhood cancer eggs, and there are no reports who ean lose their fertilityasa ofabnormalities in the children.

result of treatment. “Ifthisbe- The technique is licensed in comes an established tech- Italy and the United States.

Figure 1 ‘Ban lifted on use of frozen eggs to delay conception’, 26 January 2000. Reproduced by kind permission of Jeremy Laurance and The Independent.

14 Nameless Relations In the past, feminist attempts to challenge biological determinism have focused on refuting the largely universalising assumptions about women’s subordinate position on account of their biological role in reproduction and motherhood. Whether critics have sought to counter claims of the polluting and negative value of female procreation by arguing against the denial of creativity and historicity to human reproduction (de Beauvoir 1953), or have pointed to the medicalisation of childbirth as a loss of female sociability around the birth event (Martin 1987; Oakley 1987), feminist scholarship on the politics of fertility has been characterised by its assertion of the fundamentally gendered nature of reproduction (Ginsburg and Rapp 1991; Greenhalgh 1995). Egg freezing technology and ovarian transplantation potentially change the terms of that critique. The ‘ovulation revolution’

unfolding at the turn of the twenty-first century seeps into the deepest imaginary crevices. It challenges many cherished assumptions. First, there is the marginalisation of women’s reproduction in terms of

western culture’s disavowal of women’s roles in cultural reproduction. Since the time of Aristotle it has been thought that women make procreative contributions of ‘matter’, as opposed to the male party’s power to engender ‘form’. Such passive-active dichotomies underpin the discursive construction of women as physically constrained and reduced to positions of near immobility by pregnancy, lactation and infant care. This is in contrast to the unconstrained, creative and mobile dispersals by men scattering their ‘seed’ (cf. Collier and Delaney 1992). Arguing against traditional

assumptions that two mutually exclusive and exhaustive categories of people must pair together for the social and economic ordering of society,

feminist critiques have striven to de-naturalise the differences between women and men that render political discourse and the sexual division of labour ‘natural’.?’ Such critiques have stressed also how women are to be situated socially as historicised agents, capable of constructing, both symbolically and materially, their own reproductive outcomes. In the case of egg freezing, women with functioning ovaries — and not

just those seeking fertility enhancement treatment — would have a far greater hand in their own reproductive agency. The very notion of ‘balancing’ one’s personal and professional lives would become a quite different matter of reproductive facilitation should women wish in the future to choose the egg-freeze option. Of course, this would not be ‘donation’ in the strict sense of the term since it would be a case of acting pre-emptively to assist oneself as one’s own procreative agent. Such pre-emptive forms

of ‘self-care’ have much in common with the current biomedical shift towards tissue banks and auto-grafting techniques and may be seen as another face of twenty-first century regenerative medicine (see Chapters 9 to 10). In any case, as the roles of women and men will be seen to merge that much more prominently, both within and outside of public space, so our understanding of gender equality will shift further and present new contested ground for definitions of ‘femaleness’ and ‘maleness’.

That there can be no monolithic response to these developments is already evident. Numerous feminist theorists and activists have been crit-

What is Concealed Inside an Anonymously Donated Gamete? 15 ical of the scientific developments and social implications of the new reproductive technologies.*4 One central critique concerns the very notion

of reproductive liberalism and its anchoring within the discourse of ‘reproductive rights’.*? Many see these technologies in terms of the trou-

bling degree of reproductive choice and control they extend to women (e.g., Raymond 1994). Some campaigners condemn egg-freezing techniques as the devaluing of life by means of the creation of ‘convenience babies’; on this front Josephine Quintavalle, director of Comment on Reproductive Ethics (CORE) has been one outspoken critic.2° In The Change (1992), feminist thinker Germaine Greer implores women to throw away their hormone replacement pills. Embrace the end of your natural fertility, she entreats. Other roles exist for women than producing babies! Of course this latter line has been a standard rallying cry among feminist activists and characterises the more epistemological endeavours of feminist theoreticians. These examples aside, it is important to stress that in terms of the development of feminist theory there is no definitively

‘feminist’ viewpoint representative of ‘women’s’ thinking about these technologies (see Chapter 2 ‘Anonymity/partibility’).*”? Thus the cultural

politics of ova donation, in common with other cutting-edge developments in reproductive science and technology such as ‘cyborg wombs’ and uterine transplants, foetal therapy and germ-line engineering, promises to

unite as much as divide the very living persons these technologies are designed to serve.

‘Cosmic Egg’ Revisited Every adult woman was previously a gestating foetus whose ovaries once contained millions of immature oogenia (egg germ cells). Already at birth, the number of egg cells of the girl-baby will have depleted from around 5 million to roughly 1 million. For most of us there are only some remaining 250,000 by the onset of puberty, despite the fact that throughout her

reproductive life course a woman will shed a couple of hundred eggs, typically between 400-500. As she ages, the quality of the egg cells also deteriorate.*® Fertility experts are still puzzled by this course of events. Sci-

ence cannot yet explain fully why the ovary ages more rapidly than any other bodily organ, nor why such a bounteous efflorescence of egg cells should mark the human female embryo’s early origins.?? Nonetheless it is with renewed momentum that increasing numbers of embryo research scientists and fertility practitioners are devising ways to supplant this bio-intrigue. Their current efforts are directed towards the ‘re-sourcing’ of ova as newly multipliable and readily available biomaterial. With this venture we see that the clinical practice of egg donation takes place against a wider institutional backdrop of ovum-related technologies and appears inseparable from the cultural context of a global reproductive politics. Ova cultivation pioneers — as they might be called —

invest in the language of commodity appeals: it is against a notion of the

16 Nameless Relations universal shortage of human donated eggs that they address the acquisitive problem of bio-procurement and supply. What is at once vexing, disconcerting and promising here is the fact that the very classificatory status of human ‘ova’ as bio-cultural marker undergoes radical transformation. Much is at stake. On the one hand there are reports of various future scenarios. The possibility of a cadaver egg donation scheme for the clinical transfer of eggs removed from pre-consenting women or girls who have died, for example. The British Medical Association first mooted this possibility at its annual meeting in Birmingham in 1994. Dr Stuart Horner, then chairman of the BMA Ethics Committee, addressed delegates with news of the envisaged scheme. It would involve the issuing of an advance directive or special ‘egg donor cards’ as official token of the deceased donor’s prior reg-

istered consent. Horner was of the opinion the scheme should operate without any fixed lower age limit. Just listen to how easy it is to re-classify the age boundaries of female reproductive potential in this particular context. ‘We believe’, Horner explained ‘it could apply to any girl of any age who in a doctor’s judgement has made a competent decision’. ‘That would include’, he went on to say, ‘most 15-year-olds, a few 14-year-olds and the odd 12-orl3-year old. We say an individual must give consent in her own right’.?°

Egg donors aged just 12 oe 1 Gy PETER ANDERSON | - under-age girls being

ne ogee, Doctors back move that allows “*see80 - aeimwm §=could carry donor cardsgirls ° eetoeeaidinfertile ° Geclon”couples sold De Pom: Som Norns mercer toe ~young #rz.sneu

S “3 e-ge) suggested yesterday. modified and the word ovaries Oxford Richard Harries com- cult. Wehavetakenthelid aborted foetuses. , ve id ae The move was backed at the included,” Dr Michael Crowe told mented “I'm in favour of donor off Pandoru’s box.” The BMA decision on po aR co ae gee SI BMA annual conference, which the Birmingham conference. cards generally but not for this. Baroness Warnock, who fertility treatment comes sos er ame §8=—also decided women in their 50s “Ovarian donation would allow “It is pulling apart a process chaired the original after a dozen British SR em COUNd have fertility treatment. grieving, relatives to, fel nat which nalire Das put tagetfier, | inguley auea said slready Doon patients.”

TE es eearorren felis, Eiemecoeplesnecnce ohare He tral eld edt Setvecnt agrcengr'ts mcd ggatioes P ne treatment song cape trom undorn _— British doctors have so far —§ thul we must tmpose limits.” comme af acy after meture wemes would

babies, while allowing research into avoided using Egs from women BMA ethics committee chairman ooraecar sine °E8 ceca: Stee ahead eats

T iociacs and Os card scheme dla from Soh Korea suggest adic Cards would generally” be oad they ate the ‘sane Ses GF Pes Wines.

CRITICAL: Bishop Herries “Donor card wording needs to be cised by the Church Bishop of onstrated stilable maturity Be Hor ee ec creitact betas

Oo | diterence Defmeen wsing hs een Or eee ue Or Rai Lawrence B ~ glee from dead OF Church of England board of Derby, disagreed He | But he warned: “Each wai as exc goea eouene aunesiy to have the smyear the moral dilemmas should be separate from ‘mina to cope with a child

Se cues Gad Seve ONE a ne aoe peg ne

Figure 2 ‘Egg donors aged just 12’, 6 July 1994. Reproduced by kind permission of The Daily Express.

At the future possible use of donated ovarian tissue from aborted foetuses, the BMA however drew a line. Were it ever to be perfected and approved as medical technique, resulting children would have no traceable biological mother: the child’s mother would never herself have been born. On these grounds the prospect of ‘donations’ made from the tissue of aborted foetuses has met with far greater ethico-medical resistance, not just from clinical practitioners but also from government quarters, the Human Fertilisation and Embryology Authority, and other activist bodies (see Part III). But it is important to remember these objections originally had been

What is Concealed Inside an Anonymously Donated Gamete? 17 voiced prior to the birth of Dolly the sheep, and the development of nuclear transfer cloning techniques. Important to remember because Dolly, in a sense, is emblematic of a

marked shift in technoscientific expectations (Wilmut et al. 2000). Ooplasmic transplantation and membrane fusion technology, based on the procedure of egg nuclear transfer, involves the creation of ‘reconstituted’ eggs whereby the mitochondrial DNA from two different women are mixed together. The kinship of polymaternal genetics is just one variant of the cultural politics of enucleation. The creation of an ‘artificial gamete’ is another. Reports of ‘artificial gametes’, laboratory-cultured eggs

and sperm that are derived from embryonic stem cells that have been cloned ‘therapeutically’ from the somatic cell of an individual (e.g., skin cell) would enable infertile couples to have their own genetic children, just ‘as-if-conceived’ naturally (echoes of Modell, as cited above). The creation of eggs from self-cultured embryonic stem cells would not only ‘assist’ the treatment of infertility as ‘endogenous technique’, akin to the auto-grafting procedures of regenerative medicine noted a moment ago. In addition, it would bring about an infinite supply of human eggs for therapeutic cloning research (see Chapters 8 to 9).*! It would be seen to solve the commodity problem of supply. Moreover, what would be infinitely reproducible would not be costly to keep: by default, the designs of infinity would not belong in homologous fashion to the categorical order of the precious, rarefied ‘valuable’. The ‘mero-egg’, emanating from the replicable matter of endlessly divisible bio-substance, would become the icon of the mundane, substance of the everyday. The symbol of re-origination, mero-egg would both derive from, be encompassed by and be separable from ‘holo-egg’, the original symbol of indivisible cellular origins.*?

If certain medical researchers are keen to promote this possibility, we should not lose sight of the fact that the supply of ‘donor’ enucleated eggs would be relatively easy and inexpensive to maintain. Eggs would be ‘on

tap’, as it were, disembodied from their original human source, anonymised as limitless resource for therapeutic cloning and stem cell research experimentation. Recruited into a new artifice of genealogical unity, the mero-egg is put to work in the service of another collective vision. This time we have for contemplation the endpoint of a therapeutically enhanced ‘mankind’ envisioned as the promise of stem-cell grafts as curative fixes for degenerative disorders such as Parkinson’s disease, cardiac disease and diabetes. Now what ‘donor’, goes the orthodox medical premise, could possibly argue with the elicitation of gifts such as these? (See Chapter 8, Recipients LIT.)

Already there is ample evidence to see that the bio-sourcing of ova supports a global multi-million-dollar human-egg industry. The operation of an international black market in human eggs has led to the establishment of off-shore Israeli-run assisted conception units in Cyprus, for example, set up with a view to circumventing Israeli regulations against the buying and selling of eggs for profit (Kahn 2000: 132).** Ova fertility tourism, as

it is known, is now big business. But the flow of donations is typically

18 Nameless Relations unilateral: from poor, usually third-world women to first-world wealthy recipients. There are reports of women from Russia and other countries being flown to Cyprus, paid to have their eggs harvested, and then flown out again. The market basically caters to the need of infertile Israelis and other nationals who wish to bypass the waiting list for public state-paid ova donation treatments available in Israel. Women who can afford to do so simply go to Cyprus and buy freshly harvested eggs there: money and eggs change hands and bodies under the sanitised guise of so-called ‘gift’ relations. Once again, donor and recipient are never destined to know or meet one another: the link of anonymity between them is the ‘xeno-egg’. In the context of the emerging international trade in gametes (witness the recent cases of the sale of eggs to American clinics by British university students and the bulk import of sperm from Denmark to the U.K.), xenoegg is making links not simply across bodies but across continents too. If egg donation is now a key feminist issue for our times, there is a sense in which the human egg is emerging as the ultimate fetish object of twenty-first century biomedicine. But how exactly does this object derive its cultural value? It is at once a biological, political and kinship resource, a unique substance, precious and coveted by expectant mothers, scientists, pro-life campaigners and religious lobbyists alike. At one moment it looks to be a special ‘sacred’ object, at another it has transformed into a globalised commodity for pan-cultural transactions. This transmutability (the labile interchangeability of mero-egg, holo-egg and xeno-egg) is ‘cosmic egg’ revisited. It is a modern reworking of the ancient belief that (1)

all humanity initially had been contained inside the ovary of Eve; (2) all life emerges from an egg; (3) the egg symbolises the first moment of differentiation, encompassing the totality of all differences (Pinto-Correia 1997: 34-35).*4 The ancient and modern-day cosmic egg symbolises ‘all potentialities’.

The egg is spherical body, figure of the globe, sign of the world. It draws

into its fold mero-egg, holo-egg and xeno-egg as alternative kinship accomplices. But it is also the icon of fundamental contradiction. As the figure of zero, cosmic egg is intimately connected to the idea of Nothing, to emptiness, the void and to absence of any origin.*? Through the opposition of void/infinite, it threatens the familiar boundaries of human expe-

rience and has provoked deep intellectual unease in the fields of mathematics, ontology, logic, rhetoric and religion (Rotman 1987). One reason for this sense of anxiety is attributable to a denial of anteriority, a denial that disrupts the possibility of a given ‘intrinsic’ value as privileged transcendental or absolute origin.*® Just think for a moment how many

different words we commonly associate with the symbol 0: nought, naught, nothing, nil and love — the latter being used by partners when they play tennis. At the same time zero symbolises the object that — without its own endemic value — changes the qualities of others through its own positioning. It is a kind of ‘relative origin’ eliciting something from nothing: nothing from everything. kK*

What is Concealed Inside an Anonymously Donated Gamete? 19 I respond to these potentialities by embracing the complex of contradictions they generate. Specifically I want to put back into the picture the subjective experiences and voices of actual women. It is because the social agency of ova donors and ova recipients can be erased so easily when it

comes to policy deliberation that we do well to hear women’s own accounts. What I have in mind is the need to hear narrated ambivalence as basic evidential material in its own right. Such experiential focus builds

on recent ethnographies that have illustrated the contested relations between science, reproduction and the cultural politics of embodiment. The pioneering work of cultural anthropologist Sarah Franklin is relevant here with its analysis of the routinisation of risk and construction of the infertile as ‘desperate’ populations (Franklin 1997; see also Franklin and Ragoné 1998; Lundin and Akesson 1999). Other notable work considers the scientific and cultural constructions of the ‘techno-foetus’ (Casper 1998; Davis-Floyd and Dumit 1998; Hartouni 1997) and the cultural persistence of the ‘elusive embryo’ (Becker 2000). Fertility experts, medical practitioners and others could learn much from the fine feminist scholarship on maternal surrogacy (Ragoné 1994), pre-natal testing technology (Rapp 1999; Rothman 1986), and the constructed nature of the ‘familiar’ and the ‘exotic’ in discourses of menstruation and menopause (Buckley and Gottlieb 1988; Lock 1993; Martin 1987). But there is another agenda attached to this focus on subjective experience. Gametes are not just hidden from view. Their ex-vivo removal from the interior of the body evokes a donation whose cultural meaning is richly suffused by a particular gift rubric. In clinical discourse and the popular imagination alike, the notion of ‘gifts of life’ enjoys wide appeal. As we will see, Nameless Relations responds to this rhetorical hyper-famil-

larity by turning aspects of the traditional anthropological gift rubric ‘inside-out’. If the recent explosion in critical anthologies and interdisciplinary readers is anything to go by, contemporary discourses of the social sciences and humanities on gifts and gift giving are still alive and thriving (see for example Kass 2002; Komter 1996; Osteen 2002; Schrift 1997). But the lack of an empirically informed framework for theorising the form of contemporary gifts in modern western society has received negligible attention itself. That is an important difference. Anthropologist Linda Layne (1999) has recently taken up this hiatus by addressing the nexus between languages of the gift and what she calls ‘transformative motherhood’. Her volume can be situated in relation to the contradictions emerging with new categorisations of

maternity on the one hand, and the ambivalence generated by contemporary gifting and gift ‘relatedness’ on the other. While some commentators have speculated that gift exchange in complex society represents a moral economy of ‘redundant’ transactions (e.g., Cheal 1988), a counterview suggests a discourse of the free or ‘pure’ gift is most likely to emerge in

societies marked by a strong commercial impetus (Parry 1986: 467). Parry’s insights certainly are helpful and instructive. But a caveat is required. Despite recent anthropological critiques that the constructs of the

20 Nameless Relations commodity and the gift do not constitute oppositionally distinct kinds of power or forms of social organisation’’ anthropological theorisations on the gift are still firmly rooted in the premise that such exchange between strangers bodes a necessary contradiction in terms. This point is doubly

portentous since the ethnographic examples from which traditional exchange theories are formulated have been premised almost exclusively on examples of men’s production and men’s exchanges. Certainly, anthropologists are familiar with the different ways women the world over have

circulated as value between groups of men in their designated role as prospective affines. But ova donation is a completely different constellation of ‘exchange’ relations. It involves ‘gifts’ being made by women for other women.’ It is then through these intersecting planes that Nameless Relations documents the clash of contradictions between technology, biology, genes, emotion, intimacy, distance, gift and commodity.

Ova Donors and Recipients Who are ova donors and recipients? As mentioned in the Preface my concern is with the experiences of non-IVF volunteer ‘altruistic’ donors, that

is, healthy woman who have not undergone fertility treatment for their own benefit but all the same wished to donate. Most of the donor women whom I have befriended are married mothers with their own birth children, although some are single or divorced. Most are in the twenty to thirty-five years-old age range, although a few older donor candidates in their late thirties had managed to persuade counsellors of their suitability.

(Thirty-five years is the usual cut-off age for donor eligibility since it marks the onset of rapid deterioration in the maturational quality of most women’s ova.) Usually it is white Caucasian donors that are recruited, but in my donor sample there is some variation in ethnicity ranging from a Punjabi-born Sikh Indian, an Anglo-Indian Hindu to Anglo-Hungarian, Australian, West African and Portuguese nationalities (see Appendix I).

There is a notable mix of backgrounds, interests and financial statuses making generalisation difficult. Several donors are college educated and have worked in professional sector employment. Others are financially dependent on their male partners and describe themselves as ‘housewife’ or ‘full-time mother’. Just under half had chosen to donate their ova more

than once and could be described as ‘serial donors’. Some are regular blood donors or carry organ donor cards on their person. The predominant religious affiliation is Christian (Church of England). Many are prepared to travel considerable distance, sometimes several hundred miles, so as to make their donations at some of the busiest London clinics. Since it is illegal to pay gamete donors, only their travel expenses would be reimbursed by the clinic with an optional £15 offered as token acknowledgement of donors’ inconvenience. The motivations of donors and the kinds of ‘gifts’ they imagine they are making are complex and contradictory, to be discussed at length in Chapters 3 to 5, Donors J to III.

What is Concealed Inside an Anonymously Donated Gamete? 21 What about the other side of the story? As intimated already, egg donation is a substitutive technique and involves replacing the ovarian functioning of one infertile woman with the fertile ova of another woman. It may be required by those who have experienced premature menopause,

those affected by infertility due to cancer treatment or endometriosis, adults with Turner’s syndrome (the congenital underdevelopment of the ovaries), primary amenorrhoea or other ovarian or hormonal dysfunction. Those at risk of passing on serious genetic disorders (e.g., autosomal dominant, sex-linked and autosomal recessive traits) may also be candidates. The testimonies of recipients who agreed to participate in my research are considered in detail in Chapters 6 to 8, Recipients I to IJ. Many had

been diagnosed with the partial or complete blockage of either one or both of their Fallopian tubes, or had been told they suffered from socalled ‘unexplained infertility’. About half of the women I interviewed had experienced the onset of premature menopause whilst in their teens or twenties.*? One woman had been born without her ovaries, and another research participant had had her ovaries removed during adolescence because of ovarian cancer. Three menopausal women in their late forties and early fifties, one already a grandmother, were receiving treatment because they wanted to start second families. The average mean age

of the sample group is thirty-nine years with recipients’ ages ranging between late twenties and early fifties. Ethnic composition and nationality is predominantly British/Caucasian. It is always good to find exceptions during the course of research. In the case of my fieldwork, sometimes the surprise would consist in the very consistency of the reply. Almost every recipient I spoke to would recount long and complicated gynaecological histories, some describing how they had been transferred successively from hospital to hospital, or specialist to specialist in an attempt to complete as thoroughly as possible their medical investigations. Remarkably these drawn out ‘investigations’ even seemed to apply to those women who had reported the early cessation of menstruation many years ago! Hoping they may receive a more detailed explanatory diagnosis for their involuntary childlessness with other consultants, many had embarked on a kind of ‘fertility tourism’ at home. Often this meant agreeing to the invasive technique of laparoscopy

on repeat occasions, or undergoing multiple attempts at tubal surgery (some such attempts being avowedly exploratory rather than diagnostic) or the surgical removal of ovarian cysts. During the course of these mul-

tiple investigations, many sufferers of premature menopause had also experienced lengthy and often difficult administrations of hormone replacement therapy (see Appendix II).

In addition many recipients had undergone IVF treatment several times, sometimes over the course of several years, prior to the experience of treatment by donor. Some recipients had received different donors’ ova as many as three, four or five times with varying success: sometimes no ova implanted and no pregnancy followed, and for some women it was

necessary to face the trauma that they could not sustain a pregnancy to

22 Nameless Relations full term (see Franklin 1997; Sandelowski 1991). Others narrated so many successive miscarriages or repeat donation treatment attempts that upon our first meeting I often found myself unable to keep track of how many times exactly they had been through the rigmarole of clinical consultation, tests, scans, and medication. Besides sustaining the emotionally demanding uncertainties presented by these experiences, many would describe the considerable financial burdens placed upon them: all had received treatment as fee-paying patients in privately run treatment centres.*° In the erratic field of IVF where the success of treatments measured as ‘take home’ babies varies between 10 percent to 39 percent (dependent in part on the donor/patient’s age and the

clinical presentation of data), yet another remarkable feature was the women’s perseverance with the donor programme against all the odds. Unforgettable, too, is the profound sense of sadness many felt as they spec-

ulated on the possibility they might never be able to raise children. One couple had resorted to replacing missed children with an abundance of domestic pets and another woman who had been trying to conceive for six-

teen years had set herself up with her husband as a professional dog breeder. She proudly showed me her family of ‘champions’. Yet another recipient introduced me to her twelve cats. The loss, courage and struggle of these women battling on through investigation after investigation, treatment alter treatment left deep impressions. If their accounts are moving, they also tell us a lot about the social pressures many women embody when they idealise the belief, however unconsciously, that the most perfect representation of womanhood is always the achievement of motherhood.

Finding Method in the Oblique In the mid-1990s ova donors and recipients were not easy populations to meet. In fact, they were quite hard to find. The interested fieldworker had to work to make these ‘communities’ appear: they did not pre-exist the researcher as cohesive groups defined around particular user interests, for example, unlike some of the more recently emerged support formations

that have grouped successfully around certain activist networks (see Chapter 2). These days it is considerably easier for fieldworkers to research

this area: one can ‘enter’ through the activities of informal alliances and reach into the social spaces where former and prospective recipients can now self-organise for increased public visibility. That my fieldwork ever took off is due in part to the initial receptivity of certain medical professionals. I had been fortunate insofar as some medical staff at the infertility units I approached had been willing to listen past my early self-introductions and had facilitated certain logistics pertaining

to research access. With the approval of clinical teams at three privately run units, I was able to negotiate access to ex-donors and ex-recipients. In effect this meant my mediating through the mediations of the clinic in order to ‘get in touch’: an oblique approach that put me on course for con-

What is Concealed Inside an Anonymously Donated Gamete? 23 necting up with both sides — with both donor and recipient populations.*! Once I had followed up the necessary leads and contact details, this access moreover was granted to me away from the space of the clinic.** Insofar as

I was engaged in clinical ethnography, it is important to understand that these research interventions took place both within and outside of the clinic. As a fieldwork strategy I found it worked well to move between these public and private spaces, to enter and re-enter the clinical through the domestic and vice versa. On the one hand I could get to know more closely those donors and recipients who were keen to participate in the study: almost all of the interviews I conducted were home-based encounters, many lasting several hours at a time — generally relaxed but intense conversations. At the same time I was able to follow clinical procedures and learn more about particular techniques, to catch ‘corridor gossip’ or lunchtime talk with members of the assisted conception team. Now if this all sounds as though it ran smoothly, I want to reassure the reader that it did not! My insertion into clinical space was not always easy, mainly

because I was so obviously a non-clinical ‘outsider-insider’ and also because of the logistics of a very busy clinical team.*?

That noted, I was not only fortunate enough to be granted potential access to both donors and recipients, I was also in a position to make con-

tact with donor-recipient ‘pairs’ who had undergone their anonymised treatments during roughly the same time period — that is, within the same clinical time frame. This enabled me to move within a somewhat privi-

leged social space. For in donor-assisted conception contexts, it is the mediations of various third-party agencies that come into significant play.

These agencies, by mediating between donor and recipient, or between birth and adoptive parents in the case of adoption placements, preserve the distance that keeps the different parties separate and separable. It is

furthermore these mediations that instantiate ‘nameless relations’, though third-party agencies in their role as non-statutory bodies can also be called on to help bring people together, and indeed are increasingly likely to do so in the future.** It is important to appreciate each time I would transact a ‘face-to-face’ relation with donors and recipients, I was stepping directly into the space of anonymous sociality, into the place of the known unknown. As ethnographer I became myself a pseudo-mediator: a potential link-person. Simply my very presence and movements represented therefore a potential breach to the principles of confidentiality and non-traceability that make anonymous relatedness such a powerful medium for namelessness, invisibility and potential contact. There are of course ethical dimensions in assuming such a mediatory role. Even if I were to suspect that a donor and recipient, whom I would always meet on separate occasions, might form ‘one’ pair — a relational non-relation as it were —I chose not to divulge any

information to either partner. Nor did I indicate my hunch that one particular donor might have assisted previously another particular recipient. So I was not in the field to play the surreptitious ‘matchmaker’. In other

24 Nameless Relations words I respected and worked within the parameters of the system. Only in this practical sense did I avoid giving to elicitation its relational power.

Implicit Links and Multiple Audiences Turning now to the non-western world, the well-recorded predominance of reciprocity and ceremonial exchange systems in Melanesia is our final switch in perspective. There are several reasons for offering such a comparative relief. I should say straight away that signalling tentative points of comparison is not intended as a prescriptive agenda. It is not that we should adopt the ideas and practices of peoples from cultures besides our own, but rather that we reflect critically why the assumptions underpinning commonplace ideas and practices of ‘western’ cultures seem to us just so desirable and natural. Additionally my referencing of the Melanesian material can only be limited and indicative. One consequence of this style of magpie-mode presentation is its inability to deal with the complexities and richness generated by the voluminous ethnographic material that is Melanesian scholarship. It is thus only possible for this book to brush in with broad strokes what appear to be some common lines of concern as these converge on the following themes. First, the pre-eminence of gift exchange for the Melanesian lifeworld. As the ethnography of this region illustrates so reliably, certain ceremonial

objects embody the relational capacity of persons. Whether one finds wealth in pigs or pearl shells, ceremonial axes or shell ensembles, these are all valuables that stand for part of the person. Moreover their particular value and power is animated by the knowledge these parts are detachable from the person — because these objects can be seen to move between people, they are known to effect the possibility for social connectivity. J explore this parallel convergence (of the gift phenomenon) as a fact of productive difference and similarity between the regional contexts. On the one hand, anonymity is not about reciprocity: it is, as we shall see further in Chapter 2, about everything but reciprocal relations! At the same time, however, the predisposition in some Melanesian cultures to see the body as a conceptual model of social action affords a comparative (and contrastive) basis for probing the value of ex-vivo circulating body parts (‘persons’) in the British context. Iam asking then about the kinds of gift that people give to one another, and what ‘of’ the person these gifts are envisioned to embody as the constitution of social relations between persons.

Second, I suggest certain limited parallels are evident across the regional contexts in terms of local conceptions of agency, practices of fertility symbolism and the transfer of life essence or mobilisation of sex-

ual/reproductive substance. This theme concerns the ways in which notions of fertility serve as an idiom for conceptualising the creation of social bonds, gender relations and exchange processes, and how such sub-

What is Concealed Inside an Anonymously Donated Gamete? 25 stance passes between exchange partners as the making or un-making of sets of previously existing relations (see Chapters 9 tol0). Third, there is the preoccupation with ‘revelation’ — with making visible what are otherwise latent persons and powers. In part, this links up with the indigenous interest in the ritual production and consumption of human body fluids, especially as a scarce resource, for the symbolic transformation of persons and the activation of transgenerational linkages. But it is also true to say that in many parts of Papua New Guinea the strategy of public discourse is precisely not to reveal things. People may go out of their way not to reveal names and other forms of knowledge such as origin myths or magic spells. A certain sociality is then hidden in much of the day-to-day Melanesian lifeworld and requires an ‘aesthetic’ to reveal its contours, as is made clear in so much of the conceptual exegesis of Marilyn Strathern and Roy Wagner, for example. Broadly speaking, implicit links between the U.K. and Melanesia are worked through In terms of how things or powers appear to circulate as the products of transactional processes besides or apart from ‘what others can consensually experience of them without knowing or even meeting them’ (Battaglia 1990: 84). *x**k*

It is not hard to foresee that the work of conceptual critique and comparison will not suit everyone. To some the exercise may seem circuitous, to others obliqueness may be mistaken for the crime of irrelevance. To argue that what is concealed is the role of concealment itself is likely to infuriate genetic activists in Britain and elsewhere, especially those who are concerned with the pragmatics of delivering information and managing a climate of greater openness. Why then bother at all to juxtapose these knowledge conventions and practices as exercises in critical comparison? Indeed why bother to write such a book? The effort, I suggest, is not without its own applications. In the switching of perspectives that work over these cross-regional and thematic comparisons, bioethics experts and other interested individuals will hear concerns otherwise familiar to them as issues of personal autonomy and the limits of individual accountability. Whilst the anthropological focus on ARTs has not so far taken a strong comparative focus, other

scholarship, notably new initiatives in cross-cultural bioethics, take a wider geo-perspective and attempt to examine the interplay of reproductive science and technology across different regional and intra-regional systems. Such work is often informed by an explicitly gender-sensitive approach, but is not grounded in anthropological arguments and ‘culture’ debates (e.g., Tong, Anderson and Santos 2001). So where then is the anthropology? Perhaps it is not overly cynical to say that all too frequently scholarly disciplines are not really ‘talking’ face-to-face with one another as the ‘give and take’ exchange of different expert knowledge, despite the flurry of activity that goes by the name of cross-disciplinarity. As far as this

book is concerned, the intention is to contribute to the project of

26 Nameless Relations anthropological knowledge as critical conceptual comparison by juxtaposing a number of anthropological literatures and ideas ordinarily kept separate. Of course this is a traditional disciplinary investment and one whose importance has been reaffirmed recently with both clarity and vigour (Gingrich & Fox 2002; Lewis 1999). At the same time, by bringing together a variety of literatures traditionally kept analytically discrete, both within and beyond anthropology, it hopes to open up the salience of the comparative exercise by addressing a wider public. This is of key strategic importance, arguably even a matter of disciplinary survival. Sofar

as the ethical, legal and social implications (‘ELSI debates’) of the new technologies are concerned, there has been little integration of anthropological materials into mainstream policy debates. If the sharing of a more inclusive social imaginary might be what a cross-disciplinary project is all about, at least from within the academy, the following pages seek to make just one small step in that persistently challenging direction. That said, it is never an easy task to talk to multiple audiences simultaneously. Fertility experts and infertility counsellors, public policy advisors and research scientists, user groups and government lobbyists, anthropologists and sociologists, ethics committees, regulatory watchdogs and the media, we all may share common interests and disagree on others. We may also bring to the unfolding debates our different professional backgrounds or allegiances. Often we will be inclined to converse in different languages. Working within our different conventions, it is only to be

expected that we will feel most comfortable using different framing devices to press our respective cases. This can be both help and hindrance. It may be that we end up labouring points that to some will seem obvious, as plain as daylight. Medical professionals, for instance, do not need to be informed about egg donation protocols, whereas the interested non-medical reader is more than likely to be unfamiliar with given clinical procedures. While anthropologists do not need to be reminded of the legacy of

gift theory for their disciplinary pursuits, medical staff and others who deploy so readily the discursive rubric of ‘gifts of life’ may find such ‘exogenous’ references insightful for their practice. But how will medical professionals and other non-anthropologists import these insights? How will knowledge from a previous source (e.g., ‘anthropology’) continue to be re-internalised as ‘authentic’ cross-over? All such matters of presentation become the art of compromise, and writing ethnography is as much implicated in that art as it is the very subject of such dialogical ‘give and take’ (Konrad 2004). Shading in Melanesian refractions against the British donor ethnography, and the policy stakes of donor-assisted conception against the social

theory of anonymity, is the play of chiaroscuro. Viewing the kinship stakes of secrets in the gift through these planes — whose interactions make up a living ‘prismoid’ of a kind — therefore requires some patience on the part of the reader. Many interests will be held up together. If the switches in relief afford contrasts that are sometimes surprising, or maybe even disconcerting (no smooth joins), perhaps this unsettling may create

What is Concealed Inside an Anonymously Donated Gamete? 27 the conditions for extended debate between and across different intellectual communities. I would like to hope such inclusion would contain a

‘community’ that one would not ordinarily have detected before as anonymous sociality.

Notes 1. Melanesianists deploy elicitation as an interpretive device and metaphorical aesthetic: it is the form whereby social relations are brought forth and made visible as purposive power. It is often enjoined to the work of revelation. ‘For a body or mind to be in a position of eliciting an effect from another, to evince power or capability, it must manage itself in a particular concrete way, which them becomes the elicitory trigger. This can only be done through the appropriate aesthetic’ (Strathern 1988: 181). Elicitation may be summoned up conceptually, and indeed visually, as ‘the path along which [the] associational world is laid out’ Weiner (2001: 58). Iam guided further by the etic recognition of the relation between containment and inception (and nurturance) and the powerful imagery of the ‘multiple foetus’ as figure of encompassment and elicitation (Gillison 1993). 2. Mention should be made however of a passing interest by certain phenomenologists in anonymity as a form of transcendence. See Ebeling 1987; Merleau-Ponty 1968; Natanson 1979, 1986; Schutz 1967. E. M. Forster’s (1925) insightful but problematic essay on anonymity was concerned with how unsigned artworks correspond to what he argued is the inherent tendency of the literary art form not to want to remember the name of the author. An invisible signature may be understood as a symbol for the genuine creativity of the words written — and the imagination that produced them. 3. Incoexistence: ‘absence of coexistence, the fact of not existing together’. Oxford English Dictionary (OED).

4. On ‘presence-availability’ within Westernised frames of discursive consciousness, see Giddens (1979: 103, 202-210); also Cheal (1988: 18) and Gofffman (1971: 188-93). 5. A variation of IVF treatment whereby a single sperm is isolated and injected into the inner cellular structure of the egg. Also known as ‘micromanipulation’ technique. Largely due to an increase in ICSI treatments, the number of treatment cycles using donated sperm decreased by over a third between 1992 and 1995 to 1996, from 26,063 to 16,659 per annum. See Human Fertilisation and Embryology Authority (2000: 11). Figures for the late 1990s confirm the trend. 6. Inthe early days of artificial insemination, the practice was unregulated and no legal limit was stipulated as to the number of children that could be born from one donor. This would not be possible today. In the U.K., the Human Fertilisation and Embryology Authority (HFEA), the statutory body that has regulated the field of assisted reproduction since 1991, is required by law to remove a gamete donor from its central list once one donor’s donation(s) has resulted in the births of ten children. Every clinic in the U.K. that offers IVF or DI treatment, the storage of gametes or embryos, or that carries out human embryo research, is required by law to be licensed by the HFEA.

28 Nameless Relations 7. See Trounson et al. 1983; Lutjen et al. 1984. 8. See Cohen 1996; Sutkamp-Friedman 1996; Seibel and Crockin 1996. 9. (1) In brief, a woman’s ovaries are stimulated with hormones, multiple eggs are removed, and the eggs are fertilised in vitro with the sperm of the partner of a woman who cannot herself produce viable eggs. The fertilised eggs or embryos are then placed in the uterus of the recipient (whose cycle has been synchronised with that of the donor) or cryopreserved for use by the recipient in a later cycle. If successful, the transferred embryos implant, and the recipient gives birth to a child that she and her husband then rear. In technical terms the procedure is far from straightforward. (2) Recent medical evidence suggests there may be long-term health effects to donors/IVF patients from intense ovarian stimulation cycles. Reports based on a small number of Australian cases have suggested possible links between fertility injections made from human pituitary (brain tissue) gonadotrophins (HPG) extracted from corpses and the onset of CreutzfeldtJakob Disease (CJD) [for women in the U.K. the health scare involved the administration of HPG between the years 1956 to 1985]. See ‘300 women warned of risk 30 years after infertility treatment’, The Times, 2 September 1993, p. 2. The possible risks of ovarian cancer from IVF drugs are still inconclusive (note that much higher levels of HPG were administered in the 1970s than is the case today). Previous studies have suggested that any risk may only become apparent several decades after women have undergone ovarian stimulation; other women may experience adverse effects on account of an unknown or undiagnosed genetic predisposition. (3) There are also increasing health concerns about the safety of certain IVF techniques for the long-term health of offspring. Addressing the annual British Association Festival of Science Lord Winston, Professor of Fertility Studies at Imperial College in London, accused much of the IVF medical profession of an attitude of cavalier indifference towards possible health risks. He pointed to the perils of putting commerce before safety and called for more systematic research experimentation prior to treatment application. His criticisms are all the stronger for citing empirical studies that have reviewed the possible link between chromosomal abnormalities and the ICSI method (see note 5 above), genetic mutation rates, tumour growth and embryo freezing technique (see Chapters 8 to 9), as well as the link between IVF conception and low birth weight. See ‘Winston warns of risks to test-tube babies in later life’, The Independent, 11 September 2003, p.11. 10. The Warnock Report (1984: 36-37) which led to the passage of the Human Fertilisation and Embryology Act in 1990, states: ‘It is both logical and consistent that the law should treat egg donation in the same way as AID and that the same principles of practice ... should apply to both’. Current policy discussions and media reportage on donor-assisted conception take sperm donation as the ‘natural’ case exemplar. Presumably this is because there are far fewer donor-conceived children born as a result of egg donation. In the U.K. children born as a result of donor insemination

outnumber by about five to one those born through treatments using , donated eggs or embryos (Department of Health 2001: 3). 11. Department of Health Press Release 2003/0037, 28/1/03 ‘Donor-conceived children to get more information about donors’. 12. Modell’s (2002) most recent work analyses contrasts between North American and Oceanic forms of adoption, and traces shifts towards more

What is Concealed Inside an Anonymously Donated Gamete? 29 ‘open’ disclosure practices in the U.S.A. For other recent ethnographically informed work on North American (and Western) adoption, see Melosh (2002). Carp (1998) provides comprehensive historical overview of the ‘evolution’ of secrecy and disclosure issues in the Western adoption context. 13. Building on the field that came to be known as the ‘anthropology of birth’ following Brigitte Jordan’s (1978) pioneering Birth in Four Cultures, recent theoretical work in this area has been invigorated by comparative empirical analyses of procreation belief and indigenous childbirth knowledge. See for example Bock and Rao 2000; Davis-Floyd and Sargent 1997; Loizos and Heady 1999; Tremayne 2001. 14. British anthropologist Robert Simpson has recently broadened the regional focus with investigation of the cultural impacts of ARTs in Sri Lanka (Simpson, in press). 15. ‘Mother of newborn child says she is 65’, The Times, 10 April 2003, p. 28. 16. The HFEA does not specify an upper age limit for assisted conception,

although most fertility specialists in the U.K. regard fifty as the upper limit. Ian Craft, director of the London Gynaecology and Fertility Centre, provides egg donation treatments to women over fifty. In Italy, Professor Severino Antinori of the Raprui day hospital in Rome is infamous among Catholic clergy for similar reasons. For British media reportage of other cases of ova recipients aged fifty and above, see ‘Donor eggs fuel baby boom for over50s’, The Sunday Times, 13 July 1997, p. 6; ‘To Britain’s “most dangerous feminist” ... .a daughter’, The Guardian, 2 September 1997, p. 7; ‘Test-tube twins for woman of 54’, The Daily Telegraph, 5 June 1997, p. 1. 17. Margaret Lloyd-Hart of Tucson, Arizona, was the first volunteer ‘guinea pig’

to have a frozen-stored ovary replaced in 1999. ‘The menopause is reversed’, The Daily Telegraph, 23 September 1999, pp. 1-3; ‘Ovarian banks raise questions for medical law’, The Daily Telegraph, 24 September 1999, p. 5. 18. Objections raised, inter alia, by Royal College of Gynaecologists and Obstetricians; Robert Winston ‘Menopause for thought’, The Guardian, 21 July 1993. 19. ‘Clinic criticised over IVF twins for mother, 56’, The Daily Telegraph, 23 January 2002, p. 5. 20. Personal communication from Fran Fox, Cooper Center for IVF Donor Oocyte Program, New Jersey, U.S.A. 21. Dr Gillian Lockwood of Midland Fertility Services cited in front-page headline ‘Frozen egg baby hailed as fertility milestone’, The Guardian, 11 October 2002, p. 1. 22. Egg freezing is currently approved by the HFEA as an ‘insurance policy’ for women who are about to undergo medical procedures such as chemotherapy or radiotherapy that can damage ovaries and result in sterility. See HFEA Ninth Annual Report (2000: 27) and ‘Ovary the Moon’, The Mirror, 26 January 2000, p. 1. In lifting the previous ban on the thawing of frozen eggs for fertility treatment in January 2000, the Authority also approved the technique on social ‘lifestyle’ grounds as a means of delayed conception for single ‘career women’. See ‘Ban lifted on use of frozen eggs to delay conception’, The Independent, 26 January 2000, p. 1. The first baby in the U.K. to be born from the frozen egg of the would-be mother was Emily Perry, daughter of Helen and Lee Perry, delivered in August 2002. (As Jehovah Witnesses, the Perrys had opposed the creation of ‘spare’ embryos

30 Nameless Relations that they might not wish to have implanted subsequently. See Chapter 8, Recipients III.) To date there have been at least sixty-five conceptions from frozen eggs in other European countries, America and Japan, resulting in the birth of at least thirty apparently healthy babies worldwide. 23. Though the list is by no means comprehensive, classic statements by feminist anthropology and feminist epistemology are found in Bleier 1984; Collier and Yanagisako 1987; Errington 1990; Hubbard 1990; Jacobus et al. 1990; MacCormack and Strathern 1980; Moore 1988; Ortner and Whitehead 1981; Rapp 1995; Yanagisako and Delaney 1995. 24. Early critical voices could be heard, inter alia, in Arditti et al. 1984; Corea 1987; Corea 1988a; Spallone and Steinberg 1987; Spallone 1989; Stanworth 1987.

25. The extensive literature cannot be examined in full scope here. For an overview of different positions see Warnock 2002; also Callahan’s 1995 critique of Robertson 1994, 26. See ‘Ban lifted on use of frozen eggs to delay conception’, The Independent, 26 January 2000, p. 1. 27. While feminist commentators generally agree a male-dominated medical profession controls women’s reproduction they have elaborated upon this view in quite different ways (van Dyke 1995; Boling 1995). Those who stress connections between the new reproductive technologies, greater procreative choice and women’s reproductive rights tend to place an emphasis on women’s experiential accounts of treatments. As anthropologist Rayna Rapp writes ‘Until we locate and listen to the discourses of those women who encounter and interpret a new reproductive technology in their own lives, we cannot evaluate it beyond the medical model’ (Rapp 1991: 392). 28. See Fischel and Jackson (1989). Dr Roger Gosden, a physiologist formerly based at Edinburgh University and since affiliated with the Jones Institute in Norfolk, Virginia, is one of the leading pioneers of research into the physiology of egg cell maturation/decline, and possibilities for menopause reversal. 29. Fertility researchers (such as Dr Gillian Lockwood, John Radcliffe Hospital) have recently put forward the possibility of a correlation between ovarian failure and levels of a hormone inhibin B. The aim is to develop a predictive

test that indicates for how much longer a woman can expect to remain fertile. See ‘Career women get a baby ‘deadline’, The Sunday Times, 11 July 1999, p. 5. Recent scientific research on follicular growth development is

examining the correlation between onset of menopause and the incidence of multiple follicular ‘waves’ per monthly ovulation. Initial research implies certain Women may ovulate more than once per cycle and therefore stand to lose their eggs at a faster rate. ‘Ovulation revolution’, New Scientist, 19 July 2003, p. 16. 30. ‘Doctors approve “egg donor cards”’, The Independent, 6 July 1994, p. 6; ‘Baby donors aged 12’, Daily Mirror, 6 July 1994, p. 1. One should not : overlook the extent of the intended appropriation. Fertility specialists have advocated setting up a national register of volunteer donors based on women about to undergo sterilisation before the age of 49. All women planning to be sterilised would be asked to register. ‘Donor eggs fuel baby boom for over-50s’, The Sunday Times, 13 July 1997, p .6. 31. ‘Brave new IVF’ [Editorial], New Scientist, 10 May 2003, p. 3.

What is Concealed Inside an Anonymously Donated Gamete? 3] 32. The merogamete and hologamete are standard Western taxonomic devices within modern biological representation. The merogamete is said to be formed by multiple division and smaller than the organism, whereas the hologamete is equivalent in size to the whole organism (Abercrombie et al. 1955). Outside of the field of biology, merographic effect may also be a metaphor for the organisation of social knowledge: inside of social anthropology appreciation of the perspectivism of local worlds may show up in the way social relations are conceptualised as single figures that encompass plurality. Theoretical Melanesian merography and holography take these observations as their originary points of reference, exemplified foremost in the work of Marilyn Strathern (1991; 1992a and 1992b) and Wagner (1986; 1991). 33. Resnik (2001) discusses the issues specifically in terms of the commodification of human eggs. 34. Pinto-Correia further draws out the cross-cultural resonance attached to the egg as universal symbol. ‘The world hatches from this egg in the myths of the Celts, the Greeks, the Egyptians, the Phoenicians, the Tibetans, the Hindus, the Vietnamese, the Chinese, the Japanese, the Indonesians, the Siberians, and a number of other peoples’ (1997: 35). 35. The Hindu word for zero is sunya and the Arabic is sifra, which means empty. In 1202 Leonardo Fibonacci, an Italian mathematician who was studying Arabic methods, wrote about the sign 0 and called it zephirum. This is the etymological root of the notion ‘zero’. See Smith (1958: 69-73). 36. Much like the Derridean (1976) repudiation of an ‘origin’ that exceeds language as the ‘infinite signified’. (Hence for Derrida origins are always mythical.) 37. See for example Appadurai 1986; Bloch and Parry 1989; Carrier 1995; Foster 1990a; Gell 1992; Hart 1982; Parry 1986; Thomas 1991. 38. This lack of conceptual attention to women’s roles as cultural reproducers is partly due to the conspicuous lack of literature on processes of exchange between women transactors. (Notable exceptions include Barlow 1995; Feil 1984; Lepowsky 1990; Sexton 1992.) Besides the under-attention paid to the process of production in exchange, one reason for the sparse anthropological record on exchange between women is the exportation of constructs of gender as stereotyped sex-roles by Western-trained male anthropologists up until roughly the mid-1970s. Women have been rendered (at least in a textual sense) more passive than might otherwise have been suggestive during the actuality of field encounters (see Bell, Caplan and Karim 1992; del Valle 1993). 39. According to the U.K. Daisy Premature Menopause Support Group Network, premature menopause affects one woman in every 100. In Britain alone, around 110,000 women experience this condition. 40. My research does not cover the politics of the variability of treatment provision, so-called ‘postcode lottery’ rationing, offered to women by statefunded fertility services through the National Health Service. At the time of writing, The U.K. National Institute of Clinical Excellence (NICE) has put forward new guidelines to allow a limited number (up to three cycles) of free IVF treatment for women less than forty years old. The National Infertility Awareness Campaign (NIAC) has been an active campaigner for wider infertility provision on the NHS.

32 Nameless Relations 41. Prior to this J had submitted an application for ethical clearance by each of the clinical unit’s internal management committees. This took between two to six months to process. 42. Donors and recipients were recruited to the study as self-selecting populations. The logistics of my mediation through the clinic consisted of the following stages. I designed a questionnaire that the egg donation coordinator at each clinic posted or distributed personally to a number of donors on my behalf. This included a covering letter from the clinic stressing my bona fide role as researcher, as well as my independent status in relation to the clinic (Care was taken to ensure I would not be seen by potential recruits as a representative of the clinic.) Donors’ questionnaire responses were sent back to me directly in a pre-paid stamped addressed envelope and gave home/telephone contact details, wherever willing. Following the advice of one donation co-ordinator, recipients were contacted by me directly by telephone (and without questionnaire) once the co-ordinator had checked in advance to see if each recipient she approached as potential participant would be willing to take part in the study. The coordinator would check to make sure the recipient was happy for me to be given her telephone number. This would then be passed on to me. Upon my initial contact I believe J was sensitive in checking that nobody felt pressurised to take part in the research. I always reassured each person they were under no obligation to take part in the study and that they were free to withdraw, should they so wish, at any stage. I explained that nonparticipation in or withdrawal from the research would have no adverse impact on any future treatment since the research was conducted as an independent study. Throughout the course of the research no participant (donor or recipient) wished to withdraw after our first meeting. (There were however dropouts prior to first interview). I also took care to stress that the confidentiality of the research and the option for anonymity was built into the questionnaire design. In the ethnographic chapters of the book (Part II), all personal names (of donors and recipients, their partners and children) are pseudonyms, as are the names of the clinics where fieldwork was undertaken. All ages of donors and recipients refer to the time of interview. 43. As the research progressed I decided to spend my clinical fieldwork time at one fertility unit, and visited a second clinic less frequently. The counsellors in these two clinics were helpful and introduced me to counsellor and IVF colleagues from other institutions. Contact was kept up with the third clinic, although I found it harder to gain professional acceptance as an ethnographer within this particular environment. 44. These third-party agencies thus act as repositories of personal information: they fulfil the ‘expert’ roles of evaluation, matching, information collection and potential information provision. One can see that the donor IVF treatment centre with its clinically-based fertility counsellor(s) and the information-releasing role of the Human Fertilisation and Embryology Authority — or other ‘independent’ third-party agent (e.g., The Donor Conception Network) — mirrors the information mediating role of social workers, psychologists and the Adoption Contact Register. This is a somewhat crude but nonetheless applicable analogy to the adoption context. One major difference between the analogous scenarios relates to

eee eo sen es What is Concealed Inside an Anonymously Donated Gamete? 33 the potential number of offspring involved in the donation context (see Chapter 2).

CHAPTER 2

ANONYMITY AND THE WAY OF JUXTAPOSITION

Negative reciprocity may be not so much a consequence of social distance as a means of creating or asserting it Simon Harrison, The Mask of War (1993: 16)

Anonymity/taboo LEduction Britainhave as elsewhere, attemptstotothe regulate the field of of anonymity. assisted reproappealed heavily legal principle As originally formulated in 1984 by the Report of the Committee of Inquiry

into Human Fertilisation and Embryology (the ‘Warnock’ Report), anonymity is seen to provide statutory protection to the ova or sperm donor. The donor’s revelation as a named and socially acknowledged person constitutes an invasive threat to conjugal stability, the Committee had concluded, since it potentially represents ‘the introduction of a third party

into the marriage’ (Warnock 1984: 25,36).' On the presumption that withholding the names of identifiable persons would minimise the chance

of ‘intervention’ into the conjugal union (of the recipient couple), the Glover Report’s subsequent recommendations on donor recruitment and anonymity likewise delimited what it saw as a field of prohibited relations. ... our general view is that anonymity protects all parties not only from legal complications but also from emotional difficulties. We recommend that as a matter of good practice any third party donating gametes for infertility treat-

ment should be unknown to the couple before, during and after the treat-

ment, and equally the third party should not know the identity of the couple being helped. (Glover 1989: 15)

These ideas found their way into the formulation of subsequent British statute and form the backdrop to the Human Fertilisation and Embryology Act

of 1990 (henceforth ‘the HFE Act’). It is instructive to spend a moment

Anonymity and the Way of Juxtaposition 35 contemplating just how many fears are encompassed within the normative principle of anonymity. There is the idea that donation entails some kind of sexualised transmission of the person, as though the practice were to involve a form of adulterous, extra-conjugal relation between donor and recipient (in the case of sperm donation) or recipient’s partner (in the case of ova donation). Popular representations of anonymity, in particular the voices of religious commentators, have focused directly on what is seen to be the ‘adulterous’ party to the marriage.? There may also be the anxiety on the side of the recipient party that a genealogical connexion has been broken by the absence of an authentic genetic tie to the donor-conceived child. On both counts anonymity is thought to provide legal and emotional protection against various speculative scenarios. In popular imagination at least, the person of the donor is believed to be protected from subsequent claims by donor children for financial assistance. Or alternatively, it is held as preferable that claims to rights for further information about one’s

genetic heritage are precluded through future contact with a former ‘stranger’, the child’s biological mother or father. Similarly the mature donor-child and social parents may consider themselves protected from an ex-donor’s retrospectively enacted claim to parental rights in genetic offspring. The anticipated vision here is of a meddlesome donor figure making untoward demands possibly many years later. Warnock’s Committee had reasoned that without such protections in place, fewer donors would

be willing to come forward and assist. Anonymity therefore is seen to serve certain pragmatic ends: it ostensibly succours a steadier ‘supply’ of donors than would otherwise be the case. Seen in this light anonymisation is about making persons (as relations) invisible, and as such, anonymity is put into cultural circulation as though

it were exclusively a commodity metaphor. Making persons into unnamed identities, and thereby precluding the prospect of a future traceability on the part of donor or donor offspring, both conceals and severs social relations. Anonymity, it is thought, excises the hyphen: its power of

convention derives from cutting off relations between the donor and recipient. Note in addition that the claims made here for anonymity, namely the provision of legal protection to the donor and minimisation of the ostensible invasion of the ‘third party’ into the [recipient] family, were formulated initially in relation to sperm donation. The more recent practice of egg donation appears as though it were simply a ‘female’ variant of

these more established donations; this in turn upholding the implicit belief that women’s donations can be subject to the same principles, regulations and considerations as men’s donations (see Chapter 3, Donors I). With their longstanding expertise in matters of kinship, these are practical and policy considerations to which social anthropologists may be particularly well placed to respond. As the first cohort of donor-conceived children come of age since the establishment of the Human Fertilisation and Embryology Authority (HFEA) in 1991, so certain shifts in public

opinion have characterised more pronouncedly the contours of policy

36 Nameless Relations debate from the mid 1990s onwards. One of the most prominent such shifts makes itself known as a certain undermining of anonymity: critics insist on removing donor secrecy in favour of greater social openness. The wishes of some donor offspring to have a full and accurate description of their genetic origins for instance have combined with the protest voices of civil liberty and rights campaign activists. In responding to an increasing public awareness about donor conception issues, activists have sought to

challenge current legal policy. When we start to chart the scope of this shift, a number of players and developments come into view. The apparent convergence of interests is seen to coincide with a recent governmental review in the U.K., spearheaded by a Department of Health Open Consultation on the future practice of donor information provision.

Anonymity/openness One group of campaigners, spanning grass-roots activists, professional bodies, counsellors, children’s welfare and social work academics, stresses

the fundamental right of donor-children/adults to knowledge of their genetic origins (e.g., Blyth 2000). This position, currently endorsed by the HFEA’s (2002b) recommendation for the removal of donor anonymity, supports the recent public retraction proffered by Dame Mary Warnock. ‘Though at the time of the report of the Committee of Inquiry’, Warnock comments in Making Babies (2002), ‘I was persuaded by the argument that the supply of donors would dry up if anonymity were not preserved, I now think differently. Iam convinced that the law should be changed,

| so that children born with the help of donors would be able to have identifying information about the donor’ (Warnock 2002: 65).

Many who share such views have turned to legal instruments in an attempt to press their case. Implicitly or explicitly, their campaigns challenge the terms of the HFE Act. For instance, since the incorporation of the European Convention on Human Rights into domestic law in 2000, Liberty, the civil rights organisation, has supported the appeals of several

donor-inseminated children for the right to know details of genetic parentage. Cases have been put forward too under the terms of the Human Rights Act for the automatic provision of non-identifying infor-

mation including basic health information such as the donor’s blood group and medical history.* Through the Project Group on Assisted Reproduction (PROGAR) — an umbrella group with representatives from children’s charities and professional organisations — the Children’s Society (U.K.) recently made a direct appeal to the UN Convention on the Rights of the Child. Members of the Society sought to extend the mandate under

Article 8 of the Convention to enforce the statutory right for donor conceived children to know the identity of their biological mother or father upon turning eighteen.* In appeals such as these, advocates usually claim that a person’s ‘full identity’ is linked to the right to genetic knowledge since such knowledge

Anonymity and the Way of Juxtaposition 37 provides a basis for ensuring children’s ‘life-long emotional needs’ and ‘developmental well-being’. Such psychosocial appeals, in privileging the importance of biological information or connections with ‘true’ biological ancestors, constitute what one social anthropologist identifies as ‘genetic inheritance ideologies’ (Finkler 2000: 175-87). It is commonplace to hear these inheritance ideologies pressed into service in quite particular ways. Activists for instance will often evoke the legal precedent of adoption by arguing that the right of adopted children to their birth records at the age of eighteen presents an analogous case to donor-assisted conception.’ Proopenness campaigners are also likely to point to related developments in other national legislatures. Disclosure of the use of donor gametes to donor-conceived offspring has been subject to intense investigation in Europe, the U.S.A. and Australia. Country precedents for access by donor conceived children to identifying information include Sweden, Austria and the state of Victoria in Australia. In 1985, Swedish law was amended to allow all donor-insemination offspring the right to obtain identifying information about their donor upon reaching the age of eighteen. Austria and Australia followed Suite in 1992 and 1995 respectively (with information available for Austrian donor children from age fourteen). More recently Switzerland and the Netherlands have legislated to increase donor offspring’s right to access information about donors (see Bateman Novaes 1998; The Children’s Society 2002). In the U.K., the first offspring for whom centrally recorded information has been collected were not born until] 1992. Under the existing terms of

the HFE Act, information therefore could not be made available until 2008 for those reaching the age of sixteen, or in the case of eighteen-yearolds until the year 2010. At these temporal landmarks, it would be possi-

ble in principle for a sixteen-year-old to request non-identifying information from the HFEA so as to rule out a possible genetic tie to an

intending marriage partner. At eighteen years, there is the option of acquiring basic information about the circumstances of one’s birth; specif-

ically to have confirmed whether a conception occurred as a result of infertility treatment using donated gametes or embryos. Under present law, however, it is not possible for the HFEA to disclose any identifying information to donor-conceived children about genetic parentage. In its recent public consultation exercise entitled ‘Donor Information Consultation’, the Department of Health (2001: 1) reinforces this position. It stipulates that any legal amendments resulting in a future revoking of anonymity could not be applied retrospectively to previous donors. Regarding future donors, should there be any changes to the HFEA Act relating to the potential identification of gamete and embryo donors by donor-conceived offspring, then this would only become effective from the date of the

new legislation. In the case of prospectively applied legislation it would thus be some eighteen years after legal amendments had come into force before identifying — as opposed to non-identifying — information could be made available (see Chapters 4 and 6, Donors II and Recipients I).°

38 Nameless Relations A further contributory impetus for change, in part allied to the renewed ideological emphasis on the ‘welfare of the child’, is located at a more diffuse level in the campaign activities of self-help and infertilityrelated networks. These have built up considerable regional memberships across the U.K., as well as internationally. In the second half of the 1990s,

infertility user groups, as well as pro-life and pro-choice campaigners became more visibly active and publicity driven. Many have sought to raise levels of public awareness about sensitive social issues from the point

of the user consumer, and have attracted sponsorship funds with apparently greater facility than was previously the case, at least compared to the mid 1980s. The success of these grass-roots co-ordinated efforts is due in no small part to the increasing mass accessibility of web-based discussion groups and internet-driven publicity resources such as the Electronic Infertility Network (E.I.N.). Some of these user groups, such as AceBabes, The Donor Conception Network and the National Gamete Donation Trust, are specifically focused

on issues relating to egg and sperm donation. One of the largest such groups, The Donor Conception Support Group of Australia, has an active international membership comprising parents and donor-children from the U.S.A, Canada, Hong Kong, New Zealand, Sweden, U.K., Germany and Indonesia. Besides providing support to existing parents, donor-con-

ceived children, and anyone contemplating or undergoing treatment, many members of these groups aim to increase public awareness of donor-assisted conception as new familial forms. The Donor Conception Network for example was set up in 1993 by a group of families who had all chosen to be open with their children about their conception origins. Another recently formed regional and international support group is the Global Egg Donation Resource (GEDR). GEDR combines patient and professional support with counselling training activities, and acts as an information resource for news dissemination and research links.’ It is also worth noting the increased professionalisation of childbirth and infertility counselling associations such as the National Childbirth Trust (NCT), the National Infertility Awareness Campaign (NIAC) and the British Infertility Counselling Association (BICA). These can be credited with the facilitation of a more proactive and user-friendly climate of ‘fertility consciousness’. In tandem, there has been a diversification of mainly

grass-roots initiated and parent-oriented self-help groups supporting those with a range of experiences from miscarriage to multiple births and premature menopause (e.g., the Miscarriage Association; the Twins and Multiple Births Association [TAMBA]; and the Daisy Network [Premature Menopause Support Group]). What all these groups help to illustrate is the way an ‘affective geography’ of infertility consciousness is emerging outside the formalism of biomedical treatment protocols and clinical environments. One is beginning to see now more systematised attempts to col-

lect the personal experiences of women and men directly involved in these long, emotionally gruelling processes. New infertility ‘confessionals’ such as British novelist Hilary Mantel’s Giving Up the Ghost (2004) give

Anonymity and the Way of Juxtaposition 39 voice to related experiences. Moreover these confessionals are emerging

from within a popular culture that is becoming ever more attentive to how procreative burdens in the past could not be given name.

Anonymity/reciprocity In the social sciences and public policy arenas, the idea of making gilts to strangers first received widespread critical attention with the publication of Richard Titmuss’s classic study The Gift Relationship (1997). A compara-

tive analysis of blood donation practices in the United Kingdom, North America, South Africa and former Soviet Union, the book originally appeared in print in 1970 just a few years before the advent of IVF technology was to impact upon reproductive medicine.® Written with an eye

toward future developments in science and biomedicine, Titmuss explored the implications of treating human blood as a commercial commodity in the modern welfare systems of complex society. The central thesis — that altruism is morally creditable and economically efficient — was received with acclaim on both sides of the Atlantic. But if the British system of voluntary blood donation could be seen as more cost-efficient and morally superior to the profit-oriented blood market of North America, it was also one that linked forms of ‘creative altruism’ with ‘stranger’ relationships between ‘anonymous others’ (Titmuss 1997: 279).? Titmuss’s own position was one of integrative reformer. He envisioned a less atomised, more socially cohesive ordering of relations in the context of mass-scale, technical and professional society. So-called fellowship relations between ‘anonymous others’ could evoke, he suggested, expressive social and ethical outlets. There would be ‘opportunities for people to articulate giving in morally practical terms outside their own network of family and personal relationships’ (Titmuss 1997: 292). Since the voluntary blood donors who had informed Titmuss’s field research had claimed they wanted to help ‘the universal stranger’ as opposed to simply channelling relatedness through particularistic ties with known others, these were acts of ‘voluntaryism’ (ibid., 306, 282). They were characterised by

the fact that no anticipated return or recompense need be attached to these donors’ gifts.

It was precisely this ethic of voluntarism that Titmuss was so keen to see translated into social action. ‘Policy and process should enable men to be free to choose to give to unnamed strangers’ (1997: 310), he wrote, citing examples ranging from donor-eye banks to organ transplantation and the charitable ‘gift’ of expending foster care. Insofar as it points towards anonymity as a social mechanism for encouraging the spread of generosity towards strangers, both among and between social groups, Titmuss’s empirical blood donation research is certainly suggestive. In The Gift Relationship (1997) we also hear echoes of ethnologist Marcel Mauss on the social survival of the ‘archaic’ gift in his 1925 classic of economic anthropology, The Gift (1990), to which J return in a moment.

40 Nameless Relations But the sociologist’s ethical vision was filtered through a somewhat functionalist view of society. The bare bones of ‘voluntaryism’ was, in Titmuss’s words, ‘its focus on integrative systems: on processes, transactions

and institutions which promote an individual’s sense of identity, participation and community’ (ibid., 290). Underpinning this vision is his reference to ‘anonymous helpfulness’, a term introduced towards the latter end of the book and glossed as non-contractual moral gestures and transactions of a non-economic kind (ibid., 280). The idea of ‘anonymous help-

fulness’ as philanthropic civic engagement may seem an attractive possibility. The reader however remains none the wiser as to how the dynamic of an anonymous ‘sub-culture’ would be manifest as a configuration of relatedness amongst personal networks. From Titmuss’s account, therefore, we do not know what kind of ‘persons’ can render themselves anonymous and make anonymity philanthropically effective; what kind of person ‘peoples’ anonymity, so to speak. By contrast, an anonymous sociality predicated on relations of non-relations and instantiated as secrets within the gift could not be described as ‘integrative’ in its social effect, even though it might appear similarly donation-centric. The anonymisation of donors is particularly provocative for our discussion since it is a clear instancing of the impossibility to fulfil reciprocity and make reciprocal returns. I turn now to consider the relevance of this

observation for the policy arena by introducing non-anthropologists to some anthropological ‘longhand’. Why is the fact of non-reciprocity so significant?

In anthropology, Marcel Mauss’s influence on theories of social exchange has been pervasive. Following his seminal study, the majority of anthropological accounts of gift exchange have modelled themselves on the construct of reciprocity and on the centrality of returns as inalienable. Whether gifts have been seen to create extensive networks of rights and

obligations between gift partners in segmentary societies (Malinowski 1922) or whether reciprocity has been conceptualised as a moral norm or permanent structure of universal cultural thought (Gouldner 1960; LéviStrauss 1969; Schieffelin 1980; Schwimmer 1979), reciprocal gift giving has been valued as a particular sanctioning mechanism. Reciprocity has

been assigned value (by anthropologists and the people they study) because it ostensibly creates social order. It is code for the preservation of social integration, for the meaningfulness of social cohesion.!° Since mainstream anthropological discourse has equated the cancella-

tion of gift-debt with the potential for social imbalance and instability, non-reciprocal gifts would inevitably feature within this frame as somewhat anomalous, the fact of their incongruity attributable precisely to their sorry one-sidedness. The way that anthropologists strove to render this peculiarity into intelligible fact is more the story of how the unthinkable would be pushed to the back rather than to the forefront of critical theoretical discourse (James and Allen 1998). Non-reciprocation for anthropologists has featured as the all too fleeting ‘mistake’ of the ‘free’ or ‘pure’ exchange. Witness Malinowski’s first stab at the subject in Argonauts

Anonymity and the Way of Juxtaposition 4] (1922) and subsequent retraction in Crime and Custom in Savage Society (1926). With the exception of select writings on the Indic dan (Parry 1986;

Raheja 1988, see also Laidlaw 2000), this has been a topic largely neglected by social anthropology.!!

Our first point then is the way that anonymity blocks the principle of balance, thereby making gift giving seem as though it were fundamentally an a-social and unequal form of exchange. By definition, infertile ova recipients cannot hope to give back, anonymously or otherwise, a return gift to the one they have received from donors. They are, after all, socially situated as recipients precisely because they do not have at their ready disposal healthy ova of their own with which to start a family. Furthermore, anonymous gilts are entities that cannot be returned since by implication

donor and recipient will remain mutually unknown, one to the other. Neither party to the exchange is supposed to know the identity of the other party: each is to remain unnameable and non-identifiable to the other. Note too that the imposition of anonymity and the associated impossibility of reciprocal return are not features of gifting unique to gamete donation. They characterise other corporeal donations such as live-saving transplants involving cadaver organs or body parts — the heart, kidney or cornea, for example (see Simmons et al. 1987). But in the case

of reproductive gifts where female or male gametes (ova, sperm and embryos) from living donors engender new life rather than help sustain an existing life, the ‘exchange’ between donor and recipient through anonymised donation augurs practices of relatedness that take distinctively unexpected form.

Anonymity, then, is the occasion for witnessing the un-doing of what

Mauss had taken to be the third key obligation of gift-relations: the requirement of the recipient to make a return. Among tribes of the Amer-

ican Northwest, across Polynesia and Melanesia, in the economic and legal systems that have preceded our own — ancient Roman law, Hellenic civilisation as well as European folklore — Mauss traces a common institution. ‘The obligation to reciprocate is imperative’, he reasoned. ‘One loses face forever if one does not reciprocate ... .presents are exchanged for any and every reason, for every ‘service’, and everything is given back later, or even at once, and is immediately given out again’ (Mauss 1990: 42). Put simply, if the ‘obligation of anonymity’ breaks the convention of

return, and moreover, if anonymity is the very occasion for instituting forms of facelessness, then what happens to ‘the gift’? Where does it go? How is it presented? Who in fact can lay claim to it? These questions contain yet further speculations. Does the activation of non-reciprocity impel the unconditional death of the gift? Or is the event

of non-reciprocation the very ground for affirming the presence of the utterly disinterested and so-called ‘pure’ or ‘free’ gift? Is it possible to see gift-giving as some kind of hybrid mix of different interests and motivations? Could it be an emerging cultural form, one still unsettled in flux?

The idea of gifts as complex hybrids was by no means foreign to Mauss.'* It had been central to his view of the duplicity of the gift

42 Nameless Relations phenomenon in ancient society where systems of ‘total prestation’ blended barter, commerce and gift exchange. A mix of altruism and selfinterest meant the gift would appear as ‘apparently free and disinterested but nevertheless constrained and self-interested’ (ibid., 3). ‘Everything intermingles in them’, Mauss suggested in his opening statements on The

Gift. Through his synthetic and wide-ranging ethno-historiographical analysis, Mauss was able to illuminate how forms of social organisation that had emerged prior to the conventions of law and contract depended on the medium of gift-exchange. ‘Archaic’ gifts, instituted as social relations, carried part of the person within the thing that was given. They were Mauss posited, literally, metaphorically, and spiritually animated (hau imbued) ‘personal’ objects. Now within critical post-Maussian discourse, scholarly commentators

have continued to draw out the relevance of this theme of ambivalence and contradictory interests. It is fair to say that social anthropologists have

led the way in this work of conceptual intervention. Maurice Godelier (1999: 11) identifies a ‘double-edged relationship’ to gifts that impel decreased social distance through acts of solidarity on the one hand, and affirm, in symbolic if not material terms, inequality of status between the donor and recipient on the other. A sense of heightened superiority on the part of the donor, ‘symbolic capital’ as Pierre Bourdieu would say, may

run the gamut from subtle or misrecognised social differences in nonagonistic exchange, to highly manifest exaggerated ones with gifts that aim to outdo the recipient. Ostentatious displays of wealth such as the potlatch in the American Northwest (Tsimshian and Kwakiutl) are indicative of the latter, and, when carried to the extreme may threaten to break the very chain of reciprocity that gives life to the impetus of the gift itself.

Continuing with this double-edged thematic, we see that human ova that are travelling on their way from the donor’s body to the recipient carry the unique DNA imprint that is the embodied person of the donor herself. The most personal biogenetic ‘signature’ a donor could ever wish to display thus has its origins in a woman’s own extensional capacities: it is from the site of indigenous fertility and female-engendered procreative power that modern biotechnology ‘mines’ women’s reproductive ova as newly exteriorised corporeal substance. Moreover it is through this form of exteriorisation, a neo-classical ‘re-ensoulment’ as it were, that modern

technology works its cultural effect producing strangeness through the intrigue of the personal impersonalised. For clinical practitioners, anthropologists and policy analysts alike, a central question therefore is this: how does anonymity, as a form of nonreciprocity, not equate with the severance of social relations? In other

words, what kind of value is anonymity, and how is Lévi-Strauss’s (1969: 84) post-Maussian interpretation of reciprocity as ‘the most immediate form of integrating the opposition between self and others’ to be reworked? In order to explore this, it is necessary to consider what kind of conceptual shift is involved from the Maussian conjunction of the person-

Anonymity and the Way of Juxtaposition 43 thing, now that the ‘thing’ that is given is a corporeal part of the person. In other words, what value inheres in the transformation from person/thing to person/body? In order to answer this, it is necessary to ask firstly what exactly is being made a part, and, secondly, to what and to whom do the parts relate? Does the detachment of parts of the person’s body render the

person ‘fragmented’, for instance? If so, what kinds of social entities would such persons embody? Without understanding the relationship between these bodily parts and the persons to whom they ostensibly relate, the topical discussions on policy directives in the U.K. such as whether or not persons ‘commoditise’ their bodies/gametes if they receive payment for them cannot properly begin.'?

Anonymity/partibility Within feminist ART debates, a key conceptual critique has turned on what is commonly taken to be the problem of women’s objectification. The whole language of so-called ‘test-tube babies’ is seen as symptomatic of a patriarchal techno-culture that overlooks the specificity of women’s experiences, especially the embodied aspects of gestation and birth (Stanworth 1987: 26). In ultrasound imaging discourse or in ‘foetal-centred’ therapy women are seen to be processed as ‘living laboratories’ (Rowland 1993) or as ‘maternal environments’ (Casper 1998; Petchesky 1987). Sev-

eral commentators have responded to this by re-appropriating the term ‘technological fix’. The intention here is to convey how women’s bodies have been reduced to things simply fixed and tampered with, never effectively ‘cured’ from infertility (Crowe 1985; Stabile 1994). According to such views technology appropriates women’s reproductive autonomy and renders the body a compilation of exchangeable and replaceable parts (Andrews 1988). Women, it is said, forfeit their sense of ‘bodily integrity’. As one vociferous exponent puts it: ‘The new reproductive technologies remove the last woman-centred process from us’ (Corea 1988b). Taking inspiration from the Marxist model of alienation in which work is detached from the labourer, the entity of the ‘person’ according to these analyses is imagined to be compromised and less than ‘whole’. In many such arguments the act of detaching eggs for donation to others, or

the notion of the foetus as a separate entity to the mother, represents a malign and negative power. Action and reasoning concur here: both are seen as occasion for the separation or severance of something from the person. Whilst not intending to detract from what these critica] interventions do contribute to contemporary ART debates, a comparative lens may help us to reconsider why (bodily) detachment should be tantamount to the notion of persons as objectified selves. Let me just spend a moment introducing a particular commentary. In Women as Wombs, Janice Raymond (1994) discusses women’s bodies in the context of gift donations. She speaks of the way that the categories

of ‘donor’ and ‘donation’ comprise an inaccurate taxonomy on the

44 Nameless Relations grounds that women who donate are only a material source of eggs —a procurement of sorts (Raymond 1994: 57). Though women can be figured hypothetically as ‘both gift and gift giver’ within her stated schema (ibid.), their fate seems to be fixed in terms of an inevitable misrecognition. Since

women connote ‘reproductive gifts’, they cannot themselves be the producers of such gifts in actual practice, she claims. The political significance of Raymond’s position should not be overlooked for its germane concern with the rhetorical deployment of notions of altruism. Various strategic operations exist whereby women are made to appear in western patriarchal societies as the natural bearers of altruistic actions. Hence the all too familiar images of woman as caregiver and associated ideal of the mother’s affinity with suffering or self-sacrifice. Now within the terms of Raymond’s analysis, this perspective is transposed to the portrayal of women as ‘generous tools’. Each and every woman is depersonalised, she argues, because they are the objectification of their emotions: essentially one’s ‘generosity’ has been wrenched into an

object severed from their person. We might ask though whether there is a sense in which women do project themselves as ‘tools’ of a productive, non-objective kind? Could feminist thinking in turn see these body parts as other than the naturally owned endowments of the person ‘in’ her natural self? Consideration of such questions appear to escape Raymond’s political agenda since her own conceptual vision draws primarily upon a view of women’s bodies as the commoditised objects of a technologised ‘traffic in women’ (Rubin 1975). This is a culturally specific view of western personhood that assumes a person’s body parts ‘belong’ in a seltf-evident and originary capacity to the person’s self. The notion of the person as original proprietor of herself derives in turn

from the Westernised conception of the body as the fixed ground of a bounded and self-identical self. The so-called Cartesian cogito, the preconstituted, ontologically grounded ‘I’, is held to author its own experience

of the world. In this sense, persons are seen to be ‘individuals’, and the conceptually autonomous ‘I’ is effective because ego is detached and delimited from others. Further, on account of being a self-identical and separate subject of consciousness, the person engenders the possibility of a full subjectivity. Consequently, a sense of interconnectedness with others ostensibly implicates the loss of one’s own personal efficacy as an agent

invested with intention, capable of acting upon the world. Only under adverse conditions, as the outcome of ‘precultural’ or ‘unnatural’ activities does it become imaginable to the Western mindset the person is potentially divisible as a plurality of (interiorised and exteriorised) body parts. Further because these parts are conceptualised as belonging to a notionally ‘whole’ person, this being the presumption of bodily ‘integrity’, so a person of parts is assumed to experience their self only in terms of necessarily fractured identities (see Butler’s critique 1993). We can evince this most clearly in

terms of ‘culture’ as the transgressive abomination of the person and of society. In popular myth, the figure of Frankenstein is comprised not only

Anonymity and the Way of Juxtaposition 45 of the fragments of dead people; he is also symbol of the destructive potential heralded by new forms of social organisation (Helman 1988). I have presented this potted account with a view to drawing out a contrast — eliciting another relation, if you like. The ways in which a body of detachable parts can make itself known in the context of particular actions and social relations has been asked as the quite routine concerns of certain Melanesian ethnography. For some Melanesian peoples it makes perfect sense to think of oneself and others as corporeal persons comprised of mul-

tiple and interchangeable body parts. Marilyn Strathern’s work on the Hageners of the Western Highlands of Papua New Guinea explores precisely such interactions. In The Gender of the Gift, Strathern (1988) develops the original argument that besides facilitating certain social connexion

between persons, gifts also facilitate and ‘elicit’ certain types of detachments of persons from persons. Whereas for Mauss ‘persons’ had engaged in gift exchange because of their social status as moral representatives of groups, Strathern shows how the Hageners make themselves into certain ‘distinct’ kinds of persons as they accrue for themselves, in the process of gift exchange, particular social and symbolic statuses. Key to this twist are Strathern’s insights regarding the realisation of the body as ‘partible’: a construct which denotes how persons can detach from — and indeed attach to themselves — parts of their own and other persons’ bodies. Strathern builds on this notion of ‘partibility’ to formulate a conception of agency in terms of how Melanesian persons can act because of the way that a ‘person’ stands for a ‘locus of relationships’. In the sense that persons’ capabilities reveal the social relations of which they are composed, social relations reveal the persons they produce (cf., Marriott 1976; Wagner 1991). In theoretical terms, the partible body has masculine and feminine elements only inasmuch as these are made known in the form of ‘Same-sex’ and ‘cross-sex’ relations. This means that the partible body is identifiable as the actions of certain persons, and not as the observable physiological differences of the sexes that appear as visible markers on the surface of the body. Contrary to the single-sexed self of western philoso-

phies of gender, Strathern shows how men and women have both male and female parts that are activated in different social contexts. There is no such thing as a unitary body/person whose identity is constituted from out of the pre-existing conditions of maleness and femaleness. Persons’ bodies are gendered in the way they do things differently, thereby making persons and power ‘intersexual’ (1988: 15). ‘Much ritual attention is paid to sexual organs not because the organs sex the person, as it were, but because in her or his relations with others, the person sexes the organs’ (Strathern 1988: 208). Partible persons make relations because one’s personal influence upon another is carried in the ‘part’ that passes between them. Other Melanesianists have noted some of the many indigenous ways whereby detachable parts (of persons) are imagined as material and symbolic conduits for social power. Travelling in motion across persons, such ‘exteriorised’ body parts carry the influence of the person, or may even create new persons. Jadran Mimica (1988), for instance, describes how

46 Nameless Relations the Iqwaye of Papua New Guinea notionally ‘make’ persons by counting out their body parts. For the Maloese in Vanuatu, who live west of Pente-

cost, Rubinstein (1981) suggests that local knowledge is a potentially detachable thing: if knowledge accrues in cultural validity this is because

it becomes a special resource when attributable to particular persons. Writing of the Sambia (an Anga group) from the Eastern Highlands (of PNG), Gilbert Herdt (1984) illustrates how the semen transactions taking place between senior ‘husband’ initiators and junior ‘wife’ novices involve the identification of the penis as breast, and the flute as both breast and penis. For the neighbouring Gimi people, Gillian Gillison (1980, 1991) unravels how a bride’s implicitly internal penis is complemented by her father’s ‘external’ penis in the course of marriage exchange. What these body parts can be seen to share is their ability to activate social relations: the body is effected simultaneously as action and transaction. On still closer inspection, one might look to how these body parts are activated as different sorts of synecdochal relations. For instance, in the case of the Sambia men depicted by Herdt, semen circulates outside of the human body so as to make new male identifications. Male novices symbolically detach themselves from their mothers, and, as surrogate ‘wives’, they make a projective identification with their own impending marriage

partner (female affine). The novice’s mother becomes the flute as an instrument evoking the former relationships he once had with his mother.

At the same time the penis substitutes for the female breast and is an alternative source of sensual replacement for the mother the man has ‘lost’. In other words, such body parts engender value for the transformations they effect as bodies and persons are made into [and imaginable as] cross-transferable relations.

Of course, these beliefs are markedly different to western notions of

personhood and the notion that unified bodies represent the natural markers of bounded and self-identical selves. Indeed commenting on western styles of reasoning, Marilyn Strathern observes that ‘Euro-Amer-

icans cannot readily think of bodies and body parts as the substance of people’s interactions’ (1992a: 126). How the ova donors and recipients from Britain that I befriended do imagine un-nameable persons as sources

of relational connexion therefore offers an intriguing subject. In Part I, we will see how persons/bodies arrange themselves as varied kinds of

detachable and transferable parts. Considering egg donation as an instance of the social circulation of female exteriorised substance between

women ‘transactors’, we will ask how relations of exchange are set up

: between anonymised donors and recipients as forms of social interaction. Such anonymised persons, it will be suggested, need not be conceptualised as exclusively disfigured or mutilated bodies on account of being ‘in pieces’, but rather as agents whose relations are ‘the active life on which the person [is] forever working’ (Strathern 1992a: 113).

Anonymity and the Way of Juxtaposition 47 Anonymity/transilience The above points lead to a further set of interests, or intersecting planes, concerning the construct of the person and the social character of property. In legal terms, a person’s body has traditionally been conceived as devoid of property claims, such that one person cannot be said to have ‘property’ in another (whole) living body, hence the illegality of slavery (Matthews 1983). This view relates to the Kantian doctrine of investing a moral duty in one’s own (whole) body such that ‘{[a] human being is not entitled to sell his limbs for money, even if he were offered ten thousand thalers for a single finger’ (cf: Brecher 1994: 995). In its detailed re-examination of the ethical and legal issues surrounding the medical deployment of human tissue, the Nuffield Council on Bioethics (1995) concludes that the statutory language adopted by the HFEA Act is predominantly one couched in terms of property assumptions. The Nuffield Report points out how the Act circumvents the thorny issue of property by emphasising the need for consent prior to the removal of gametes, but nonetheless rei-

fies body parts as things by decreeing that the control and transfer of

gametes and embryos rest finally with the donor(s)/licensed clinic (Nuffield 1995: 67-70; 73). It also draws attention to how the question of parts of the body, as opposed to a body conceived as an intrinsic ‘whole’, should be the conceptual basis upon which subsequent legal claims can be

determined. These are constructive observations. At the same time, though, it is possible to see how such critical pointers are themselves steeped in the historically and culturally situated western tradition of ‘private ownership’. Since the Report assumes that valued goods/body parts may be transferable as objects between legally constructed individuals, it sustains the notion of property as consisting in objects exercised by individual actors who are predisposed to defined rights vis-a-vis others. This question of individuals’ rights over their body parts has been stimulated by state-sanctioned decrees on the sale of organs and commercial

procurement of human tissue, as evidenced for instance by American John Moore’s claim that as the world’s first patented person he had been ‘essence-raped’ (Vidal and Carvel 1994).'* Whilst Moore proclaimed himself to have been ‘harvested’, the American Supreme Court ruled that his cancerous spleen had ceased to be ‘his’ property once it had left his body. Thus, the possibility that a person is able prospectively to donate ‘his’ or ‘her’ tissue after the act of removal was thereby invalidated by the Moore case. Another legal approach, again endorsing the view of ‘no property in the body’, argues contrariwise that tissue only becomes property after the event of its removal. At the time of its removal such substance is said to be res nullius: it belongs to no one. It may only be classified as ‘property’ once it is brought under control, received by and housed in a new body,

in other words, transferred to the uterus of the recipient in the case of gametes and ova donation. Now though the terms of reference deployed by the Nuffield Report fall back upon a rhetoric of property idioms — the dominant language is one

48 Nameless Relations of procurement, use, disposal and product development — the Report does

point constructively to the indeterminate stance of contemporary jurisdiction in this field. It notes that ‘the current state of English law makes it

unclear (at best) which of these approaches (or another) represents the law’ (1995: 72). Nameless Relations attempts provisionally to fill this hiatus

by re-conceptualising the issue of ‘ownership’ as a relationship of nonrelations between persons. ‘In the Name of the Un-named’ acknowledges the arrival of a potentially ‘other’ social order where anonymisation stands also for the time of non-ownership and idioms of non-possession. Anonymity is a symbol for a collectivity founded in and through the agency of a ‘someone’ whose identity is neither necessarily traceable nor self-bounded as a known categorical order. This realisation brings with it certain liberating effects. It lets us glimpse the ‘other side’ of anonymity — what it is that stands outside the legal and normative conventions of anonymity/taboo. We have seen how the donor is equated with the figure of a ‘thirdparty’ person according to British regulatory statute. To name the donor, to make her (or him) an identifiable person threatens conjugal stability, some proponents say, since it potentially represents the introduction of a third party into the heterosexual marriage. In certain psychoanalytic theory, by contrast, the intervention of the third person in the form of the oedipal father has been cast as the rescuing intervention. ... the attribution of procreation to the father can only be the effect of a pure signifier, of a recognition, not of a real father, but of what religion has taught us to refer to as the Name-of-the-Father. Of course, there is no need of a sig-

nifier to be a father, any more than to be dead, but without a signifier, no one would ever know anything about either state of being ... Jacques Lacan, Ecrits (1977a: 199)

Lacanian theory has been organised centrally around the observation that the intervening father, as the third term, symbolises the establishment of social order, law and language. It is in ‘the Name-of-the-Father’ that the ostensibly suffocating symbiosis between pre-oedipal mother and child is interrupted and reconfigured as exclusive relation. For Lacan, the father, the Name-of-the-Father, sustains the structure of desire with the structure of law because it is enacted as symbolic capacity. The symbolic father signifies the subject’s severance of complicity with the Law, and as such becomes imaginable as the dead Father, witness Freud’s (1938) Totem and Taboo (Lacan 1977b: 34). In the context of the new reproductive technologies, could the third term play a similarly emancipating effect? In shifting our focus to the site of a novel procreative register, we will look for evidence of a different kinship imaginary, one mediated through the rescuing interventions committed in the ‘Name-of-the-Un-named’. What happens to the figure of the autonomous self-unitary individual and to

idioms of egoistic possession from within the cultural space of the unnameable? What is anonymous sociality?

Anonymity and the Way of Juxtaposition 49 Clues may be found in the changing form of the gilt’s ‘return’. Moving away from the conventions of balanced equivalence and reciprocity logic, what we are now able to start to map out is a distinctively diffuse, extensional field that goes by the name of ‘transilience’. What we have in the place of reciprocal counter-returns are transilient persons. Transilient is defined as ‘extending across from one point of support to

another’.’? Instead of thinking of a centralised ego from which things radiate outwards and to which things/relations are impelled to return (and belong), we may imagine modes of transilience. Within transilient social space the category of ‘the person’ becomes socially prominent for the relations of support it traverses. Let me clarify. A notion of persons as

‘transilient’ draws upon elements of extension, imagination, regeneration, dispersal and diffusion, circulation and multidirectional flows. Because transilience is a polysemic construct whose semantic register traverses such a wide range of meanings, different chapters in this book follow closely these shifts in application noting their relevance for multiple actors across specific contexts. In Standard English for example the term

connotes a wonderfully evocative geological register. It refers to the processual formation of rock substance, in particular the transition of one

mineral or rock structure into another. Anonymous sociality may be thought of as marked by its own temporal traces or ‘rings’. Like the concentric bands of wood corresponding in number to the years of a tree’s growth or to mineral deposits accumulated within a geologic sediment, the substance of transilient relations is made from the anticipation of a future, as yet unknown, kinship whose processual activation sometimes may span several years. Transilience is not simply an etic device. Transilient persons become ‘real’ — know themselves to be alive — when they try to elicit others by activating what would otherwise remain hidden as concealed relations. Campaigners and rights activists for donor information provision will recognise here the process of piecing together over time knowledge about one’s genetic origins. Search strategies are often made real as elusive kinship tracery. kK *K*

Organised as a series of recursive inter-articulations, the book splices dif- | ferent narrative moments to juxtapose experience and speculation, policy intervention and clinical practice. There is considerable criss-cross motion between the narratives, a backtracking here, a ‘mirroring’ of a storyline there. In this movement across donors and recipients we are able to trace the faceless forms effected by transilience. Part II, ‘In the Name of the Un-Named’ presents the main donation/ recipiency ethnography. I argue that ultimately all ‘sides’ (donors, recipients and related sets of offspring-siblings) may be seen as linked to the other in terms of the real and imaginary effects of irrelational kinship. With this observation we have the contours of ‘relations of non-relations’

50 Nameless Relations — the makings of anonymous sociality — as the paradoxical modern-day survival of the Maussian ‘archaic’ gilt.

When women donors seize the opportunity to assist other women in achieving their desired goal of motherhood, in what sense does the practice egg donation reinforce traditional perceptions of women as the prototypical nurturing caregiver? Is something more challenging underway? Donors ] to II (Chapters 3 to 4) explore donors’ views of themselves as active procreative agents and situate women’s narrated contradictions against the paradoxical emergence and recession of the ‘free gift’. These paradoxes are located further in terms of the biographical career of the gilt on the one hand, and an unexamined category of maternity on the other.

By separating the different and at times confusingly overlapping discourses of anonymity, it is possible to identify the kinship figure of the ova

donor as progenetrix, as well as to see the significance of donors’ own ambivalent connections to transilience. Chapter 5, Donors III goes on to explore the gender and kinship symbolism of arresting menstrual flow as diverted blood. I should emphasise that this is an aspect of the ova donation experience that is systematically excluded from mainstream biomedical accounts. Rather than imagining notions of reproductive substance as the innate and unique characteristics of particular persons, several case studies illustrate how women act to redirect sets of previously existing relations. In this context the a-geneticism of local discourse brings to the fore a culturally significant nexus between anonymous sociality and local notions of non-ownership. In this economy of transilience, we see that bodily parts are not owned as a person’s past productions but circulate as ‘other’ time and in ‘other’ social space as the collective extensions of ‘someone’. Chapter 6 switches sides. Recipients I outlines the different clinical strategies of egg-sharing, egg-giving and egg donation as the background context for analysing critically the connexion between anonymisation, kinship distance and the ‘poisonous’ effects emitted by the gift rubric. We

see that different orders of knowledge are brought into play. The presumptions of anthropological theory, the classical thesis of reciprocal equivalence, are now a recessive palimpsest for tracing the presumptions

of certain clinical practices, namely, how the ideals of equivalence between donor and recipient set up a series of ‘matches’. The question of

how much information people are prepared to share as the making of ‘likeness’ is discussed in light of the views of some recipients on ‘donorrelease’ policies. The significant literature on the social welfare and psychological aspects of secrecy surrounding DI programmes provides the backdrop for the critical discussion in Chapter 7, Recipients I. Although much has been written

already on the issue of telling donor-children about their conceptive origins, to date there has been no direct call for an integration of anthropological materials into mainstream policy and related academic debates in this area. I suggest this is an oversight. It is one committed in part by a form of disciplinary avoidance. But it is also, from beyond anthropology,

Anonymity and the Way of Juxtaposition 51 a marker of indifference and pervasive impatience or even resistance on the part of various publics to hear the specific relevance of the anthropological enterprise, broadly defined. In Chapter 7, I offer a cultural exegesis of concealment and disclosure as a tentative remedial step. The deepening interface between ARTs and therapeutically-oriented research-based programmes raise new questions about the social agency embodied by genetic donors, and specifically the cultural value attached to ‘donated-to-research’ human embryos. Chapter 8, Recipients III concerns the embryo donation decisions made by ova recipients and asks how research-based genetic donation might shift the cultural terrain of

praxis-based IVF. In what sense does the notion of ‘spare embryos’ undergo medico-scientific, clinical and social redefinition in the context of stem cell research and therapeutic cloning? The dilemmas faced by ‘recipients-as-donors’ in relation to the decisions they make or seek to ‘disown’ are offset in Chapter 8 against the ‘sacrificial keeping-while-giving’ that

characterises embryo donation to research. We see once more how the search and trace strategies of donor-conceived children and different sets of siblings and parents surface as another occasion for the activation of transilient relations. Part III shifts to some present-day and future applications linking again anthropology and anthropological theory to issues of contemporary practice and public policy. Chapter 10 introduces the collectivised figure of ‘hyper-embryo’ whose generation facilitates the infinite re-circulations of

the transilient person through the extensile mediations of stem cell research. One kind of call for genealogical unity, envisioned as therapeutic endeavour, co-exists alongside the spatio-temporal dispersal of tran-

silient kinship, as embodied by embryo-donor conceived children for example. Chapter 11, ‘Unconcealing Regenerative Transilience’ considers Western debates about the surrender of ovarian tissue from aborted foetuses as the cultural ‘problem’ of ‘skipping’ generations. It juxtaposes the

Western perception of the ‘life-giving death’ against the regenerative reproduction of persons. Introducing relevant exemplars for discussion of ART problematics, the commentary holds up various rites of the deceased that characterise Melanesian mortuary exchange. What can be seen to cir-

culate in regenerative form in these instances are the traces of multiple non-identity substantiated by anonymised persons as various non-particularised sets of relations. Again this is recognisable as a drawing forth of transilience, as the activation of transilient persons. The closing chapter speaks through ‘xeno-egg’ and her kin accomplices in the evolving political trajectory of oo-logicalities.

Notes 1. The moral philosopher Dame Mary Warnock had chaired the Committee whose members comprised medical practitioners, social workers, legal

52 Nameless Relations representatives and government observers. Absent was any representation from user groups or infertility patients. 2. As John Habgood, former Archbishop of York, once observed: ‘The intrusion of third, or even fourth parties into the reproductive process breaks the normal continuum of love, sexual intercourse, gestation and parental care’. ‘How to tell Frankenstein the yuk stops here’, The Sunday Times, 9 January 1994.

3. ‘Call to identify sperm donor in human rights test case’, Guardian, 11 September 2000, p. 1. 4. Article 8 recognises the right for children to preserve their identity including ‘nationality, name and family relations’. 5. In the U.K., policy directives on anonymity have some precedence in adoption legislation. Following the first Adoption of Children Act in 1926, the Hurst Report in 1954, the Houghton Report in 1972 and further recommendations that no person should be cut off from his or her origins (Triseliotis 1973), the Children’s Act of 1975 (section 26) legislated in favour of granting to adoptees over the age of eighteen, the right to obtain certain information about their adoption and birth registration (copy of birth certificate revealing their adoptee’s original name, place of birth, birth parents’ names and addresses at the time of birth). Recent changes have been the developments introduced by the Children’s Act of 1989 and the setting up of an adoption Contact Register scheme whereby information is only released to registered adoptees if birth parents have already recorded their names with the (mediating) Register General. See Howe and Feast (2000) on aspects of the reunion process. 6. As this book goes to press, the HFEA is undertaking a consultative review of sperm, egg and embryo donation (the ‘SEED Review’) and is due to report to the Department of Health (Winter 2004-05) on the viability of donor identification, to be enforceable from 2023 onwards. This extended review follows proposed changes to the law, announced by Melanie Johnson, the Minister for Public Health in January 2004, which would enable children born as a result of donations to seek identifying information about their genetic parents once they reach eighteen years of age. 7. The Resource was set up in 2002 and currently has its administrative headquarters in London. Future plans include fostering international links with interested parties through web and conference networking. Further information available at: . 8. The world’s first IVF ‘test-tube’ baby, Louise Brown, was born in England in July 1978. 9. With his reference to ‘creative altruism’ Titmuss (1997) acknowledges the thinking of Pitirim Sorokin, citing his 1954 publication The Ways and Powers of Love.

10. Now generally held to be less convincing among anthropologists, an early etic formulation characterised relations of dependence by the exchange of inalienable objects between related transactors, in contrast to the objective relations established by the commodity exchange of alienated objects between independent transactors (Gregory 1982a). 11. Note too that which is not reciprocated may be quite independent of the social flows of dynamic circulation. Annette Weiner’s (1992) thesis of inalienable possessions modelled on the paradox of ‘keeping-while-giving’ is taken up later in Recipients LIT.

Anonymity and the Way of Juxtaposition 53 I2. n fact Mauss himself uses the term ‘hybrid’ (Mauss 1990: 73). 13. In the U.K., people providing gametes for donation cannot be paid more than £15 for each donation, excluding reasonable expenses. See HFEA Act 1990, section 12(e); HFEA (1998; 2001). 14. Upon discovering that the removal of cancerous tissue from his body had subsequently been cultured without his consent into an ‘immortal’ cell line, Moore proceeded to sue unsuccessfully his doctor at the University of California claiming a violation of his property right in his body. At issue was the fact that the (his?) cell line produced blood proteins of important therapeutic value for the treatment of immuno-suppressive diseases, and was sold subsequently to the drug company Sandoz for $15 million. 15. The Concise Oxford Dictionary of Current English, 4th edition, 1951.

Blank Page

PART II IN THE NAME OF THE UN-NAMED

Blank Page

CHAPTER 3

Donors I

Come Superovulate! | aon a darkened seminar convention room, a projector lightThe is flicked to reveal the outline of a textbook anatomical figure. female shape has been reproduced and copyrighted by the commercial manufac-

turer and feminine hygiene supplier, Tampax Ltd. We, the assembled viewers, have gathered together at Credo clinic from where one of London’s busiest egg donation programmes is co-ordinated. Tonight the clinic is holding one of its occasional informal ‘open-evening’ sessions for nonIVF donors and would-be recipients to meet clinic staff and find out more about the treatment regimes on offer. In front of us stands a sprightly, jocular man. This is Quentin Anderson, consultant gynaecologist and head of the private assisted conception unit at the hospital-affiliated clinic. ‘The ovary is like a warehouse. The testicle is like a factory. It is easier to mend a warehouse than a factory’, Anderson proclaims, as he points the laser-guided pen light in his hand at Tampax Ltd Woman. Her outlined ovaries illuminated now by a ball of flickering red light, our speaker continues the explanation. “The difference between the testicle and the ovary is fundamental. I consider the pelvis to be the battleground. The fallopian

tubes are like fishing rods that sit behind the uterus. The tubes are the good wicket keepers. When we do an embryo transfer with IVF, we ship the embryo back into the good wicket keeper, or if she refuses then it’s back into the uterus’. Besides the chance to ask questions, the evening was also the occasion to receive a rather particular message. For what the audience including visiting anthropologist had been invited to hear was a bubble of mixedup metaphors couched in various gender-inflected stereotypes. By way

of war-related, cricket, fishing and cooking analogies, the framed comparisons had been dependent for their rhetorical effect on a particular

58 Nameless Relations discursive strategy: at work was the play of simultaneous objectification and personification. Offset against the disembodied, de-personalised entity of the subject is the body part personified: the fallopian tube allegorically moralised as the good wicket keeper. The idea of reproductive substance as an essentially ‘biological’ part of the person is a frequent feature of the expla-

nations provided by IVF practitioners on the ostensibly ‘fundamental’ dif-

ference between women and men. Our biology instructor goes further with the point that these differences can be defined in physiologically determinist terms as the natural difference between the ovary and the testicle. From the standpoint of feminist critique, there is nothing particularly novel about the use in mainstream Western biomedicine of such imagery and the cultural associations they are intended to support, as depicted for instance by anthropologist Emily Martin’s (1991) cultural critique of the ‘romance’ between the egg and the sperm.' However the associations that run through the gendered homologies we hear that evening serve an addi-

tional political purpose. What we have is a story line about the cultural politics of corporeal extraction and surplus. ‘Ovary: passivity: storage: woman’ versus ‘testicle: activity: production: man’ is an utterly conventional string. But, the same juxtaposition is also — potentially — the very moment for the cultural re-invention of the egg itself (see Part III).

IVF and donor-assisted conception are procedures whose success depends in large part on the drug induced stimulation of multiple egg follicles. In fact many practitioners will explain to patients why the treatment is more or less pointless unless the woman concerned has been able to produce more than one egg. Pointless, they say, both according to the logistics of the egg retrieval and embryo transfer procedure, and in terms of the dictates of commodity logic: the need for the donation system to incur financial revenue and reproduce profit depends, as it does for patients, on the maximisation of ‘chances’. More eggs make more embryos make more chances for conception that hopefully will make more babies (see Chapter

7, Recipients II). The whole treatment regime is thus predicated on the value of excess and the desirability of cultivating a surplus of eggs through superovulation, something made manifest in turn by the highly conspicuous generativity of the woman egg donor as prolific producer. The version of the donating body set out by medical discourse regards the stimulation of ‘more’ ovarian follicles in terms of the augmentation or reinforcement of a person’s naturally ‘instrinsic’ bodily substance. Accord-

ing to the analogies worked over at such open-evening venues, women are not to be situated socially as persons who actively prepare and produce new forms of growth over time. As metaphorical ‘warehouses’, they are not valued as productive persons but simply the containers — the storage houses — of productions already ‘produced’. Practitioners may complement such notions by stressing how ‘multiple egg stimulation’ is simply a treatment to ‘salvage’ the number of eggs already naturally ‘in stock’.

The burden of the argument is to convince prospective donors and IVF patients that there is nothing too artificial involved in the technology.

Donors I +9 Whereas women are born with eggs as though they are in some manner ‘complete’, the testicle, standing in as synecdochal metonym for the general category of ‘man’, is deemed to manufacture sperm constantly.’ This medical model of simply augmenting ‘what is already there’ presumes that women who make themselves into ‘assisted bodies’ in their capacity as ova donors do not themselves actively produce forms of assistance. The political effect, in other words, is the denial of women’s efficacy as social agents. It is by such combined insinuation and metaphorical gloss that women

who attend such open evenings can be seduced into feeling better about

the treatment programme and regimen protocol. For their part, egg donors are recruited to believe they are doing something that improves upon ‘Mother Nature’. Likewise IVF recipients are encouraged to glimpse

the possible outcome of the wished for ‘take-home baby’ beyond the physical rigours and statistical (im)probability of the treatment. A medic such as Quentin Anderson can also feel better about himself. His intervention can be justified in his own words as standing in simply for what ‘God Almighty has already provided, I don’t really do anything else’. Everyone, it seems, is given a set of credentials. Furthermore, our speaker is proceeding to reassure his audience just how productive he can be! Attracting potential wealth to his unit in the form of private patients, he has performed over 5,000 surgical laparoscopies over the years. He has repute. But Anderson is also a ‘big man’ who knows that the support of other men will be essential to his own pro-

ductive efforts ‘in the battleground’. Just listen to the sexual politics within the space of the reproductive clinic. Analogies to warfare, cricket and fishing now over, our lesson in female reproductive physiology condenses a travel-related metaphor in its explanatory justification for malefactor infertility. ‘Sperm may look happy and nice down the microscope, but this is misleading. They may not necessarily be able to finish the journey. Sperm might be knackered — just like men!’ It so happens that several of the fifty of so couples present tonight have come from all parts of the U.K. for this open-evening ‘taster’ session, some travelling from as far away as Scotland to attend. This is an observation our speaker will ply with dexterity into persuasive fact. ‘When sperm go off in all directions’, he continues ‘this is like the way commuters might start off at the same place but all end up in Brighton, Manchester or London. (Peals of laughter from the audience.)

These typifications of men and women are astounding in several senses. For one, they have gone largely unchallenged in the very reproductive settings in which they continue to be produced as doxa. But there is also the sheer range of donors’ experiences and the complexity of reasons why women elect to come forward and donate. Second, these reasons have been omitted to date from government-initiated enquiries and the associated reports relating to practices of donor assisted conception in the U.K. Consequently, in much of contemporary policy debate, donors are still seen mainly as ‘types’ rather than as persons invested with social

60 Nameless Relations and moral agency. The prototypical ova donor without need for her own IVF treatment and hence not engaged in ‘egg sharing’ (see Chapter 6, Recipients I) is still seen as ‘altruistic’; in many clinic-run sperm banks, the prototypical sperm donor is still seen as the young student who donates for ‘beer money’. In both instances, the implied model donor is the white British heterosexual man or woman. It is true that the Warnock Report does mention differences between

egg and sperm donation by way of the health risks posed to women donors. It does not, however, go on to question whether and how women’s perceptions of these risks may contribute to different local understandings of what it means to donate. This is because the presumption still holds that egg donation raises ‘the same issues of social attitudes as sperm donation’ (Glover 1989: 38) and that it is therefore legitimate to model women’s donations on the older practice of sperm donation, as discussed in Chapter 1. In addition, it is often said that a donor profile con-

sists of medical and psychological tests that ‘reveal’ one’s personal identity: a certain fixing of the prospective donor’s eligibility through an ostensibly objective process of evaluation. Skilled practitioners perform this service, computerised printouts present the results. There is of course a far richer story to tell about what makes a woman transform herself into a voluntary, non-compensated ova donor in need of no fertility treatment for herself. Hearing such stories involves unearthing a rather different way of viewing what it means to talk of ‘donor profiles’. My donor interlocutors had many stories to tell and came from varied backgrounds. As elaborated in the following chapters, multiple voices co-

mingle. There are donors with birth children of their own, childless donors, single parent donors, donors as parents of children conceived by DI. There are women who donated with their still functioning ovaries after hysterectomy and donors with compromised fertility due to damaged Fallopian tubes. I was to meet too donors whose own conceptions had been involuntarily delayed, donors who had previously terminated a pregnancy or who had experienced spontaneous miscarriage, donors brought up in adoptive families who had not traced their biological parents, serial donors making multiple repeat donations over a number of years. All in all, not

only are these voices resoundingly rich, they are deeply imbibed with paradox and ambivalence. Paying critical attention to these multiple discourses is of direct relevance to policy and conceptual issues: it is important to enhancing critical understanding of the ways in which concepts and practices of anonymity, gift and kinship recombine with each other to create newly emerging, if unfamiliar kinds of social relations.

Why do women donate? What kind of gifts do they make? What of themselves do they give? In what sense can we speak of the ‘biographical career’ of the gift? This chapter starts to separate out the divergent strands of women’s discourses by discussing how, as conspicuous and conscious generators of multiple eggs, ova donors both validate and invalidate the

objectivised versions of female innate substance. We see that women’s apparent complicity with the biomedical account is undermined in many

Donors I | 61 cases by donors’ indigenous metaphors of reproductive substance. Linked

to this, we see that women’s engendering of their generativity — their attempts to ‘make more’ of themselves through a potential progenitivity — is invested in an unusual combination of notions. This analytic exposition helps to locate the cultural specificities surrounding women’s technologically enhanced prolificity. It helps to draw out the forms of social agency whereby eggs are transformed not simply into unique reproductive gifts but into very particular kinds of infinite reproducibility.’

Free Gift Emerging ... ‘The generosity of the gift that must withdraw, hide, in fact sacrifice itself in order to give’ Jacques Derrida, The Gift of Death (1995: 3)

When I first started meeting with ex-donors I was somewhat struck by their reluctance to comment in any detail on certain aspects of the egg induction process.* To an outsider, the process seemed an exceptional commitment, if not an onerous and risky physical undertaking. Usually I would bring with me some copies of the information leaflets distributed by the assisted conception clinics, simply as an aide-mémoire since this is information all donors would have discussed with the nurses and clinic counsellor before commencing the donation treatment process. Reading aloud a few sentences from the HFEA guidance literature IJ would wait for their responses: Drugs containing hormones will be given ... Whilst taking the medication some women experience mild side effects. These may include hot flushes, feelings of depression and irritability, headaches and sleeplessness ...

... very rarely (in about 1% of cases) the response to the superovulatory drugs is excessive and a large number of eggs develop causing the ovaries to swell. Side effects such as nausea and vomiting, abdominal pain and swelling, and shortness of breath occur. A patient may also feel weak and faint and

notice a reduction in urine output. These serious complications require urgent hospital treatment to restore the fluid balance and monitor progress? (‘Egg Donation’, HFEA Patient Information Leaflet)

It was easy to notice that most women seemed quite uninterested in these

verbal reminders. Nobody for instance volunteered to describe in any detail how the hormonal secretions triggered by the pituitary gland inside the brain had been ‘overriden’ artificially by the drug regime. Donors lis-

tened patiently to the excerpts but these were not good conversational prompts. Few participants wanted to talk about complications and health risks. For their part, overriding a woman’s natural bodily rhythms is something fertility practitioners talk about most of everyday. At the clinic, medical staff would refer to this colloquially as the physiological process of ‘switching off’, ‘down-regulation’ or ‘de-sensitisation’. Sometimes I would

62 Nameless Relations hear the expression ‘wiping the slate clean’. Either way, these are all euphemisms for the hormonally induced state of premature menopause — for the truth is that in order to become an ova donor a woman will have to become herself temporarily menopausal.°® Yes, menopausal! Overriding the reproductive functions of the donor’s body is the preparatory stage before a donor receives a course of daily fer-

tility injections to boost follicular maturation for superovulation and the stimulated growth of multiple eggs. Though fully cognisant that these hormonally induced changes were part of the medical process of gifting, my donor interlocutors did not consider it important to dwell on the fact these ‘extraordinary ovulations’ had formerly altered, albeit temporarily, the usual functioning of their reproductive system. In fact, my questions relating to the rigours of treatment prompted at times an almost comical

obmutescence on their part. If the majority of donors seemed unduly bothered as to how a usual body function had been altered, this was my

problem, not theirs! Naturally I wanted to understand why so many women seemed unduly alarmed about the consumption of these fertility drugs. Why, I wondered, were these donor women ready to jeopardise their health without any explicit accompanying narrative about health risks and potentially fatal side effects?

‘Not a Hardship at All’ Let me illustrate first how even amongst those donors willing to acknowledge the fact of temporary changes to their reproductive physiology, there is little concern the process involves anything physiologically disturbing or

exceptional. Although some donors mention that the nasal spray functions as hormonal suppressant, they do not develop an explicit discourse about themselves as transformed persons temporarily ‘switched off’. Alice, a donor in her late thirties and mother of three birth children has donated

five times over the past three years and describes herself as ‘a normal, average every-day kind of woman’. She sees donation as an ‘extension’ of a natural body process because it is proof that something ‘more’ is now taking place inside her body. MK: Did you find this quite a complex, quite a complicated procedure to understand? Alice: I probably didn’t take it all in at first. I just really went along with it, maybe naively. I feel I knew enough about it, but gradually over the years,

I’ve learnt more and more about it, and with a natural curiosity and the willingness to find out these things, about how it goes.

MK: Because listening to you explaining it, it sounds quite complex. How you have to have the injections to boost the eggs and the pituitary gland is shut down, and it sounds like there is a lot going on inside a person’s body to get this whole process going. Did you think it was a lot that was going on? Alice: No, not really because I consider it just an extension of your natural body process. It sounds complicated but then you could turn round and say:

Donors I 63 ‘Well, all you do is you have one injection a day, you have a sniff every four hours — twice before bedtime so you don’t have to worry about that bit —- two ultrasound scans, a visit at the beginning, a visit at the end. And that’s it’. So

you could actually say it like that to condense it just into one sentence.

Perhaps I looked a litthe more puzzled than I should have given away, since Alice continues to explain: And again every month it’s a normal process. A normal monthly procedure is you might produce more than one egg, you might have one to ten eggs and they’re just follicles anyway. The egg is in follicles so you might have empty follicles every month. It’s still a natural thing, procedure. But it’s just that bit more advanced up the ladder, if you like. All you’re doing is just helping nature along by producing more eggs and then just giving them to somebody else ... it’s very simple, that’s how it felt to me ...

(Alice, late thirties, mother of three, serial donor)

Alice agrees that what is donated is in some sense different to her normal monthly cycle, although, on balance, she does not think that this procedure entails her doing something different with her body: what she ‘gives’

is rather a similar kind of production to her ‘natural’ monthly productions. Here her notion of ‘more’ conflates extra quantities of her body as detachable body parts with the advanced form of a powerful technology: ‘... So I just look at it as amore advanced procedure of a natural thing, it’s

a little bit more powerful’. Since she is saying that she ‘does’ what she is otherwise naturally endowed with, her view of herself is thus exactly in line with a conception of ‘the person’ predicated on natural and innate body substance. She, like others, reproduces the gender stereotypes put

forward by mainstream clinical discourse, as evidenced at the openevening introduction sessions. Betty similarly refers to having ‘more’ eggs, and again this is seen to be just an extension of a ‘natural’ part of her body. ... for me to generate more eggs than I would normally do ... they were actually injecting me with a good blast of certain hormones to make me mass-produce eggs basically. I was just generating more eggs to give them more to take from me to make it worth their while taking them. Because I think if there’s less than three eggs, they won’t attempt it, because they say that it’s a waste of their time and a waste of my time. They just explained that it would be making me mass-produce eggs basically. (Betty, mother of two in her early thirties)

Betty borrows the commodity expression ‘mass-produce’ she has heard at the clinic to convey a sense of how her body, prepared with ‘a good blast of certain hormones’ enables her to ‘... give them more to take from me

to make it worth their while taking them’. She is easily reassured any untoward side effects to her health will be dealt with effectively by the medical staff. There is nothing to worry about: it is very unlikely anything will go amiss with the treatment, she reassures me.

64 Nameless Relations Another donor regards the nasal spray as something she can fit into her schedule without inconvenience. Cathy says this is literally untaxing; a small object you can simply stick it in your handbag. When I spoke to somebody else who had donated, then I felt I could fit it around my day, then J was happy to do it. I wasn’t really so worried about what it was going to do to my body, I mean as long as it all got back to normal ... I said to her: ‘what about the sniff? Is that going to be a nuisance? Do

I have to be at home all the time to take it?’ ‘Oh no’, she said, ‘it’s like a nasal spray, you Stick it in your handbag if you’re going out. You can literally fit it in’. (Cathy, 31-year-old childless woman, has donated directly to her sister twice, both attempts unsuccessful)

Delia, a married mother in her early thirties with a previous conception history of repeat miscarriage has donated her ova on three occasions. She says she is adamant that she will donate another four times before she reaches thirty-five and explains how ‘they were just increasing what normally happens naturally’, reinforcing Alice’s point when she intimates she is simply a passive recipient of the effects of technological intervention. Technology is described by her as ‘an improvement on what mother nature does’, so that the locus of improvement, though stemming from her body, is not narrated here as her own achievement, but rather something that is brought out from her body by practitioners positioned as ‘them’.

Delia: I didn’t really think about any of it ... other than they were just increasing what normally happens naturally. I think I just looked at it as just an improvement on what Mother Nature ... . I didn’t think of it as something that shouldn’t be happening because this is not a natural thing. I just thought it’s a natural thing happening anyway and all these drugs are doing is just increasing someone’s chances. Mk: Were you ever worried about any damage to your health? Did you ever think about any risks entailed?

Delia: You can have as much damage as having your wisdom teeth out, can’t you?

(Delia, serial donor, mother of three in early thirties)

The idea that these procedures were not physically demanding, so that it was possible to prepare one’s body for donation without too much effort, was translated into the conviction that donation was something that came

rather easily to women. It was a natural capacity, something women knew they could do. In the following excerpts Emma and Cathy talk of donation as a simple and quick procedure. Though they downplay the considerable amount of preparation time that must be invested in the process, it must be stressed that these accounts are partial, full of paradox and contradiction. Later we will see that many women do regard egg donation as a specifically female-gendered effort in contrast to the simple, quick procedure of donating sperm.

Donors I 65

Combining her commitments as a single parent and college student, Emma has a hectic organisational schedule. But the donation experience is not seen as one that has drained her energies nor even consumed too much of her time. Emma: ... there is nothing involved, I mean it doesn’t take anything to donate eggs, it’s not any time really.

MK: When you say that there is nothing really involved and that it doesn’t really take any time, would you say that it is actually quite an easy thing to do?

Emma: Yes, it is. I mean all you’ve got to do is go up to the hospital a couple of times. The [nasal] sniff is not really very much. Just remembering when to take it and making sure you take it. And the injections are nothing. They hurt, but that’s about it. (Emma, mid-twenties, single parent mother of one)

Cathy articulates similar views. ... | would certainly probably think about doing it again if it helped some other person. Because it isn’t a hardship. I think if more people knew about it they’d probably actually be happy to do it. It’s a series of injections, a little bit of counselling and a small op. And that’s all, it’s not time really ...

Fay, who has donated twice and plans to donate again before her twentyfifth birthday, describes herself as a ‘working-class mum’. Recalling the emotional pain upon finding herself unable to conceive quickly after the birth of her first child, she talks in a no-nonsense way about the little time donation takes. Her involvement in the process is seen as slight compared

to the laborious efforts and uncertain treatment outcomes she knows awaits the recipients. For me it’s not so bad. I go up there, I take the drugs, I come home, and I do the business. I go up there and then come home. At the end of the day my

little bit is over in about a month, whereas theirs [recipients] is hopefully just beginning. (Fay, 23-years-old, full-time mother of two)

The above excerpted passages show how women perceive they are doing something ‘natural’ because they would normally produce more than one egg in the course of a monthly cycle. These comments would appear to be nothing more than a straightforward reproduction of the clinical discourse of gender stereotypes and female innate substance. In other words, they seem to vindicate and comply with the objectivised version of the donating body informing mainstream biomedical discourse.

However, the absence of an explicitly narrated discourse about the health risks and arduous nature of donation cannot be seen as suggestive of docile bodies whose interiors are penetrated, in this case literally, as

the objects of medical surveillance and intervention. An exclusively

66 Nameless Relations Foucauldian account would not be hearing that it is in the very moment of their refusing to acknowledge the pain, discomfort and risk involved with the ova donation process, that women’s actions also approach the disinterestedness that characterises the ‘free giit’. The donation as ‘natural’ biological event thus configures another sub-text, one that according to Derrida (1992) subjects themselves could never articulate without undoing the very paradoxical impossibilities that make the real, disinterested gift inconceivable. In the discussion on ‘anonymous helpfulness’ in Chapter 2 we saw that at the time of his research in the 1960s, Richard Titmuss was already attuned to the implications of the spread of complexity for applications of new technology. Importantly, he recognised that such technological developments, whilst heightening the social need for gift relationships, could simultaneously engage the involvement of anonymised persons. This, he indicated, amounted to ‘a refusal of friendship and intercourse’ (Titmuss 1970: 209). Here we come to another para-

dox: the moment the gift is deemed ‘free’, without interest and calculation, the form of the gift as quintessentially social and implicated in relations, appears to have vanished. Anthropologist James Laidlaw observes a similar quality of imperson-

ality underlying the practice of alms giving amongst Shvetamber Jain renouncers from Jaipur in India. Practising renouncers who receive food from householders are not real strangers in the formal sense since they are not estranged through non-contact. However every effort is made to keep social contact with their donors to a minimum. No expression of gratitude is conveyed, no house may be visited on consecutive days, all food collected by each renouncer is mixed finally as one collective sub-

Stance thereby depersonalising what was previously offered by each donor family as distinctive dishes, their individual contributions. ‘Food is given (though it is something else that is received) without anything else changing: no obligation, reciprocation, mutuality or sociality comes into

being. Indeed, even if they know each other, the parties behave as Strangers in the transaction’ (Laidlaw 2002: 61). Impersonality, he suggests, is not only a condition of the commodity, it is similarly a feature of the free gift (supatra dan). Here Laidlaw follows, albeit from a different direction, Jonathan Parry’s (1986) suggestion the free and unreciprocated gift is most likely to emerge within a developed commercial economy where it blends alongside the commodity as part of the social dynamics of advanced industrial societies. In taking his cue from observations of the major world religions, Laidlaw goes on to conclude, however, that it is the socially entangling gift - the one promoting friendship — that donors reliably prefer over and above philanthropic anonymous donations (2002: 63). Why, and on what basis, is this move made to close down the anonymous from within the space of the free gift? The following section argues that it is only when reproductive sub-

stance is contextualised by anonymised ova donors in relation to the actions and interactions they produce, that notions of suffering, sacrifice and prestige can be registered as a recognisable feature of their donation

Donors I 67 discourses. We will see how these actions and interactions may best

approached as various metaphors of assistance, facilitation, initiation and intervention. In turn, we will see how women’s apparent disinterestedness is contradicted in other parts of their account. As the next section

suggests, these were interventions that, in many senses, women also wanted to imagine they could have instigated quite independently of the high technology of medical ‘assistance’. This too was another reason why these processes came to be imagined as all very ‘natural’: they were part of women’s visions of power and enablement. Testimonies of Assistance

How do donors think of their bodies as detachable parts? What ‘of’ the body is carried in the person who gives? Of what kind of substance do women make ‘more’? When asked to explain the meaning of donation several women make unsolicited references to gifts that are ‘free’. ‘to give freely requiring or expecting no reward’ (Sadie, mother of two in mid-thirties, schoolteacher) ‘giving freely and without reward — nothing financial’ (Valerie, full-time mother of four) ‘Giving up, giving for free’ (Maev, mother of DI-conceived twins)

‘to give something without expecting anything back’ (Miriam, mother of two) ‘Giving something of your own to someone who is in need’ (Joni, single, no birth children, donated to friend) ‘To give something away for free, knowing what it will be used for but not exactly where, when or by whom, as in money, eggs, extra clothing’ (Phoebe, single, no birth children, regular blood donor)

Rather than evoking a specific meaning, these ideas about giving freely span several registers of assistance. The most frequently articulated, if vaguely and imprecisely formulated sentiment was the wish to help by giving someone else the chance of parenthood. Dea’s comment is exemplary. A single parent, she explains she wanted to donate because it is: ‘Just the feeling of helping someone to have a child’. Linked to this, the idea of giving ‘chances’ came up repeatedly. Embedded within the discourse of ‘helping’, this was an idiom that appeared to be interchangeable with the notion of ‘gift of life’. ‘The knowledge that even if no babies were the result, at least I gave someone the chance’ remarks Felice, mother of two who has

donated three times. It is worth stressing that these notions, indicative of the type of response elicited in early, superficial conversations, are ones that donors appropriate and modify from the clinical discourse of

68 Nameless Relations ‘assistance’. The medical staff and much of the clinic propaganda on dona-

tion, as disseminated through posters, information sheets, as well as in face-to-face counselling, aim to reinforce the belief that donors do not give recipients actual babies, however they do nevertheless facilitate new life

because they increase recipients’ chances for successful conception. Notions of donating ‘chances’ and of making ‘gifts of life’ are therefore clinical euphemisms for avoiding terms of interpersonal relatedness. It is surely significant that what is left out from this medico-clinical discourse is precisely the ways in which anonymous donors can make ‘gifts of life’ and ‘chances’ as certain imagined relations and relatedness. Usually

these relations are narratavised as abstract and depersonalised non-relations: though they cut across the semantic field of ‘someone’, ‘somebody’, ‘no-one’, they are nonetheless imbued with the intersubjectivity of sharing, as Meena and Miriam indicate. I wanted to donate as soon as I read the newspaper article. I felt the joy of being pregnant but with the thought that somebody else would be producing the babies. I don’t have a sister to share my personal thought with. This way I have shared more than my thoughts, I’ve shared a part of my body with four unknown friends. It was a very satisfying feeling and I’m very glad that I went through it. (Meena, mother of three, experienced difficulty conceiving her first child) There were lost of reasons, but the main [one] was giving birth to my two children [it] was the most wonderful thing I’ve ever experienced. So much joy! I felt so bad knowing other women could not have my happiness. I really wanted to help! I love many people and love helping other people. I would give my right arm if I didn’t need it so much. (Miriam, mother of two)

For many donors it is important that these gifts carry some kind of specilically gendered aspect that passes between the women. This is narrated

most explicitly by way of references to maternity and mothering as a shared, intimate knowledge base, donors referring typically to both the rewarding and burdensome aspects of parenting. With the idioms of ‘giving chances’ and ‘helping others’, donors appeal implicitly to prospective recipients (and to other donors) as persons who raise or wish to raise children. But they also empathise with what they imagine must be recipients’ difficult plight: getting through these stressful treatments with their necessarily uncertain outcomes. Partly this is because they draw upon their own experiences and parenting knowledge, whether these are of repeated miscarriages (Nina; Delia; Adele; Jean), previous terminations (Cathy), delayed conceptions and difficult pregnancies. Chances are not just to be given between discrete individuals; they are something donors hope to see distributed amongst women and infertile couples as a kind of collectivised allocation of hope. Several donors had friends experiencing infertility, or had witnessed relationships breaking up on account of involuntary childlessness. Some

Donors I 69 had previously experienced directly for themselves the difficulty of conceiving a child (Cindy; Emma; Fay; Meena; Maev [male factor]; Naomi

[male factor]); an additional sub-group had undergone investigative infertility tests prior to the non-assisted birth of their children (Chantal; Emma; Shena). Since having children of my own, I feel that involuntary childlessness would

be one of the saddest things that could happen to a couple. A couple I’m close to, their relationship ended due to infertility. (Muriel, early twenties, married, full-time mother of two) I wanted to give out of compassion for women unable to have children. (Suzanna, married mother and practising Christian)

Empathy may also be evident as feelings of guilt. As a 27-year-old mother of six, Heather says she is painfully aware how others could not achieve

what she must go out of her way to prevent. ‘I had a friend who can’t have children and I wanted to be a surrogate Mum for her. I don’t know if I could do that, but I just wanted to do something to help. I feel guilty that I could have children so easily and that so many people can’t’. Donors

would also talk about ‘enabling’ others not just to become pregnant but also to ‘fulfil somebody else’s life’. Stressing their abilities to assist, women would frequently refer to themselves as a ‘means’, or describe themselves as donating a ‘way’ or a ‘method’ of enablement. ‘Giving a helping hand’ or offering help ‘on the front line’ may be evoked also as a depersonalised ‘means to an end’. Intimately Impersonal

When Gill describes how she has been more of a ‘method’ than anything else, she goes on to say how she does not think of the eggs ‘as eggs’. Many women similarly say that the eggs are not ‘the actual thing’; that they are

not ‘like a physical thing’ or that they ‘haven’t come from my body’. Emma for instance comments how: ‘I don’t think the eggs are mine, they’re not something physical that they’re my eggs. I don’t even think of them as eggs’. Donors here seem to be trying to create an alternative non-

biological context as the originary basis for these female life sources. Sometimes this is expressed as though the substance of the egg is not a ‘human thing’. For instance, a few women would draw analogies to ‘chicken’s eggs’, or would stress how the egg has no particularly privileged Status as a reproductive capacity of the body: ‘they are just like a fingernail or something ... they are just a normal part, like any other part’ (Gill).

With these descriptions women’s discourse appears de-stabilised and unfamiliar. This is because they bring together different conceptions of relatedness that do not fit with the conventional register of biogenetics and its underpinning of kinship as ties founded through the cultural idiom of shared biological (‘blood’) substance.

These depersonalised formulations are suggestive once again of the paradoxical refusal of the donor to name the ‘gift’ as something that has

70 Nameless Relations been given. However while insisting that the connection between donors and recipients is not [carried in] the biological substance of the egg itself, my donor participants also bring to light a modified evocation of the nonappearance of the gift. Even within same sentences, women will comment that the egg is not ‘a living thing’ nor a living part of me’, but that it is still a ‘gift of life’. Or they will comment that the eggs are something ‘special’ though they are just a ‘bundle of cells’, or ‘just a very little part of me’. In the following passage, for example, Ivy equivocates between eggs that are special and personal, and eggs that are just a bundle of cells. Here we can see the hybridity of the gift complex emerging through a form that fuses the personal with the impersonal. It’s something very special. It’s a little bundle of cells really and that’s literally all it is. It’s just a bundle of cells but that bundle of cells can bring so much joy, it’s unreal. This tiny minute microscropic thing can produce so

much happiness and everything else. Again you’re giving something to them that is going to help them in their life ... it’s very difficult to explain unless you’ve actually done it. I was talking to a couple of friends of mine who’ve done it and when we get together we chat about it ... what happened and how we felt. And we all get very similar feelings. The fact that it is a feeling that you get so deep down that they’re hard to explain. They are so personal ... you'll share them. (Ivy, mid-twenties, full-time mother of two)

Ivy is describing the inconsequential nature of the egg as a biological subStance. Partly she conveys this with her comment that the egg is a ‘tiny microscopic thing’; something she substantiates with talk of the ‘happiness’ that the egg, as her gifted body part, can produce as kinds of interactions she has instigated. The substance she gives is not a personalised

part of her own biological body, but it is a personal thing she has done. When Ivy and others say how the egg is not the connection between them, they nevertheless also want to convey how the body parts they make symbolise mutual connections between strangers. What becomes rather more difficult for them to formulate are the terms by which they can make distinctions between ‘the egg’ as a physical substance deriving from their bodies, and the part of their persons that the egg represents as a type of action and interaction. In the following excerpts women start to formulate how they are drawing distinctions between body parts as biogenetic substance on the one hand, and body parts as the extensional parts of their persons on the other. Betty tries to re-contextualise the bio-substance of eggs by positioning them as things that do not come from an interior locus. What she gives is not ‘the thing inside’. I do see it as a gift. Almost like if you closed your eyes and imagined it, this egg would be irrelevant. It would be a big box of bows I’m giving her. I don’t see it as the thing inside. I just see it as me giving something to her that’s going to enrich her life. It’s just a very little part of me, which is adding to

Donors I 71 her happiness. J don’t think of it in terms of a child. It’s just my way of giving somebody what she really wants in life. (Betty, early thirties, mother of two)

Other women comment that they donate a way of somebody having a child rather than themselves donating half a child. Here idioms of ‘cutting off’ come to the fore as when women say they cut off from the eggs after the donation. At other times quite the opposite will be stressed, precisely to affirm how there was never anything in the first place from which to disassociate. To be perfectly honest I tend just to cut off once I’ve donated and then I just started thinking in January, well maybe somebody has had a baby that I just helped things along a little bit with. But apart from that it was almost like I’d switched off. I did it, passed the eggs on and then it was over. (Gill, mid-thirties, mother of one) Alter I had donated I didn’t feel like: ‘oh it’s gone and I’m empty now’. Like maybe you'd lost a baby or anything like that. I don’t think I’ve given away a baby, I don’t think it’s anything like adoption. I felt like it was more of a

continuation of a high where I was passing on this feeling and these eggs onto the women who were going to get my eggs. There was no sort of cut off like: ‘they’ve taken my eggs away’. Bang. That’s it’. (Alice, late thirties, three children, seria] donor)

This set of ideas highlights women’s practical agency in the donation process. Donors realise that through their actions they can effect a change, what they do has a meaningful impact for others. I gained the fact that I went through with it and hope that someone is now a mum. J felt really good that I had done it and not just talked about doing something. (Rita, mid-twenties, unmarried full-time mother of two) Part of me is pleased that maybe because of my small part somewhere two people have got their dream — a child.

(Adele, mid-twenties, mother of two) I feel J gave someone a chance. It was something that I really felt compelled to do. (Betty early thirties, mother of two)

The knowledge that someone somewhere has a new life beginning thanks to my help! (Fay, 23-years-old, full-time mother of two)

Jean experienced a very difficult pregnancy with her second child who was born five weeks prematurely. She had previously experienced the trauma of four miscarriages and had to be hospitalised for six months prior to the birth of her daughter. She comments:

72 Nameless Relations I feel that I have done something worthwhile and positive to help someone else have the years of pleasure, joy and hard work that children bring. I feel very proud that I donated my eggs. (Jean, full-time mother of two)

Anita’s husband disapproved of her donating saying that women who give others their ova should be paid some recompense. He looked upon the clinic’s private enterprises as commercial exploitation. Anita disagreed, emphasising she was not in the donation for financial gain. She describes her actions as being outside mercenary exchange. Money did not come into the equation. I think I tend to drift along vaguely concerned about everything that’s not perfect, like most people, but have never really done much about anything. Donating eggs gave me the feeling of actually doing something specific that may be of positive benefit to someone else. Peter says I shouldn’t donate for

free while the hospital charge large amounts for treatment. I don’t think that’s anything to do with me. Anything to lighten these women’s burdens, like reducing the waiting list by one, if that’s of help I want to do it. (Anita, mother of two children, assistant for creative design company)

Meena’s philanthropy also locates the eggs she has created for others’ benefit as actions outside the field of monetary exchange. She is undertaking a form of charitable entrepreneurship. Since I married, money-wise times have been hard. There’s not always much money to give to charity. By donating my eggs I have done my ‘special’ bit for charity by giving something that I could afford.’ (Meena, mother of three, experienced difficulty conceiving her first child)

Cathy explains donating ova to her sister as the mark of an unconditional

kin relationship. There is no question she would not offer to help: her actions might even mean loss of life, a form of sacrifice outside of the parameters of commodity value. To me it’s the greatest gift I could ever give her. You can’t put a price or anything on that. It’s a bit like saying: ‘if a bus comes out, would you run out in front of it and stop your sister from dying?’ Of course you would. (Cathy, 31-year-old single woman, has donated directly to her sister twice, both attempts unsuccessful)

This theme of facilitation is closely allied to the metaphor of initiation. Fay, for example, expresses how she starts things off when she talks of ‘that little extra kick to get them going’. Several women seem to want to think of themselves as some kind of generative point of new inception and growth, and at such moments their comments are suggestive for the way their actions eschew strictly biological procreations. In the following passage, Betty talks about ‘starting things off’ as a kind of ‘joint effort’. To

her this connotes a point of connexion, both a physical and imaginary bond, between donor and recipient.

Donors I 73 I think there’s got to be something between us. I think there’s got to be something because ... because I gave my eggs to start things off and they continue the process so we’ve sort of made something that’s been a joint effort even though I didn’t have much to do with it. But without me, it

wouldn’t have been possible. There’s got to be something between us ... it’s just ... it’s the most peculiar thing to try to explain ...

... And Free Gift Receding ...

Despite the semblance of an unconstrained desire to help others, donors’ actions were not in fact totally disinterested. According to philosopher Jacques Derrida as soon as a gesture could be recognised as ‘gift’ it would of necessity be annulled through gratifying images of goodness, sentiments of generosity, self-approval, narcissism and such like. The gift’s conditionality, in other words, is premised on and through the place of aporia;

the gift does not present itself and hence cannot be made to appear as such, neither to the donor nor to the potential recipient. It is only residually classifiable as ‘the would-be gift without debt’ (Derrida 1992:15). Certain gains arising from the ova donation experience for women suggest the free gift can be seen to effect symbolic ‘returns’ to the donor. Changes in self-perception tend to be conveyed as feelings of satisfaction, happiness and achievement, all further manifestations of donors’ extensional agency that appear, in turn, to put the free gift into eclipse. Becoming Spectal

The idea one had become a ‘better person’ with a sense of heightened seltesteem was not unusual. I feel a little less self-centred, and therefore a little more tolerant, giving and understanding. (Phoebe, Catholic, single, no birth children)

I often think about it and I do feel better about myself for doing it. I like myself more. I think I can’t be all bad!

(Fiona, mother of three) Satisfaction, a good feeling of giving — happy, fulfilled and useful. (Suzanna, mother and practising Christian)

At first I did not know how I felt but afterwards I felt really good, really happy inside. Something else I had achieved in life. I just feel really pleased that I have done something else good in life and not bad.

, (Sally, divorced single mother)

Giving others the chance to procreate and start new life means putting one’s own life and good fortune into perspective. One is necessarily an agent through this relational implication.

74 Nameless Relations Satisfaction. Glad to assist someone who hasn’t been as ‘lucky’ as myself. (Leila, has donated three times, self-described as ‘white British working class’)

I don’t take my children for granted. I realise I am truly blessed. (Delia, practising Christian, mother of three, has donated ova three times) I have gained experience. (Marguerita, twenty-year-old college student, Catholic) I can be a little proud of myself as I’m not an angel by any means. To suffer a little pain to help somebody is not much to ask, especially if it means the world to somebody else. (Miriam, mother of two) I feel I have been of positive help to this field of medicine. (Sadie, mother of two, schoolteacher in mid-thirties) Feeling better about oneself might also mean feeling oneself to be somewhat special. Excitement, a sense of purpose and pride. Also I felt special. It is the

most selfless thing I have ever done and I am proud of what I do. It has made me a better person. (Delia, practising Christian, mother of three, has donated ova three times)

Feeling special converts the gift into a vehicle of differentiation: it makes the person of the donor into an entity of presumed singularity. This may be articulated in terms of imagining one is engaged in something unique.

Even those women who have made repeat donations on separate occasions, so-called ‘serial donors’, often describe donation as a one-off event. The knowledge that I may have helped somebody else in a fairly unique way is a real morale booster. (Cindy, married, three children, mature trainee hospital nurse) Emotionally I gained an ambition. I was thrilled and felt a special sense of worth to have been able to donate for someone. To give someone a piece of nature so unique, it’s almost like knowing that you’ve given something you can’t buy on a supermarket shelf. (Imogen, mother of two, part-time nurse)

Ova donation is also regarded as ‘special’ on account of the self-evident fact it is something only women can do. It is, as many said, ‘one’s own thing’, or as Cathy puts it, a ‘celebration that Iam a woman ... it’s some-

thing that men can’t do and we can’. However since not all women choose to donate, it is therefore associated with exclusivity, a symbol of prestige, an imagined augmentation of an inter-female world of imaginary ranking and hierarchisation. A sense of feeling better about oneself could resonate with an imagined reinvention of self. Many participants would stress such things as deriving a newly found sense of purpose in life, and some seemed to feel as though they had undergone a symbolic rebirth or were going on to start life afresh. Alice, for instance, makes ‘more’ of herself by cancelling out the fact she may feel ‘less’ of a woman after a diag-

Donors I 75 nosis of uterine endometriosis led to her undergoing a hysterectomy five years ago. Superovulation is not only about making more eggs, it induces

for some women a compensatory effect. Alice makes it known what is brought back is the symbolic return of her powers of fertility. I think it was terribly important that the first time I donated it was something I could do again, but also something — I had lost my sense of identity over the years bringing up three children — and was probably feeling under the weather. And then going to have quite a big operation, well, the hysterectomy. I think I had lost myself and my donating was bringing me back to me again. And I didn’t need to ask permission from my husband ... and it was something that I could do ... and I went to London. I went and had the injections, you know, I did it ... it was for me ... And they said at the clinic: ‘well, did you tell your husband?’. Not till he got home and I had written the letter by then. And I said: ‘I am going to do this. I’m definitely going to do this’.

(Alice, late thirties, three children, seria] donor)

Cindy echoes Alice’s thoughts. She had had difficulty conceiving her chil-

dren and three years prior to her decision to donate was advised to have

a hysterectomy. Acquiring a technologically enhanced prolificity is restorative, a powertul healing medium in its own right she says. I felt sad when J had my hysterectomy, even though I didn’t really want any more children and being able to donate my eggs made me feel a lot better. (Cindy, married, three children, mature trainee hospital nurse)

Alice goes on to intimate the symbolic extensions of her many metaphorical ‘growths’. It wasn’t daunting, no. And I think I’ve grown with it. I’ve grown with the clinic as it’s got bigger. It was smaller before. And then I’ve had all the media coverage. But then I’ve also personally gone on and got a job, I’ve learnt to drive, so it’s like a whole procedure of my life. A lot of things happened from

there ... it was like a new opening, a new me, so it led to an awful lot more things and even personally probably gave me a lot more confidence. And again, I think it was very important it was something I could do for me. I wasn’t mum, or the wife of ... you know. This is something special I could do for me. Yes, I was doing this for me, not for ... obviously the end result was for somebody else but that procedure was for me. Some women say I’ve got to talk to my husband before I do this. Well it’s my body, it’s my eggs, they’re my eggs, I’m entitled to do with them what I wish. Prestige and ‘Fame’

As Alice remarks, feeling better and special might also reinforce a sense of autonomy lost and regained. Considerable emphasis was given by several

women to the enactment of donation as one’s own personal decision.

Holly, who donated indirectly as anonymous cross-over to help a friend, : remarks that donation is the ‘turning point of me knowing that I could do

76 Nameless Relations something like that on my own’.® Like others, she makes a point of men-

tioning that donation is something for which she will not first require somebody else’s consent — usually the male partner. ... the fact of knowing that I did it afterwards. It’s boosted my confidence,

made me ... helped me get stronger. That might have been the turning point, of actually going there and going on my own and doing it. I had many people saying to me they would take me there and they would come with me. My husband said: ‘I’ll hold your hand, I’ll come with you’. ‘no, I said, ‘I’m alright on my own’. And I think that might have been the turning point of me knowing that I could do something like that on my own. (Holly, donated six months after birth of her daughter, ex-nursery school worker)

Gaining a rewarding sense of achievement from donation might also be subtext for the otherwise unarticulated wish to recreate existing familial ties. Some women would talk about commitments and constrictions in domestic space. Others claimed they felt as if they were made invisible by partners or friends, or would mention difficulties regarding division of labour in the household. For some, avoidance of intimate physical contact with partners was introduced more coyly as grounds for donation action.’ Anonymised donors could literally achieve their gender attributes, or so they would imagine, by creating for themselves an extra domestic space of female (collective) life. Though they would not in any obvious way link up with other women, ova donors — much like the ‘big men’ leaders in moka exchange within the Hagen cosmos described by Marilyn Strathern (1988) — could detach parts of themselves so as to effect themselves as agents. In so doing they detached themselves spatially from their male kin sO as to participate in a more or less exclusively female world of female reckoning.!° Meena, a Punjabi-born Sikh Indian, has lived most of her adult life in England. She had an arranged marriage in her late teens and has viewed her husband and in-laws as increasingly restrictive and old-fashioned in their ways. The very fact Amarjit allowed her to donate has re-energised their marital relationship, she comments. Now she holds him in renewed respect. When I offered to donate to an anonymous donor I was told [at the clinic] that I was the first Asian woman to do this. Asian men can be very possessive about their women. They get suspicious if you look at another handsome man. I have a lot of new respect for my husband since he gave me the go-ahead to be a donor. I joked with him afterwards that it felt like having an affair with an unknown man but he saw the funny side of the joke. I told him that some other man’s sperm would be used to fertilise eggs inside an anonymous woman.

Likewise Delia associates donation with a renewed or ‘other’ sense of identity mentioning how she has made a ‘new direction’. What in her case seems to be ‘new’ is the distinctiveness of not being taken for granted

and overlooked by family or friends. Stepping out of her conditioned

Donors I 77 roles, she imagines how donating makes her into an ‘other’ person: she no longer sees herself solely as a nagging mother and wife, but imagines how she could be a celebrity or royal figure with a high profile thanks to the publicity she has received. What generally is being envisioned with these associations is women’s enacted self-elevation; the possibility to rise up symbolically as ‘famous’ persons. As Delia explains: Iam alot more confident, aware of other people. I feel special, important, and useful, it’s given me a purpose ... it’s a new direction. I’m not taken for granted. It gives me more than what it takes out of me. I just feel so good about it. I can’t really explain it. I feel that I’m a better person, it’s done so much for me, for my confidence and like being on television, I wouldn’t have believed it. I’ve been in a magazine now. I think it’s quite funny really that all these people find me so interesting that they want to talk to me but you know all I want to do out of it is get more donors. And I’ve become quite a celebrity. I felt like a queen ... it makes you feel so special. Instead of being a mum making people do things they don’t want to do or a wife who is always nagging, now here I felt like number one, the top dog ... Normally I don’t feel like I’m doing anything. But I couldn’t wait to donate again because at last I am doing something for me ... it’s a sense of

achievement. It’s something I am good at. It’s worthwhile and special. Something I’m proud of. Something other — other than just being a housewife ... Before I had the children I was working and I had a sense of status, was quite well paid. Then the babies came along and you have to learn how to look after them ... it’s so easy to put yourself down.

Many women would voice such ideas, though usually talking in more prosaic terms about their donating as a way of instigating some kind of reversal of their usual status in the home. As imaginary kinds of social ele-

vations and forms of prestige, such ‘reversals’ were always modelled in terms of altered relations between persons; in particular women articulated the aspiration their identities could be reaffirmed by others — usually

immediate kin. Delia imagines she becomes a ‘number one, top dog’ in contrast to her otherwise less well-recognised status as mother and house-

wile. It is a social position she knows only too well for the ease with which, as she says, you can ‘put yourself down’. I was intrigued to find out what clinic staff would make about donors’

notions of feeling special and the sense of heightened status so many reported. What I encountered was little surprise on the part of my professional respondents and a certain amusement at the clinic when voicing my enquiries. “Of course donors are special! We need them!” It is important that donors would feel special as soon as they called to enquire about the programme, the infertility nurses explained. What I gradually came to see was that the institutionalised donation system plays on some donors’ low self-esteem and works it to its advantage. A certain environmental exclusivity had been ‘designed in’ to the donation system itself. ‘As soon as they step in, they must feel they want to donate. Donors are wonderful people, they’re doing something special’, the head of Credo clinic told

78 Nameless Relations me one day over a canteen lunch at the hospital. ‘We always give our donors a signed thank-you card and box of chocolates when they come round from the anaesthetic after egg retrieval. It’s all there waiting in their room’. Fay, who describes herself as a ‘working-class mum’ is one donor susceptible to such techniques. The clinic, she says, represents the material comforts of a hotel and going to donate is ‘luxury time’. In the following excerpt she articulates how certain procedures overseen by the egg donation co-ordinator, as well as her subsequent stay overnight in the hospital wing of the clinic, make her feel deserving of personalised attention. To donate gives her back the finesse of detail she misses at home. It literally makes her a person. Every particular detail about you is noted, you’re treated as a person. It’s the best bit of pampering I’ve had for ages. I had my own carpeted room, bathroom, towels, dressing robe, stereo system, flowers. All the mod cons of a hotel. Terrific! I had bottled water, tea, sandwiches and newspapers. It was a working holiday, gave me time away from the children and I was doing something I want to do rather than something I have to do. And the staff

smile at you. They greet you warmly. They really want you to be there, make you feel comfortable and relaxed. They look forward to you coming back again.

(Fay, 23-years-old, full-time mother of two)

Themes of aggrandisement and power seem to be a persistent backdrop to women’s notions of imagining themselves as ‘special’, and in their way these conceptions constitute a localised version of women’s discourse of ‘making more’. Feeling special and needed, receiving personal treatment and gaining a sense of personal achievement, these are in addition subtle

clinical strategies to encourage donors to enlist with the donation programme in the future. So long as she meets certain clinical requirements, an ova donor ideally should want to return and donate again and again. ‘It’s Something I Must Do!’

Some women did indeed speak of donation as ‘an absolute conviction’. It enjoined, they said, a sense of commitment and was described as something they knew they had to do: nothing and nobody could deter them. Some women from my research had already donated their eggs several times, and others commented they were intending to make repeat dona-

tions as frequently as possible, usually at six monthly intervals, until reaching the upper age limit of thirty-five set by most clinics. As Ivy says, donation is not only something to which she feels committed; it is something she anticipates getting ready to do. I know when my time is coming up, when the six months is drawing near ... it’s a commitment, something I have put on myself ... doing what you said you would do long after the mood that you had said it in has left you ... [really feel a commitment to these women. (Ivy, mid-twenties, full-time mother of two)

Donors I 79 Many women report they had felt their ‘minds had not been able to rest’ until after the donation, or as Emma puts it, the prospect of donating was like having a ‘bee in my bonnet ... almost like a fixation’. Such thoughts seem to be related partly to many women’s feelings that donation was something that they expected they would be able to carry out successfully, and partly to the way they could feel important and worthwhile through these actions. Lucy says for instance that: ‘it’s something that you feel deep down ... I mean I’ve never picked up a newspaper in my life and said, “I can do this. This is what I want to do”. It really was as easy as that. I just read the article and I knew I could do this. I want to do this’.

We saw earlier how donors would tend not to stress the involved

nature of donating, particularly downplaying the temporal aspects of the programme and its health-related risks. However, rather different views could transpire upon subsequent interviewing or even during the same

conversation. Another image of personal worth and heightened selfesteem concurs around notions of undertaking work and fulfilling some kind of occupation or ‘important job’. Delia, who donates at regular intervals, explains how donation is not a hobby or ongoing past time but rather something more structured and involved. Comparing herself to her husband who works as a bank manager, she comments: It’s what I do. It’s almost like an occupation. Like what I do. I’m in-between now. But as soon as my fifth month is up, I shall be there again and I literally sort of work everything around it. I’m a housewife first I suppose, but I’m also an egg donor. That’s one of the things that I do. (Delia, practising Christian and mother of three, has donated ova three times)

Explaining the commitments of her ‘job’, donation emerges as a process involving the structured re-deployment of her time. It takes up a lot of time. You can’t go away because you have to be having your injections. There were things like last time I had to give up my exercise classes. Everything had to be moved out of the way. (Delia)

Betty similarly draws analogies to the work of donation comparing it to a ‘career’. Moreover it would be something she knows she could do well; ‘T can go full blast ahead with this ... launching myself properly into it’. Pro-

gressing forth with her career seems to be based not just on the likely knowledge nothing would be wrong with the quality of her donated eggs,

but on account of the realisation ‘it was from me and nobody else was involved’. The donation in other words is seen as unique, special, a oneoff. At the same time women attribute a singular value to their actions: the gifts they produce cannot be compared to the work involved in donations of sperm. Whilst men, they would say, could simply go into a room and come out again in a matter of minutes holding a sample of semen,

women make a different kind of donation. They were involved in a process that involved a re-organisation of their usual schedule: they had

to travel to the clinic, make alternative child-care arrangements, and

80 Nameless Relations make time for the monitoring and administration of injections. As some women remark, they had to structure their days around this ‘donating’ time for many weeks and this could be an inconvenience or ‘hassle’. This noted, only rarely would donors acknowledge how bruised they had became from the daily fertility injections, or how the nasal sniffing gave them headaches or nausea. These comments were brought up as negligible side-remarks and were not ones that structured their narratives. Passed off lightly, these were almost always couched in humour. They call it minor surgery, but it’s major, really major surgery, I can tell you

that! I felt like I had been kicked and jumped on by a horse. I was so battered and bruised; my behind was like a dartboard, you know, from where all the injections had been! But the staff, they just treated me with such gentleness, like for instance when they rolled me over [from the bed] to the trolley to go to theatre. (Fay, 23-years-old, full-time mother of two) The first time round I just had a bit of a tummy ache and I was back to work the next day. The second time I actually felt really sore and it was like a very bad period pain. My stomach was very blown up because I think they must have pumped a lot of air inside me to get at my ovaries. I felt like they must

have had a good dig around. Apparently they have to go to each follicle whether there’s an egg there or not — just to check. I felt they must have had

to have a good old dig around in my body to find what they were looking for!

(Lauren, mother of two, donated twice, computer analyst)

I stress again that such observations do not provide the main narrative focus of donors’ accounts, and comments about investing their time are noticeably tangential to the main conversational drift of donation as something easy, quick and ‘natural’ that women knew they could do.

Summary Link We can say without too much controversy that donors’ testimonies of assistance are structured around notions of helping, sharing, facilitating and initiating, but in what sense are these actions necessarily constitutive of ‘gifts’?

Eventtul biographies tell the object’s ‘career’ as the story of ‘classifica-

tions and reclassifications in an uncertain world of categories whose importance shifts with every minor change in context’ notes Igor Kopytoff (1986: 90) in his essay ‘The cultural biography of things’.!! According to ova donors, it is not the case that anonymised gifts move in and out of dif-

ferent spheres as sequestered stages or chronological events. The gift’s career, even when limited to the temporally bounded act that is the specific time of donation, displays multiple vacillations of meaning and value that are co-configured as simultaneous features of its ‘biographical’ trajectory.

Donors I 81 The ambivalence of women’s discourse can be explained by the obser-

vation their narratives appear to duplicate the medical mode! of the donating body only in certain instances. Further, we can see that women’s complicity with the medical account reinforces the possibility of conceiving the donation as the gift ‘freely’ given, at least in the realm of theoret-

ical possibility. But the analysis suggests this also is an aspect of the account that cannot be taken at face value. By developing their own metaphors of reproductive substance as action, ova donors both reinforce and challenge conventional images of female altruism as acts of self-sacrifice. By examining in detail the different shifts in narrative focus, we see some of the many reasons why donors, as persons, cannot be reduced to simple ‘types’, contrary to existing public policy formulation. As a brief enumeration the following interplay of paradoxical features — as based on donors’ testimonies — is already in evidence: 1. The idea of female reproductive gifts as special and unique, engendering women’s ‘own thing’ is inflected often by women’s past experiences of maternity. The engendering of women’s donation as social exclusivity may also be evident as the imagined instantiation of an alternative female economy outside of commodity logic.

2. The anonymised gift makes the person into ‘distinctive’ agent, but in the very moment of action, the person of the donor is a collectivised body. Distinctiveness is predicated on the form of collectivised action. The ova donor stands for ‘many women’, just like she stands in for ‘multiple eggs’ she has produced which are retrieved as the products of superovulation. 3. The anonymised gift is revealed as simultaneously disinterested and interested. As an unconstrained, disinterested gesture, there is refusal in monetary recompense; ova circulate outside of commodity valuation; gifting is beyond pre-determined price and may be interchangeable with an unconditional kinship. At the same time, however, the gift appears to enter into commodity circulation when it is objectivised as depersonalised ‘thing’. At least three possible and inter-related renditions of the gift as pseudo commodity follow: 4. Reproductive body parts are seen as superfluous to one’s own needs: as

human ova are diverted from their usual course (from menses into action) women’s discourses converge with and crucially re-appropriate clinical idioms, namely the transformation of waste substance into utility.

example. |

5. Genetic material is imagined as dissociated from its genetic source; notions of alienability concur with analogies to non-human eggs, for

82 Nameless Relations 6. Human ova dissociated from their genetic source and non-attributable

to specific origins are put into circulation through the medium of anonymity as though anonymisation were singularly representative of commodity value.

Beyond the time of donation itself, this ‘career’ of the gift becomes yet more complex, dramatic and relationally intertwined in the paradox of non-relation, as we will explore in the following chapters.

Notes 1. See also Errington 1990; Laqueur 1990 and Konrad 1998 for critiques of the interior anatomy analogue of the person whereby ‘inner body’ is cast as symbolically equivalent to ‘nature’, and the related conflation whereby genitals stand as signs of reproductive capacity. 2. The idea that ova are not being constantly produced by the woman throughout her reproductive life cycle is biomedical doxa (see Chapter 1 ‘“Cosmic Egg” Revisited’). But the contrary idea that the fertile human male manufactures several hundred million sperm per day is, besides anything else, not a view held universally across cultures. Herdt (1981, 1994), for instance, claims that the Sambia of the Eastern Highlands, Papua New Guinea, do not consider men to be the natural producers of sperm. Male persons are thought to possess a semen organ (kerekukereku), but unlike the fertile female menstrual blood organ (tingu), the male organ is small, hard and empty at birth. 3. I take the liberty of presenting the trajectory backwards: we first meet the figure of ‘hyper-embryo’ and the extensional field it elicits in Chapter 8, Recipients III.

4. See Appendix III for a detailed description of the Treatment Protocol. 5. According to HFEA statistics, the number of treatment cycles begun for the period of 2000/2001 would mean approximately twenty-four women per year risk adverse effects from Ovarian Hyperstimulation Syndrome (OHSS). In 1994 one 26-year-old woman died from the syndrome after treatment at a private hospital in Merseyside. See ‘Baby drug kills test tube mum’. Daily Mirror, 24 February 1994, p. 1. 6. This biomedical imagery of ‘clean slates’ is additionally powerful because it unwittingly generates its own ambiguity as to how the natural foundation of ‘sex’ ostensibly precedes and predetermines gender. ‘Nature’ is something that can be drawn out from persons both because it can be interiorly suppressed as natural attribute and because anovulatory persons, imagined as bodies of simulated menopause, can be made from these same ‘suppressed’ bodies. The significant point is that once Nature has been ‘drawn out’, a second nature, in effect a simulation of the first, repeats and enacts what non-assisted bodies would have done, only now to exaggerated and altered effect. 7. As discussed in Chapter 5, Donors III, Meena’s motivations are multifaceted and complex in their origin. Notions of philanthropy and acting for the social good would be articulated sometimes as the desire to ‘improve the world’,

Donors I 83 and a few women occasionally would draw analogies to missionary work overseas or to the supply of aid to developing countries (Nancy, Kate). 8. The act of anonymous ‘cross-over’ donation is explained in Chapter 6, Recipients I (see ‘Gift elasticity and the infertility industry’). 9. Abstention from coitus is necessary prior to treatment; unprotected sex is strongly advised against for the month following donation in case of accidental pregnancy; usually due to the fertilisation of eggs that could not be retrieved during the ovum ‘pick-up’ collection procedure. 10. British ova donors do not act to eliminate the opposite or cross-sex part of their identities. However, like Hagen ‘big men’, a different identity can be said to be effected as a deliberate contrivance (cf. Strathern 1988: 122). 11. The entity of reproducible ova had not escaped Kopytofi’s attention as a primary candidate for future commoditisation in complex technological society. Writing in the mid-1980s, he had in mind the unfolding scenario of assisted conception including egg freezing and associated developments such as national and international egg trafficking.

CHAPTER 4

Donors II

LTing January 2003 deliberations the Department issuedPublic a pressConsultation release followthe earlier ofof itsHealth six-month on Donor Information. Speaking at the Human Fertilisation and Embryology

Authority’s annual conference, the Health Minister Hazel Blears announced that children who had been conceived by donation since 1990

would be able to request non-identifying information about their donor/biological parent from the HFEA when they reached the age of eighteen. The announcement was indicative of a potential sea-change but was not meant as peremptory. Any proposed change, Blears confirmed, would follow a further consultation period with clinics, practitioners and user groups and would be dependent upon subsequent parliamentary approval. Responding to the government’s announcement Olivia Montuschi from the Donor Conception Network welcomed the move and sought to raise public awareness about the value and need for egg and sperm donors. Different attitudes should prevail regarding donor recruitment strategies at clinics, she urged. ‘Like blood, tissue and organ donors, gamete donors should be valued for the life-giving and altruistic contributions they make to the well being of their fellow citizens. With this recognition, donors may more easily acknowledge the responsibility to those conceived with their assistance — to make known their identities if asked, and supply family histories and details of relevant medical conditions’.! A charity and activist self-help group committed to pro-disclosure, DC

Network members include would-be recipients or ex-recipient parents with donor-offspring as well as a number of DI conceived adults. Many members believe donor offspring are entitled to grow up with knowledge of their conception origins and in the course of campaigning for greater openness, the Network has suggested gamete donors recruited in the future might even want to play a more direct role in the child’s life. As the Network’s ‘Anonymity Statement’ puts it: ‘Potential donors should be prepared for and relaxed about the possibility of being contacted later in life’.?

But how would ex-ova donors feel about the possibility of being con-

Donors IT 85 tacted later in their life? Would they feel relaxed about this, and if so, how involved would they like to get? What would their ‘campaign message’

sound like? Before turning to their views, a brief word on traceability issues.

Current policy debates about the merits of pro-disclosure and anti-disclosure tend to present anonymity as a monolithic concept and practice. But in practice the de-identification of persons is a complex logistical and administrative challenge. That there is no such thing as a single or ‘pure’ anonymity is something increasingly recognised in public health medicine, especially as applied to emerging initiatives in the new genetics. So-

called ‘epidemiological surveillance’ is a cornerstone principle of the longitudinal research study of gene-environmental and lifestyle interactions comprising the U.K. national ‘BioBank’ collection of anonymised DNA samples.’ As a research enterprise dedicated towards future preventative medicine, biobanking depends crucially on cultures of traceability

that can link up anonymised biosamples with a particular person’s (‘donor’) genetic profile. But the process of establishing interlinked per-

sonal health information, of qualitative relevance both to a particular individual as well as across populations, depends equally on protections of privacy and confidentiality, both to prospective genetic donors and their families. In recognition of this the Medical Research Council (2001) is one among a number of regulatory bodies that has made provisions for different degrees of coded data, as well as its processing and storage by informational ‘custodians’ or trusted third parties. ‘Unlinked anonymised’ data

refers to information that cannot be cross-matched for the purposes of identifying any specific person. It depends on severing the link between an identifiable individual and a person’s health information so as to prevent any possible correlation between person and data in the future. Considered by some as logistically impossible given the uniqueness of any single person’s DNA signature, unlinked anonymised data is also described as ‘irreversible anonymisation’ or may be euphemised as a situation of ‘permanent de-linkage’. Contrariwise, ‘linked anonymised’ data contain informational strings or codes that can be de-encrypted to enable authorised persons (e.g., informational custodians, caregivers) to make person-

alised identifications. This category of anonymised data is held in ‘potentially identifiable’ form. It is said to facilitate ‘reversible anonymisation’. In other words it allows for informational, statistical and epidemiological cross-correlation (see summary in Human Genetics Commission 2002: 91-95).

Although donor assisted conception traditionally has been a treatment-based rather than research-based field (see Chapters 8 to 9), it may

be helpful similarly to identify non-relatedness as different degrees or ‘strengths’ of anonymisation. Paying particular attention to some of the kinship implications of different categories of anonymity, this chapter

presents an initial schematisation of non-relatedness as degrees of anonymisation. We begin with a brief survey of strong, weak and indeterminate anonymity.

86 Nameless Relations Categories of De-identification and Degrees of Anonymisation Strong Anonymity

Donors in favour of strong anonymity typically express no Jasting desire for further knowledge about their donation. Asked what sort of relationship, if any, they would ideally like to have with the recipient, those who had articulated idioms of ‘cutting off’, as described in Chapter 3, were most vocal in their desire not to establish any sort of connection with the recipient beyond the time of donation. None at all. I have served my purposes. That’s what I intended to do in the first place. (Sally)

None at all. I just wish them all the luck and happiness in the world! (Miriam)

I’m quite happy the way things are carried out. I don’t wish to know or have any involvement with the recipient. (Lucy)

When asked whether knowledge of the fact of a pregnancy might increase a donor’s interest in establishing some sort of relation with the recipient,

a range of donors again insisted on their preference for maintaining anonymity and non-connection.* My life is too busy. Plus it would only make me feel uneasy knowing who she was. (Sally)

I didn’t donate to become a mother or substitute ‘aunt’. I did it to help someone’s dream come true. (Leila) No, because I gave up all rights to the eggs and so have no wish to meet the recipient and her partner. (Fay) No, I might start thinking it was half my baby. (Ivy) Absolutely and most definitely not. Too closely involved, would be entering

a minefield. It is her baby and she should rear the child as she sees fit. (Delia)

These objections turn centrally on a possessive modelling of persons in which the terms of biogenetic ownership are valued as singularly exclu-

sive. The typical donor response is sublimated through the denial of parentage: ‘It’s her baby, it’s her child’. The aversion to establishing known donor-recipient ties as explicit kinship linkages is linked therefore to the refusal, on the part of the donor, to identify herself as the genetic mother

of the offspring in question. The donation may also be seen as forms of knowledge or past action that cannot be reversed. It is precisely because past conceptions cannot be ‘de-conceived’ (neither donation decisions nor existing children are reversible) that some donors fear they may become

Donors IT 87 over-involved with a donor-conceived child — especially so should their own life circumstances change in years to come. What if I did not like her? Would I ask for my eggs back? (Adele)

Due to my past infertility, family life is very important to me and in diftfer-

ent circumstances I would have liked more children. So, I would worry about the effect of knowing that I had a child by my donated egg. (Maev) I would be worried about getting too involved, if there was a problem with the child — a learning disability or handicap, for example. I may feel that I would want to interfere with the child’s upbringing, that I would become part of its extended family. Also, if I had problems with my family, i.e. a

death of one of my own children, I may feel I have a claim to my halfgenetic donated child! (Imogen)

These comments illustrate that it is not just a matter of considering how best to overturn the legal parameters of anonymity as certain policy advocates espouse (see Chapter 2). Imogen and Maev are concerned about the dangers of parental over-involvement by the ex-donor and have wondered whether they might be moved to establish a kinship tie in subsequent years should anything untoward reverse their own maternal status. Should more knowledge about their donation be made available to them in the future, some women say they might view their maternal status differently, both with regard to the children they parent [by birth] and to any genetic donor-conceived children. In the next chapter we will see how reproductive donation functions more explicitly in some donors’ thoughts as a type of ‘insurance cover’. In sum, strong anonymity is characterised most usually by donor disinterest in the post-donation outcome, both the immediate and long-term consequences. In public policy and legal terms strong anonymity is analogous to ‘irreversible’ and ‘unlinked’ anonymity, terms borrowed from information retrieval in the context of donor samples research and the national biobanking experiments.’ In donor conception contexts, irreversible anonymisation only remains efficacious so long as links can remain broken. Untraceability is about ensuring non-linkage between a specific individual’s identity as ex-donor and other parties who may claim a potential interest in accessing information about that person. The irony, of course, is that donor disinterest may feature simultaneously as the very semblance of the ‘free gift’. Indeterminate Anonymity

For another sub-group, strong anonymity is modified by a more marked ambivalence toward the donation experience. When asked what, if any, relationship donors ideally would like to have with the recipient, and whether they would be more interested in establishing ‘link-up’ were the recipient successful in her treatment, those expressing a more openly uncertain viewpoint responded in the following ways:

88 Nameless Relations In an ideal world it would be nice to know the outcome and perhaps even to know about any children as they grow up. But this could be very difficult particularly if you found you did not like the other couple or agree with their customs or beliefs. It is probably better not to have a relationship with them. The only exception being: if you were donating to friend or family. (Cindy)

I don’t know, but I think it would be difficult to have a relationship. (Heather; Buki) Perhaps we could be friends — maybe possible contact. (Clarice)

‘Indeterminate anonymity’ recognises the benefits of donor-identifying information as ‘released’ knowledge. However, it takes parallel note of the

desire to withhold information as the setting of certain limits. Those donors in favour of receiving identifying information or supportive of the transmission of donor information to others were willing to revoke their identity and traceability, yet would often set boundaries to the envisaged relation in terms of its elicitation as fully exposed ‘relatedness’. There would be some curiosity — maybe just to have a brief description and/or photo. (Nancy)

Just to know everything works out as they would like it to - no more. (Naomi; Dee)

Exchange of Christmas/birthday cards maybe -— that sort of thing. (Suzanna)

Where the possibility of contact between donor and recipient and/or donor-conceived child and donor is envisioned as limiting, the elicitation of a relation often has an anticipatory cut-off point built in to its imagined actualisation. Just to know that she was pregnant would be enough. I wouldn’t want to complicate things. I wouldn’t mind becoming pen friends, but no more. (Fiona)

In the following excerpt Amily is responding to a question on donor infor-

mation. I have asked what importance she attaches to the donor-conceived child finding out personal details about her. She delimits the anticipated relationship by setting boundaries to ‘degrees of curiosity’. Only enough to satisfy curiosity. It is not important to me, but if the child is

questioning then it will be important to them, and the questions must be answered. If the child seeks information, then that will need to be satisfied. They need to know certain things. I simply confirmed that as I had no other children, there were no sisters/brothers to look for. I also stated in my free-

hand pen-portrait that they had been given a life to enjoy and make the most of. I hoped they would do this and be happy. Physical details are kept plus the information above. I think this is good enough.

Donors II 89

Edwina similarly puts down limits remarking: ‘I would be willing to ask any questions about myself from the receiving woman, or her child. But I have three children, conceived with my husband, and would definitely not have any more’. Others would say the anticipated relationship should

not be one that is imposed by the donor upon the recipient. It must be activated mutually as a joint reckoning and be dependent upon the recipient’s initiative. For Valerie it is important there is ‘No relationship unless the recipient is keen, but I would like to know if a successful pregnancy was established and a baby born’. In a similar vein some stressed that the possibility of contact with the recipient’s family should be something that is left open as a negotiable arrangement, something to be worked out in stages or played by ear. Flexibility of outlook marked these responses. It would be totally up to the recipient. I would at no time refuse any contact but also I would not wish to push myself upon the recipient just because I had donated eggs. (Jean)

None, it’s their baby, their life, but if something was to happen, major changes to the child’s life, or the laws changed and if I was contacted then I would help as much as I could in the child’s upbringing, but I would be the last ‘relative’ to be contacted, wouldn’t I? (Phoebe)

Donors were asked a further set of questions about the importance they attached to fact the donor-conceived child might have certain knowledge about their identity and life. I suppose it helps to know a little about me as my genes are part of the child

but I do not consider it to be of vital importance unless there are medical factors which may affect them in later life. (Ute) Personally, knowing that the child knew of any diseases in my family history is quite sufficient. However, should the child know of the egg donation later on and want to know about me, I would not mind. (Davina)

It wouldn’t bother me if the mother decided not to say anything. It would be up to them. (Fiona)

If the child is told well and good, and if not, then there’s not a problem. (Moira)

Not particularly concerned, but I feel that if a child was troubled by not knowing this information then it should be available. (Maev)

I only gave basic non-identifying details, and if ever the child wanted to know a small bit about me, then that is fine. (Eileen) Not important for me or any child. In fact, possibly better that nothing is known. I’m adopted and this gives me that opinion. I did though attempt to find a few reassuring details for the recipient for the form [non-identifying pen-portrait] as I know I would, for instance be pleased to know that anyone donating an egg to me was a graduate, had travelled a lot etcetera. (Anita)

90 Nameless Relations The above comments are indicative of an indeterminate modelling of anonymity. In these cases anonymity is characterised by semi-disinterest —a less absolute form of disinterestedness than in the strong model — also ambivalence and explicit contradiction, indifference and non-resolution.

At times donors’ commentaries demonstrate then explicit avowals of uncertainty or contradiction that may veer towards either ‘strong’ or ‘weak’ versions of anonymisation. In terms of public policy, indeterminate anonymity is envisioned as potentially ‘reversible’: the possibility of future

contact between donor and recipient and donor-conceived offspring is imaginable for some, though usually this is envisioned to take a constrained, limited form. Overall, these views suggest a greater reflexivity by donors over the temporal dimensions of donating. Donation is not seen as something bound to the present moment, the actual time of donating, but

rather extends beyond the course of a specific treatment to embrace the more long-term implications of the donation event for multiple parties. Weak Anonymity

Where donors are moved by the more ardent desire to know the identity of the recipient or establish contact with donor-conceived children, indeterminate anonymity shades into its diluted ‘weak’ formulation. In sum, the desirability for making identifying information available overrides the

Significance otherwise attached to the normative preservation of the anonymised person as non-traceable and non-identitifiable. In such cases

traceability becomes the very form of elicitation: it is the medium by which people — donors, recipients, children — hope to know that they can come to be known as ‘relations’. Those who are keen to explore the possibility of establishing contact may envision a range of ways for activating

presence through face-to-face exchange. Some donors may be satisfied with a one-off meeting either prior to or after the donation event. I would like to meet them just once before I donated to them. As much for their sake as for mine, so they could see I was not an alcoholic or druggie. Also so I could give a more detailed history of eyesight, hearing problems, health etcetera. The sort of things that get asked about the child at clinics and schools. (Felice) None! Well, perhaps one brief meeting, again just out of curiosity. (Anita)

Others may wish to follow through a more open-ended exploration of the donor-recipient relationship. Some may already anticipate with hope the cultivation of an ongoing relationship: the recipient may be figured as a ‘special friend’, someone with whom the donor can have a lasting ‘bond’ as ‘rewarding experience’. I would like to know what sex the baby was and later when they have grown up to see what they looked like. (Moira) I would like to know her progress during pregnancy and when she has her baby. It would be nice to have a special friend to tell me about the baby’s progress. (Meena)

Donors II 1 Despite what I have said about the pitfalls involved in such a relationship, I would still be interested in meeting the recipient or communicating by post. If things worked out well it could become a very rewarding experience as there would always be a bond between recipient and donor. (Cindy)

Though occasionally overlapping with indeterminate anonymity, some donors in this category indicate it would be important to know that donorconceived children born from their eggs would have access to personal information about them. The most common explanations given spanned the following: (1) health considerations (usually genetic inheritance, allergies); (2) emotional welfare of the donor child; (3) empathy with the curiosity and desire of the child to fill in perceived gaps in knowledge about oneself in relation to the birth mother and (4) concern over what information will be passed on to the child about the donor’s motivations. It’s very important. I am adopted and was given no details about my mother.

If the recipient told the child it would be nice to know they had some details. (Rita)

The baby should know that he or she was a very rare gift for their mother. And that they should love their parents. And I think there’s no harm in the child knowing certain things about me or my life. (Meena) It is important to me to know that they know a bit about me and my family. I don’t really know why. Whether this is just a form of vanity, I hope not. I like to think it will make any children feel more secure about themselves. I think children should be given as much information as possible about their biological roots. If only to reassure them that they are not at risk from any genetic disorders. (Cindy)

Very important. J feel that all children everywhere should have a legal right to know the identity of their genetic parents. (Rosemary)

Those in favour of contact at a later date imagined a variety of reasons for connecting up. Yes. It’s important for the child, rather than me. | left a contact so the recip-

ient couple or child can contact me. People need to know their past. (Clarice)

Maybe a small photo attached to the [non-identifying] details, just to see what I look like. Everybody has curiosities. I would like to meet so questions could be asked and answered — what I look like and what sort of personality I have. (Naomi)

Adopted children can suffer tremendous traumas and expense tracking down their natural parents. I would hate to think a child born of the egg donation programme may have these same problems. I would like to see a register set up now with this is mind so if a genetic child of mine reaches age eighteen and becomes obsessed with finding out about me she or he could do so easily through an intermediary. (Odelle)

92 Nameless Relations In general we may say that weak anonymity supports the transmission and revelation of identifying information. Its core cultural values are traceability and identifiability, as made evident in the process and act of re-union — the wish to trace, make contact with and possibly meet faceto-face with the particular parties involved in one’s donation. In policy terms this means making identifying information available through a third party intermediary. This could be by means of an independent holder of a Contact Register, for instance, granted the legal right to main-

tain and release voluntarily recorded personal details. In the model of weak anonymity, expressions of ambivalence are replaced by: (1) the emotions of anticipation to gain further information about the facts of donation; (2) the motivation to trace and search a genetic relative and (3) the desire to gain more knowledge about different parties involved in the act of donation and the kinship consequences stemming from that act. The different parties include: the donor, recipient, donor-conceived child, genetically related half-siblings, genetically related full siblings, the latter being conceived through embryo donation.® In its most extreme instantiation, proponents suggest that all donor-assisted conception knowledge,

including retrospective donations, should be information that is made identifiable and available as accessible knowledge (see Chapter 2). Ultimately it is possible a system of weak anonymity could give way in the future to the total dismantling of anonymisation cancelling out both its ‘strong’ and ‘indeterminate’ versions.

Knowledge Outcomes and the Form of the Return Gift Is there any common ground linking these different categorisations of strong, indeterminate and weak anonymity? Clinic-based research conducted by Abdalla et al. (1998) found that 94 percent of egg donors enlisted to a British study had chosen not to complete in free-form style the space on the HFEA-administered donor information form that allows inclusion of additional personal information. The so-called ‘pen-portrait’ is the donor’s unique chance to transmit special information to donor-off-

spring, to document her own personal ‘messages’ (see below Figure 3, section 19). According to the findings presented by Hossam Abdalla’s research team, giving away more information about oneself than was absolutely necessary was something that had not been volunteered freely.

Rather, the prospect of adding further personal information was kept back, withheld as part of the ‘gift’ itself (cf. Chapter 8, Recipients III). Were this finding to be confirmed across all licensed clinics, the centralised collection of such pen portraits will yield scant, and importantly, inconsistent

information in the future for information-seeking applicants. There is a sense however in which information is already behind itself. Knowledge of donors and recipients identities’ is not necessarily withheld on account of the single information abstainer. Knowledge may be compromised on other counts.

Donors IT 93 ete Douor Information Form | , , Centre| | | |Form.D 00000031560 1 This form is registering* A new individual [| Changes to details already registered [| Oo For changes (see Directions for Completions 2) ignore section 2 and complete 3 and other relevant sections below.

2 This form is notifying corrections to form [D| L | | | | | | | | | | | See Directions for Completion 3

3 Form completed on Day| | | Month | | | Year| } | | | | | , 5 This donor was also registered as patient/partner no. | | | | | | | | | | | | | If the donor was previously registered and their details are unchanged complete sections 7 to 19 as applicable

Current Sex* Female[ NamesSurname Forenames Male[ ||

6 Personal details a} Date ofbirth Day | | | Month| | | Year| | | | | Tick if date is approximate| |

Names at birth (if different Surname

| Country | | | from current nares) Forenames

7 9 an 7 en nee ieennnmennemnenmmmnintaimientatt birth Registration district (if known)

7 Date gametes first used (or supplied for use) in treatment ‘Day| | | Month | | | Year| , | | | | 8 Any donation at other centres* Yes | | No [|

9 Ownchildren* Yes [| No[ | Height (m| | | | | Weight (kes)| | | | 10 Ethnic © White[ | Black Caribbean| | Black African] | Black Other

group* Indian [| Pakistani[ | Bangladeshi{ | | Chinese[”_| Any Other

11 Eye colour* Blue[ | Brown[{ | Green|] Grey] Hazel[ | Other? 12 Hair colour* Black[ | Brown Dark | Brown Light| | Red[ | Blonde[ | Other’

13 Skin colour* Light| | Medium[ | Dark{ | Othert 14 Religiont 15 Occupationt 16 Interestst 17 Last UK centre for new donor/patient/partner known elsewhere (if known)

18 Previous donor no. only to notify a change to the number of an individual already registered | | | | | | | | | | | | |

Completion of this section is optional for the donor, but must be brought to his or her attention. - ee 19 The space below is provided for you to give a brief description of yourself as a person. This should be something that could be passed on to any child born as a result of your help. The parents may also see it.

Figure 3 Donor information form. Reproduced by kind permission of the Human Fertilisation and Embryology Authority.

Clinic audits by the HFEA Licence Committees reveal that a number of treatment centres have not submitted reports with accurate or fully completed details of patient/partner names, reference numbers and treatment dates (HFEA 2000: 7). If there is an informational hiatus already in place, for some donor offspring the consequences may be immense, even irreversible. In the future when intermediaries come to enter personal data in their capacity as administrative ‘custodians’, many informational matches will be missed and classifiable only as non-retrievable — that is, outside the field of classification. Persons as potential cross-correlating relations simply will not show up: the donor-recipient relation becomes officially clas-

sifiable as un-nameable: it is evident as non-link. This is significant on many counts. It is not just knowledge itself but a possible re-connection between genetic kin that stands to be lost.’ Moreover the loss incurred by informational hiatus is apparent in another sense: we have as yet no official archive with which to assemble a comprehensive material culture of donors’ statements in the form of detailed testimonies of assistance. In this

94 Nameless Relations sense too information can be said to lag behind itself: it is evident as evanescent form. These points are the interface to another critical gap in the system, a form of non-knowledge that donors themselves embody as a vital ‘missing link’. As discussed in Chapter 3, the medical discourse of the donating body denies women cultural efficacy as socially recognised agents. This denial of agency is further apparent because donors are not entitled by law to know whether their ‘gifts’ effect significant treatment outcomes for

others. They do not know whether their actions have helped to bring about new human life. The logistics of an anonymous donation system in its strong and irreversible form require the donor never to find out how many of her eggs will fertilise successfully as embryos, whether a preg-

nancy is established or a child born as a result of her actions. In other words, once the donating body is transformed from a ‘whole’ body into a number of detachable and circulating body parts, these parts cannot be traced back to the person of the donor.® All the more interesting then that one of the most noticeable features of donors’ accounts was the similar

patterning of responses given to the issue of immediate post-donation knowledge. Many would talk of their disappointment at not having some idea of what had happened to their eggs post-retrieval. The consistency of women’s views on this matter is testimony in itself to the deep-felt conviction generated by this form of non-knowledge. Whatever their stance on anonymity, similar views were shared by almost all donors about the importance of receiving information about the outcome of past donation actions. What is so striking here is that those favouring distance and complete severance of ties, as well as those donors preferring possible contact and connection with recipient families, appear to be more or less united in this regard. I really feel strongly that not to know at least whether a pregnancy was established is a most unfortunate condition of donation and we should be given at least that minimum piece of information. (Valerie) I would only like to know if the donation was a success insomuch as a pregnancy occurred. Not what was born or where. (Lucy)

Would have been nice to know if pregnancy had been achieved — and successful. No further information. (Leila)

I don’t necessarily want to know all the details, but it would be nice to know if anybody was actually successful in their attempt to have a child. (Cindy)

I would dearly love to know if someone became pregnant through my donation, although I can quite adamantly say this is all I would want to know as I relinquished any further responsibility as a condition of donation. (Penny)

Donors IT 95 To have the knowledge there had been a positive outcome was part of the ‘make-believe’ donation narrative; it was a way of imaging a fairytale world of eventful resolution shaped by the axiom ‘all is well that ends well’.’ I would just like to know that she got pregnant. I'd like to know if it had a happy ending. (Fiona) So that I could be happy in my own mind that my time and energy had not been wasted. Call it an ‘ego-boost’ if you like! (Fay) Just to know that it wasn’t a waste and that a woman has ended her ordeal to have a child. (Dea) Because then J know my donating was a great success. And someone got pregnant through me off my eggs. (Sally)

J just wanted to know if it was successful. I know it does not work every time, I would have been sad if it didn’t, but I do know there’s a chance of it not turning out. Just that I would have liked to have known how things went and whether the women had a boy or girl. (Miriam)

I would love to know the outcome of my donation. I would feel disappointed and let down if I knew that the outcome had been unsuccessful. (Suzanna)

These donors all articulate how knowledge transmitted back to them would validate their actions. Such knowledge therefore becomes the form

of the return gift. Knowing whether or not their actions have had the desired effect, whether or not they have helped someone, reflects upon the value of their persons as social agents. It is what comes ‘back’ to the person of the donor. As Ute remarks: ‘It would be nice to know if the out-

come of the donation was successful and I’d be more inclined to do it again if this was the case’. The project of donation represents for many ex-

donors an unfinished enterprise mainly because of the uncertainty whether or not any children have been born through their eggs. Recalling the day she received a ‘thank-you’ card from a recipient via the hospital, Delia comments: ‘I just got this card and it’s so confirming that there is somebody out there. You know you’re beaming all this stuff to Mars and getting a reply’. Delia’s feeling that there is somebody out there is precisely about the acknowledgement she receives from an exterior confirming source: what is being ‘beamed back’ is the knowledge that her actions have had some constructive effect — for herself and for somebody else. Meena was told she produced twenty eggs and that four prospective recipients were expecting to receive fresh embryos after fertilisation. The unfinished nature of her gift transmutes into commodity logic analogies. ‘It’s like wrapping up a Christmas present and your Mum and Dad say

you’re not allowed to open it, but you’re dying to know what’s in the package’, she remarks. ‘That’s how J feel not knowing the outcome’. Jean

knows five eggs were retrieved from her during the surgical ovum

96 Nameless Relations pick-up, but not how many recipients were expecting to receive from her. She comments: It doesn’t feel quite right, as if there’s something missing. I would like to know what happened to the eggs after —- whether it was successful and if it was a boy or a girl. It would make it more worthwhile if I knew what happened.

Muriel and Odelle echo these sentiments: I feel happy that I produced fifteen eggs. I was told that three couples would receive help. I am at this time still wondering [ten months post-donation] if any of the women did get pregnant, keeping my fingers crossed this is so. All

I know about my eggs is that one of the recipients managed to fertilise at least one [egg], since I received an anonymous note from her. On a purely emotional level, I would love to know that at least one family had a child from my eggs. This would make me very happy. (Muriel) I would desperately like to know the outcome of my donation. I have been told Iam not allowed to know. I would simply like to know whether, and if so, how many eggs [sic] were successfully implanted, whether the pregnancy was successful and the sex and date of birth of any offspring. I do not see how knowing this would be any breach of confidentiality and it would mean so much to me to know whether there are any children carrying my genes. Since the legal maximum for donation is ten children, how can we know whether to volunteer for further donations if we don’t know the outcome of the first? (Odelle)

Neither Inalienable nor Forgettable We saw in the previous chapter that eggs represented reproductive substance that could not be valued in terms of the ownership of the person. The question of whose eggs these are came to be replaced discursively with a vaguely formulated rhetoric, namely the idiom of ‘chances’ and associated discourses of hope, facilitation and sharing. Now although

donors comment they are not the owners of their donated substance, these local conceptions of ova as a-genetic are bound up with notions of not forgetting as much as they are with ideas of ‘cutting off’. Lucy, Fay and Meena are all describing how something about the experience of donation does not leave their person. In Lucy’s case, this becomes manifest through

her appeal to ex-donors who form a ‘club’. Women who join are automatically lite members, she thinks, because what they have done is something that stays with them for life.

, ... It’s something you’ve done in your life ... you’ve done it once and it’s always with you, so therefore you will always know you've done it [even if] other people might not. But you will always know you've done it and that makes you a life member. All the time you think about it and you remem-

Donors II 97 ber doing it, then your membership stays in force ... I know I’m a member, so I don’t need a card. I know. It’s just something you know you've done.

Through this imaginary projection of a social collectivity, Lucy manages to invest in something for life. An anonymised agent is not simply an impersonalised force: those who join the club have ‘done’ similar kinds of lifetransforming actions. Even if she cannot have knowledge of the outcome

of donation confirmed back to her, she can still make herself remember the purported agency of her actions and ‘link up’ with like-minded others. When Fay brings to mind another imaginary scenario, that of bumping into a recipient on the street, it is not important that the woman she meets be the same recipient she once assisted in the past. She just would like to meet ‘a’ recipient and find out whether things turned out well. Like Lucy, Fay is also talking about making knowledge from her actions and speculates in the following passage as to whether her donation has made any difference to someone, whoever and wherever that person might be. I would love to go up to the person, I would really and truly love to go up say in three or four years time and meet the person I gave to and say: ‘Well, fantastic!’ Whether or not to know it’s my child or whether they knew or not I’m a donor. Just to bump into somebody on the street and say: ‘Well I had donor eggs and this is the child’. Great stuff because there’s a chance it could have been mine — it could have been somebody else’s, but the feeling is always there. At the end of the day you would love to meet a person and say to them: ‘all the best, I hope it all goes well for you’. Not to say to them: ‘That’s my child — I’ve given something that’... But to turn around and say to them: ‘Well I hope it works and al] the best and if it doesn’t work get them to give me a shout and we'll try again.’ (Fay)

For Fay, ‘the feeling is always there’ as well as the admission that she does

not have a connection with the donor child, or a connection with a specific recipient. As she says, the point is not to be able to claim: ‘that’s my

child’. What matters to her instead is that she has been a successful ‘method’ (cf., Gill in Chapter 3, Donors I), or to offer her willingness to donate again. These notions presage other donors’ conceptions about relatedness across and between unknown persons — an irrelational kinship that is never finally fixed and nowhere permanently anchored ‘in’ a particularised relation as the elicitation of a single person.

When Meena talks about a sense of something given that does not leave her person, she combines notions of the genetic and a-genetic by conflating the extrinsic with something that once was ‘housed’, or contained. Instead of the imaginary social space of a special club for exdonors, Meena wants to convey, much like Emma, that the eggs in transit from her person do not actually come from ‘my body’. They are more mine when they are in my tummy. Afterwards they are mine

in a different way, I suppose. They once belonged to me, but afterwards

98 Nameless Relations once they are transplanted they are the other parents ... they once belonged to ... [mean a house. Once you sell it, it’s not yours anymore. That’s yours when you're living in it —- which is the same as, like I said, once the eggs are in your tummy then they are definitely yours. Once you give them a different home, then they’re not my eggs ... but there will always be a part of me that still thinks they belong to me ...

‘They are mine in a different way’, she says, and the extent to which this

departs from a naturalised ownership of her body parts only becomes clearer when situated within the overall context of her account (see Chapter 5, Donors II). Notions of ‘belonging’ connote a kind of rhetorical

slippage that re-occur throughout these accounts precisely because notions of substance as purely biogenetic are in the process of being symbolically re-configured.

Women’s accounts of how they were ‘synchronised’ together as a donor-recipient pair during the treatment provide another instantiation of relations of non-relations. Donors would say such things as: ‘It’s almost as

though we’ve known each other for a long long time. We don’t know each other, we don’t know each other’s names, but we know we’re in hospital together at the same time. I just try and imagine how she feels. You think of each other whatever the other will think. I feel that there’s this link and you can really touch on it (Delia). Fay’s comments are typical for drawing out a sense of intimacy-at-a-distance between these mutu-

ally unknown, untraceable persons. She feels she knows the recipient intimately and that her gift enacts a ‘personal’ kind of extension of herself. Although I don’t know who she is or what sort of background she comes from or anything like that, I don’t actually know her personally, I feel as

though I know her almost intimately. It’s a personal thing to me. It’s between me and the lady in question who is receiving. Although you don’t know who she is or what she looks like or what she does, you’re giving to them personally from you to them. (Fay)

Alice also talks about her gift as something that is ‘woman to woman’ and

regards this as something personal on the grounds that she is helping ‘somebody’. The kinds of connections she draws upon touch upon ‘similar experiences’, she says, which seem to relate to perceived commonali-

ties between the women, partly in terms of their similar status as (potential) mothers. Alice imagines how giving the gift would be like her receiving the gift; it would be as though she were having a baby, at the same time though differentiating donor from recipient in their abilities to make up ‘part of a package’. We've both been through similar experiences, except I’m giving and she’s receiving. We’re both part of a package where I’m the giver and she’s the receiver. And maybe because we’re both women and I’m giving her some-

thing she hasn’t got. I can imagine it quite well, I think, because I’m a woman and because I’ve had children and it must be just absolutely the best thing in the world. Because I suppose I imagine it to be me, as myself, and

Donors II 99 how I would feel. So I would imagine me receiving the gift and me taking it

and me having a baby. It must be the most wonderful thing in the world. (Alice)

For Alice, Betty and other donors, idioms of initiation and notions of jointness do not constitute the commonality of a shared bio-genetic sub-

stance, but refer to shared actions and shared time during which the donor is thinking of herself as somebody who contributes a ‘means’ of facilitation. Donors thus make their body parts into both real and imagined relations, and it is these relational persons, as kinds of actions, that constitute the ‘time’ of their gifts. Holly makes this quite clear when she refers to herself as a kind of distant support. She is active in a construction that is separate from the matter of her eggs as reproductive substance: I’ve just helped part of the process along. I’ve sort of provided part of the scaffolding and somebody else is building the tower block. I’ve just provided the means for the pregnancy and as far as I’m concerned once my eggs have gone, then that’s fine by me. You know they’ve gone and somebody else is using them ... it was just an egg and I just helped get them started off...

She reflects further how her assistance consists of adding an ingredient. I just sort of started the process off. Somebody else is doing the rest of it. The father will fertilise the egg, the woman will carry it, she’ll do the bringing up

of the child and whatever. I just thought perhaps I can just do a bit to help things along without actually having to have another baby myself. Just assist a bit by adding, you know. Just adding in one of the crucial ingredients, really ...

(Holly, mother in her early thirties)

Holly sees herself as a kind of frame for others’ subsequent constructions. She imagines herself to be busy assembling something when she provides part of the scaffolding, but it is somebody else who goes on to make the tower block: it is the recipient who brings the child to life. To take up the

earlier analogy presented from mainstream medical discourse, Holly’s gametes cannot be said to belong to a ‘warehouse’ since her eggs only have efficacy because she actively produces the support as transformative

actions for another. Like many other donors, she confusingly couches aspects of her rhetoric in traditional procreative idioms of ‘adding’ (in the sense of bio-genetic substance) in order simply to stress how the ‘jointness’ she envisages is not comprised of the physicality of an actual procreative presence. Though this notion of ‘adding in’ a crucial ingredient sounds genetically informed, Holly does not mean to say that her gift is the transmission of her own genetic characteristics. What she is talking

about is the novelty of reproduction as a detached continuity between herself and another woman. The connections Holly ‘shares’ with her recipients are the connections of not knowing each other, and a vital part

100 Nameless Relations of the tie that makes this into a form of relatedness is the recognition that this constitutes relations of non-relations.

Remote Parenting? As well as describing feelings that are ‘always there’, many donors within their same narrated accounts also talk about how donation involves ‘no responsibility’. This ties up with certain of their notions that after donation, ‘that’s the end of it’, as well as with their preference not to have any kind of parenting involvement in the raising of a child born from donated eggs. Stressing how the eggs are not ‘mine’, nor how the eggs represent

‘my child’, the kinship they envision is mediated through a relational rubric of ‘no ties, no commitment’. Such articulations again reveal different gradations of disconnection; there is a continuum of different degrees of remoteness, itself indicative of rich ambivalence.

When asked whether there are any circumstances that might arise to initiate feelings of responsibility for a child born from their donation, one sub-group of donors indicate categorical refusal. These replies are indicative of ‘strong anonymity’. No, I gave up any responsibility when I donated my eggs. You would return a Christmas present when bored with it, would you? (Betty)

I do not even want to know it has been born. Only in my worst nightmare would somebody knock on my door claiming that I was his or her mother. (Delia)

For others, it is important ‘there’s no attachment’. There’s nothing, there’s no attachment. And J’d much rather it that way. I] don’t mind helping anybody with the donating, but I don’t want to know the child, see the child. I don’t want to know all the ins and outs ... how it’s doing. I don’t want that ... (Jean) They’ve [eggs] gone now. I’ve passed them to her and I’ve got nothing with it — no ties, nothing. Why not help somebody else? (Emma)

Others similarly inclined to detachment post-donation likened themselves to a dependable figure to whom the child could turn at a time of crisis; not a spiritual godparent as such, just someone who could step in as the ‘best last resort’. Only if the parent died and there was nobody left in the world [to bring them up]. I wouldn’t want the child to go into care after being wanted so much! (Miriam)

If the child became orphaned and needed care then I would help. (Stephanie)

Donors II 10] No, I wouldn’t feel responsible but if the parents died and I was asked to give the child a home, were it in my power, I would not refuse, in the same way that I could not refuse any child who needed my help. (Sadie)

I would feel responsible for the child only if they had no other way to turn to. Imagine having twenty children turn up on your doorstep and tell me that Iam responsible for their upkeep. Looking after my own three is quite enough! (Meena) I do not feel any obligation at all to the parents or child. I would however volunteer to take on responsibility and would like to be given first option in the tragic event of the child being offered for adoption. I would also like to

leave the child something in my will as I have no children of my own. Unfortunately J can’t because I don’t know if they exist, let alone who they are or how they can be traced. (Odelle)

Maev anticipates the crisis coming from another direction. The donor child might stand in one day as compensatory substitute for the loss of her own natural offspring. In this instance the need would be activated on the part of the donor, not the donor-conceived child. If anything tragic happened to my twins, in the event of death, say, it would be very hard for me if there were a child somewhere that would never be in my life. (Maev)

Others invoked a future sense of responsibility on grounds of health. This

might be initiated by the donor’s actions or awareness, rather than as response to the child in question. Some such views were tinged with a sense of guilt, the donor allocating moral blame to herself with the belief it is her egg as genetic substance that may be attributable as causal agent in such misfortune. If the child was born with a ‘female’ inherited disease or illness that really affected her life, that came from me, that I, or my family do not know about, or if the child lost all its family and there was absolutely no-one it knew who could take over the care, then I would feel responsible. (Phoebe) If the child was handicapped due to a fault of mine, so, if the egg was someway imperfect. (Fay)

If a child was born from my donated egg that for instance had Down’s syndrome or some sort of genetic disease I would feel enormously responsible because of the massive undertaking that that would necessitate. (Joni) If I develop a killer disease that could be passed on to my children. (Ivy)

These are important voices to take into account from the viewpoint of donor-conceived children’s own articulated claims, especially considering the wishes of some donor offspring to have a full and accurate description of their genetic origins. As the numbers of children reaching the age of majority will increase in coming years, and as campaign activism for the

102 Nameless Relations right of donor offspring to know their genetic origins looks likely to gain public momentum, it might be easy to overlook the concerns of genetic mothers. They have disappeared from the original procreation scene, after all. So far as recipient families are concerned, the anonymous donor will have faded long ago into the background even though she may in fact be very much in the minds of some rearing parents — both those ex-recipients who want to forget and those who would wish to know more (see Chapters 6 and 7, Recipients I to II). Since the preferences stated here represent the views of donors at the time of their donation, a sixteen or eighteenyear-old who applies to the HFEA for confirmation of their kinship status would thus be reading these testimonies of assistance through the filter of a considerable time-lag. There is however another side to consider. Those for whom the protections of donor anonymity — or at least certain aspects of non-identity associated with ‘strong’ anonymisation — may have played an important part in their original decision to donate have no readily available campaign platform upon which to propagate their views. By virtue of their non-identity they are a classic example of a ‘muted’ population. On these grounds too, it is easy or simply convenient to sideline the views of exdonors. All the more important why testimonial work should be recorded as present histories-in-the-making so as to document how, if at all, the views of donors may change over time. As their birth children mature and as avenues for contact open up in respect of possible legal changes, those subscribing formerly to strong or indeterminate versions of anonymity may find their feelings become increasingly ‘weaker’. As Muriel com-

ments: ‘I would not wish to have any parental responsibility for any resulting children, however should the law change so that the child could contact me, I would be happy to meet/talk to them’. A consumer advocate for the Donor Conception Support Group of Australia and the parent of three children conceived using donated sperm, Caroline Lorbach (2003:

77) cites the case of John, an ex-sperm donor: ‘I don’t regret the anonymity, but I do wish there had been a mechanism for becoming a ‘Yes Donor’ at a later date’. Will it be the case that a significant number of ex-gamete donors would wish similarly to seek de-anonymisation? When raising this question it could be misleading to deduce women’s kinship emotions and interests from those of male donors. Let me expand on this

point by pointing to women’s specific interests and the ambiguity surrounding the category of the progenetrix.

Negotiated Maternity and the Ambiguous Progenetrix The woman who is carrying or has carried a child as a result of placing in her of an embryo or of sperm and eggs, and no other woman, is to be treated as the mother of the child. Section 27 (1), Human Fertilisation and Embryology Act 1990

Donors II 103 If donors make it clear that they think of themselves as having no a priori claim over the substance they donate, first by stressing how the eggs are not ‘mine’, nor how the eggs represent ‘my child’, they are caught however within the very moment of their refusal. It is not simply that, as Derrida suggests, the gift may be an impossibility. It is something of a semantic trap even to make mention to the entity of ‘my child’ in the first instance. I would like to try to illuminate one dimension of the problem by pointing to the categorical differentiation between social parent donors and nonsocial parent donors. The former refers to women who are already birth mothers of existing genetic children when they donate. Non-social parent donors, by contrast, are childless at the time of their donation. There is a significant history appended to the formulation.

Prior to developments in ART, the category of mother had been assumed to be interchangeable with the woman who both produced the egg and carried the child. Rupture to that biological continuum became an evident and necessary feature of egg/embryo donation and surrogacy treatments as identified in Helena Ragoné’s (1994) detailed anthropological study of commissioning couple-maternal surrogate relationships.!° Now when The Glover Report published its findings on New Reproductive

Technologies to the European Commission in the late 1980s, it noted it may be advantageous to adopt ‘a more flexible concept of parenthood ...

allowing the possibility of double fatherhood, rather than thinking that either the social or the biological father must be the father’ (Glover 1989: 57)’. Notions of flexible parenting forms and multiple parenting roles were, however, ideas that had not informed the Warnock Committee’s earlier remit. It had recommended that the child conceived through insemination by donor (and by implication the child conceived by egg donation) should be legally treated as the legitimate child of its [social] mother and her husband. This recommendation was enforced subsequently by the Human Fertilisation and Embryology Act (1990: 15), which defines ‘mother’ exclusively

as the woman who is, or who has been the carrying mother. With this ruling gestation and parturition receive for the first time a privileged status in law over biogenetic substance. The biogenetic component of motherhood, valued hereby as less ‘nature-proot’, less material and less able to compete for the status of ‘real’ kinship proponent, ostensibly takes second place to the irrefutably visible act of gestational ‘carrying’. She who can be seen to expect the birth of the child, who nurtures the anticipated relation in vivo, becomes nameable as definitive ‘mother’. But what is gained and what is lost for the concept of maternity with this particular shift from female seed to soil? The term ‘genetrix’ is generally and with good reason unfamiliar to clin-

icians and other health professionals working in the field of reproductive medicine. I import it deliberately into the debate from its traditional locus within a specific anthropological literature on kinship relations, and suggest that it can be pressed into service as useful shorthand descriptive. When British anthropologist John Barnes (1973) suggested that the category of physical fatherhood be broken down analytically to discriminate between

104 Nameless Relations different notions of the ‘physical’, he drew important attention to the distinctions between the genetic father, the genitor and pater. The point Barnes highlights is that that each of these male identities might be assumed by dilferent men as ‘fathers’. The ‘genetic father’ could be defined as the man who

contributes male physiological substance; the ‘genitor’ as the man who is widely believed and thus culturally recognised by others as male progenitor; and ‘pater’ as the social father generally held responsible for the practicalities of childrearing. The ‘genetrix’, by logical association, is the woman who is culturally recognised in society as the person contributing female genetic substance. By shifting emphasis away from the primacy of so-called ‘genetic kinship’, Barnes showed how the Western assumption of a unique and necessarily male genitor (the monogenetic premise of ‘one child, one genitor’) could not be invoked straightiorwardly as ‘natural’ fact (Barnes 1961: 298). But the related question of how the female equivalents of genetic mother, genetrix and mater are to be conceptualised has been largely overlooked in anthropological theory, in large part because there is no ethnographic record

of a society in which the concept of maternity is entirely absent.!' As just mentioned, one of the complications generated by the human reproductive technologies — highlighted particularly though not exclusively in disputes over maternal surrogacy cases of claims to custodianship — is the ‘fact’ that the genetrix may not be interchangeable with the mother who gestates and gives birth to the baby. In thinking about strategies for engendering reproductive identity as forms of so-called ‘collaborative reproduction’ (e.g., Robertson 1994), it may be helpful to revisit earlier anthropological debates about the divisibility of parenthood. It is helpful to see how these can be read as precursors to contemporary concerns and oversights. A specialist in adoption amongst Oceanic societies, Ward Goodenough has suggested that the construct of parenthood can be analysed by making distinctions between its three overlapping forms. These he identifies

as: (1) physical parenthood which is functionally derived from ‘... the human process of procreation’; (2) psychic parenthood which is functionally derived from ‘... the human capacity to form emotional attachments’; and (3) jural parenthood which is functionally derived from ’... the social necessity to order human relations according to a code of rules

in Which social relationships are categorised and differently assumed rights and duties’ (Goodenough 1970: 391). According to this schematic model, parenthood is a complex of rights that can be reallocated through

adoption and fostering ‘transactions’. These jural rights exist, Goode-

nough claims, within a model of human reproduction in which the alleged ‘social’ roles of motherhood and fatherhood are the pre-determined and pre-jural ‘psychic’ attributes of parenthood. What we have here is a model in which jural rights are produced by a biological frame that naturalises these rights as causal relations for the ascription of an essentially sexed parenthood.!? In other words, the rights are determined ‘before’ the jural acquisition of parenthood, which comes ‘after’ the social recognition of biological parenthood. The natural/physical, the psychic and the jural dimensions of parenthood can be seen to overlap with each

Donors IT 105 other in a constellation of temporal injunctions. But the reasoning here is somewhat self-contradictory since the temporal orderings of the analysis have not been made explicit. As a result, the jural element is presented as unequivocally socialised, thereby enabling the concealment of its own production through the pre-social structures of natural and psychic parenthood.!? In sum, Goodenough’s analysis starts to bring together a com-

plex of parenting forms delineated through various interdependencies between the biological, legal and emotion realms. While this may be a helpful initial formula for current-day assisted conception scenarios, the analysis remains deeply flawed. In brief, the analysis remains committed to the prioritisation of jural rights as though claims to parenthood can be embedded ultimately and unconditionally within a biologically informed account of naturally derived kinship roles. Writing a few years later Esther Goody’s theoretical analysis of parenthood (Parenthood and Social Reproduction, 1982) seemed to offer a decisive

move away from this focus on jural status and jural rights. Her model, developed in the context of West African studies on child fostering, set out to examine the roles and task of parenthood. What Is it that parents actu-

ally do? Goody had asked. Her answer was that parenthood is divisible into several different and interrelating roles, each of which is concerned with a particular prerequisite for social replacement. These allegedly universally applicable roles are identified by her as: (1) conceiving and bearing children (2) endowing children with ‘birth-status’ identity (3) the nurturance of children (4) the training of children, and (5) the sponsorship of children to adulthood. Performed by different people this divisibility of parenthood into different roles challenges earlier Malinowskian and Parsonian monolithism. However, it does not liberate itself from the functionalism that for so long had inspired those very claims. (Goody’s functionalism is undeniable in the light of her claim that parenthood is about social replacement through human reproduction.) In this account one’s identity is a pre-ascribed narrative that simply reflects a pre-existing kinship system. When Goody then introduces the notion of performancelinked rights (defined as roles (3) to (5)), the social function is still bound up with a biological underlay that has not been made explicit on account of the way it has been naturalised as a normatively desired ‘natural’ fact. Identity is conceptualised as pertinent to transfer precisely as a type of claim or entitlement (as with social property and Goodenough’s delega-

tion of rights). This means that the ‘transfer of identity’ can only be effected through a change of jural identity, by adoption for instance, and

hence Goody, much like Goodenough, is not concerned here with the genesis of the socially ascribed meaning of rights and duties. Despite the obvious limitations of the author’s functionalism, the analysis does however envisage the theoretically enriching possibility of ‘mapping the distribution of parental roles’ (Goody 1982: 18). Now the potential for divisibility of parental roles is something that finds a clear expression in the novel possibilities opened up by many of the assisted reproductive technologies. Divisibility coheres around the fact

106 Nameless Relations of: (1) the separation of human reproduction from the act of sexual intercourse; and (2) the plural processes and temporally discrepant phases of reproduction undertaken by different people with differing psychological

and bodily contributions. In one of the earliest social commentaries charting these changes, Robert Snowden and colleagues (Snowden et al., 1983) proposed the following categorisation of multiple parental roles for assisted conception parenting:

1. genetic mother — the woman who produces the egg. The authors reject the term ‘biological mother’ for its imprecision to distinguish clearly between the potentially divisible roles during pregnancy.

2. carrying mother — the woman in whose uterus the embryo is implanted. Again the authors dispense with the term ‘pregnant mother’ on the grounds that it offers an imprecise description of a current condition. To call a ‘carrying mother’ a ‘pregnant mother’ when the ‘carrying’ occurred some time previously creates terminological confusion.

3. nurturing mother — refers to the role of the woman raising the child.

4. complete mother — refers to cases where roles (1) to (3) are undertaken by the same woman. The authors stress that the term ‘complete’ is not intended to convey the quality of mothering, only the concurrent fulfilment of all three roles. 5. genetic-carrying mother — refers to the woman who does not keep the child after birth, for instance surrogate mothering or unwanted conceptions given up for adoption.

6. genetic-nurturing mother — refers to the mother who does not ‘carry’ the foetus herself, whether for medical reasons or as a matter of personal decision.

7. carrying-nurturing mother — refers to the woman who receives an egg/embryo; the female equivalent of donor insemination.

8. genetic father — the man who provides the sperm. 9. nurturing father — refers to the role of the man who cares for the child but is not genetically related to it.

10. complete father — the man combining genetic and nurturing roles. Same qualifications as for point 4 above. Which biological links count as parenthood? This is the question to which these categorisations address themselves. Translated into the questions: Who is the mother? Who is the father? Snowden and colleagues correctly

Donors IT 107 note that this is a ‘natural question to ask but it is one for which there is

no answer at the present time’ (1983: 34). Although the intention to recognise multiple parental roles is undeniably helpful, one of the problems with this terminology is the way these roles have been filtered principally through the biological grid of bodily processes and bodily parts. The categorisations, as such, do not move away from the biological ontology that ultimately they would be intended to displace. Further, whilst recog-

nising that the opportunities afforded by the new technologies create newly divisible roles and relationships between different sets of parents, the authors persist in regarding the family as the functional reproductive unit of society for the perpetuation of social life. A related point must be that these categorisations do not take central account of the forms of facelessness endemic to donor anonymity. The key figures they delineate are all recognisable because they are all ‘traceable’. With these observations in mind, let me return to the specifics of ova donation and the emergence of the ambiguous progenetrix.

Although the majority of ova donors I met were married mothers under the age of thirty-five years, clinic staff were well aware that the shortage of eggs and egg donors could give way to eligibility exceptions in the system of clinical accountability. In the clinics where I did fieldwork those women who offered evidence of a ‘proven fertility’ came to be supplemented on certain occasions by women who were childless at the time

of their intended donation. Now a term other than ‘childless donor’ is necessary since in certain cases this may be a technical inaccuracy: a donor’s status as non-genetic parent cannot be presumed precisely on account of one’s submission to the requirements of the anonymous donation system. The institutionalised donation system withholds the conferral of specific kinship reinventions. This too makes a relation of a kind.

Donors may or may not become a genetic parent through the act of donation, and their status as such may or may not be validated as knowl-

edge that has been made explicit. Non-social parent donors may be defined as women who are childless at the time of donation who: (1) may become a genetic [non-social] parent through the act of donation and (2)

remain unsure as to whether or not this change in their status may be attributable to them. This sub-group of donors may be categorised formally as ‘non-social parent donors by progenetrix (status invalidated)’. If the recipient became pregnant and gave birth to a donor-conceived child,

condition (1) is fulfilled. If the recipient donated anonymously and remains uncertain of the outcome of her donation, condition (2) is fulfilled. Either way, kinship is mediated through anonymity. By contrast, those childless donors who give their eggs to help a friend or relative and for whom the donor’s intervention effects a change in the recipient’s status as parent will gain knowledge: they will know whether the act of their donation simultaneously transforms others into genetic mothers. Alternatively, if changes in the law shift practices of anonymisation from a strong to a weak modelling of relatedness it is possible that newly available knowledge — through the release of ‘donor-identifying

108 Nameless Relations information — will effect the same knowledge outcome. Either way, this sub-group of donors may be categorised as ‘non-social parent donors by progenetrix (status validated)’.'4 Now the significant point, as we saw above, is that the majority of donors want to be able to shift their status

from one of non-validation to validation. As has been argued in the preceding passages, it is not the case that women necessarily wish to establish concrete relationships with the recipients or with the children born from the donations. They simply want to know if a particular out-

come has been achieved as a joint (re)production on account of their efforts — whether ‘a tower block has taken shape from their scaffolding’,

to borrow Holly's idiom. All of these doubts, uncertainties, aspirations and feelings of ambivalence cannot be contained in the categorical descriptor ‘genetic mother’ (Snowden, Mitchell and Snowden 1983) or ‘genetrix’ (Barnes 1973; Scheffler 1991). We must appreciate too that these different categorisations of nonsocial parent and social parent donors are applicable at the time of a woman's

donation. One’s adherence to these categorisations may shift over time, just like the biographical career switches that make the gift and commodity intermingle as irreducible value paradox (Chapter 3). It may be the case that a donor subsequently will have genetic children ‘of her own’ in her capacity as birth mother. A post-donation career switch from nonsocial parent (by progenetrix) to social parent (by progenetrix) not only changes the mother’s immediate maternal identity and parenting status, it has potentially long-term kinship implications for the genetically-related offspring of both sets of (donor and recipient) parents (see Chapters 5, and 7 to 10). Alternatively, a donor may remain a non-social parent for life, either voluntarily or due to various constraining circumstances. For all these reasons we need to see how the different forms of anonymity (its strong, weak and indeterminate manifestations) relate to different kinship aspirations and challenge conventional notions of the ‘genetrix’. Ethnographically informed analyses of the negotiability of parenthood may help dismantle the link between biology and kinship’s ‘inescapable moral claims and obligations’ (Fortes 1969: 242). If the negotiability of parenthood becomes the enactment of flexible forms of child rearing and care ‘delegation’, then flexible parenting forms — premised on the distribution of multiple roles and configurations — help us to rethink the way we conceptualise relationships as entitlements, as forms of ownership and rubrics of possession. This means redefining what a child/parent ‘of one’s own’ means as well as the way we perceive persons as temporally mediated and ordered relations built around expectations of permanency. As illustrated with the categories of social parent and non-social parent donors, it will not do simply to equate the (pro)genetrix as the woman who is recognised in society as the provider of female genetic substance. The discursive

shiit from the biogenetic register to the primacy of the gestational that accompanies the divisibility of maternity empties the term of its cultural meaning but floods it simultaneously with excess ambivalence. Women — and men for that matter — can take this indeterminacy and use it as the

Donors II 109 ‘raw material’ for a radical, wholly inventive form of reproducibility: there may be many hidden and unexpected surprises behind the facelessness of anonymous mediation, a point I will amplify in the next chapter.

Notes 1. ‘Cautious welcome for move to give donor-conceived children more information’ (28 January 2003). Available at: . 2. ‘Anonymity Statement by the DC Network’ (20 December 2001). Available at: . 3. See House of Lords (2001: 5: 11). 4. I should stress that this question was intended to ask specifically about donors’ interest in establishing relations. It should not be confused with the separate though related question about knowledge of donation outcomes, as considered in the following section. 5. The HFEA has imported the terms already. See Human Fertilisation and Embryology Authority (2002c: 18). 6. It remains to be seen whether the suggestion that more men (sperm donors) than women may be willing to have their identities revealed to children holds true in the long term. See HFEA (2002b: 8). 7. With regard to the HFEA’s Information Register, the likelihood of nonmatches increases in direct proportion to the consistency of information collected from each of the licensed clinics. Moving to pre-empt further informational loss, the HFEA is engaged currently in an ‘historical audit of information’ relating to all live births since August 1991. The objective is to ensure the Register will be able to act as an authoritative mediator in future requests for informational ‘link-up’. See HFEA (2002a: 12). 8. Assisted conception units operate along slightly different procedural rules; in some cases donors do manage to extricate, or are volunteered, nonidentifying information about the donation. See further Chapter 6, Recipients I,

9. Views confirmed by some clinic based and psychological studies. See Power et al. 1990 and Schover et al. 1991. 10. Cf. Fox 1993. With the new possibility to separate the roles of genetic

- mother and carrying mother came recognition from a number of anthropologists of an unprecedented technological feat in human history. See Riviere (1985). 11. See Scheffler (1991: 372). 12. Note Goodenough borrows heavily from sociobiological theory mixing in Malinowskian and Parsonian-based claims concerning the monolithic structures of the familial unit. As ‘psychic’ forms of parenthood, motherhood and fatherhood are presented as though they were ‘natural’ facts of anatomical sexual difference whose ‘role’ relational properties are made manitest by functional sex roles. It is thought to be children’s necessarily more direct relationship with women which makes motherhood the more basic of the primary parental roles, he argues. 13. On the one hand ‘the definition of jural motherhood is dependent on

natural motherhood’ and on the other, ‘by jural motherhood ... we are not talking about a biological connection or a psychic bond but about a social

110 Nameless Relations role that is culturally delimited and publicly sanctioned’ (Goodenough 1970: 393-94). 14. For sperm donation, the terminology would be modified by gender accordingly: non-social parent by progenitor (status validated) and nonsocial parent by progenitor (status invalidated).

CHAPTER 5

Donors I]

Donating Agency, Extension and Intersubjective Spacetime [. heightened Chapter 3 self-esteem, (Donors I) we followed a connection donors’ subjects’ imagined conferral between of celebrity status and the receding movements of the free gift. Fame, however, can be brought to people in many different ways. In her ethnography of interisland hospitality and food transmission for the Gawan peoples of Papua

New Guinea, Nancy Munn argues that food substance represents the processual value of spatiotemporal transformations because of the way it can be converted into symbolic prestige. Food and its consumption can be converted into fame as an extrabodily component of the self because it extends beyond the immediate person of the donor. It is additionally the means by which the Gawan island projects itself within the wider world of the Massim inter-island community, thereby creating itself as ‘the agent of its own value creation’ (Munn 1992: 20). It is through this medium that the island and its inhabitants act out the implicit belief that they produce kinds of externalisations of themselves beyond themselves.! Munn’s theoretical ethnography may be helpful for our purposes on several accounts. First, it illustrates how the symbolic dimensions of value con-

firm particular social images of the inter-island partners and their relations | as food transactors. Although the symbolic media are different in each of the regional contexts under consideration — food substance and bodily reproductive substance respectively — certain illuminating parallels are evident. Second, Munn’s analysis fruitfully explores how persons as agents cir-

culate spatially and over time as embodied kinds of value. To the Gawan way of life, fame is effected as a series of subjective transformations of inter-

subjective relations. These transformations are developed conceptually in terms of the notion of ‘intersubjective spacetime’. Broadly summarised, this

112 Nameless Relations etic construct serves as a theoretical handle with which to describe local conceptions about the imagined nature of projecting the self beyond the self. This chapter takes as its starting point the ways in which donors’ narratives about gifts, bodies and body parts are articulated through the idiom of collectivised spatio-temporal linkages. We explore how body parts converted into extracorporeal value are imagined as ‘relations’ that keep living on through multiple others over time and through space. What is ‘intersubjective spacetime’? In Munn’s terminology, the notion of spacetime functions analytically as a ‘value parameter’ that enables different potencies or different levels of value to be established. The scaling whereby these differences are relativised takes place according to certain

‘capacities’ of extension, which are synonymous with spacetime itself (Munn 1992: 8). By this Munn implies that the construct of spacetime is not only deployed with reference to practices of expansion and extension, but that ‘spacetime’ is a cultural medium whereby the general value of an action may be evinced as an instance of a ‘level’ of (spacetime) potency. Value is something that can be made apparent because of the ways that ‘extension’ infers an intersubjective capacity to develop spatiotemporal relations beyond the self. This capacity, in turn, is manifest as ‘a multidimensional, symbolic order and process — a spacetime of self-other relations constituted in terms of and by means of specific types of practice’ (Munn 1992: 10). Across separate though-interlinked islands, value can be measured as the greater or lesser extensions of spacetime that Gawan agents effect through their actions, and ‘intersubjective spacetime’ therefore makes value evident, or socially recognisable, because it refers to the personal embodiments of these extensive capacities. It is these intersubjective extensions of the self that Munn then goes on to describe as ‘spatiotemporal transformations’ .* In the following sections, I suggest the notion of ‘intersubjective spacetime’ is a fruitful conceptual base from which to consider the creation of value as symbolic vistas of circulation.* Reproductive gifts transferred by anonymised donors create symbolic value in part because gifts are imbricated in remembered or anticipated events, which set up relations of transilience. As a way of acting upon the world, transilience radiates as diffuse practice. In the context of anonymous donation, transilience belongs as

much to what is passed outwards from the direction of donors as to the form of non-reciprocity itself. In Donors IJ (Chapter 3) we saw that the return some donors would wish to exact from their anonymised gift, namely knowledge of the conceptive outcome of one’s past donation, comes from no site-specific source. The form of the return comes from no one as such. It is dependent on the coming together of multiple interests and claims from various sources at different points in time including such processes as information collection, information provision, information retrieval, information release and knowledge acquisition. Now given that the metaphor of transilience is itself polysemic and crosses a range of fields as ‘strategies of elicitation’ (Weiner 2001: 131), it is important to isolate the specific activation of transilience in any given context.* This chapter

Donors ITI 113 starts to look at the activation of transilience as an extensional field of relations, something we encounter again in subsequent chapters from the perspective of recipients and donor-conceived children. It is important to understand that whilst these formulations are not representative of any particular official discourse on human reproduction, this is not simply an abstract exercise without pragmatic inclination. There is a related ‘applied’ question: how might the conceptualisation of anonymous sociality as the

intersubjective spacetime of transilience and transilient relations inform current policy debates about the ethics of donor information management (see Part III)?

Reproducibility and Relations of Non-relations Odelle: Genes by Proxy

A single woman in her mid-thirties, Odelle works as a hospital-based senior registrar and describes herself as somebody without immediate prospects of marriage and children. Her ‘biological clock is just ticking away’, she says and while she does not want to ‘just go out and get pregnant’ she remains troubled by the idea of ‘never being able to pass on my genes’. An only child reared by parents who valued a sense of family continuity through the generations, she wonders whether her attempt at ova donation is ‘a selfish way of passing on a bit of me onto future generations and also to help someone else as well. Although I must admit the selfish motive was more important than the desire to help’. Her reasoning however seems more complex than a condensed version of classic sociobiological explanations. Instead Odelle deploys what is now a popularised understanding of a scientistic discourse (‘selfish genes’) so as to draw out

a conception of genes and genetics that is not principally biologically informed. Further, since donating her ova involves bringing to mind, or in

some sense anticipating the figure of another woman as a person relationally ‘connected’ to her, these are not simply ‘selfish’ intentions. Odelle

is able to talk openly about the nature of these donor-recipient relations because she herself acknowledges that the status of these ties constitutes an imaginary kind of relationship. Sometimes she makes this explicit by

mentioning the relation to her recipient is one based on a ‘fictitious friendship’, or that the recipient can be figured as a ‘somebody’ who ‘somewhere’ will receive the help she has given. Part of the ‘fiction’ that makes them into ‘friends’, she says, is the action of exchanging between

them not simply body parts but actions that locate them as different agents. This is what Odelle imagines can be extended apart from her in time and space as their shared ‘characteristics’. Yet what these shared characteristics encompass is the ‘method’, as Gill put it earlier (Chapter 3, Donors I), of the one person (donor or the recipient) being creatively trans-

formed ‘through’ the other. She uses the term ‘win-win situation’ with which to describe how both of them become ‘like’ each other, both deriv-

114 Nameless Relations ing benefit from the other, in terms of what the other ‘somebody’ does for the other. Here the ‘gift’ slips into a virtual contract, a mutually interested ‘bond’ involving a non-specific relatedness without concrete ties or obligations. But this putative likeness is only founded by virtue of an imagined difference between donor and recipient. Whoever has received her ova is

probably a far ‘better’ person, Odelle remarks, since unlike herself the donor has managed to create a stable network of relations and friends within which to assume her parenting responsibilities. (Such a view happens to be quite unrepresentative of the ideal conceptions recipients generally entertain of donors as uniformally wonderful, amazing, brilliant women. See Chapter 6, Recipients I.)

Odelle and her recipient create connections-at-a-distance between themselves because these ‘live on’, the one through the other. The reciplent Odelle helps will, she hopes, have a child, and Odelle will live on through the transformations she effects, namely as a ‘somebody’ who can imagine herself as keeping vital her sense of place as the continuing ‘part’

of her birth family’s genealogy. This sense of place, of being a part, becomes enacted as the extensions of her person when she makes ‘new’ gifts; however these extensions do not originate from the fixed point ofa body that is understood to be implicated in the prior ownership of its [body] parts. Because Odelle’s donated substance is not conceived by her as a physiological part of her body, she is not in any sense having her ‘own child’. She is acting instead ‘through’ another person to extend and con-

tinue herself in another form; something she occasionally describes as having a ‘child by proxy’. Any resulting child from the donation would not be ‘hers’, and she would be quite happy for the recipient never to tell the child of his or her genetic origins, she says (cf. Chapter 4, Donors II). Echoing the views of many other donors, Odelle considers it is the woman receiving the ova who ‘plays the major role in the creation of a new life and without her the life would not be possible. She grows the baby and goes through pregnancy and labour, and it is her body which has achieved

this’. The reconfigurement of reproductive substance from a biological part of her body into the transformed and shared capabilities of others, is not a transposition that is worked through as the possessive ownership of her genes ‘in’ one’s person. Rather, she extends herself in social space, much like the Gawan islanders depicted by Munn, as the embodiment of altered time. This form of the intercorporealised transfer of anonymised body parts is, in a sense, the material and symbolic paradox of ‘no-bodies’. Commenting on how the ‘child by proxy’ is her estranged genetic child, her language switches to the significance of imagined connections. ‘I’m not thinking the reality of what the child will be like, more the image of fantasy’, she says. Later in our conversation she looks at herself from the perspective of an older woman, commenting from a future anticipated time as to just what kind of ‘parent’ she imagines herself to have been. Sketching out these imagined relations as prospective retentions of the past, she indicates that an anonymised relation of transilience to the child effects a ‘bond’ whose emotional resonance will probably shift according

Donors III 115 to her own life-course, specifically her own recognised effectuation as ‘mother’. Whether or not she becomes birth mother to a child she will go on to raise herself, transilience will have been effected through the donor child’s attributes as a living being, a real person. When I’m an eighty-year-old spinster sitting alone by the fire I shall feel comforted by the hope that whatever else I have or haven’t achieved in life it may not have been wasted. I won’t mind never having seen children or grandchildren because I will know they are out there somewhere, and because they will be in my imagination I will be happy as I shall make them successful, rich, handsome, pretty and be spared the reality!

It would be an over-simplistic reading to see Odelle’s articulations as simply a ‘female’ version of monogenetic theory according to which men, as active inseminators, may sow their seed with abandon in different fields (Delaney 1991). The body parts that Odelle donates are parts of herself that she transforms as renewed time since her genes are former ‘personal’ relations. By making her body parts into gifts of life for others, she manages to make relations with others in a significant way, passing herself on as an active form of present absence so as to Keep alive times from the past.

The ‘relation’ she makes is not only prospectively oriented to her unknown genetic child, but to previous generations that she has never seen nor known directly. Through her gifts she transforms herself into a medium whereby the past and the future, as the actions of others, continue to pass through her. This is neither ‘selfish’ in the sociobiological sense nor an ego-psychological rendition of object-relations theory accord-

ing to Western psychoanalysis; nor indeed it is suggestive of the unproductive retentions of the ‘greedy’ person who has consumed excessively.’ Policy Link

Is Odelle going to remain a non-social parent without birth children of her own? Or will her identity shift from childless progenetrix of dubious effi-

cacy to birth mother and validated social parent? (See Chapter 4.) In either case, she will keep the donor child ‘in mind’ reconfiguring its meaning to her over time. Such projective imagining and re-imagining is the continuous work of transilience. What is so striking about Odelle’s account is the underside of her story — the untold narrative whose storyline cannot be ‘finished off’. To Odelle it does not particularly matter that no known relation is established with any genetic offspring resulting from her donation. Non-knowledge can be compensated for by the continuous work of transilience that keeps ties alive as imagined relations. Odelle might be spared the reality of direct parenting, but she will ‘know’ future generations of children as happy and accomplished persons since their capabilities flow as extensions of her person: in effect she situates herself as a continuing part of their life trajectory. In irrelational kinship, the ‘invisible’ child can be ‘kept’ simultaneously near and far. For those who would like to pull the strings of attachment nearer and hence make anonymity that much ‘weaker’, the aesthetic is

116 Nameless Relations one of activating information through its release, of ‘unconcealing’ knowledge ordinarily kept hidden. For Odelle there is a practical conse-

quence to such activations. This concerns her status as ‘progenetrix’ (Chapter 4, Donors IT). If only she knew more information about the out-

come of her donation, it would be possible to include any donor-conceived child in her will. A release of information would keep the channels of social circulation open beyond death through others’ activation of relational non-linkage.

Should Odelle go on to have birth children, there are in addition the kinship implications for the two sets of genetically related half-siblings. Non-knowledge is an extensive ramifying field of its own that can cross the generations since there is every possibility these children may also never know about or meet each other. The eventuality of the ‘connection’ is in part dependent on what each set of birth parents decide to tell children about their conceptive origins. As discussed in the previous chapter,

these decisions are also dependent on whether an ex-donor has had her progenetrix status validated in terms of an informational ‘return’. Knowledge that is not known cannot be passed on as the potential ‘substance’ with which to activate a reconnection many years later. It is like the heart of the pearlshell that never dies because it never hatches (Weiner 1988). Penny: Relations as Ripple Effects

Penny has donated twice and plans to donate at least one further time. Her account of what is involved in ‘the process of achieving something for

somebody else through my ability to produce’ is not typical of all nonsocial parent donors (by progenetrix) without birth children.® The fact of her childlessness at the time of her donation is a significant factor in her decision to donate; moreover it is one that has completely passed by the eligibility vetting procedures of the assisted conception unit where Penny donated.’ That noted, the following exposition is not intended as a moral commentary about the rights and wrongs of donor selection criteria. As a single woman aged thirty-four with considerable financial debts,

Penny wonders whether she will ever be in a position to start a family. She has approached the donation venture as a ‘project’, she says, because it is part of ‘my life-plan to have a child’. The donation, she explains, is a ‘joint achievement’ in which she gives ‘my physical abilities for the ‘financial abilities’ of others. As ‘special’ capacities these ‘abilities’ are activated as symbolic media between persons rather than as a formal contractarian

arrangement of one transacting person with another transactor. ‘What I’ve given is something that cannot be bought or manufactured’ (cf. Imogen, Cathy and Meena in Chapter 3, Donors I). She further makes this clear when she classifies eggs as belonging to a different categorical order of bio-substance to that of blood, tissue or other organs. ‘To me, donating eggs is a far more restricted donation than donating blood because of the limited productivity of a woman, so it’s far more a part of you, it’s closer to me’. Since her reproductive gift is part of her ‘limited productivity’ as a woman of déclining fertility, it is ‘restricted’ and given as a personal part

Donors III 117 of her. As such it is emblematic of value that is already invested in a temporally charged social relation. ... and age being somewhat against me, I decided it would be a comfort to know that perhaps someone else could ... [having] the comfort of knowing there’s a chance I may have a child through someone else who can give that child so much more than I could and who will cherish that child so much more due to the circumstances of his or her birth. If I ever do have a child of my own ... I don’t know, but ... the knowledge of the joy perhaps given to another woman which then has a ripple effect, touching other members of that family and their friends. That’s just great.

When I ask her to describe the physical aspects of donation, her reply largely echoes Odelle’s concerns. She too has acted to undertake an entrepreneurial ‘re-engineering’ of the female biological clock. Everything I did was basically in preparation for having a child at some non-too-distant future date. By convincing myself that someone has had a successful pregnancy through my donation, I feel less pressurised that ‘baby-making’ time is slipping me by and like to think that someone else may have a child and be able to give him/her the kind of life I could not.

Donation becomes a form of pseudo-procreation, a way of achieving maternity should her own attempt at conception fail in the future. In Penny’s case the physical demands of ovulation preparation and egg retrieval appear to be compensated for by the ‘return’ donation sets up. The return is both symbolic and material: it consists in the substitutive knowledge a biological safety net has been set in place. But the ‘return’ that is the gift in its temporally delayed form is discernible in other ways. The ‘ripple effects’ Penny puts into action make connections, metaphorically touching others and yielding new waves of reconstituted relations. Though her biological productivity is finite, she nevertheless transforms herself into her own ‘bio-engineer’ whose productive agency circulates

‘through’ others as the spatio-temporal effects of transilience. In this instancing of the person as extensional, we can see once again that repro-

ductive substance is being shared, but the kinds of imagined relations Penny enacts are not reckoned by her as the fixing of genetic ties of ‘blood’ (relatedness). Penny is an example of a donor who makes effective action from out of

the uncertain knowledge set up by the conditions of anonymity. If she is not successful in her own procreative ‘life-plan’ and will not raise her birth child as social parent, then at least the knowledge of her past donation as progenetrix — as the fact of a possible conception(s) — is an outcome

whose uncertainty gives something back. It is, she says, ‘just the knowledge, the thought that perhaps somebody else has had a child from my eggs, not that it is my child’, that matters. What other women refer to as the disappointment of not being informed of the outcome of donation has become embodied for Penny as the knowledge of relations that can never finally be circumscribed, settled or fixed. In other words, Penny falls into

118 Nameless Relations the category of donor endorsing ‘indeterminate anonymity’. Extensional space-time is thus created from a sphere of action in which social relations are not entirely compressible into a rigid format of predetermined knowledge or value. Penny thus deflects the time of the objectification of being

named, transforming the potential of not knowing into a conceptually fresh space. She is additionally efficacious as social agent because she keeps prospects open. Policy Link

Penny had not previously disclosed these ruminations to family or friends,

let alone to donation counsellors, and so the fieldworker is somewhat privileged to have been party to this testimony. But will others who feel they deserve to know such facts also get to hear them? How well can knowledge travel back? If Penny does raise a birth child in years to come, will the fact of her past donation be knowledge that is shared with her child and the child’s genetic father? How will it be disclosed? If ever released, will such information generate unforeseen dilemmas and ‘run-away’ with itself? We do not yet

know how children will react to the news their mother once gave away her eggs to help someone else have a child before they themselves had been conceived and born. The knowledge is instantly ‘relational’ since it exposes the existence ‘somewhere’ of a genetic half-sibling. It is relational, and specifically transilient in nature, because it sets up irrelational kinship.

And from the other perspective, that of recipient families, how will donor-conceived children assimilate such testimonies? The question is hypothetical since this is not a class of information the HFEA has kept on its central register. In theory at least, a donor-conceived child could have as his or her conceptive origins story the following account. ‘My genetic mother gave away her eggs to my (social) mother because she wasn’t in a relationship with a man and couldn’t have a child herself but she wanted

the possibility that she may have had a child, rather than doing nothing and have no offspring at all’. If testimonies of assistance were documented systematically as information-rich sources, say by a third party holder of

a non-mandatory Contact Register, and if donor-conceived children accessed the motivations of their genetic mother or father, it is conceivable

many such children would want to make contact with the genetic donor. It is probable many would feel they would like to be in a position to give ‘back’ the missing knowledge withheld from donors at the time of the donation: the validation of their status as progenetrix/progenitor would become the return gift as discussed in Chapter 4. Such disclosure dilemmas, as local decisions activated over time and often across the generations, constitutes the cornerstone of a ‘genealogical ethics’ (see Konrad 2003b, Konrad 2005). Rita: Donating Adoption

Rita, mother of two young pre-school children, is another donor who makes one set of uncertain knowledge relations into the form of still more

Donors III 119 uncertain knowledge. Like the kind of extended ‘genealogy’ that Odelle enacts, the ‘gift of life’ Rita creates may be seen as the continuation of pre-

vious relations in altered form. Persons are extended as new relations because they are re-conceived as the continuation of ‘old’, and significantly still unfinished relations. In this particular case, Rita’s history as an adopted child plays a significant part in the unravelling of her donation account. Rita found out around the age of seven that she had been adopted as a baby. Never having met her birth mother she has often wondered about her and makes a particular point of mentioning how hard it would have

been for a young unmarried woman to have kept a child born out of wedlock — this being Rita’s understanding of her birth mother’s predica-

ment based on information supplied from her adoptive parents. Some ambivalence runs through her account when she calls to mind the significance of her biological mother as an unknown and untraced relative. ‘J just feel every now and again I would really like to see her. It’s not a burning desire to come face to face with her. I’d like to. It doesn’t matter. But I'd like to. It’s a lot of hard work trying to trace her’. In Rita’s account, the themes of knowledge, unknown relations and anonymity converge as the transilient supports of different untraceable persons. By donating her ova, Rita is able to construct new imaginary relations with her birth mother, getting to know her better through a corporeal transformation of the vital life her mother once ‘gave’ to her. These connections seem to work symbolically at various overlapping levels. On the one hand, she repeats her birth mother’s decision of many years ago when she chooses to give over to another woman a part she reproduces of herself. Though mother and daughter do not give ‘like’ things of themselves in the sense of identical body parts, they do enact similar kinds of relations as reproductive agents. Both have extended themselves from out of the procreative power of their bodies, and it is this that creates between them the interaction of a common substance. ‘Through’ a recipient who is an untraceable ‘stranger’, and therefore stands in as the embodiment of her unknown mother, Rita enacts new relations with her birth mother, transforming the previously untraceable connections of the time of her own gestation and birth into new kinds of extensional continuities. ... lt must be so hard to give a child up and not know where I was going ...

I don’t know how much information she was given as to what the family was like that I was going to. I’m sure she was given some, but that’s like with the egg donating. Iam doing the same sort of thing as my birth mother was doing and I am quite happy in one respect that the child, if there was one, would be alright. My mother gave me up for what she hoped was a bet-

ter life and I’m giving a couple my eggs to give them a better life, in the respect they’ll have children in it. I’ve given my eggs to somebody so hopefully their lives will be better ...

Already a mother with birth children, Rita now enacts a different reproducibility of self by embodying part of her past through the birth she has

120 Nameless Relations hopefully enabled for another stranger, also unknown. Like Odelle and Penny, relations pass ‘through’ her as she instigates new forms of continuity and change. In this sense, she makes her mother more immediately ‘vital’, bringing her to life as an imagined and more direct physical presence through the act of donation. A closer affinity to mother is established by setting in motion similar kinds of uncertainties to those she imagines her birth mother must once have lived through, namely decisions about making, keeping and giving away new life.

What Rita wants to be able to give ‘back’ to her birth mother in this double-gift structure is some information about herself. ... | would just like to say to her [birth mother] that everything is fine, that I’ve had a really good life and find out whether she had a good life as well. And I just feel closer to her now because I know what it would feel like to give children up — not that I have given a child up. But I feel closer to her

even though J don’t know her. I know her name and that’s about it. But I feel closer to her because J have children and I know what she must have gone through to think ... that I’ve got to have a better life without her ... she couldn’t give me the future that she obviously wanted to ...

This is one kind of activation of the transilient relation as (re) connection. A search strategy to trace her birth mother has proved futile: it has led to insufficient activation of the desired relation. Effecting a transformation of herself as ova donor, what has not been traceable before now starts to take form as something that can be known, but only by being non-identifiable —an emergent irrelational kinship, in other words. As with Penny, gaps in

certainty are experienced for the fresh openings they create since Rita, like her birth mother, will never find out — at least within an irreversible donation system premised on ‘strong’ anonymity — what has happened to the part of herself she has given to somebody else. Policy Link

Once again, these kinds of biographical details are not the sort of information kept on the HFEA register. In terms of the present system of information provision and disclosure, donor children could not hope to find out such details about their genetic parent. As for her ‘own’ birth children, Rita was undecided whether she would tell them about the donation. She indicates it is unlikely, ‘it’s not that important’, but she will play it by ear. Should her birth children know this fact about their mother? Why should this matter? To be sure, this form of disclosure could not be premised on the claim to make available medically relevant information — this being one of the justifications for openness in the case of donor-assisted conception (See Chapter 6, Recipients I). In terms of its kinship ramifications, however, the information is a profound knowledge. It invites the question of whether a donor’s own birth children will themselves want to instigate a reconnection with genetically-related half-siblings who may be dispersed across several different and unrelated households (see Chapters 7, Recipients IT and Chapter 9). Where the incentive for kin connection is

Donors ITI 121 instigated by the birth children of the donor there could be several different relations of transilience to traverse as the process of making genetic knowledge explicit through various sibling relations. Meena: Receiving Pardon

Meena, whose renewed respect for her husband was mentioned briefly in Chapter 3, is a Punjabi-born Sikh Indian with three birth children. She explains the associations she makes between donating eggs anonymously and donating money to temples back home in India so that God will hear her wishes and give her pardon. The donations interlink symbolically for her because they are both ways of extending her person through others as her own and others’ collectivised substance. Both types of action involve food and cooking; incorporating and making continuous the work of others as previously particularised kinds of relations. When she found it took her longer than she hoped to conceive with her second child, Meena sent money to relatives in India to get pardon for herself, thereby clearing her name. A sacrifice to ensure her ritual purification was needed so as to rid her of past sins. Only then would she be blessed with the procreative agency to start another life cycle. Her gifts of ova to multiple recipients — the clinic tells her twenty eggs were retrieved and allocated between four recipients — re-enacts the time when she previously gave gifts to God; when she remembers what it was like to want so much to become pregnant again. This pattern of associations is made more explicit when she explains how the money given to temples is converted into food ceremonies where everyone shares the same substance. What she sends to others to help her create new conceptive life gets converted, she says, into the sustenance of many persons. It is shared as parshad (holy food). Moreover, the women and men at the temple will share a part of each other through her when they eat, even though she was not physically there in India, at that time. In this sense she considers herself to have been present as a part of their actions: she facilitated their food and they ate ‘with’ her to help her get pregnant from the food she gave to them. Meena thus activates relations of transilience as the intermeshing of memory, anticipation, projection, and extensional relations of support. As far as her specific role in reproductive donating, she explains her

involvement is limited to the provision of the ingredients for the birth mother’s subsequent cooking of the child. This is something she transposes to the joint activity of having shared substances between herself, the recipient and the recipient’s partner. Her gifts of life to ova recipients thus

re-enact the Indian temple scene in which sharing is the medium for effecting important transformations. The following are some excerpts from parts of our conversation. I am enquiring into what it involves for her to provide the recipient(s) with her ingredients and she is telling me a little about how she believes the child is made. MkK: So you said that the ingredients came from you and from another man. And what happens to the ingredients. Do you make them into a meal?

122 Nameless Relations Meena: I provide the ingredients, he provides the gas cooker, I suppose ...

and the mum cooks it in a little oven ... after nine months ... that’s when you open the oven up and see the end product. And then you enjoy the baby don’t you? It’s the end product.

MK: How do you enjoy the end product? ... Perhaps ... when you have a dish you have made with others you might enjoy it when you eat it with others. How would you say this end product is enjoyed? Meena: This is something you enjoy once for life, for keeps ... it’s for life because when I bake a cake or something like that I’ll probably eat it that same day. I mean you’ve gone to a lot of trouble for that as well — cooking it — but like a baby, that you can watch it grow, enjoy it learning new things.

Meena imagines the division of conception as the joint productions of herself, the recipient and the recipient’s partner. They are each of them acting as agents because they are each of them doing something to get the

meal ready. She provides the substance whereby the social mother can cook the child, and the recipient’s partner sets her transformations in motion by providing the flame of the gas cooker. Their actions represent moments of initiation that the birth mother goes on to transform into the time of her gestational production. As she says later on, the birth mother is not passively cooking the child because she is “a little oven’ — she is not simply some kind of receptacle or container for the foetus’s growth. The birth mother, Meena says, is the primary worker who makes the most sig-

nificant contribution towards putting together the meal. These thoughts come together as her belief that the child is a meal that is only ‘eaten’ in the sense that it is enjoyed for life. It keeps on being eaten, never being finally consumed. What is kept is something that is neither alienable nor inalienable from her person. This is because what is hers ‘for keeps’, as it were, is not something that comes back directly to her as her exclusive ‘return’, but something that is circulating between persons in social space as the previously enacted product of her work. The child, the ‘end product’, emanates as the performative interactions of others’ multiply extending, ongoing intersubjectivity. Within this flow of transilient relations what has to keep circulating as persons’ continually interchangeable parts can never be finally consumed and ‘finished off’. This kind of continuity is like the figurative ‘opening spaces’ that Penny and Rita make from out of their uncertain knowledge regarding the unknown outcomes of their respective donations. I go on to ask her who has done the most work and gone to the most trouble in assembling the meal. Meena: I reckon the mum who cooks it has done a lot because she’s let her husband fertilise an egg from another woman. She’s like given her permission because she might ... the baby is going to fertilise in her tummy, but actually she hasn’t got any part of it ... like a triangle — there’s no part of her in that baby. Only her husband’s and some other woman’s. But she is going to bring that baby up as her own and J think she would give it more love

Donors III 123 than I probably would have because she was so desperate to have it. J think she plays quite a big part in it as well. MK: So whose baby is it? You've said that she would bring it up as if it’s her own but none of the ingredients came from her? Meena: Yes, exactly.

MK: And the ingredients came from you. So whose baby is it?

Meena: Well it would be hers. It would be hers once it’s formed. Because she’s gone to all that trouble, you know, for it to fertilise in her tummy. Mk: And is there a way in which it is yours as well because you have provided the ingredients? Meena: In a way, yes, but I wouldn’t put any claim on it. MK: So then in what sense is it yours?

Meena: I just did the shopping for the ingredients. I provided the main ingredients. MK: Was this a difficult or long shopping trip?

Meena: Yes, it was very. It was quite emotional — especially with all them injections I had ... [had to do a lot of thinking whether it was the right thing to do. And what would I feel about it afterwards? And I was told that I could go back but there was no change in my mind. I was adamant that I wanted to doit...

Meena thinks the child only has a relation to her as ‘her’ child because she went shopping for the ingredients, and because this was a taxing task for her to do involving considerable moral equivocation. There is no claim to

ownership over the child here, nor even a local language with which to begin to articulate idioms of possession. As with Odelle, Penny and Rita, the body parts Meena gives become something other than a biological substance from her body. When she talks about how she does not ‘own’ the child, it becomes clearer how her body parts have become the ‘parts’ that the birth mother is now activating as her own productions. Finally, it is because this meal is never outrightly consumed, but always enjoyed, that it assumes the form of a collectivised non-propertied substance. It becomes the partaking of a common kind of body; one that has no recognisable boundaries, and one that cannot be known as the single body of any particular person.® Many persons will know, enjoy, relate with the child who embodies the form of many others as the extendible parts of their past actions. Because many stages are involved in the conversion of the gift from ova to materialised child, traces of the original donation no longer appear as such. Meena’s shopping has changed form. This disappearance is both the condition of possibility for the emergence of the free

gift and the conceptual and pragmatic link to the moment of paradox

124 Nameless Relations whereby the free gift is coaxed into the semblance of its own shadowy recession. Meena’s observation that the anonymously donated body parts will remain connected to her ‘for keeps’ is the template for this fundamental ambivalence.

Summary Link Like Munn’s account of Gawan inter-island hospitality, this donation ethnography explores local conceptions of agency by asking how symbolic

constructions of value are made and performed as intersubjective extensions of the person. In each of the above-mentioned cases studies we see that donors combine notions of ‘living on’ through unknown others with conceptions of the self as a relational support facilitating and assisting irrelational kin. For donors, transilience takes the form of making ‘scaffolds’ (Betty), or of wanting to help ‘busloads of women’ (Delia). The common dynamic is

the desire to stretch oneself out as relational non-relation; indeed for some, the field of dispersal ideally should be as wide as possible so that one produces multiple eggs for multiple recipients. This is nothing necessarily unique to acts of donation, nor indeed to British social life. A notion ol traversing across persons as transilient kinds of relations is evident from anthropologist Debbora Battaglia’s depiction of working ‘sabsabarl’. For the Sabarl Islanders making up part of the East Calvados Chain to the far south east of mainland Papua New Guinea, the organisation of body parts into constructive relations of support (/abe) and dynamic complementarity (gaba) mirror the physical constitution and potential for the foetus/person to grow. This relates to the importance for the Sabarl of maintaining an ideal internalised balance between bone (/aba) and flesh (gaba) subStances through ‘dry-lean’ (kevekeve) and ‘greasy-sweet’ (posa) food consumption. Activating relations of support and complementarity mean that

male and female substance can be manipulated to obviate distinctions of sex between men and women (Battaglia 1990: 38-41, 46). Accordingly, Sabarl islanders become persons who can be embodied by the generic and incidentally invisible substance of hinona: the partible, extra-bodily life

force that animates a person as the generative future of others (ibid.: 53-54, 71). Alternatively one might see here an analogy between the spreading of oneself as a continuous flow of ‘ripple effects’ (Penny) and the men in Sambia culture that Herdt tells us are able to keep themselves strong ‘by having their sperm safely contained in many boys, who are likened to a sort of magical string of semen depositories for one’s substance, spread throughout society’ (Herdt 1984: 192).’ In the British context, these observations suggest women donors’ cultural mediation relate to an economy of circulation in which parts do not belong to specific named persons, but become apparent as the multiply

detached parts of persons’ extensions/extendible selves. Parts are not owned as person’s past productions, but circulate as ‘other’ time and in

Donors III 125 ‘other’ social space, both as the collective extensions of ‘someone’ and, relatedly, as a type of common substance. This substance is common to a physically absent ‘someone’ since it comes to be shared as parts continually in the process of being re-circulated, with these re-circulations making up, in turn, a body of ‘no bodies’. The final part of this chapter turns to focus more explicitly on one of the most pervasive idioms of this logic of non-proprietorial ownership: the mediumship of ‘someone’.

Dispossession, Effraction and Non-traceability What Goes Round Comes Around

The gift — impossible social gestures symptomatic of the sterility of the cyclic motif! To hope to approximate the gift’s conditions of possibility, one

must interrupt the value of the circle and find its ‘instant of effraction’, claims Derrida (1992: 9). Not so simple, since the field of exchange envisioned by the philosopher is practically ubiquitous in its range. A coagu-

lated circulation is not simply homologous to the entire economy of goods; it spans rather the economy of identity, knowledge, time and consciousness, as well as the whole economy of the unconscious.?° If the gift is that which would escape the measure of discourse and memory, and is therefore unnameable and perhaps even unthinkable — outside of discourse itself — could anonymous sociality, as logos of the un-named and indeed literalisation of the un-nameable, be one way of accessing this space of radical exteriority? The notion of a body of ‘no-bodies’ is formulated most explicitly by those donors who say it does not matter who receives the ‘chances’ — the gifts of life — they make, so long as somebody somewhere benefits from what they do. Some women would make analogies to blood donation so

that when they talk about making procreative fertility into something assisted and shared, many draw upon associations with which they are already familiar in the context of popular discourses of blood transfusion. Jean for instance describes how her six monthly blood donations ‘repay’

somebody for the life they gave [another somebody] many years ago. What she keeps on re-donating is a way of remembering how somebody once helped to keep her younger brother alive. Jean: The main reason that made me give blood from when I was eighteen was the fact that my little brother had a blood transfusion because all his insides were twisted, and if somebody hadn’t donated that blood my brother would not be alive. So once every six months, for about half an hour I suffer a slight little bit of discomfort but I save somebody’s life. Or I help to save

somebody’s life. And in actual fact what I am doing is repaying for all they’ve done for my brother. Because he’s now still alive. And if it hadn’t been for them, he probably wouldn’t be.

126 Nameless Relations MK: Does it matter to you that there are different people to whom you are expressing your gratitude? Jean: No, no... .it’s only once every six months and J won’t ever stop doing it. I have just decided that because somebody gave their blood to save my brother then I would give my blood to help somebody else. Who knows? Maybe over the years I may be. The chances of that are about a hundred million to one, but it could be possible. (Jean, full-time mother of two children, donated once and planning second donation)

Like Fay who spoke of bumping into ‘a’ recipient on the street who might

not be the same person she actually helped (see Chapter 4, Donors II), Betty can bring to mind a non-specific recipient as a person in general. She can picture ‘a’ person, but cannot picture ‘the woman’. ... With my donation, I can’t picture the woman, but I can picture a person, but I can’t picture a test tube or a petri dish. With what I did you can almost

see the end result. You can’t physically see it but just with seeing women who are pregnant ... just seeing anybody and you think: maybe, maybe | helped that person. Not that person, but a person like that ... somebody somewhere ... just a person ...

(Betty, early thirties, mother of two)

If these interchangeable and free-circulating body parts are never finally ascribable to a knowable, traceable person, one way in which donors

delimit the otherwise infinite extendibility of such dispersed flow is through recourse to the value of renewal, regeneration and dispossession. In anticipation of the discussions on re-donation (see Chapter 8, Recipients IIT) and the nexus between transilience and regeneration in chapter (Chapter 10), let us look at how women imagine themselves to be constituted and re-constituted as ‘fresh lease[s] of life’. By drawing parallels between her social identity and domestic life to describe how ‘things’ can keep on being effective through different kinds of action, Delia comments how several aspects of her life —- her household organisation, the kids’ toys, events like car boot sales as well as her own body parts — have no essential value as ‘natural’ property. When I found out that they could use me, that they could use my eggs, I was just really chuffed... . I was maybe a bit of use that I helped ... we believe in recycling. We buy recycled paper, we keep all our newspapers separate and our tin cans — we're very much into that. It’s the same sort of thing with my car boot sales — I’m just recycling my junk. I think it’s a very good idea. They take on a new lease of life, I think. You’ve got things that are of no use to you anymore.

I bought that little rocking horse from a friend and yet it sat in her room collecting dust — it drives me mad now, it’s got a terrible squeak to it, but it’s made a difference to the kids’ lives — that’s given a whole new ... because the kids love it. And yet in my friend’s house it just sat there. I think it’s the

Donors LI 127 same if I were dead, my heart wouldn’t be doing me anything but it could give somebody else so much — a whole life, whereas if I’m lying dormant, it’s

no use to me ... my eggs are just absorbed now — nothing happens to them. You think of all the women that ovulate and nothing comes new, whereas get them out of the womb and they could help people ... (Delia, mother of three in early thirties, serial donor)

What seems both self-evident and counter-intuitive in this narrative is the

way in which Delia’s comparisons are all of the same order: a rocking horse is akin to her own reproductive eggs: it is about doing ‘recycling’. Recycling a part of herself — life just keeps on going: ova donation is about

Delia extending and transforming herself in space and time through a corporeal agency. From whom the egg has come and to whom it is going as it ‘journeys’ ex-vivo are not relevant here: the egg is non-filiative; it is not something of determinate origins.

Fay develops a variant of this recycling discourse with her vivid imagery of ‘continuous circles’ that seem as though they are ‘peopled’ with life. People come afresh ‘onto the horizon’, an intersubjective space-

time, that is continually expanding as these newly enacted relations. What Fay thinks of as her multiply divisible body (the social horizon) is in fact the site of conducting these social relations. You certainly realise that it’s amazing machinery, in the fact that as fast as you remove one bit, another bit appears — particularly with that area. It certainly makes you think very hard about that bit of your body — when you consider what it does. No machinery can do that. Produce something out of nothing. They have to have something to start with. You’re basically one large conveyor belt. As fast as something is chopped off the end, somebody else is coming over onto the top, like an escalator almost. As fast as it drops off one end, as soon as somebody gets off at the bottom, somebody else gets on at the top and it goes like a continuous cycle and until the day when it actually stops ...

It was only really since doing this once and now going through it again that it’s really struck home the fact that this is how it is, and that as fast as you remove it, another one appears, as fast as you cut your nails, they grow. As fast as you cut your hair, it grows. There’s always something there to replace it ... .As fast as one donor gives and receives, there’s usually another donor on the horizon also waiting for somebody to receive. There will always be

people waiting to receive ... the world is made up of people giving and receiving. One company gives and then somebody gives back. And so it goes on ... 1am giving eggs, she’s receiving them. Hopefully she’s going to be giving life to the baby, and in return I’m receiving happiness for the fact that it all works out OK. It’s all a case of giving something really. If somebody gives something, somebody has to take it, and vice versa. She takes an awful lot of risks. ]am giving something to her. She takes risks, I basically take home the knowledge that I’ve done something to help somebody and hopefully she gives life to someone else. So it is always

128 Nameless Relations a continuous circle in that respect, not really a conveyor belt ... it’s always going around ...

(Fay, 23-year-old mother of two, donated twice, plans to donate again)

This excerpt, quoted at considerable length due to the unusual imagery, evokes social relations as the interlinked cycles of gifting and bodily growth. As with Delia’s narrative, Fay’s reference to her interiorly active body and her person as someone involved in ‘the world [as] made up of people giving and receiving’, shows no switch of perspective between what is internal and external since social relations are ‘seen’ for the way that the body is composed of the (past and future-directed) actions of others. Fay’s talk of unstoppable growth ties up with what she sees as the circulatory potential of continually renewable re-circulations: it is as fast as somebody gets off that somebody else gets on; it is as fast as you remove one thing that another thing appears; it is as fast as you cut your nails that

they grow; it is as fast as one donor gives and someone receives that another donor will give and somebody else receive. Social transactions, mediated by and as anonymous sociality, are the flows of ‘a continuous cycle’ in which everything must keep on going. What Goes Round Comes Around (Again)

As discussed in Chapter 2, the presumption within a system of reciprocity

is that every gift always responds or repays some imagined or remembered emotional or material obligation. Philosopher Rodolphe Gasché, whose theoretical critique follows the Derridean displacement of the circle motif, argues there is no such thing however as an opening gift since ‘the donor is always already a donee’ (Gasché 1997: 115). What the donor gives is always already a counter-gift, the first gift representing nothing other than the counter-prestation. In refusing the possibility of any fixed

or originary point of departure to which one could direct a return, such movement of exchange arrests the flow of circulation as linear extension, as conceptualised by traditional anthropological theories of ‘restricted’ and ‘generalised’ exchange. According to Gasché and Derrida, the gift without

origin opens instead onto a multitudinous plane, and in so doing cancels the very figure of the ‘recipient’, the person who receives. Indeed, so ubiquitous is the plane of the gift that there is only a continuous stream of gifting initiated by the nominal ‘donor’. Without any delineated act of reception, the donor’s image can only be reflected back to him or her as the undifferentiated figure of the donee. It is from this stance that Derrida is able to posit what he sees as Mauss’s greatest paradox and omission: The Gift never considered the subject of the gift because Mauss’s essay is in fact all about taking (Derrida 1992: 82). In the worlds of donor-assisted conception, infertile women who structure their life around the successful birth of children are evidence enough that recipients do exist. Donors clearly exist too. But there may be contexts

when acts of donation do indeed give way to a more fluid reckoning of gifting, recipiency and relatedness as the above case studies on modes of

Donors III ]29 transilience have shown (see also Chapter 8, Recipients III). Fay and Delia’s

account of gifting, and other women’s anonymised mediations as ‘someone’, suggests there is no fixed or originary point of departure to which one could return. With Fay, what gets broken off or detached from her

body is, she says, something that is imagined both as a process, in the sense that the parts are her body’s cyclicality, and as an intersubjective process that is ‘peopled’ by persons. When she switches narratively between the interiorly active body and her person as someone involved in ‘the world [as] made up of people giving and receiving’, the effect both conceptually and rhetorically is to de-stabilise the category of the person as a discrete, singular and bounded unit. The possibility of thinking something such as originary property collapses since imagined forms of contin-

uous gifting and renewal are manifest as the continuing extensions of persons, preserved and transformed at one and the same time. So far as the theoretical endeavour goes, it is not the figure of the recipient who requires cancellation by way of her routine transformation into ‘donee’. It is rather the way we re-think the form of return that matters. Godelier (1999: 44) correctly points out that it is not necessarily a question of giving back (‘exchange’), but rather a question of giving again. The commentary so far has shown this up as the projections of transilience. By

way of brief recapitulation, let me summarise how extensional transilience implicates the spacetime of ‘irrelational kinship’ as donors’ local conceptions, enacted through the substance of anonymous mediation. Odelle thinks of her genes not as biological body parts, but as the parts of previously embodied relations that can pass ‘through’ her as continuing time. She donates a sense of keeping alive her family history and the social significance of her enduring place within it. Penny thinks of herself as donating an ability that passes ‘through’ her as the finite productivity of her reproductive years. She donates something that she will not be able to do a little later on. It is in terms of a generalised ‘somebody’ through whom her actions are able to pass that she conceives of her actions as ‘ripple effects’. Rita donates a way of making somebody else’s life better, just like she imagines her mother once did for her. It is this elicitation of a meaningful non-relation that makes an imagined ‘link’. Meena thinks of the ingredients for a meal she co-produces with strangers as the ceremo-

nial food she previously gave to unknown others. Back home in India those who ate ‘with’ her during cleansing rites were sustained by her gift and they prayed on her behalf to deities to help her achieve a pregnancy. Over in England, she (re)donates, less as a form of repayment than as a kind of commemorative sharing that simultaneously can last for keeps.

Her extra-corporeal substance becomes a remembering for life, and beyond. In all these cases, reproductive substance is shared between persons/bodies; however it is not shared simply because it has been mixed bio-genetically. What the French School critiques tend to overlook, excepting the social

theory of Pierre Bourdieu, is the enormously crucial factor of temporality in the construction of gift as value.'! Derrida, in fairness, does raise the

130 Nameless Relations question of the gift’s temporality but only to retract its relevance at the very point of assertion so that the gift is seen as something extra-temporal, outside of time and beyond the present (Derrida 1992: 9,14,24). Influenced by Munn’s schema of ‘intersubjective spacetime’, I have argued that donors make transilient relations with recipients by enacting forms of anonymous relatedness that are dependent as much on irrelational nonlinkage and dispossession as they are on intersubjective anticipation and remembrance. Contrary to the biological model of the single-sexed self and the functional model of human reproduction, women’s multiply circulating body parts have been shown to have value as the extensional and transferable parts of transilient persons over time and through space. The ways in which different women’s substance becomes enacted as a remembering for life relates to the way donors transform time as extensions of themselves. Though donors do not have their actions reflected back to them from an exterior source, thereby remaining unaware of the recipient’s treatment outcome, they do pass both literally and metaphorically ‘through’ several persons and they thereby do make relations as the incorporated parts of ‘others’ bodies.

Notes 1. Alternatively, food consumption may come to acquire symbolic meaning as acts of an unproductive and self-focused kind, symbolically suggestive of a ‘selfish’ person. Remarking on the descriptive label for a greedy person as ‘one who eats’, Munn suggests that retentions of the self are personally registered as corporeal effects because a consuming body is one that is held back, as opposed to one released outwards to others (Munn 1992: 49). This association reveals one way in which Gawan notions of personhood are premised on forms of social action and the social relations constitutive of these actions, as opposed to the ontological primacy of the self in the western canon. 2. Further, Munn suggests the notion of spacetime is pertinent not only to the intersubjective extensions of the self. It is instructive also to the ways in which the social relations effected by these extensions constitute the very spacetime in which these actions are experientially lived out, or enacted (a processual and dialectical argument). It is in the sense that ‘a mode of spacetime defines a form in terms of which the world is experienced by the agents whose actions perform it’ that Munn depicts Gawan women and men as autonomous agents. 3. A vista is a ‘long succession of remembered or anticipated events’. The Concise Oxford Dictionary of Current English, 4th edition, 1951. 4. ‘Strategies for epiphanic manifestation’ is James Weiner’s (2001: 131) rendition of the compressive and expansive devices by which a multiple layering of meaning will produce the effects of its own form. It is a bringing forth of the invisible; an enactment of the unseen as purposive power. 5. According to indigenous conceptions of Gawan personhood: see note 1. 6. From my research sample to date (donors 1 to 62 inclusive), other women who at the time of their anonymous donation had no birth children include

Donors III 13] Amily, Joni, Phoebe, Moira, Shena, June and Marguerita. Women with no children at the time of donation who gave non-anonymously to a known relative or friend include Cathy, Dilpha and Kirsty. 7. On some of the side routes set up (and blocked off) by ‘bypassing’ within the assisted reproduction industry more generally, see Konrad 2003a. 8. This example of collectivised substance as depersonalised, non-attributable and non-traceable to any single particular person has close parallels with Laidlaw’s (2002) description of the mixing of food by Jain renouncers in receipt of alms from different Indian households. 9. For the sake of clarity, the axis of comparison here has nothing whatsoever to do with same-sex relations, whether practised ritually or otherwise. 10. Derrida suggests the gift can only really feature as a trace of ‘radical forgetting’ (1992: 17), a forgetting moreover of such extreme alterity that the signification of loss goes beyond the unconscious of repressed memory, challenging even the speculations of a subject de-centring psychoanalysis. 11. It is as part of his conceptual attack on the shortcomings of phenomenological accounts of ‘naive humanism’ and structuralist objectivism that Bourdieu argues that the construct of reciprocity cannot relate to an objective form of ‘delayed exchange’, comprised hypothetically as kinds of preregulated and mechanical returns. Reciprocity, he argues, is not some kind of ‘inert gap of time’ (1977: 6), but the performance of intervals of time lived out as social practices. These practices, he stresses, are embedded in the strategic deployment of relations of power, domination and méconnaisance: ‘Once the possibility is admitted that the ‘mechanical law’ of the ‘cycle of reciprocity’ may not apply, the whole logic of practice is transformed’ (Bourdieu 1977: 9). In Bourdieu’s account, however, whether time has been withdrawn or extended by one transactor to another is collapsed to the homogenous likeness of ‘strategy’ per se. Since the denial or extension of time to others becomes the functional equivalent of strategy and strategic action, the reader gains no insight into how temporality might be embodied differentially by diverse agents. Nor does one gain insight into agents’ own perceptions of these differences. What thoughts and what actions follow from the deferred expenditure of time; or, if this develops into a recognised pattern of action, what are the shifts in power and for whom? How are the politics of gender relations constituted when ‘an inert gap of time’ is filled with the strategies and desires of agents who have different claims and social statuses in a particular social context or society? These are questions that Bourdieu leaves unanswered.

CHAPTER 6

RECIPIENTS I

I do want my donor to know that I am very grateful for what she has done. And I personally can’t tell her but I really hope that in the system somewhere somebody has managed to put that over. She may feel she doesn’t want that and what’s important for her is that she’s going through the procedure and helping. I just personally would like her to know. I would prefer that she knew. But she will never be able to know from me. (Yasmin, 33-years-old, second ova donation treatment resulted in birth of daughter)

W: women to become recipients, they they will never be ableagree to make a return gift. Ova that are know received anonymously are taken on condition of their non-reciprocation, although not without deep feelings of gratitude. On the one hand, these gifts cannot be returned since prospective recipients are by definition incapable of producing their own healthy or ‘viable’ eggs. Women will be reminded of this fact every time they self-refer for infertility treatment. But return gifts also are pre-

cluded from entering the field of exchange since donors and recipients usually do not know the identity of the other. In a donation system where anonymity prevails, social relations between gift partners appear severed and thus distinctly impossible. On the face of it, the gift whose origins cannot be made known appears to travel in one direction only: namely, from donors to recipients, from the fertile to the infertile.

In the light of these observations is there any sense in which the gift ‘lives on’? Might the insistence on non-reciprocation itself encourage the perpetuity of the gift? If feelings of recipient indebtedness might persist post-donation, do recipients see themselves as constrained or invested with power? The next three chapters engage these concerns. We ask how recipients figure the person of the donor and what recipients themselves think they are receiving. But a caveat first. While an overview of clinical procedures might lead one to think the gift is in fact everywhere, this apparent ubiquity only masks specific interests.

Recipients I 133 Gift Elasticity and the Infertility Industry During the 1990s HFEA-licensed clinic centres resorted to the develop-

ment of various recruitment, selection and treatment strategies. In attempting to overcome the shortage of ova donors able or willing to offer donated eggs, these strategies conflate different types of donation and different categories of IVF donor. What is noteworthy as well as ultimately confusing about these various strategies is their nomenclature. ‘Egg donation’, ‘egg-sharing’ and ‘egg-giving’ are practices whose common semantics mask the fact that each entails different procedures and requirements. Promotion of the generic terminology of ‘gift’ blurs what are in practice

vital distinctions. From another perspective one donor may encompass ‘many donors’. Fgg-sharing ‘... @ unique situation in which the egg provider is both an IVF patient and an egg donor’

HFEA Code of Practice, 5th edition

Egg-sharing, a variant of egg donation, is a scheme whereby women with fertility problems of their own can elect to receive reduced-cost IVF treatment in exchange for sharing anonymously some of their superovu-

lated eggs with other infertile recipients. Since eggs are exchanged between the infertile women without the intervention of a healthy nonIVF ‘altruistic’ donor, what the women share, so to speak, is their infertility. The usual practice is for half the total number of eggs retrieved from one woman (‘donor’) to be designated for simultaneous sharing with the other would-be recipient IVF candidate.! Note that as with anonymous egg donation, neither woman in the egg share scheme has any direct participation in the choice of ‘her’ fertility partner: this remains the clinic’s prerogative (Ahuja et al. 1997). According to British-based fertility practitioners Kamil Ahuja and Eric Simons, egg-sharing is a fairer, more ethical way to administer treatment since the altruistic non-IVF donor, the woman who needs no medical treatment for herself, is spared the risks of drug-induced superovulation and accompanying procedural health complications (see Chapter 3, Donors

I and Appendix III). Instead, treatment provision is kept ‘within’ the anonymised sub-population of the needy infertile who would be exposed to these health risks in any case on account of their own IVF cycles. Other proponents of the egg-share scheme advocate its financial advantages for patients and describe it as a ‘win-win’ situation for recipient and donor: exchange amongst this sub-population ‘gives’ its members more chances of IVF success (repeat cycles) at less expense. Where a patient can expect to pay around £3,000 for a single IVF treatment cycle, egg-sharing means

the ‘recipient’ will pay a reduced fee in the region of £800. It is not unknown for some consultants to ‘sell’ their services as good value: treat-

ment offered as “a three-for-the-price of one” deal. While this type of ‘trade’ in egg-sharing has received considerable criticism amongst various

134 Nameless Relations publics and the media (e.g., Hall 1993; Hornby and Hennessy 1994; Rogers 1993), it has met with a number of additional objections from within the clinical community itself. Dependent on how clinical teams decide to select such ‘donors’ (e.g.

whether or not egg providers are limited to fertile women undergoing sterilisation or to IVF couples treated for male infertility), it is certainly more likely though not always inevitable, that the recipient may be allocated poorer quality ‘donor eggs’ than would be the case with a donor who has no fertility problems of her own. In addition considerable anxiety has been expressed concerning the exercise of undue coercion, especially where it is a case of poor young women surrendering half their eggs to richer older women whose pregnancies will enhance the clinics’ IVF

success rates. Those women who would prefer not to egg-share may worry that their abstention from the scheme could disqualify them for further treatment should they need to undergo repeat cycles in the future.

Furthermore women may experience heightened feelings of failure should their superovulation yield a disappointing number of eggs — hardly sullicient for one person’s treatment, let alone two or more persons. Such

disappointment may set up complicated relations of indebtedness between the clinic and woman concerned. Recent evidence suggests that this category of ‘donor’ finds it disturbing to think her recipient may have

conceived successfully with one of her eggs whilst her own treatment from the same cycle failed (Boden 2003). Egg-giving

With its misleading euphemism of ‘egg-giving’, this scheme confuses still further the apparent elasticity of the ‘gift’ rhetoric. In a more recent vari-

ant of donation, and, as it turns out, a relatively short-lived one,? the prospective IVF candidate (would-be recipient) gives consent to donate anonymously all her superovulated, extracted eggs from one treatment cycle before she is able to receive her own treatment in kind. This treatment will be administered to her without cost of payment. In practice, she becomes then the deferred recipient who expects to undergo treatment in the future as though this were ‘for free’. Despite the ‘donor’s’ best intentions to benefit another woman, this

arrangement is in fact more akin to ‘egg pawning’: the woman who ‘donates’ effectively loans her eggs as advance security against the promise of a future treatment.’ The clinic is positioned as the institutional pawnbroker exacting an advance ‘yield’ from the egg ‘donor’.* Further, since the transfer of eggs takes place covertly, off-centre stage and away from public view, perceptions of a lack of transparency about clinic practices can lead easily to charges of exploitation and commodification of women and their bodies. One might ask, for instance, what assurances could be given that the eggs from the ‘donor’ are not distributed to more than one recipient, and thus become the source of a lucrative intra-clini-

cal trade? Does not the semblance of a ‘like’ for ‘like’ gift exchange obscure what, in certain instances, might be the occasion for a systematised profit-making?’

Recipients I 135 Egg Donation

Egg-sharing and egg-giving are both derivations of egg donation. Whilst ege-sharing is deployed in cases of IVF where women do not necessarily need assistance from third party donors, the treatment of egg donation can only work if the intended recipient ‘borrows’ eggs from other [fertile]

women donors. In this sense the egg share scheme has been imported from the ‘older’ practice of egg donation. In any case it would be patently

ridiculous to think an infertile egg recipient might wish to donate eggs that had been harvested from her own superovulated body since, in the vast majority of cases, she has de facto no ovaries or healthy eggs of her own. Let me emphasise for clarity’s sake that all the testimonies presented

in this book come from women who had required assistance from egg donors; none of my research interlocutors had been recruited as a ‘donor’ into ‘egg-sharing’ or ‘egg- giving’ schemes.

As explained earlier, recipients usually receive eggs that have been donated anonymously (see Chapter 2) although non-anonymous donations may be permitted following the deliberations of an internal ethics review committee or prolonged discussion by members of the clinical team.° It is also possible that the distinction between the anonymous and non-anonymous may blur so as to create further slack in the already elastic, expanding, gift rubric. At ‘Harmony Clinic’, one of the assisted concep-

tion centres in London where I shadowed medical staff, a so-called ‘cross-over’ donation system was in operation. In these schemes the wouldbe recipient would be encouraged to try to recruit a friend or relative, usually a sister or sister-in-law, to donate to the clinic donor pool on her behalf. By introducing a donor to the clinic, the prospective recipient is allocated

another unknown woman’s donated eggs that have been ‘crossed-over’ anonymously. Her ‘known’ donor in turn assists another non-identified recipient couple, and so on. Assisted conception clinics make the cross-over strategy seem appealing by offering what is in effect a queue-jumping ser-

vice: potentially women can receive their treatment more promptly than otherwise would be the case. In other words, the supposed advantage to prospective recipients is the possibility of ‘buying time’. However, would-be recipients must first recruit donors to donate on their behalf before they can

take up this option. Many women simply cannot find anyone, although it is not unknown for fertility tourists from overseas, mainly Arab women, to bring with them to the U.K. young nieces or sisters whom they have ‘persuaded’ to donate. As for those recipients unable to recruit willing subjects from their immediate circle of friends and relatives, many would resort to anonymous recruitment tactics, as advised by the clinic. They would place adverts in the local press, make hand-written cards to pin up inside shop supermarkets, libraries or doctor’s surgeries. Some would use recruitment posters and leaflets designed by The National Gamete Donation Trust and

available at many of the licensed clinics or supplied free-of-charge to would-be-recipients upon request (see Figures 4.1 and 4.2). Many couples now deploy the website as a publicity and campaign tool: some have set up their own web pages based around written ‘testimonials’ about their past treatment attempts and IVF/donation career history.’

eee ee

136 Nameless Relations no' He ee — a fsi ae he;

_. = National Gamete

ee Donation Trust

ieee For the giving and Lae Aeesareceiving of the

aoe ii potential eC for life

Figure 4.1 For the giving and receiving of the potential for life. Reproduced by kind permission of the National Gamete Donation Trust.

Your Most Natural Gift for Childless Couples

bie ae Mae ee Childiess couples wanting babies often can't have them without help. The help they need is sometimes just medical or surgical assistance. However, in some cases, they may need to receive donated eggs or sperm in order to have a family. Would you consider helping someone else to have a baby? To find out more about becoming an egg or sperm donor contact:

Or contact: National Gamete Donation Trust Tel: 0161 276 6000 PO Box 137 Manchester M13 0YX Registered Charity No: 1069222

Figure 4.2 Your most natural gift for childless couples. Reproduced by kind permission of the National Gamete Donation Trust.

Recipients I 137 In the following section we see how recipients articulate their own discourses of gift elasticity. It is helpful to begin by setting off these rationalisations against the views of those who claim to prefer donation by known or related (non-anonymous) donor.

Anonymity, Kinship Distance and ‘Poison’ in the Gift Ulrike was diagnosed with hormone deficiency, ‘streak’ ovaries and began

to suffer the symptoms of premature menopause in her late teens. Recently married, her sister has donated directly to her on one previous

occasion, but no embryos implanted after the transfer. A subsequent attempt by an anonymous donor was also unsuccessful. Ulrike explains the ideal situation: I would prefer Alicia’s eggs because I think obviously we’re family. It’s not so much physical] likeness but there are characteristics in my sister that are in me. My elder sister [Jane] has got two girls and a boy and the middle girl looks exactly like my sister that’s donated. The family resemblance in all of them is there. I’m not sure what I believe about your make-up [sic] being

bred into you, so to speak, but I do know my sister’s family history and | know her medical history. It’s the nearest we’re going to get to Howard and I having a child on our own. Having said that, it’s not so important that J] won't accept a donor egg. It’s the ideal situation but if my sister turned around and said she’s not happy about it, that wouldn’t be a problem. It’s not something I feel so strongly about, but ideally, yes I would. (Ulrike, 28-years-old, two previous unsuccessful donor treatments)

These ideas of keeping relations ‘within the family’ are seen to make human reproduction less unpredictable than they might otherwise be. Donor assistance is about building the known into what is otherwise a

contingent and ‘extra-ordinary’ conception. It is thought that the unknown element of a conception from an anonymous and non-attributable source can be assuaged through the admixture of physical resemblance and particular personal characteristics. Ulrike wants to be able to ‘place’ subsequent offspring against relations she can predict and thus lay claim upon. Relations of proximity are imagined here in biogenetic terms as the nearest biological substitute: the sister ‘stands in’ for Ulrike and the whole family unit. Zoe similarly would have preferred a sister-sister donation. Diagnosed with ‘resistant ovary syndrome and complete ovarian failure’, she has had

four unsuccessful anonymous egg donation attempts and is not sure whether she can afford to continue with the expense of further treatment. Fleur, her sister, has offered to donate directly to her, but the clinic has reservations. Since her husband (Zoe’s brother-in-law) has been told he has a low sperm count and the couple are still trying to conceive their first child, the counsellor has advised against a sister-donor candidate. In fact the counselling team went on to refuse Fleur’s admissibility to the treat-

138 Nameless Relations ment programme not only in her capacity as a relative donor but as anonymous cross-over donor too. They raised ethical objections on the grounds of possible family tensions in the long-term future between the

sisters should Zoe’s treatment be successful whilst Fleur and Reggie remained involuntarily childless. Zoe nonetheless holds fast to her wish for a sister-sister donation. ... That would have been nice because perhaps with that I would have felt that there would have been still like a family link there. It’s as close as you can get to being your own, sort of like a blood tie. (Zoe, 38-years-old, four unsuccessful donor treatments)

Amongst the recipient women I met these views expressed a minority sentiment. Yasmin, for instance, was reluctant to ask a friend or relative to donate on her behalf. It would put too much of an obligation onto some-

one since it is such a ‘big thing whichever way you look at it’, she explains. Ravinder’s sister, Shahana, was ruled out from the outset as a potential donor. J have a sister in-law and I would never dream about asking. I myself wouldn't like to have a friend or relative donate to me. It’s a bit like selling a car to your best friend. People know all about it [egg donation] and if they are motivated enough they can ask for the telephone number of the hospital or they can find out for themselves ... (Yasmin, 33-years-old, mother of one donor-conceived daughter)

Not exerting pressure over another is seen as an essential part of keeping the donation intact. Since one cannot by definition request someone to give voluntarily to you, removing the gift from a matrix of obligation is a precondition of gifting itself. Anonymity is seen to preserve the form of

the true gift. It avoids all trace of coercion. This was to emerge as the prevalent view amongst my informants. Several recipients in favour of anonymous donation (Tess, Hilary, Nita, Luisha, Fern, Sinead, Clara, Thea, Sian, Una, Sarita) had turned down offers of help from sisters and sisters-in-law. Some would even refuse help from relatives offering to help indirectly as anonymous cross-over donors. Fern prefers to defer her treatment for an unspecified period than to accept help from someone she knows. She turned down offers of assistance from her sister and sister-in-law, both of whom said they were willing to donate on condition their eggs would be received directly by her. Yasmin, Fern and others are aware that the demand of a gift can spoil a relationship. They realise it matters how actions and relations originate. We saw in Chapter 2 that the gift phenomenon in anthropological discourse has been shaped by the classic Maussian thesis of the embedded-

ness of persons in gifts and gift relations. The gift is said to embody something of the person: ‘to make a gift of something to someone is to make a present of some part of oneself’ (Mauss 1990: 12). As for donorassisted contexts, too close a relation might mean that too much of the

Recipients I 139 person is carried in the gift. As a consequence the gift might ‘go wrong’ and become a source of potential harm. The moral nature of socially embedded gifts is precisely a feature of the Indic theory of gift sacrifice. Noting the misfortune borne by the person of the recipient, anthropological and Indological debate discusses local beliefs

about the gift’s moral contagion. Jonathan Parry (1986) for instance describes how Brahmin priests from Benares are in danger of receiving

harmful confessions. Unless they can save themselves through ritual cleansing they will accumulate the bad deeds of the pilgrims and mourners who visit them. Collectively the priests become a figurative and literal ‘sewer’ when they receive the sins of the donor; without appropriate expiation these ‘recipients’ stand to contract leprosy and die unexpurgated in hell. Writing of North Indian village life, Gloria Raheja (1988) considers the ability of different caste and intercaste relationships from Pahansu to ‘digest’ the poison and inauspiciousness of the donor ‘sacrificer’ (jajman), including his household and village. With gifts that are made from assisted conceptions, ‘poison’ is not carried intentionally in the substance of the gift with any intended objective of causing harm.’ Indeed, recipients would acknowledge repeatedly what they presume must be the ‘brilliant’, ‘kind’ and ‘exceptional’ qualities of their anonymised donors. Rather, the gift’s potential toxicity turns on the way acts of recipiency are seen to reflect other pre-existing social relations. A friend or relative can always make comments, draw comparisons, get in the way. These interventions might be hurtful and produce unexpected harms even if the child grows up in an environment of openness. Relations of proximity may, in cases, be perceived as too proximate. The structuring prohibitions of anonymity as taboo are intended precisely to

negate that perceived danger by freeing up the space of substitutive replacement as predictable arrangement (e.g., one sister for another). The hazard of ‘toxic’ diffusion was one of the unintended effects of reproductive exchange between Vera and Hattie. Between them the biological and social mothers of seven children all genetically related as halfsiblings and cousins, the two sisters describe some of the reasons why the

whole donation event has evolved into the time of continuing moral equivocation and post-donation disagreement. Vera, thirty-three, diagnosed recently with resistant ovary syndrome, partial blockage of both Fallopian tubes and premature menopause, had been adamant about receiving eggs from her sister so as to ‘keep the fam-

ily relation going’. Her first-born child suffers from what her mother describes as ‘mild mental retardation’; a condition the medical practitioners have assured her after numerous investigative tests that is without any known genetically linked chromosomal aetiology. Gemma’s disability has been attributed, rather, to a complicated birth event and has not been the primary reason motivating Vera and Owen’s subsequent search for an egg

donor. Although Vera had some apprehension about ‘pummelling her [sister] into it’ and expresses feelings of guilt about putting her sister through the physical rigours of the drug regime, it was, she says, the

140 Nameless Relations ‘nearest thing to having my own’. Hattie, thirty-six, is the natural mother of three children between the ages of eight to fifteen. Since her successful donation a few months ago, she is genetic mother and maternal aunt to Vera’s triplet boys. For her part she would have preferred an anonymous donation had she been in her sister’s position. ‘I would worry that if it was a sister who had done it for me, that they would be watching over me on how I looked after them’ (Hattie). Vera and Hattie were always in and out of each other’s homes. They lived nearby and invited me to stay for the day on a number of occasions. Much discussion turned on the decisions that had led up to the clinic assessment, the preparations for the treatment and events post-donation. Vera often could be heard reproaching Hattie for what she assumed to be her greater influence and power over her family since the treatment. Hattie in turn vehemently denied any such superiority. These perceived relations of dependence, based around the sisters’ respective assertions and rebuttals of claims to parenting rights, were to culminate in serious differences of opinion regarding the future disposition of the four frozen embryos ‘remaindered’ from Hattie’s donation (see Chapter 8, Recipients III). The continuing sense of debt felt by Vera conforms closely to the expec-

tations of a conventional gift system predicated on reciprocal relations. Anthropologists have argued that the mechanism of reciprocity ‘evens up the score’ (Schietffelin 1980: 505) noting how an otherwise inevitable ‘sidedness’ (Sahlins 1965: 146) between exchange partners represents a symbolic devolution into a mutually satisfying symmetry of equal kinds of social relations. Though things exchanged may be concretely different they become equal in value in the sense that a balanced reciprocity represents the ‘hallmark’ of equality (van Baal 1975: 19) through the matching series of reciprocal prestations. This ‘matching’ of powers to make like returns has been theorised as the form of delayed exchange with continuous debt partnerships (see e.g., Gell 1992: 145). Tess, mother of one donor-conceived daughter, makes sure she avoids the inevitability of ‘sidedness’. Simply the possibility of being held to account by a sense of continuous debt partnership was reason enough for her to articulate strong reservations about receiving eggs directly from her sister. Rhoda, Tess’s sister, had donated on one occasion as anonymous ‘cross-over’ to help her get prioritised on the clinic waiting list but in the

event scans revealed Rhoda produced just two eggs and her treatment cycle was abandoned. Imagining the kinship consequences of a known sister-to-sister donation, Tess comments: Rhoda has got two boys and I’ve had a girl and she would love a girl. So if it had been my sister’s egg how would she have handled it? Would she have handled the baby? You just never know. You say ‘I wouldn’t’ [feel anything], but when it happens you don’t know how you would feel, so that was the main thing. And also, she’s got two boys and they would have been half related in that sense. Not just cousins, they would have really been half brothers or half sister and brothers. And how would that have affected them later on in her family? (Tess, 39-years-old, mother of one donor-conceived daughter)

Recipients I 141 Like numerous other recipients, Tess wants to avert the potential for ‘poi-

son’ that she believes the ‘matching’ of (symbolic) returns between known relations would make so manifest. But matching, it is true to say, happens also to be a feature of non-reciprocation. In the next section we move from social science gift theories that see matching as a return equivalence to clinic-based strategies for matching persons as degrees of informational relatedness.

‘Like with like’ and the Equivalence of Matching In an anonymous donation system such as the one described here, ‘matching’ revolves around the imputed importance of finding and selecting appropriate partners as reproductive substitutes. Specifically, matching is the clinical practice of allocating a recipient to a donor and in most fertility centres is a responsibility delegated to the egg donation co-ordinator. She is usually somebody with nursing qualifications or training in human embryology. In brief, this is what happens. Ova donors and recipients are synchronised biologically through hormonally based drug regimes and ‘paired up’ with each other as simultaneous ‘like cycling’ procreative partners. A fertile egg donor effectively stands in as the biogenetic matched ‘equivalent’ for a recipient whose ‘missing’ genetic substance she replaces. This is a more literal rendition of replacement than the synecdochic substitutions imagined by recipients such as Ulrike and Zoe I mentioned a moment ago. The donor, for her part, will take a course of fertility drugs to boost the excess maturation of a number of follicles and eggs. Meanwhile the recip-

ient will need medication to prepare her endometrium to receive an embryo or embryos and is brought to menstrual synchronicity with the donor. All such synchronisation between each donor-recipient pair must be monitored precisely by the egg co-ordinator, orchestrating closely with the ultrasonographer. Everything will have to be co-ordinated logistically without the women (and their male partners) ever meeting each other during their clinic appointment schedules. Unlike chromosomal meiosis — the central biological event in fertilisation — donor- recipient matching is not supposed to be a randomised affair. During interviews and alter initial assessments, the egg donation co-ordinator will take a checklist of the physical characteristics of each treatment candidate; these will be documented and kept in a secure central reference file. In effect, certain bodily features and inherited genetic traits (eye colour, hair colour, complexion shade, height, weight, and so on) become the metonymical substitutions of these anonymously partnered persons. Sometimes these physical similarities are supplemented by secondary concerns such as personality types. At Credo Clinic I sometimes would hear

the co-ordinator remark informally to a colleague with words to the

effect: ‘Yes, I think they'll go together because they’re both bubbly/shy/quiet’. While a note of personal interests, hobbies and reli-

142 Nameless Relations gious affiliation is documented, and indeed is formally required by way of

completion of the Donor Consent Form for the central records of the HFEA, such details usually play no decisive role in the determination of what makes a suitable match. It is said by clinic staff that one of the best-valued skills of the co-ordi-

nator is her ability to draw together visually, in the mind’s eye, what future offspring would look like when all parties to the conception are blended into one entity as the mix of a viable ‘match’. This was described to me when I asked for explanations of what made a match ‘good’. The hoped-for baby should look, at least to the practised eye of the co-ordina-

tor, as though it could have been a ‘natural’ (non-assisted) conception. And it is in this particular sense of having already drawn a cognitivevisual map of relations as genotypical cross-relatedness, that the arrival of

new persons is anticipated well before the physiological event of birth itself. In turn, it is this same anticipatory schema that belies the sheer con-

vention underpinning the clinical discourse of matching. The uptake of biomedical technology can be seen as both responsive to and reconfirming of genetic inheritance ideology. To ensure the making of ‘good’ matches, the normative space of the assisted conception clinic ultimately succumbs to, and encourages, the biogenetic bias and pretensions of many prospective parents as would-be recipients. Though by no means all recipients displayed these pretensions, very many women I talked to had considerable anxieties about ‘passing off’ donor-conceived children. A common sentiment is the desire to make offspring seem as though

they are one’s natural ‘own’. Recipients would stress how fortunate or relieved they are that their children ‘look’ like a family member. Sometimes, women’s entire accounts seem to be structured in terms of how they can make physical similarities between themselves and their offspring seem more ‘real’ or more obvious than just apparent similarities. One commonly evoked idiom is the idea of persons as ‘spitting images’. Susie, mother of a two-year-old donor-conceived daughter, comments

with relief on the shared physical similarities between her husband and child: ‘I must admit — not knowing what the donor looks like but from his pictures and even looking at her now, she’s like the spitting image of him .... This kind of sentiment runs throughout very many women’s accounts

and often supports their hope that others outside of the family likewise will be able to trace imputed similarities. Although Tess, another recipient,

manages to find a reassuring likeness between her daughter and niece, here she is talking about her concern that others’ scrutiny could threaten to undermine her feelings of maternal ownership in her child. When she was born I didn’t want people to come to the hospital to look at her as if she was some kind of ... ‘well? Who is it that she looks like?’ that sort of thing. But it was a case of ... ‘oh my! she’s really her dad’s girl, isn’t she!’. And then occasionally a few people would say ‘oh! I can see a bit of you in her’ and I would just say ‘oh yeah?’ I don’t look at her [daughter] now and think: well, I wonder if that woman had that kind of shape face or

Recipients I 143 nose. We don’t even think about it ... I mean she’s ours ... But to outsiders, I didn’t want them [to wonder] ... Really I suppose, we just wanted to protect her. (Tess, 39-years-old, mother of one donor-conceived daughter)

Una similarly latches on to the desirability of establishing a ‘spitting image’

in an attempt to make her young donor-conceived child appear to be her ‘own’. At this point in our conversation, attention shifts to the way that the notion of a genetic connection rests upon the presumed physical likeness of kin as persons with evident ‘traceability’. Oh, she’s the image of her father! (laughing) And it’s freaky really. And I’m very pleased with that. And people just look at her and say ‘gosh!’. And I think, well yes ... she’s also fair, my husband was very very fair as a young man. The other freaky thing is —- which is so nice for my girl — is that my hus-

band’s brother has a Jewish wife, but my husband’s people are very fair and Jewish, but his wife is very dark, obviously Jewish-looking, and I’m very dark but not Jewish, and her children are very fair and very blonde and very Anglo-Saxon-looking. And she’s as dark as J am. So there’s a similarity because her blonde children and her black hair don’t go together and my black hair and my blonde child don’t go together ... so my little girl has got first cousins, they are the natural first cousins with the two fathers and the brothers. So her actual blood relatives are exactly the same as her, they’re blonde and blue-eyed, yet their mother is black [sic] like black hair and dark like I am.

(Una, late forties, mother of one donor-conceived daughter)

Comparing herself to her brother-in-law’s wife and non IVF-conceived children, Una finds a ‘freaky’ but comforting likeness between the two families. In each bilateral pairing, the child’s blonde hair and the mother’s dark hair can be cross-matched intra-familially so that the semblance of a resemblance makes both sets of cousins and both sets of parents seem as though they are the cognatic reproductions of the other. And because in this case the dissimulation is a substitution that can never be traced back to its procreative origins (Una is hoping), the source of difference produces what she, as former ova recipient and social mother, takes to be a ‘freaky’ kind of reproduction.'® So in this particular narrative about the optics of making one’s own, likeness will have been made as invisibly as it comes to appear naturally. Conception secrets, it is felt, need never be revealed because [genealogical] knowledge about who is related to whom

appears to have been rendered ‘natural’: relatedness seems perfectly ‘transparent’, in need of no particular emphasis of explanation (Cussins 1998). Several women recipients similarly said they would be pleased if family and friends were to remark upon a strong physical resemblance between father and child. Others talked more directly about ‘cancelling out’ the figure of the donor, noting in this regard how confirmations of imputed kin likeness would compensate and thus literally ‘cover over’

what the social mother otherwise might still remember as her former genetic ‘omission’.

144 Nameless Relations These examples all show how the effects of equivalent matching can be

imagined as one aspect of conventional kinship modelling. Degrees of likeness come to be elicited from the surface of the skin on account of the social mother’s knowledge of her consanguineal discontinuity. This happens to situate recipients primarily on the side of cultural conformity and convention. We can see for instance how the work of concealment is not jimited simply to the clinical procedures of biomedicine and the rhetorical obfuscation of the commodity in the gift. The recipient/social mother’s reckoning of relations of visibility is premised on the suggestiveness of

continuities that are shaped from a pre-existing bilateral and patrilineal kinship frame, and whose ultimate ‘equivalence’ serves to isolate the donor socially as the excluded progenetrix. Even under the sway of new reproductive technologies and alternative family forms, kinship conventions in Britain presuppose it is natural to imagine that a biological transmission requires a particular social transmission as its evident counterpart. This is perceived as the proper way to make a person self-evident However, whom are recipients really pleasing when they conform to the pervasive pull of genetic inheritance ideologies in these scenarios of matching? If donation programmes at clinics are set up in such a way so as to respond to what practitioners know to be the preferences of their clients, then anonymisation and secrecy and biogenetics all feed off each other so that the IVF and donation industry can remain a healthy market. Anonymity, in other words, is recruited here into the service of conventional kinship and this is undeniably a cultural project. At the same time, however, anonymity removes itself from the conventions of a gift system predicated on reciprocal relations and allows for the inventiveness of relational reckoning, as embodied by ova donors. The tension shows up in the ‘informational gaps’ comprising donor profiles and the perceived problem of verisimilitude.

Degrees of Information and Informational Gaps Other recipients are somewhat critical, less of the biogenetic ideology that legitimises a regime of clinic-based matching than of the procedural operations supporting its endeavours. A number would point to what they see as the informational ‘gaps in matching’. Having reached the top section of the clinic waiting list, it is customary to be given a brief donor profile of the intended match, most usually relayed over the telephone. In some cases this description would be followed by some kind of subjective comment from the donation co-ordinator: ‘oh, she’s a really good match’; ‘yes, she is a lovely person’. Often prospective recipients were put under extreme pressure to make a decision about the suitability of a donor, the co-ordinator adding she required an answer one way or the other that same day. Some women recalled jokingly how they had tried to leave frantic telephone calls for their husbands at work to confer with them about the decision. Others felt they were being swayed by the clinic to agree to a match

Recipients I 145 that more or less had already been pre-decided for them. A few wondered how possibly they could be expected to make such an important decision on the basis of such scant information — knowledge of some physical characteristics and a brief summary about personal interests. Ulrike for example is adamant she did not receive sufficient donor information. They told me her hair colour, eye colour, height, weight, religion, occupation, and her interests. They ring you up and say: ‘We’ve got a donor who’s five foot ten. Is that okay?’ And you think: ‘How the hell am I meant to make a decision on that sort of information?’ I mean anything is okay [if

you put it like that]. You can’t [know]. You’ve got to assume that you haven’t got enough information to make the decision because it’s neither one thing nor the other. They’re telling you a little bit but you couldn't make a rational decision based on someone’s height, age and size. How do you decide that’s what you want to see? It’s difficult because they can’t tell you anymore to preserve her anonymity and yet if you didn’t have that little bit of information you really would be feeling you’re stabbing even more in the dark. (Ulrike, 28-years-old, two previous unsuccessful donor treatments)

Other recipients would comment on the importance of receiving more donor information in terms of health implications, specifically genetics. The most common concerns were pragmatic: not knowing about inherited allergies or food intolerances. It is precisely such issues about the kind of information that ought to be released that has shaped the British gov-

ernment’s recent rethinking of gamete and embryo donor information policy. In its public Consultation on Donor Information, the Department of Health (2001) considers whether the provision of non-identifying information about the donor should be made available upon its request to the recipient party. The Consultation presented the issues to the public by way of two key categorical distinctions. First, existing donors who have previously donated are set against prospective donors of the future. Second, identifying information is distinguished from non-identifying infor-

mation. The Consultation concludes with the proposal that any legal changes could not be applied retrospectively so that whilst it would not be possible to reveal any identifying information about ex-donors, the disclosure of non-identifying information may however be approved in the near future — subject to further consultation. Peggy, a prospective recipient in her mid-forties echoes Ulrike’s concerns about matching. She has had her application to start a second family with the direct assistance of her adult childless daughter turned down by several clinics and has been through two unsuccessful anonymous egg donation treatments. Not only is she keen for more non-identifying information to be made available to recipients, more specifically, she suggests

non-identifying information should be made available at the point of delivery prior to any treatment preparation. Here she is talking with some

irritation about the resistance she encountered with her endeavours to extricate more detailed information from the egg donation co-ordinator.

146 Nameless Relations I don’t think they ask enough of the right questions because what you get is [information about] height, build, eye colour, hair colour and their interests. Now IJ think without having any release of [identifiable] information you could still know so much more about that person. It’s quite easy to build up a profile of somebody. I know it’s fairly subjective, it’s just whether when you interview that person you found them lively or sparky, or what have you. But I just found it was like prizing information out of them. It was so difficult. And the more information I had, the better I came to feel. But you almost feel that you’re being difficult, to ask any questions at all. (Peggy, mid-forties, mother of four birth children, two unsuccessful donor treatments)

Anonymity preserved as non-identifying donor information seems to be the best way forward, Peggy thinks, because she appreciates how some

recipients and donors might not want to have to deal with, or evade, unsolicited information. But her observations raise the more fundamental question of what it is that can be said to constitute a ‘donor profile’. What is it that gives a person an ‘identity’ in the eyes of the other? It is not

something necessarily ascertainable through scientific and objective scrutiny, she says. The human touch that comes with a skilled and discerning ‘profiler’ whose expertise would be deployed solely to such ends might make all the difference. Information, she thinks, could be gathered as more nuanced donor profiles without compromising donor identifiability. The anonymised person could still be ‘known’. She continues: I know some women feel threatened by knowing the person and I can fully understand that, I really do. Sol think in a sense the anonymity works well. But there’s no reason why that person can’t be totally anonymous and still you [the recipient] know a lot about them. You can read a magazine article or pick up a profile on somebody and know them quite well and they are just called Mary or Mark or whatever in the article, but you anyway have a feel for them. And somebody who is good at profiling people could build up a profile of that person, and that could be their job, specifically to do that. (Peggy)

Sarita, still childless, agrees with Peggy that while information should not

be forced upon others, at the same time a greater flow of knowledge in the direction of recipients could be facilitated. Preparing for her third donor attempt she recognises the delicacy of informational flows as processes of social transmission and respects the preferences of those recipients not interested in donor information release. Maybe recipients fear they are going to end up with somebody who they think is ugly and plain and they [the clinic] are going to virtually tell you that and have that person rejected all the time, but in actual fact that wouldn’t happen. People who are going to come forward and donate eggs are obviously quite positive people, in many ways — you know - they’ve really got to have something about them to do it in the first place. But I can also understand that other people [recipients] might not feel like that. They might feel totally threatened by knowing. They might say: “it’s my baby. I

Recipients I 147 don’t want to know anything about the donor. I’ve made this baby mine’. And if they feel like that then it’s up to them not to be told. You don’t want to have information forced on you either. (Sarita, early thirties, one unsuccessful donor treatment)

The Idea of ‘Donor-release’ The British preoccupation with clinic mediated matching and a centrally regulated licensing authority contrasts the North American system where the IVF industry remains unregulated and the phenomenon of ‘identityrelease donors’ has given way to a type of consumerist-led matching. In the U.S.A most hospital-based and private physician IVF centres deploy financially compensated anonymised donors with the recipient expecting to pay anything from $13,800 to $22,000 for one treatment attempt. This includes the programme fee, psychological screening of the donor, the egg

donor’s fee, the recipient’s treatment fee, legal representation for the recipient couple, medical insurance cover for the donor and recipient, the donor’s legal counsel, the donor’s travel expenses.

Many of these American treatment programmes, together with the independent agencies specialising in the process of mediation between anonymised donor and recipient, nonetheless make donor profiles available for public viewing on the internet. Any would-be recipient is able to ‘screen’ these profiles from the comfort of a networked home prior to her contacting a clinic or agency with an initial enquiry. At Egg Donation Inc,

which operates from two centres in California and Maryland, the Egg Donor Database includes considerable information about the three hundred or so enlisted donors, bar their name and address. The following ‘anonymised’ donor details are available at the click of a mouse:'! colour

photographs; personal, health and educational details. An interactive search tool assists the browser in viewing donors by particular characteristics (e.g., hair or eye colour, ethnic or religious background) or geographical region. Sherrie Smith, one of the counsellors employed at ED, Inc., explained to me that ‘every [recipient] parent should be the gatekeeper of genetic information’ in what is essentially a system of ‘cus-

tomised donation’. As part of this process of institutionalised donor release, the recipient is presented with pictures of her chosen donor from three different stages of life (baby, adolescent, and currently as adult).

She also gets to see pictures of the donor’s children and can peruse a detailed fifteen-page questionnaire the donor has completed. Some independent agencies offer similar visual aids and information about their preselected donors who are marketed as ‘beautiful people’ (bright, attractive, excellent health with college degree). ‘Dream Donations’ based in Massachusetts provides no treatment services in its capacity as fertility ‘broker’ but espouses a similar philosophy of personalised donation. Acting as an

intermediary between the recipient, donor and fertility provider, it

148 Nameless Relations ensures the donor is integrated anonymously into the recipient’s treatment plan.}? Smith went on to explain that at ED, Inc., the flow of information trav-

els not only from the chosen donor to the intended recipient, but also from recipient to donor. Via the clinic every donor receives a one-page let-

ter written by the interested recipient (who has pre-selected her) that introduces a few basic details about the couple, the history of their infertility problem and whether or not they have any children. The donor has the last say and is free to decline her services. At other private centres in the US, those donors who do not agree to visual forms of identity release can leave non-identifying donor profiles in the ‘anonymous donor notebook’ for subsequent viewing by prospective

recipients. Alternatively a clinic co-ordinator can facilitate matching through her mediation. In these cases the recipient is invited to provide a photograph and write a letter about the kind of donor they would like. The co-ordinator then selects two possible donor candidates whose details are presented to the recipient either as written information or as a phone appointment. At first view, certain aspects of the American ‘donor-release’ system might seem appealing to British couples. Yasmin and Ravinder who are planning to tell their daughter about her conception origins when she is a little older, explains they would have liked to keep some sort of visual evidence about their donor. Ravinder to Yasmin: I’m sure one day Charlotte is going to turn round and ask us what does the donor look like. And that’s where we’re still deciding between ourselves what we can offer. What if she actually wanted to see a photograph of the donor? Yasmin to MK: Yes, I would like to have had a photograph of the donor to keep just purely in case she really wanted to know. Because I’ve got a friend who’s got a child who’s adopted and she’s got no problems with her being adopted at all. But when she got into her teens she wanted to know whom

she looked like. And in fact her mother did have a picture of her birth mother [to show]. And that satisfied her and she never had any problem with it again. I feel that if we do any option that would have been a nice option to have.

However, in contrast to Peggy and Ulrike who would have liked a more specific donor profile from the clinic, Nita thinks there is the danger of over-selectionism. Less information might be more democratic, she suggests, because otherwise potential parents might treat the choice of a donor as a consumer’s market. I’ve not really wanted to know too much about it [matching] because I think sometimes the more you know, actually it is not always so helpful. I think sometimes you just want to get on with it. I feel that if you started saying she’s got a big nose or a little nose, or she’s got big lips or thin lips, well

then you'd start choosing how you want your baby to look. And I think

Recipients I 149 that’s when it becomes dangerous, because I don’t see myself as particularly attractive. Say I could donate my eggs, what if somebody might not want a

baby with my nose even though I was willing to donate and they would really want a baby. None of us are perfect are we? (Nita, 37-years-old, mother of one donor-conceived son)

Fern echoes Nita’s concerns about the potentially adverse effects of selec-

tionism. She suspects recipients would be more selective about donor matching once more information is available, something in turn that could decrease the supply of ‘suitable’ donors. This link between donation

as the consumer’s personal choice and the implicit commodification of

persons had originally informed the position taken by the Warnock Report with its pragmatically based objections to the release of identifiable donor-information. In a move that pre-empts all these reservations Peggy deflects criticisms saying ‘it is only natural a recipient wants the best start for one’s child’. Knowing more about the person of the donor would provide a sense of reassurance, if and when she were next to achieve a pregnancy, she explains. There would be comfort to be gained from knowing more information even if the specific characteristics of the donor would be ones she would not ideally choose as her first preference. At this point in our conversation, she refers to her second donor with whom she successfully conceived a child but miscarried at five weeks gestation. I’m not trying to genetically engineer this [donor-conceived] child. I just didn’t want somebody with red hair and I didn’t want somebody overweight. There’s a tremendous amount of red hair on my side of the family and actually the one thing I did say to them [at the clinic] was that I don’t really want a donor with red hair please. Well, guess what! My last donor was red-haired and she was overweight! They also told me she was quite a quiet person. But when I knew about her, then I felt comfortable again, even though these were things I didn’t particularly want. Because I just knew about her. Somehow J thought when I have this baby and I pick it up and it’s got red hair and it’s overweight, I'll think: ‘oh yes, you’re like your mum aren’t you!’ And it will make me laugh. I will be delighted somehow. Because [ will know this person. I will know this baby ...

... So if they say to me the woman that has donated is a big fat red-headed woman but my goodness, she’s really funny or she’s really nice, I know that if I get a big fat red-headed baby it will make me laugh. Because it will make me think: ‘you’re kind of like your mum!’ And your mum was a good generous person. She donated to me! (Peggy, mid-forties, mother of four birth children, two unsuccessful donor treatments)

Peggy wants to be able to feel she can imagine certain concrete character-

istics about her donor, and to be able to convince herself she would ‘know’ this person. To establish a sense of maternal connexion to the child (and make it ‘her own’) the ‘correct’ transmissions of donor information are required. A successful transmission depends on the correct channelling of donor information. The importance of an identifiable

150 Nameless Relations transmission, or at least one that can be thus imagined, lies in having the prior knowledge of knowing where things, particularly personal traits, come trom. But authentic bio-provenance is not simply about biophysical similarity and the genetics of resemblance. It is about achieving a palpable sense of connexion. It is about making, and being active in, the channels of heredity. Finding a connexion, seeing a resemblance in others: it is all a matter of how relatedness is passed on. What Peggy’s commentary shows is how ‘likeness’ can be established by bringing together different pieces of information from different sources.

Mismatching Although the stated aim of clinical matching is to select a donor as though

she were a credible genetic substitute for the recipient, the shortage of donors often means it is unlikely the traits of any one person can be matched up to any exact degree. Since co-ordinators have at their disposal

a finite number of characteristics with which to convert single persons into potentially matchable ‘pairs’, there arises a covert hierarchisation and ranking of these personal features, often with one or two traits assuming predominance over the others. Though approximate similarities in height and build always follow skin colour (categorised as ‘ethnicity’), the co-

ordinator typically constructs a measure of ‘likeness’ on an individual basis for each recipient. In consequence, the physical characteristics outlined above, though indisputably a guiding criteria for the matching of persons, can only serve in actual practice as an ideal frame for the envisioned metonymical exchange of ‘whole’ persons. The recruitment of ‘cross-over’ anonymous donors by prospective recipients generates therefore not only an actual material increase of new supplies of eggs for the clinic as a donation system in its entirety, but means additionally that the system could make hypothetically ‘better’ matches between selected donors and recipients. Connections could be made from superlative ‘fits’ between persons. Some recipients, however, suspected the presence of informational] gaps despite these assurances of proximate matching. The characteristics might sound similar, but was this really a ‘fit’? Was she really like me, they would ask rhetorically. Some recipients even joked that the donors the coordinator had described to them at each planned treatment all seemed to

like doing the same things with their spare time. How was it, they bemused, that so many donors liked knitting, cooking, exercise or reading? Did the clinic perhaps manufacture donors? (Such utterances preceded more recent debates on the ethics of human reproductive cloning.) One recipient was so concerned that the hobbies of both her allocated donors had sounded practically identical that she questioned the clinic whether she was getting the same donor with her second attempt. What this recipient told me she really feared was that the physical characteristics had simply been fabricated the second time to make it seem as though

Recipients I 15] the two women were different. The eventuality was distressing for her to

contemplate since the clinic had been informed she did not want to receive eggs again from the same donor by whom she had experienced already one failed attempt. Such protestation aside, it was much more usual for recipients not to be so explicitly critical about procedures at the clinic. Recipients were gener-

ally compliant with the way the regime worked or positioned them to conform. This was expressed when recipients told me, their voices sometimes giving way to embarrassed and barely audible whispers, that they thought they would be perceived as difficult and ungrateful were they to decline repeatedly the offer of a particular donor. Even when the details about a prospective donor would indicate what in their opinion seemed an unsuitable match they worried whether their perceived ‘hyper-selectivity’ might debar them from having a say over potential matches in the future. As Hilary put it, ‘it would be churlish not to accept a donor ... and it might go against me’. Above all, it was important not to be perceived as too demanding a patient, many said. These feelings of ‘obligation’ towards the clinic show how constrained the act of recipiency can be even with the protections of anonymity in place. When anthropologist Pierre Bourdieu made Mauss’s gift even more ‘polite’ by transposing it to the ‘sincere’ fiction of disinterestedness (1977:

171), he referred at the same time to the political operations of méconNdissance or misrecognition. Bourdieu’s view is that misrecognition denotes the way that the fictional nature of gifts tallies with the disinterested gestures of ‘ego’ — what we might replace in this context with the bioeconomic and moral space of the assisted conception unit. When he then connects the duplicity of symbolic exchange, what he calls the ‘fake circulation’ of the ‘fake coin’, with the non-material returns and expectations that gifts and gift giving harness, he perceives of the material gift as transmissively laden with psychical intention. It is because these intentions may not always be ‘received’ and acted upon in ways originally countenanced that there can be, as he says, nothing ‘mechanical’ about the exchange. Whereas the control invested in the personal decisionmaking surrounding ‘customised donations’ in the American system exacts a price, and can be criticised for its market-driven profiteering, these examples from Britain show how ‘hidden costs’ are built into the system as polite fictions. Feelings of uncertainty, denial, fear, anxiety, disappointment, compliance are all part of the ‘complex of obligation’ that

clinics exact from recipients. These ‘costs’ can be hidden to seem as though they are a routinised (‘disinterested’) part of going through what patients know only too well to be the expected stresses of all ‘high-tech’ assisted conceptions.

152 Nameless Relations “You See What You Want to See’ If suspected mismatches bother some recipients, there are others who see the ideal of substitution as an irrelevance. Ella, a 51-year-old recipient expecting twins, was not particularly bothered about achieving an exact match. Physical resemblance can be just as much the outcome of a process of fluid adaptation to one’s environment as it can to biogenetic heredity, she notes. In fact it would be rather good, she says, to have different genes to pass on! That way she can start to erase the memories of an unhappy

childhood and distance herself from the former actions of her birth

mother (see Chapter 7, Recipients Il). She is quick to impress on me that she herself is the embodied proof of these assertions: as she was growing up she started to look like her adoptive mother and to family outsiders who were none the wiser, mother and child looked as though they were natural ‘blood’ relations.

Fern mentions that her aunt and uncle have adopted children who look just as if they were blood-related. ‘You see what you want to see ...’.

she says. Nita also echoes a similar environmentalist view: I’ve now moved on to my next donor because my last donor had to cancel. Well, she doesn’t really sound a close match. She’s twenty-eight with four

children and she has green eyes and darker hair colouring to me. But I believe children grow up how you bring them up, I don’t think they come genetically because it’s like the wolf boy who lived with wolves and he started to act like a wolf, didn’t he. (Nita, 37-years-old, mother of one donor-conceived son)

Another way in which recipients would set about refuting the significance of a genetic tie is apparent from their remarks about the work of gestation. Many women, including those who valued correspondence of matching, would emphasise their roles in feeding the foetus with blood as part of the gestational process of making the donor-conceived child their ‘own’. The following vignettes examine the ambivalence characterising recipients’ narratives over making children their ‘own’. In particular, we

see how women often make seemingly contradictory statements, both within as well as across given narratives when they uphold and refute traditional idioms of biogenetic relatedness. On the one hand many recipients point out that knowledge about or identification of a specific donor

would get in the way of their productive processes of making the child into what they term their ‘own’. Knowing the identity of the donor might put them in mind of that person when their child ‘acted up’ or at significant times such as birthdays. To forget the donor means overlooking the genetic-gestational hiatus of discontinuous and differentiated procreation that the infertile recipient believes she embodies. Anonymisation is seen as the crucial support to such attempted erasure. But moments of disavowal coalesce as moments of gratitude and remembering: recipients make their children their ‘own’ not simply by forgetting the figure of the donor as cancelled kin. They also make memories as the time of agency

Recipients I 153 and as their (own) multiple enactment of continuity. If recipients go on to make donor-conceived children parts of themselves, it is their actions that become the substance of these relations.

Blood Food Lines Metaphors of growth, nurturance and nourishment are predominant images informing recipients’ accounts and would often unfold narratively as a complex set of shifting associations around certain blood imagery. Blood is conceptualised as a valuable source of nourishment to be sup-

plied as a kind of ‘life-force’ or ‘lifeline’ that can activate relatedness through the feeding relationship. In many of these local accounts there is both a conceptual distinction and conflation between blood substance as bio-genetic and inherited material on the one hand, and blood substance as somatic, non-reproductive bodily material on the other. The conflation is evident when women stress the productive nature of

blood and attribute to it the special power of growth. Yvonne is com-

menting here on how she ‘takes over’ from the egg donor: forms of | srowth are likened to the circulation of blood that takes place as the ‘interiorised’ relations of the social mother’s embodied gestation-work. ... we knew the eggs were being fertilised and it wasn’t my egg. It was somebody else’s and I think at that time, yes, she was passing on to me an egg. It wasn’t a being, it wasn’t a baby or anything. It was just this little tiny speck and that was it. But the more the egg grew into a foetus and a baby, the more it became you and less of the donor. The more you go into your pregnancy, I personally found it got less and less to do with the donor and more and more to do with me taking over ... (Yvonne, mid-thirties, second ova donation

treatment resulted in birth of daughter)

Yvonne makes a connection between growth as an interiorised relation and forms of socialised exclusivity when she comments how nobody else can have a ‘look in’ on her gestational production. Moreover there would have been a quite different activation of kin relatedness to the donor child had she employed the services of a maternal surrogate as gestational carrier. ... it is really the mother that gives you life, gives birth to you, and feeds

you, everything inside her. And when I was carrying her, I felt she was totally mine for the next nine months — nobody else could have a look in...

I feel like Iam her ... far be it from genetic mother ... but I carried her and gave her oxygen, and fed her in the blood food in me. I wouldn’t let another woman carry the baby even though it was my husband’s genes and then hand the baby over ... In me the child is growing and you feel it.

Removing productions from sight, making growth hidden, this relationship of feeding is activated by the somatic movement of blood, where food-substance takes on value as a capacity circulating between bodies

154 Nameless Relations not yet detached from each other. Winnie likewise sees blood as the mother’s ‘stream’ that is ‘going around the baby’s system’ and ‘running through her veins’. ... it’s my body that’s given her life and it’s my blood that’s going to be going around the baby’s system, so apart from that tiny little beginning. Otherwise

it’s completely us ... apart from that tiny little beginning, she is ours ... it’s my blood that’s running through her veins. It’s my body that nurtured her for nine months. Apart from that tiny tiny little cell to begin with ... really the only part of you in that child would be your blood stream and whatever influence you have on it once it was born. (Winnie, 34-years-old, fifth ova donation resulted in birth of daughter)

Nita describes herself as her daughter’s ‘lifeline’ during pregnancy. She makes the baby ‘her own’ because ‘it was good giving birth to her, very emotional. Nobody can take that away from me. I had to have forceps in the end, so J actually gave birth to her. So at least I didn’t have to have a caesarean. And I breast-fed her for eleven months, so I really enjoyed her. I gave her life so she’s still my blood and I fed her all through the pregnancy and that side of it. I loved what was inside me. I loved what I was carrying’ (Nita, 37-years-old, mother of one donor-conceived son). Tess and Val also comment on processes of feeding as social relations that recipients need to activate. Tess imagines she can cancel out the fact of her reproductive ‘discontinuity’ because ovulation and fertilisation are ‘silent’ physiological processes that do not necessarily produce any recognisable symptoms. She can thus ‘cover over’ and make good the geneticgestational hiatus. ... there was a chance, and albeit it wouldn’t be my egg, but it would be my baby because I would be the one to feed it and nourish it and deliver it. And so Without me it wouldn’t be there really ... Without my husband and without me, my daughter wouldn’t be here anyway because she would have just been ... well, that month’s cycle basically, non-existent. (Tess, 39-years-old, mother of one donor-conceived daughter)

I had all the symptoms of the normal pregnancy, so really I wouldn’t have felt my own egg being released and you don’t feel, you know, like the fertilisation part of it, so really —- what other part — how else could I have felt closer to her really? Because the initial starting of her — you’re not aware of it in your own body anyway that it’s happening. So, the first signs that I knew that I was expecting ... it was just like the normal heartburn and then all the morning sickness. So really, it was just as if it was mine really. (Val, late thirties, fifth treatment attempt resulted in birth of donor-conceived daughter)

Similarly, Zoe who has been suffering the effects of a premature menopause for nearly the past twenty years and has undergone four unsuccessful donations sees maternal-child resemblance as an inevitable ‘fact’ of the mother’s gestational productions. She imagines the embryo is already ‘hers’ at the point of transvaginal transfer.

Recipients I 155 It is just an egg to start with and it will be growing inside of you, won’t it. Whenever I’ve had my treatment I can honestly say that J feel that that is mine going into me. I never feel that’s somebody else’s when they actually put them in. I never think “oh, that could be that lady’s down the road, or that lady I’ve just met, or whatever”. It doesn’t even enter my head. I don’t even wonder what it’s going to be like and whether it would it resemble me? Because I’m sure that in some respects it’s got to resemble you, hasn't it? If it’s been inside you and grown inside you ...

(Zoe, 38-years-old, four unsuccessful donor treatments)

Ideas of making own may also manifest as idioms of parental nurturance. Peggy talks about bringing out latent talents in children as part of the facilitation of a good ‘transmission’, and as part dependent on the adequate

flow of non-identifying information about the donor. Her point is that knowledge of a person’s genetic heredity may be used as knowledge for social nurturance and not simply as important health information about possible hereditary susceptibilities. Social nurturance is material continuation of the physical ‘feeding’ of maternal gestation. If the donor has an interest in reading, what exactly does she like reading? Which subjects did she enjoy at school? And if they said she’s very musical, I would like to know that. You'd like to think that if a child showed any sign of musicality, you’d think right that could be encouraged because we know that, because I’m not musical so it would have to come from somewhere. There are potentials in children that people who know about that, the parents can nurture. (Peggy, mid-forties, mother of four birth children, two unsuccessful donor treatments)

Women who use this kind of blood imagery are not however deploying traditional Euro-American constructs of kinship when they claim off-

spring as their ‘own’. They are not saying that relatives by blood, as derived from the order of nature, represent permanent and immutable ties. Nor that the involuntary character of blood as the ostensibly ‘objective’ basis of these ties forecloses the possibility of choosing who one’s relatives are (Schneider 1968). Neither do they say here that they can trace their blood via a common ascendant or through certain relatives in the

sense that notions of blood ‘in the veins’ are suggestive of a common blood pertaining to a particular heredity. In other words, blood is not envisaged here as singly constitutive of a biogenetic relationship or of a biogenetic fact of nature. When recipients deploy from out of existing folk beliefs the familiar sentiments of ‘being of the same flesh and blood’, they do so only because they have no other readily available idiom with which to describe the kinds of ties they imagine they are in the process of forging. What they are talking about is a blood-food that is all about volition and choice, one that has nothing ‘objective’ about it. Along with the circulation of blood-food it is envisaged that many different feelings will be transmitted, all of which go toward making the baby a person in its own right, as well as a person already implicated in particular relations.

156 Nameless Relations It was reasons such as these that supported the belief shared by many recipients that egg donation could not be likened straightforwardly to adoption. However, activist campaigners who advocate for the right of donor-conceived children to know about their biological origins often make analogies between gamete donation and the precedent of adoption law. In the absence of a genetic tie many recipients would outline what they imagine is a biological continuum of relatedness that privileges the gestational and birthing experience. Susie would have been prepared to adopt a child, but she wants to make clear the two practices are not exactly the same. Egg donation would just be preferable because it is part of Will [husband] and it is part of me because I’m carrying it. Whereas with adopting, it’s neither of you in the child even though you’d be bringing it up and eventually you'd class it as your own but you wouldn’t feel that close bonding to it the day it was born or the minute it was born. In me the child is growing and you feel it. (Susie, 36-years-old, mother of donor-conceived daughter)

Although Susie simplifies considerably the hugely challenging as well as financially costly process many adoptive couples face in achieving adoptive parenthood status, the point she makes is that ova recipients are able to derive a palpable sense of ‘taking over’ from the donor: With adoption you just go along, sign a paper and be handed the baby. Not that I wouldn’t do it if I didn’t have Meriel. I’d still do the adoption if it came down to it.

A few women would talk about relatedness by drawing on processes of gestation and growth as forms of work. Their narratives emphasise their sense of active participation in the relation they make. Describing the

birth of her daughter, it is the painful actions, and sheer incredible achievement oi getting ‘a melon out of a straw’, that play on Una’s mind

long after parturition. She has decided that her daughter will not be allowed to play dangerous sports at school since ‘I have not put my life on

the line needlessly’. This protectionism stems partly from her desire to preserve what she sees as her past achievement as child-bearer. Vera also starts to feel responsible for her children well before they are born. She

talks about making her children ‘hers’ in terms of the decisions and choices she has to make upon finding out she is carrying triplets from her sister’s donated eggs. This proves all the more difficult for her since she is already mother to a young handicapped daughter who requires her constant attention. She takes on board conflicting advice from the hospital and relatives, and throughout the time of gestation deals with her doubts and fears about the consequences of selective reduction therapy. All these

are embodied by her as her productions and comprise the traumas of thinking loss, risks and wondering about rearing children with congenital complications. Carrying difficult decisions as well as potential lives, the

Recipients I 157 children are made her ‘own’ because of what she has chosen to do in her capacity as social agent, ‘... not because of where they came from or anything like that. Just because of the baby, that I felt that they were mine, totally mine because I was responsible even well before they were born’. When Yasmin refers to one of the donor-conceived twins she miscarried, she establishes relatedness to her lost child by preserving the memory of similarly shared kinds of inter-uterine life. The fact of resemblance is forged through a past connection with her birth mother. ... and I also kept the picture of her twin, and then I’ve got another picture of her with the scar of the twin when the twin had gone so that I can show

her. I just keep them for her really. I was always very interested in the chances because my mother had a miscarriage before me and I always used to sit as a child and think: ‘I just think I might not have been around if she ... if that one had progressed’. So I Kept the picture of the one that got away

for my daughter so she can think the same in a way. That that was the one that might have been me, but wasn’t ... (Yasmin, 33-years-old, second ova donation

attempt resulted in birth of daughter)

Recipient and birth daughter both have been the arbitrary consequences of others’ failed conceptions making resemblance something that can be

established between them as the shared embodiment of like kinds of chances, or bio-physiological survival. It is partly the precarious nature of inter-uterine existence that Yasmin imagines provides a source for con-

structing knowledge of common origins between them: she hopes that her daughter ‘can think the same in a way’ since both their respective mothers have miscarried embryonic life. Yvonne develops this theme of inter-generational relatedness through the maternal line. The ‘work’ of women’s procreative reproduction is ‘carried through’ as female-maternal genealogies that establish interlinkages as though they are social kinds of ‘cycles’ between women. It’s like a cycle really. I have a daughter who maybe she chooses wants to have a family of her own, and she has a daughter, and that daughter will carry on. So it’s like a cycle on the female side of things. Male ... men, well, fair enough, [they] play their part but women actually carry the child for nine months and feed it. I think it’s a cycle within the women. No disrespect to the males at all. But they’re just there to fertilise the eggs. Whereas the woman does most of the work.

Task Yvonne whether she traces this cycle back to her mother and grandmother. I think so, because you normally remember your grandparents. Grandad as well. But I think it’s always the mother that comes in the forefront. I was always closest to my father ... but at the end of the day it was my mother that gives birth and goes through everything ...

158 Nameless Relations ... [mean the doctor is there to help the donor as much as me, but at the end of the day I think it was down to the two of us to make this work. As much as the doctors and gynaecologists have to make it work. But I think it was down to us to make it work both ends. For her to get the ripe eggs and for me to carry it through ...

(Yvonne, mid-thirties, second ova donation treatment resulted in birth of daughter)

The above examples show how recipients conceive of forms of personal continuity in terms of the decisions and actions they take. The semblance of ‘lines’ of continuity between generations takes effect not simply as a measure of a lineal descent reckoning pursued through the transmission of innate body substance. It is shaped rather by the ways women actively make and seek significant relationships with others — these reflecting the vicissitudes of their own experiences, backgrounds and previous relations.

Summary Link The views of recipients are difficult to categorise neatly. This is because of the partial and often contradictory nature of their multiple discourses. On

the one hand, women seem to endorse their anonymised [non-] identities, seeing sanctioned concealment as a security against unwanted intrusions such as questions about the conceptive origins of their children. At these points women could be identified as supporting a genetic inheritance model of reproduction, and indeed would support the procedures of clinical matching that not only favour the positioning of women as mutually faceless, but also privilege the intrinsic status of biology. In this context it is the question of what their children would look like that tends to dominate their accounts, and it is in part through the similarity of physical appearance that recipients felt confident they could assert the social

identities of their children as their ‘own’. In this sense recipients ‘misrecognise’ the spirit of assistance and fail to receive the same body parts gifted to them by donors. It is not surprising that where little information is conveyed to a recip-

ient about a donor, little information may be known about the overall logistics of making ‘matches’. Anonymity is rendered here in its most ‘flat’ composition. That is to say, it becomes evident in terms of its complicity

with a lack of transparency. That information may be kept ‘hidden’ as a

valuable resource in its own right was a suspicion some recipients adduced as the pretences of matching. Straining against this view and countering its most basic assumptions, recipient social mothers also indicate what they take to be their ‘ownership’ in the person of their children is not something that rests on a pro-

prietorial principle of the biogenetic as irreducibly natural substance. Instead, they envisage connections in terms of the cultural ‘work’ they see themselves producing through the multiple recognitions, resemblances,

Recipients I 159 decisions that they set in motion. Thus, many informants can be seen to take the procreational idiom of identities of ‘flesh and blood’ further when

they go on to imagine how their somatic blood constitutes productive flows that circulate independently of biological ties of descent and inheritance. We have seen that persons act as transformative agents such that the division between the genetic and the gestational based on a model of the fragmentation of roles does not refer simply to the partibility of the body as parts/substances circulating extra-corporeally between persons.

Divisibility of roles and processes are the enactment of transferable actions, identities and identifications between differently extendible and differently relational persons. Thus, it is not only because recipients cannot be expected to initiate a return that they are neither subordinated nor socially inferior to donors in any symbolic sense. Critically, it is because recipients make their own versions of themselves as ‘reproductive’ persons independently of the ‘biological’ substance of (missing) eggs. They

thereby assume equal kinds of identities to the productive agencies analysed previously as the making of donors’ social relations, although this is quite different to Gouldner’s conception of the generalised norm of reciprocity entailing the duty of obligation based on persons’ past behaviour.'?

Notes 1. The HFEA decided to allow egg sharing in 2000. Treatment centres are required to set a minimum number of eggs that need to be collected in order for sharing to take place. According to guidance set by the HFEA, if this minimum number is not reached (after superovulation and egg retrieval), then the egg provider should be offered the option to use all her eggs for her own treatment. 2. In November 2003, the HFEA announced its outlawing of the egg-giving scheme for licensed treatment centres in the U.K. The following comments relate to past practice. 3. Critics again make analogies to ‘egg trading’. ‘IVF doctor is accused of “egg trading”’, Evening Standard [London], 2 December 2002, pp. 1-2. 4. Note that for health reasons, the egg-giver will have to wait an interval time of at least three months between each of her stimulated superovulation cycles.

5. The HFEA is currently undertaking a review of egg-giving arrangements. One woman who sold the tabloid press the story of her experience as ‘egg giver’ stressed the adverse psychological and physical effects caused by her intense drug protocol. Kylie Sidney had suffered from extreme pain and ovarian hyperstimulation and was hospitalised with a suspected pulmonary embolism, a potentially fatal clot in the lungs usually caused by deep vein thrombosis. ‘The IVF deal that nearly killed me’, Evening Standard [London], 2 December 2002, pp. 16-18. Sidney has set up the ‘IVF & Egg Donation Emotional Support Group’. Available at . (Global Egg Donation Resource Patient Support).

160 Nameless Relations 6. Note that in the late 1980s, the recruitment of anonymous egg donors was so low that in a reversal of contemporary events donation between relatives, usually sisters, was encouraged. 7. See for example the ‘One-in-six’ group available at: .

8. Except that ‘keeping it in the family’ might refer to a recipient family who would wish to have their donor offspring related as full siblings through the Same genetic female line (donor) and social father, as opposed to donor siblings related as half-siblings with different donor mothers. 9. On the link between ‘poison’ and contagion in the context of predictive genetic knowledge, see Konrad (2003c). The disclosure of certain genetic information may ‘save’ lives, but equally, what for some persons is embodied as too much information can do untold harm. 10. Una’s choice of the term ‘freaky’ also portends the double-edged juxtaposition of the arbitrary with the monstrosity of the abnormal and the perpetration of ‘strange facts’. In this sense the desire to appear as if a ‘natural’ conception has taken place resonates with the fears associated with breaching ‘the normal’, as well as with the perception that ultimately what has been surpassed, is an original act of (pro)creation (see Konrad 2003a). 11. One simply contacts the clinic for a username-password which provides one with instant access to the website’s donor database. Further information available at . 12. Further information available at . 13. ‘We owe others certain things because of what they have previously done for us, because of the history of previous interaction we have had with them’ (Gouldner 1960: 171).

CHAPTER 7

RECIPIENTS II

Te secret’s power as sacred force concealment depends even more on its revelation and on the oscillation between and revelation in the twilight zone of the “half-known”’ writes Michael Taussig (1999: 204) in his cultural critique of the negative productions of ‘defacement’. Taking public secrecy as its main conceptual problem, Taussig’s post-Hegelian analysis offers a theoretical response to his own anthropological observations on the ethics of state imposed military rule in Columbia. Living the fear induced under states of emergency and by the repressive ‘law of silence’, the anthropologist describes the non-visible ‘presence’ of secrets whose multiple forms of revelation are made most evident as the cultural work of defaced lives. Despite the horrendous massacre and unexplained ‘disappearance’ of millions of peasants, people somehow survive the system because there can be, as he suggests, no end to the work of ‘unconcealing’ or unmasking. One is simply carried through by the ‘spectral radiance of the unsaid’ (Taussig 1999: 6). These insights may be helpful for the way others in far less oppressive regimes, their civil liberties more or less intact, approach the generation of

knowledge and non-knowledge as transmissively laden productions of effacement. If secrets can be said to carry certain ‘magical’ properties and

may sometimes come to life in the form of the evanescent gift, then knowing what not to know and living one’s life in relation to ‘active not knowing’ (ibid.: 7) are ethico-cultural animations that give fundamental shape and meaning to sociality. The secrets generated by third party anonymous donor conception lie inside and not beyond any such sociality. It matters therefore how people

implicate themselves in forms of non-knowledge and how such nonknowing is elided in cultural terms with other social practices. Present-day understanding of some of the impacts of growing up within donor-conceived families has been enriched by the large and growing literature on the social welfare and psychological aspects of secrecy surrounding AID programmes.' Much of this literature questions the social management of

162 Nameless Relations information: whether and how social parents should tell donor children about their unusual conceptive origins. While doubtless a salient concern, the focus on the ‘best interests’ of the child that features so predominantly within this welfare and counselling-oriented field tends to pro-

duce interventions of a normative and pragmatic kind that pay little sustained attention to some of the subtle, more elusive workings of culture.” By contrast, this chapter proceeds through the ‘half-known’ to elucidate the processual unfolding of the life of secrets as local moralities of information disclosure and non-disclosure within and across the generations. This cultural perspective allows us to see — literally to foreground —

why the question of anonymity’s operations may sometimes seem remarkable precisely for what cannot be said to be unspeakable. Recent empirical studies on anonymity and disclosure issues with populations directly affected by assisted-donor-conception technology, as opposed to more general surveys of public opinion, point to the tendency by recipient couples not to want to reveal the circumstances of conception directly to the child. To date these quantitatively researched empirical

studies have focused exclusively on sperm donation and provide an indicative statistical breakdown of recipient couples’ disclosure intentions.*? As a greater range of donor-conceived families come forward and

talk openly about their personal experiences, so a richer and more contradictory picture from the ground is likely to emerge — one that cannot be subsumed by statistics alone. Already by encouraging its members to selforganise, parent-based and donor-ofispring support groups such as ACeBabes and the Donor Conception Network help advance public awareness in this area: their local and regional meetings enact a living documentary

of the growing numbers for whom genetic knowledge means indetermi-

nate bio-provenance. But how will these support organisations, and indeed the wider recipient community, exchange amongst themselves different viewpoints and contradictions? How do families with donor children articulate the range of meanings given to non-knowledge of genetic origins? How is this evident as new cultural data? Since those who would

wish to excise the taboo of anonymity cannot ‘speak with’ those who occupy the name of the un-named and whose voices therefore remain muted, who in fact is talking to whom and through what rationale and justifications? Far from covering over the extent of contradiction and willing a united ‘position’ for future policy — whether pro-anonymity or anti-

anonymity — it is precisely the work of culture to make explicit these differences. The contributions of social anthropology become relevant and pressing here.

Accountability and Blood Manipulations J first met Wendy and Peter some two years after the birth of their donor-

conceived daughter. On each of my visits the couple would repeat that they were decided firmly against disclosure in the future. As Esme grows

Recipients I] 163 older, it is important to pre-empt the hurt that can be caused by secrets ‘coming out’ in a bad moment, Peter would say. ‘Why make life more complicated and add extra burdens. Life is a finite thing. You want to make somebody’s passage through life as even as you can’, Wendy would add. In its extreme, adherents of this view appeared to believe that there is noth-

ing actually to tell the child! I would frequently hear ex-recipients convincing themselves they would not need to tell their donor-children about the genetic mother: ‘that other woman’ (the donor), they would say, ‘is not important because I am her mother’. Recipient parents thus manipulate blood ties by perpetuating non-truths through acts of omission. Partly what moves such rationalisation is the fear of maternal rejection and loss: recipients would worry that revelation of a donor’s past procreative involvement might change the nature of the child’s future relationship to the non-biological parent(s). Covering over the excluded donor as forgotten relation can be seen as the enactment of genealogical amnesia: it is a way of overcoming the loss that the devices of matching for example attempt to conceal, as discussed in the last chapter.* But manipulating the illusion of blood relatedness is not simply the local reasoning of reciplent communities within the worlds of ART. It has been recognised as a form of strategic kinship reckoning by other cultures.

Consider the ways in which the Bush Mekeo kin of the Central Province of New Guinea mix and unmix their bloods so as to make themselves accountable to each other as various symbolic ‘conceptions’ and

‘de-conceptions’ during the time of marriage and mortuary feast exchanges. Analysing the indigenous conflict between endogamy and exogamy, Mark Mosko (1983: 29) argues that Bush Mekeo social structure is reproduced over time by various ‘manipulations’ of blood identities whereby ‘new social personae are literally begun’. Metaphorical connections between the indigenous notions of body (kuma) and clan are traced in terms of the processes of respectively ‘opening’ and ‘closing’ the mutu-

ally constituted boundaries of each. In this way affinal reproduction between cognates, engendered by the procreative ‘mixing’ of bloods, is reiterated mimetically at the structural level by the periodic de-conception that is the clan body’s blood.

Now the opportunity for these new mixings is seen to depend on the temporary and fictitious abrogation of ‘one and the same blood’ identities

that all parties know to be a ‘lie’ (bifonga). Bilateral kin who share the ‘same’ blood are thus ‘manipulated’ (ifa kekapaisa) into non-relatives of

‘different blood’ so they can marry in accordance with the rules of exogamy. Upon death however, bilateral kin are ‘manipulated’ into nonrelatives and therefore assume the status of potential affines. In symbolic

terms, the meat or culinary bloods that feast-givers endow to feastreceivers during these mortuary exchanges stand for the bloods of those women who were incorporated into the clans of the feast-givers at the procreation of the deceased and deceased’s parents. Thus, ‘de-conceiving’ these bloods is symbolically equivalent to clans purging themselves of the ‘foreign’ blood by which the very conception of their respective members

164 Nameless Relations was originally possible. In this account of the homologies between bodyclan reproductions, the value of what is ‘replaced’ is constituted as the reclamations of bloods that were once ‘lost’ in previous generations of procreation. It is this possibility of ‘undoing’ relationships and redistributing persons over time as the aesthetic of regenerative reclamation, which is seen to keep local social life orderly and continuous. This exogamous impetus of the Bush Mekeo to purge themselves of ‘foreign’ blood resonates with ova recipients’ interest in transforming the third party exchange of genetically non-related material into a relation-

ship of continuity. By analogy donor-conceived persons are ‘de-conceived’ when social mothers nurture gestating foetuses with ‘blood-food’ so that they may come into being as ‘their own’ (see in Chapter 6 ‘Blood food lines’, Recipients I). In the British context however ‘manipulations’

are often messy affairs and full of ambivalence. Recipients may spend long periods of time undecided or simply unable to work out their position on telling. This may seem the easier way at least for the present moment, some women would say, certainly whilst infant children are of pre-school age. Alternatively recipient couples may disagree between themselves over the issue of disclosure. Where a sperm donor has not Stood in as genetic substitute for the male partner, it may be men in the relationship, as genitor, who nonetheless seem more preoccupied to keep knowledge about the conception ‘covered over’. Max, for instance, does not see the point in telling their daughter about her conceptive origins since he is her natural father. Tess, however, disagrees. She thinks it is the child’s right to know. I just feel she should know really that she was very wanted for us to have gone through all of that, and obviously somebody was very caring to have done it for us to have her. I may change as time goes on. But at the moment, I just feel that I think it’s her right to know. But whether we will, I can’t say because we’re a bit split on it. 1 mean at the moment nobody knows about it apart from my sister. So again, that’s how it would be left, but obviously if we tell her, then it would come out. (Tess, 39-years-old, mother of one donor-conceived daughter)

Max defends his position with an analogy to adoption and the ‘backtracing’ of persons. I don’t really feel there’s any need [to tell] because it’s not like adoption. Like when you've adopted a child obviously the woman has actually given birth

and given the baby up. Or the child up. So there is a person that they can trace because she’s given birth. So there is that person that that child can trace. But with this, you see, there is no way that she could trace [anyone] because all she was was an egg. I mean obviously all she’s [donor] done — she doesn’t even know that she’s here. That’s the end of it, they [clinic staff] don’t say [to the donor] that ‘yes, there was a child come out of that collection’.

(Max, husband of Tess and natural father of donor-conceived daughter)

Recipients I] 165 Max and Tess imagine the identity of the donor eludes full traceability because during their pre-treatment counselling sessions at the clinic in the

early 1990s they were reassured that anonymous donation meant that resulting offspring had no legal right to trace the genetic-donor parent. Max and Tess are not alone in their understanding of the permanence of donor anonymity. Their comments show that very many couples during the 1990s had limited appreciation, or indeed no knowledge at all, of the administrative complex of information collection and analysis set up by the British central licensing authority, the HFEA. Nor were they aware of the potentially mediatory powers of an entrusted third-party information

holder. In fact, once their treatment attempt was over, the recipients I befriended hardly gave any further thought to the consent forms and other documents they had dutifully filled in and deposited at the clinic. For much of the 1990s, clinic-based infertility counsellors and prospective

parents assumed alike that the long-term kinship implications of the donation, and associated collection of genetic and personal information, required no further reflection. The guarantee of anonymisation put all their consciences to rest. By contrast, a pro-openness stance in favour of telling the child, family and friends usually correlates with a heightened scepticism about the bioclinical emphasis on genes, genetics and physical resemblance. While disclosure might be favoured by some, many families grapple with sentiments that go against the received grammar of biogenetic relatedness. Finding a new explanatory language begins, some would say, by integrating the fact of conception truths into the fabric of family life. This entails an ongoing process, itself part of the necessary preparation of disclosure, rather than the ‘outing’ of a secret as a shameful and abrupt revelation. Peggy ‘de-conceives’ collusion thus: I think it’s quite frightening that people won’t tell their children they were adopted. It must be like some growing frightening secret that you’re terrified of getting out as they get older. I think you have to make it feel right from the beginning, so that there’s no big secret. Not make a big thing of it, but I do think that ... the child just grows into it because it’s always [been] an established fact. I don’t think it should be some shocking truth when the child turns fifteen or eighteen or whatever. (Peggy, mid-forties, mother of four birth children, two unsuccessful donor treatments)

Ravinder, Yasmin’s husband, recalls his bewilderment upon hearing how others make plans to ‘lay down’ foundations that aim to preclude difficult questions. We are talking together about a local support group meeting for parents with donor-conceived children that the couple recently attended. Ravinder: I was quite shocked in fact there was a woman there who said that she wouldn't tell anybody at all including her child. They were going to

keep it all a complete secret. ,

166 Nameless Relations Yasmin: And the reason for that was because they were afraid of what people in the village would say. And I was just flabbergasted. My view was ... and I said it to her: “well, what do you think you’ve done wrong?” And she

said: “Nothing”. I myself have been completely open about it with everybody and that will include Charlotte [daughter]. I’ve never had a single negative thing said to me ever about it and I’m not afraid to answer people’s difficult questions. Because they might ask difficult questions ... the usual one is: “well how can you think of her as being your child?” It’s a very difficult question to answer because the simple fact of the matter is that she is and you do. And you actually don’t think about it in any other way. So that is hard for people to grasp. (Yasmin, 33-years-old, mother of one donor-conceived daughter)

Zoe, approaching forty, has undergone four unsuccessful donation treat-

ment attempts and is still intent on making plans for her fifth go. Throughout the donation process she has kept a record of her endeavours which she describes as her personal ‘donation file’. This is a diary type scrapbook filled with notes, clinic correspondence, news clippings and copies of her advertising recruitment campaigns for an anonymous ‘cross-

over’ donor. Over the years Zoe has updated the file with meticulous attention. She has added in the dates of blood tests and ultrasound scans, each of the days she experienced vaginal bleeding, lists of all the fertility drugs administered to her, notes about medical protocol, descriptions of treatment side effects and invoice receipts from the clinic. The file, she

explains, is designed to show any future child how much its parents wanted to conceive: it will be used as an aide-mémoire for explaining the facts of assisted conception.

In documenting these procreative misconceptions, Zoe becomes an active ‘bio-engineer’. In this case it is not blood that is ‘manipulated’ into a different substance as a set of relations; rather the process of ‘unconcealing’ is welded together from multiple ‘primary’ materials and emotions, namely paper evidence, financial depletion, procreative struggle, never-ending disappointment. Assembling these materials together, Zoe’s

‘bio-archive’ is the beginning of a new descriptive language about the (pro)creativity of non-linkage.

But however much has been ‘told’ by any one party cannot detract from the fact that there may always be yet more to know. Taussig distinguishes between the secret revealed and the secret exposed. Where revelation is partial and keeps the secret in tow as the ceaseless generativity of half-known knowledge, the moment of exposure is one of final magnitude. Exposure is both the impossibility and banality of the endpoint, a destructive energy that tries to ‘master the secret by evacuating it’ (Taussig 1999: 7). We will see later how this observation is germane to the kin-

ship ramifications of transilience and why the ‘sacred surplus’ of the anonymised donation means that secrets run on exponentially. For the moment, I want to introduce Ella whose articulations about the ‘hallfknown’ help to elucidate the work of culture as the irrepressibility of active not-knowing.

Recipients IT 167 Revealing-while-keeping the Secret (Ella’s Effacement) A 51-year-old recipient currently expecting twins, Ella introduces our discussion about knowledge disclosure by drawing on her own experience as an adopted child. She recalls the abrasive way her adoptive ‘stepmother’ blurted out news about her genetic origins to her when she was thirteen years old. It was a shock. Facing late motherhood for the first time, she sketches out with me the basic elements of a future ‘truth-telling’ narra-

tive about the donor twins’ conceptive origins. ‘Telling’ children, she thinks, is all about gradual shifts in emotional awareness and responsiveness on the part of a parent to a child’s curiosity. I think it’s a matter of when the question arises. More often than not it will probably be when they go to school and come back with bits and pieces

about sex and things like that. Or possibly even beforehand if someone turns around and says something like: ‘Oh, you haven’t got your mother’s colouring, have you!’ I think it’s a question of awaiting the opportunity and grasping it, but obviously it shouldn’t be too late either. Except I don’t think you can plan because you don’t know how the word is going to crop up. But just to take advantage of it when it does.

She continues to explain how she would refer to the person of the donor. I’d say that I carried you, you were in my body for nine months and it was Daddy’s sperm. Which is not a lie, in fact it’s the truth. And then just gradually expand on it as time goes on. If it were an older person I would tell them exactly what it was. Something like unfortunately I myself wasn’t able to have children and there was a lady who was prepared to donate her eggs. I would say that the father wanted children as well and that you’re

definitely his child, but also that I carried you in my womb those nine months and you've got an awful lot of my characteristics. It was only just a little egg that started off that wasn’t mine. Once again, it depends on what the child is like and what sort of things they respond to. I don’t think you can really set down rules. But you’ve got to accentuate the part that they’re wanted. And if you’ve brought them up and shown them the love, you'll have no problem in accepting it because they will remember that.

Ella is emphasising there can be no clear-cut guidelines or objective rules

to follow in such situations. The importance of not forcing unwanted information upon people is a lesson already learnt. Having successfully traced her birth mother, she is familiar with the converse: the skill of drawing information out of people and the contingencies involved in the transmission of sensitive information. She also knows how people can be ‘killed off’ through dishonesty. Secrecy as the ritual killing of persons enjoins the secret that is ‘spent’ on account of its sacrificial destruction:

the creation of certain [child] victims. Her birth mother not only disowned Ella and three of her sister siblings when handing them over to separate adoptive parents, she furthermore ‘buried’ the fact of her very existence by telling subsequent friends that the children had died. ‘Her

168 Nameless Relations death’ is information Ella has pieced together gradually, extracting ‘secret’

knowledge from her so-called ‘stepmother’ whilst listening in from ‘behind the door’ on hushed-up family conversations. As the story goes, Ella’s mother conceived a further three children, but it was not until the birth of the first boy child that she felt able to rear as her own these subsequent offspring. As for Ella’s birth father, he lost interest in the family, moved on elsewhere and cut off paternal ties with the remaining children. Only able to trace and make contact with one of her non-adopted sister siblings,she has never met in adulthood her five remaining siblings, each of whom, she is given to understand, broke off contact with both birth parents. Aged twenty-one, Ella managed to meet up with her birth mother. Preparing for their first reunion meeting, she wondered about all the usual things: what would her mother be like? How would they get on? But she was also curious as to how her ‘re-arrival’ would be elicited as public knowledge, as the evident ‘undoing’ of a past lie. Alright, I haven’t found very good things out about my mother, but I have found out. She knew I was alive, and yet she told all the other kids and other people that I had died at the age of four. When I went up there [to visit her] she had organised a party for me. She didn’t know how I was going to react at all. It could have gone the complete opposite but I wanted to meet her and I thought what a wonderful idea to have a party. But I did wonder: how is my mother going to tell everybody that this is her daughter, the same daughter that she had told everybody previously had died at the age of four? And I had a very quiet giggle to myself over that.

It is this history of severed ties and reconnections that makes Ella such a sensitive information broker of genetic knowledge for her own childrento-be. Should the twins at some stage wish to trace the identity of their genetic mother, she would support their efforts, and would be curious to meet the donor herself. But the process of information acquisition should never be imposed upon another disinterested party, she adds. Information should flow willingly from source and find the way of its natural path by

mutual consensus. Ella echoes here Peggy’s earlier concern about not forcing unwanted or excessive information on another person (see Chapter 6, Recipients I). Prompted by me to imagine the possibility of a reunion meeting sometime in the future with her anonymous donor, Ella responds by assimilating the figure of the donor back into the picture. She explains how she would be ‘guided by her emotions’. Ella: I think I would enjoy telling her if she wanted to know how the children had turned out. I would want to explain why it was important to have children and how gratetul I was she had given me this opportunity. But also I’d like to be able to prove to her that if the children did turn out talented, then perhaps this would make her feel proud as well. To prove to her that I

had used this opportunity wisely, and if she felt proud as well, I’d feel chuffed. But I’d be guided by her emotions, very much so. I respond to peo-

ple’s emotions and reactions because I feel that you have to. If a person

Recipients I] 169 doesn’t want to know something, I’m not going to upset them by telling. So I'd be guided by her emotions in that.

MK: Do you think it could be something of a special relationship between yourselves if you would meet up after all this time had passed and your children, too, would have grown up? Ella: I think it would be far more relaxing for both Duncan and I because the time had passed. It would be special from my point of view but I can also look at it from the person who donated. For her it was just an egg. She didn't give [away] a human being. It wasn’t even fertilised [When she gave it]. It could just be like a small organ, or something like that. So this is where I would be guided by the emotions and actions of the person. I mean if I gave an egg I would be curious to find out how it had ended up and if it was OK.

But also I can understand if other people don’t feel the same way. If you donate ten or eleven eggs, then to them it would be helping other people but it’s not so much of a closeness, so this is why I say be guided by the other person’s emotions.

In this narrative the gift and the secret are intertwined in each other’s continuous ‘unconcealing’. The gift ‘lives on’ through the form of its return: honouring one’s role as a good parent is part of the indigenous notion to make a symbolic ‘repayment’ to the donor for her gift.’ The secret ‘lives on’ because it can never be fully spent — it cannot be ‘exposed’

as a final truth. Whichever way one turns there are informational gaps: Ella’s adopted history has given rise to ‘lost’ relations with her natural father and full genetic siblings. Similarly the donation experience has opened up knowledge of the existence of unknown relations between anonymised donor and recipient, and between the respective women’s genetically related half-sibling children.

The following sections go on to outline some of the reasons why assisted-conception by donor differs from the adoption experience. We shall see how telling a ‘truth’ is not just a one-off disclosure made by senior kinsfolk to juniors, typically parents to children. The life of secrets and its unfolding over time enjoins multiple pathways, persons and trajectories as the instantiation of genealogical ethics (cf. Chapter 4, Donors II).

Whatever Happened to You? Former recipients whose treatment outcomes have been successful some-

times send the clinic photographs of their babies as a ‘thank you’ memento. Occasionally some mothers would drop by to ‘show off’ their children to the fertility consultant who had helped them. Staff on rota would break from their duties and gather round the visitors for a moment or two. There would be a flurry in the corridor and the raising of voices. ‘Congratulations!’, ‘Fantastic!’, ‘What a miracle!’, ‘Oh, let’s just take a snapshot!’

170 Nameless Relations Photomontages of donor and IVF babies are common decorative adorn-

ments in clinic waiting rooms, hallways or the consulting rooms of assisted conception units. One sees displayed an assortment of babes-inarms, tiny smiling faces or sleeping bodies whose infant lives only touch each other as overlapped picture edges. Placed underneath large glassframed clipboards, these visual exhibits are the ‘success stories’: the sperm and eggs that fertilised, the embryos that survived and implanted to arrive into the world so many months later. Smiling back at them are the next round of hopeful parents to-be and their honorary facilitators, the proud clinic staif.

Apart from these fleeting encounters, families and the clinic usually lose touch with each other. Certainly after the first twelve months or so

post-donation, those recipient families who have no remaindered embryos in storage for possible implantation at a later date will have no pressing need to remain in contact (see Chapter 8, Recipients II). For its part, the clinic is simply too busy with the present immediacy of patient eligibility, treatment protocols, data administration or inspection auditing, to look any further into the future. And so it comes to pass that nearly everyone becomes distanced from the long-term kinship dilemmas built up around the ongoing ‘life of secrets’. Everyone, that is, except the parents and ex-recipients, their children and independent counsellors. For many recipients, active not-knowing is implicated in the temporality of remembering the donor and the act of donation. There is rumination about what information could travel back to the donor as conception outcome details. Much as Ella did, these recipients would try to imagine

the person of the donor and sometimes would wonder whether they might make contact one day, or possibly meet up. All such speculation preserves the gift as an open-ended vista of unfinished exchange. Winnie and Hilary say that they would not mind the clinic telling the

donor that their treatments had resulted in successful pregnancies (cf. Chapter 4, Donors II ‘Knowledge outcomes and the form of the return gift’). Putting themselves in the position of the donor, Zoe and Sinead imagine it would be reassuring to have the concrete evidence that one had

helped somebody. From time to time Winnie tries to imagine what the donor might be thinking beyond the immediacy of the donation event. Although she does not know ‘the other side of the coin’, this other side is one whose existence she cannot easily forget. They’re never going to know ... J think they must be a special kind of people really to be able to do it. They know somewhere that one of their eggs is a little person. Or perhaps they don’t think about it after they've done it, I don’t really know. I don’t know the other side of the coin. Whether they have any regrets? Or whether they sometimes think like I do? I wonder if the donor ever wonders whether any of her eggs ever came to anything?

Like I sometimes wonder about them, because I wonder if they ever do wonder. I don’t know if it’s a two-way thing or not? I don’t think you can ever stop wondering about some things ...

(Winnie, 34-years-old, mother of one donor-conceived son)

Recipients [I 17] Despite the fact that all of Zoe’s treatment attempts have been unsuccess-

ful, she is interested to know whether any of her previous donors ever ‘figure in’ the recipients to whom they have donated. I’ve often wondered whether the donors ask, or the hospital gives them, any details about the recipients. You know, the same sort of thing that they tell us about the donors. Whether they say: ‘we’re matching you up with such and such a lady’. It’s crossed my mind several times whether the donors get told about us or do they just never know anything? And they [donors] just do it because obviously they want to help. But I think if that was me, if it was reversed around and I was being the donor, I’d just ask [the clinic staff]: ‘well, what’s that person like?’ And just to be given a brief detail like we’re given. Not to know actually who they are.

But perhaps some of the donors don’t wish to know, or perhaps they don’t feel that they should know, or perhaps they just think that they’re doing it because they want to help and they don’t want to know anymore than that. I'm sure if it was the other way I would like to know a bit about [them]. [To have] the same sort of details. But don’t get me wrong, I don’t keep harking on about it and thinking to myself she’s got such and such features or she’s this or that age. It’s just nice [to know]. Basically why I write down that [information] is so that J feel I’ve got something to relate to in case it works. (Zoe, 38-years-old, four unsuccessful donor treatments)

Similarly, Sinead has a cascade of ‘I wonder’ questions ... . Isn’t it a shame she'll — I don’t know -— I sort of feel that she should experi-

ence the joy and pleasure that it has given us. It’s nothing tangible really. You know someone has done something really amazing for you and you’d just like them to realise somehow what it is they’ve achieved because it is so tremendous. But how do you achieve it, how can they possibly grasp it? I do think about her as a person, not just as a means to an end, but as a person. I look at her [my daughter] and I try to decide I wonder what she looks like. I wonder whereabouts she lives, what sort of lifestyle she leads, how many children she’s got. There are only questions, just thoughts really — questions of ‘I wonders’. (Sinead, mid-thirties, currently pregnant expecting twins, mother of one adopted son)

For Wendy the figure of the donor is somebody she is ‘never going to for-

get’, and about whom she continues to wonder since the birth of her daughter. Even though she is adamant that she will not disclose to her donor daughter details of her conception, and wants to convince herself that the person who donated is irrelevant and needs no mentioning, she remains a presence within her thoughts. ... just that this person flits back in and out of your life at certain points. Like

she’s quite uppermost in my mind now because you’re talking about it and she was uppermost in my mind on Sunday because again we were talking about after the programme. And sometimes she comes back to me every now

172 Nameless Relations and again like when I put Esme to bed. She’ll come back to me at those times. They are always sort of private moments, usually when I’m here at home. (Wendy, late thirties, mother of one donor-conceived daughter)

Thea, mother of nine-month-old donor-conceived twins, has experienced persistent feelings of post-natal ambivalence during her efforts at maternalchild bonding. Am IJ a fraud, she asks? Only her mother knows about the egg donor and Thea has no current plans to disclose the circumstances surrounding the twins’ conception. Anonymity, she says, keeps the donor and her doubts at a safe distance. But despite all the uncertainty and concealment, Thea feels an ‘invisible bond’ between herself and the donor. She says that her donor is someone she ‘will never forget till the day I die’. But does her donor think of the recipient from time to time in the same way? Sometimes I look at the babies and I think of the donor. Does she perhaps look at other babies and think that they’re my donated eggs? I wouldn't know whether she’s thinking that. Or perhaps she’s washing up at the sink and thinking I wonder if those eggs in February, if there’s been any babies from that? Are there any babies now? So I wonder whether there are any moments that I think of the donor, so does she think of the recipient? (Thea, 26-years-old, mother of donor-conceived non-identical twins)

Hilary evokes her donor as a ‘lost friend’ but neither her parents nor parentin-law know anything about the egg donation. As for their three-year-old daughter, the couple are not planning to divulge their conception secret. It’s a bit like thinking about a long lost friend or something that you haven't seen for many years but you still think about. I think the feeling will always be there. Every time I look at her [daughter]. Without the donor she wouldn’t be here. (Hilary, early forties, mother of donor-conceived daughter)

Wondering about the post-donation thoughts of donors, Yasmin thinks it

likely that there is a longer-lasting impact on them than their simply donating and then forgetting about it all. I don’t know how donors feel about it. They may think of it as some simple thing that they just do and they don’t think about it. But from my point of view I can’t imagine that it amounts to that only ... ... It’s two pronged. The first prong is I would like to know a bit more [about

the donor] because I think it could be an issue later on for my daughter and I would like to deal with any issue that came up in a positive way. From my point of view, just a sense of wanting to say thank you, that’s all. I don’t

know these ladies, but I do feel quite a bit for them and I don’t think it would be harmful in any way for me to be able to say thank you — I really don’t. In fact I’ve probably got a better ... in an odd way got a better relationship with them even though I don’t know them than anybody that I do know. Because anybody that I do know isn’t prepared to do that for me, as far as I know. Nobody that I know has decided to be a donor.

Recipients II 173 Anonymity here encompasses multiple and seemingly contradictory strands. As we saw in the previous chapter, Yasmin thought it best to avoid the danger of emotional entanglements from too proximate relations. She was concerned about the motivation of the gift and its possible ‘poisonous’ effects. Anonymity engendered the disinterested ‘pure’ gift through the form of unknown relatedness. On the other side however, Yasmin and Ravinder are critical of the secrecy and evasion that accompany anonymisation and untraceability. They plan to tell their daughter about her genetic-donor mother and would welcome the opportunity to meet other donors in a group situation, possibly also to arrange a link-up contact with their donor. Ravinder to me: J think that the thing with the donors is that we can totally

differentiate the difference between the two [genetic mother and social mother]. I can’t really understand it when people say they can’t approach it. Charlotte is our child and somebody’s helped us get that child and that’s all there is to it. People make a very big deal about the donors and whether we should meet them or not. I think I would like to meet the donors really. I would have liked to meet all the donors. Yasmin to Ravinder: I would have certainly liked to meet them as a group.

And even our donor individually. I certainly wouldn’t have minded. In terms of a group, I really wish we did meet them as a group. MK to Yasmin: Before the donation or afterwards? Yasmin: It doesn’t matter. We could do it before or afterwards.

Anonymity and secrecy are operationalised as logically distinct concepts and practices according to these views. At its most basic, anonymity is a mechanism for keeping the identity of the donor hidden whereas secrecy has to do with keeping the genealogical origins of the child hidden. The reason, however, why these differences cannot be kept distinct in practice

turns upon the perpetuity of the effaced gift as evanescent form. The anonymised gift of donor assisted conception ‘lives on’ not as the form of

delayed exchange that anthropologists have theorised as reciprocal returns, but as the form of transilience. Within anonymous sociality active

not knowing, occupancy inside of the twilight zone of the imagined or known ‘half-known’ — to borrow Michael Taussig’s words — sets up ‘unfin-

ished’ relations whose unconcealing make persons ‘transilient’. Transilient relations may be evident as the spatial ramification of genetically related half and full-siblings across separate and otherwise unrelated family units. At the present time the social complexity of such extended familial networks has barely impacted on policy debates. Certainly in cultural terms the kinship pertaining to sets of anonymised offspring has received far less sustained attention than it merits. Typically the issue is only ‘seen’

to be a problem in terms of inadvertent incestuous union between siblings. Let us consider a broader picture of the eventualities.

174 Nameless Relations Money Manipulations and Ova Pathways Within anthropology, it is well known that Mauss’s interpretation of the Maori ‘hau’, the so-called ‘spirit’ of the gift (see Chapter 2), reflected a case of ‘third party intervention’ that set up what he referred to as a ‘chain of users’ (Mauss 1990: 11-12). A precursor to Lévi-Strauss’s (1969) theory of ‘generalised exchange’, Mauss uses this notion of the ‘chain’ to

demonstrate how, even in a case more complex than two-way dyadic exchange, gifts are impelled to return to the ‘original’ owner, to the ‘place of origin’ (ibid.,13). Thus, whereas the principle of anonymity in contem-

porary British law posits the donor as the potentially intervening third party to two marriage partners, Mauss’s version of ‘third party intervention’ relates to the theme of mobility and the extensionality of the gift, and of social relations, beyond two reciprocating partners.°® To signpost how the anonymised reproductive gift ‘lives on’, not by virtue of its anticipated return and the familiar frame-device of reciprocity but as the form of transilience, we need to understand a few basic procedural details about the bioeconomics of clinical practice. A summary exposition of the intra-clinical allocation of post-ovum ‘pick-up’ retrieval will help to situate more closely what is at stake. Here my brief tour of clinical practice means stepping inside the domestication of contingency to face directly the evasions of transparency thrown up by certain ‘money manipulations’ in terms of their kinship effects. Note that I present this as the fieldworker’s own ‘inspection’: my ethnography is not part of the formal audit process undertaken by HFEA representatives during their mon-

itoring inspections of each of the licensed clinics. My observations, however, may well have relevance for such accountability processes. Taming Contingency (I): Ova Pathways and Directing Flow

Although a recipient is supposed to be matched up personally to ‘a’ donor,

it does not necessarily follow that this donor constitutes her ‘personal’ match (see Chapter 6, Recipients I). This is because one donor may be donating at any one time to more than one recipient, once clinic staff have converted her exteriorised ova into ‘batches’. After an ovum ‘pickup’, the embryologist will divide the total number of retrieved ova into multiples of three, so that each cluster of three ova represents one ‘unit’ which will later be graded dependent on the maturational growth of each of the tissue-cultured embryos. The principle of divisibility by three reflects the original legal upper limit of three embryos to be transplanted in the course of any one treatment cycle.’ When distributed across several persons, these units are referred to as ‘batches’. Let’s consider the example of a donor from whom ten eggs have been

retrieved. Two units of three plus one unit of four could make three batches, which represents three possible dispersive sets or possible ‘pathways’ (see Figure 5). I draw upon the notion of keda pathways that has

been used within the Massim world in connection with the exchange routes along which ‘valuables’ (kitoum) travel and circulate over the

Recipients IT 175 course of time between ‘kula’ exchange transactors (Leach and Leach 1983: 25). However, the pathways envisioned here are allocatory tracks that are not synonymous with the ‘roads of gift debt’ (Gregory 1982b: 344) endemic to the reciprocity model of exchange. I am referring rather to pathways as conduits of inscribed activity. In relation to the implicitly political muscle of intra-clinical allocation, the connection between pathways and ‘diversions’ (see Appadurai 1986; Campbell 1983; Munn 1983) seems far more pertinent, as does Debbora Battaglia’s notion (1990: 135) of the ‘kinetic “evidence” of the course of a social relationship’ and James Weiner’s (1995) ‘energetics’ of absent objects.

Now the greater the number of ova retrieved during ‘pick-up’, the sreater the number of alternative sets available for activation as possible

dispersal pathways. It may happen for instance that one recipient will receive all ten ova. Alternatively, two recipients may receive six and four ova each. Or two recipients may each receive three ova, and a third recipient four (cf. Andrew Strathern’s [1971: 100] analysis of pig-moka). Needless to say, the greater number of pathways created as separate chains, the greater the financial revenue incurred by the clinic. This is simply because the greater number of people treated, the more expenditure is gained by the clinic. It is thus in the clinic’s financial interest to activate multiple pathways wherever possible.®

D R -- “= I" @ (10 ova) D

R| @elee o | e (6 Ova) R? OS (4 ova) R! _ oe (4 ova)

D = Rr o-R?(3 ova) ead (3 ova) Figure 5 Alternative ova pathways. Divided into units of three, a batch of ten ova from one donor travels along different ova pathways, usually up to a maximum of three different recipients.

176 Nameless Relations It is important to realise that the contingent nature of these pathways is in part attributable to the indeterminacy at the root of the institutionalised donation exchange system itself. In large part, this has to do with the fact that the quantification of ova is something that can never be exactly predetermined, fathomed as certain knowledge in advance. In other words, the social entity that is the figure of the would-be donor can never be set as a pre-fixed or stable formula in relation to the would-be recipient. This is not just because the collection of ten ova may on one occasion go to two recipients, and on another to three women. It reflects the procedural limitation that the exact amount of ova produced by and retrieved from indi-

vidual women will always be the arbitrary variable of each donor’s completed cycle. Furthermore, this variability is something beyond the realm of technological control since it is mainly an outcome of the way the individual bodies of (differently aged) donors react to the hormonal drugs comprising the treatment ‘regime’ (see Appendix LIT). Such reactions

cannot be known in advance. Furthermore, the day of ova retrieval may hazard its own surprises since there is always also an element of contingency surrounding the surgical removal of eggs from each collection. For instance, some ova will need to be discarded prior to their fertilisation invitro due to their inferior ‘grade’ whilst others may have shown up in prior scanning sessions but cannot be visualised or located at the time of the transvaginal probe-extraction. Now the matching up of donor-recipient pairs as processes of temporal synchronisation is premised centrally on the value of anticipation. However, because of the lack of certainty as to how many units the enumera-

tive breakdown of one particular donor’s collection will equal in distributive range, the donation co-ordinator works on the profit-maximising assumption of ‘preparing’ the highest feasible number of recipients per donor. In practice, this means she works towards organising the

maximum number of batches as the maximum travel or circulatorypotential of any one donor’s retrieved ova. As it happens, these anticipations are products of yet other more ‘hidden’ contingencies. Taming Contingency (II): Ranking between Recipients

The potential to allocate one donor’s extracted ova to more than one person means that multiple recipients need to be arranged spatio-temporally in a way referred to by clinic staff as ‘lining up’. As we have seen, one of the important tasks of the co-ordinator is to pair a recipient with a donor as the closest genotype ‘match’. However, when ova are travelling simultaneously along multiple pathways, multiple recipients will need to be placed in a ranked order against the name of a given donor with a view to the forthcoming transfers. These differently prioritised recipients represent reserve possibilities and form a secondary sub-queue to the primary queue of the main waiting list for egg donation treatments. In this way ‘waiting women’ come to be transformed into hierarchised reserves. A ‘number two’ woman, for instance, would only become an actual recipient if the donor whom she ‘shares’ with recipient ‘number

Recipients II 177 one’ — the woman placed temporally ahead of her in the waiting list queue — produces enough ova to warrant the creation (sub-division) of a second ‘batch’. According to the principle of divisibility by three, this will have to be anything upwards from five ova, because five ova is one ovum short of two ‘units’. The recipient lined up as the number three reserve is

therefore ‘dependent’ on ‘her’ anonymised donor producing a larger amount than a two-fold allocatory path. Technically, all she may receive in any one preparatory treatment cycle is simply the contingency of the hope that there could be enough eggs from that particular ova collection to reach her.

For the recipients, this prospect of sharing-at-a-distance usually involves an intersubjective envisioning of anonymised others. It is as much through the ways in which ‘lined-up’ women could but would not receive eggs at particular times, as to the times when they became actual recipients that women became most aware that they were ‘part’ of a waiting system comprised from such imagined relations. Thus it is very much as the embodiment of these non-equal reserve possibilities that such soselected women formed — as a virtual, invisible queue — an internalised ‘ranking’ amongst themselves. Recipients would speak of themselves as numbered persons, saying such things as: ‘I was the number one woman’ or ‘I was lined up as the second recipient’. Some would go on to tell me how they had not been able to receive any ova on a particular occasion, even though their bodies had been ‘prepared’ hormonally with the requisite drug protocol for the eventuality that they might be able to do so. This ‘lining up’ of numbered women as anticipated recipients is not simply a matter of quantification: of counting out a number of collected eggs as (equal to) readily transferable ova or embryos. The allocatory pathways torged by the donation co-ordinator are the clinic’s endemic ‘production’. Another way of saying this is to point to the concealed fact that ‘the body’ of the clinic requires its own ‘preparation’, facts I began to appreciate as I shadowed Sylvia, the egg co-ordinator at ‘Credo Clinic’. The simultaneous ‘preparations’ of the donor and the intended recipient(s) have to be set in motion before the approximate indications regarding the quantity of maturing follicles are shown up in real time by the ultrasound scanning roughly some three weeks later. Since it is logistically

impossible for the co-ordinator to wait until the ultrasonographer has scanned the donor’s body before she proceeds to arrange who and how many recipients should be prepared with which donor, another source of potential ‘waste’ for the clinic is exactly this contingency. Preparing too many recipients means ‘mismatching’ an incorrect ratio of recipients to any one single donor (cf. Chapter 6, Recipients I ‘Mismatching’). If it happens that recipients who had been physically prepared with costly medical drugs could not in actual practice al/ become matches simultaneously — on account, say, of the donor producing fewer eggs than expected — then those women who did not receive eggs had not really ‘received’ any ‘gifts’ at all. Pari passu, they could not be expected to pay a treatment fee for these unaccomplished attempts. For though in practice the primary cur-

178 Nameless Relations rency in this exchange system is time, it is not possible to charge patients simply for the experience of anticipation. For the recipient a cancelled treatment, unless diverted expediently to another ostensible ‘matched’ donor, becomes ‘equal’ to the inconvenience, upset and health dangers of

having been artificially primed with progesterone for no reason other than the hope of possibly having a chance to receive some eggs from the designated pathway.

How Ova and Embryo Pathways Make Half-siblings Susie is explaining how the donation system at the clinic positions wouldbe mothers as the ‘number one’ recipient. On her first treatment cycle she found herself designated as a lined-up reserve in case ‘her’ donor would produce a large number of eggs. Although she does not know the precise

details of allocation relating to her own treatment, she appreciates the dynamics of pathway flow: Well, say she donated roughly eight and I was on top of the list, they would say to me: ‘right, she’s got eight eggs. Do you want to have three and freeze three, or not?’ It never bothered me because you've got less percent success rate for frozen eggs so I said ‘No’. So then the next woman has a chance of having eggs as well. Sol [would have] had three, the second woman [would

have] had three, and a third woman could have had two. So that would make the eight eggs up. But I could have chosen to have them frozen, so then the next woman would not have a chance until the next go. But if I was second on the list, you still have to prepare yourself for receiving the eggs because the donor could have donated say twelve eggs. So that means you could have had soine eggs implanted. But if she only donated say six eggs, then the top of the list could choose to freeze them. So you still had to prepare yourself but you could have been let down. The day before they might say ‘Oh no, sorry, she didn’t have enough eggs, or the first one wants all the eggs’. (Susie, 36-years-old, second ova donation resulted in birth of daughter)

This interdependence-at-a-distance between ranked anonymised recipients encompasses yet another ‘concealment’: there is in all likelihood fur-

ther interdependence whose precise ‘relational’ form has still to be unravelled. When prospective recipients and clinic counsellors first meet each other, their discussions usually do not bring to the surface the potential relational impacts that these ova and embryo pathways implicate. The fact that the donor’s birth children and the recipient’s birth children are related genetically as half-siblings through the maternal line (ova donor) is something that tends not to be discussed openly at the first encounter between clinic staff and recipients. Nor is this something that usually is made explicit to consenting donors the very first time they visit the clinic as a potential donor-to-be. Likewise little if any attention is paid to the fact that the multiple dispersal of ova makes genetic kin out of the half-sibling

Recipients I] 179 children born to similarly lined-up, temporally synchronised recipients.’ Nobody is inclined to labour the point these pathways might one day be retrospectively activated as the future ‘shared’ awareness of a ‘cancelled’ kinship. The snapshot pictures of IVF babies adorning the clinic walls are thought to say enough. For a donation system whose rationale is founded in and through the logic of anonymity, calling forth the immanence of kinship as anticipated relations of non-relations would only go against convention. It is therefore not surprising that such ‘strange’ relatedness is kept covert, conveniently bracketed off as the name of the un-named. Despite the obviation, the unsaid does not pass by completely unnoticed. When Winnie went ahead with her fifth donation attempt, she was placed on reserve and says she wonders how the ‘number one’ lined up recipient fared with her treatment: It’s not just the half siblings with the donor’s children- it’s all the half-siblings with the other would be recipients waiting in the queue all at the same time as each other. I wonder whether there’s another little being not dissimilar to my daughter somewhere. (Winnie, 34, successful fifth ova donation)

Yasmin and Ravinder are continuing our earlier conversation about disclosure. I introduce the issue of half-siblings by asking Yasmin if she ever wonders whether any other recipients were successful in conceiving with eggs donated from the same donor. Ravinder replies that the possibility of relatedness between recipient families through half-sibling children was brought home to them by way of a chance encounter. He starts to recount one of the trips made to the clinic to do ‘his bit’. In the waiting room, before being called by the nurse to provide his fresh sperm sample, he noticed another man with similar physical and facial features. On the day of Yasmin’s embryo transfer, the same man turned up in the waiting area and Ravinder guessed the co-ordinator must have teamed him up with the same donor. When he then saw this man standing next to his wife who happened to look not too dissimilar to Yasmin, his suspicions were confirmed. Yasmin takes over from Ravinder at this point, once more figuring the donor through extended projections: I used to wonder ... I always wanted to find out whether she got pregnant, but I never asked. Anyway they wouldn’t tell me probably. So yes, it’s a very

novel idea actually. Because the way I used to think about it being very novel was that I had decided that I thought they were Jewish because they had a Jewish name and he looked Jewish. And I always thought it was a bit funny because Ravinder is a Muslim, so I thought it could make a good book! So I used to think about it but I don’t think about it now. Just really because I thought it was a bit ironic. (Yasmin, 33-years-old, second ova donation resulted in birth of daughter)

Relative to other recipients’ attempts Sinead is one recipient who has managed to extract a considerable amount of information from the donation co-ordinator. She knows various characteristics and details about her

180 Nameless Relations third donor, a 32-year-old mother of two measuring five foot three inches in height, whose donation has resulted in her current pregnancy. In addition she has a more detailed ‘insider knowledge’ of the clinical allocation of the retrieved eggs. As her donor produced twenty-two eggs, these had

been divided into three separate batches (two batches of eight and one batch of six) and put into motion along three separate ova pathways for three simultaneously lined-up recipients. Here however Sinead’s knowledge stops. She does not know how many embryos were viable and fertilised and which, if any, of the three recipients became pregnant and possibly had children. Nonetheless, simply the information that twentytwo eggs once existed is enough knowledge, she says, to initiate the thought there could be potentially several half-sibling children from this donor dispersed across the three separate households. I ask Sinead to elaborate on the implications of this both from the point of view of the twins she is carrying and her young adopted son, but she is clearly hesitant to say anymore. Within anonymous sociality and assisted donation contexts it is true that not everybody wants to be an imaginative prognosticator. For Zoe, the existence of multiple donor-conceived children from the same donor is possibly more painful to conjecture since she remains childless. In this excerpt she can be heard thinking through the implications in terms of her planned fifth donation attempt. In actual fact they would be like blood relations in some form. Not fatherwise, but motherwise. Because if you‘ve got children and you know somebody else has got children by that same donor, in actual fact they’re sort of half-brothers and half-sisters. If you knew they definitely [existed], you would have that sort of niggling feeling that these children have got like halfbrothers and half-sisters somewhere in the world. Not that it would cloud my mind that I would have to meet them, but like you say you would have that there that obviously they have got another set of brothers or sisters ... ... I’ve often wondered say like with the next donor I will be using. Things go through my mind and I wonder whether they have they used that donor before and then whether or not it worked. Because if so that would mean that there is a woman somewhere that could either be pregnant now or has got a child by that donor already. And then I would be using her, so yes! I’ve never really thought about it in terms of actually meeting up, but I’ve often thought that there is a possibility there that she’s helped somebody else get pregnant and then she could be helping me. Like you say, there’s two sets there somewhere ...

(Zoe, 38-years-old, four unsuccessful donor treatments)

I have been suggesting that, within anonymous sociality, active notknowing sets up ‘unfinished’ relations whose unconcealing makes persons ‘transilient’. Such transilience can be accessed from the moment the reproductive gift makes its first appearance. Namely, the fact that multiple sets of recipients may receive eggs from the same genetic donor, the fact that successful conceptions lead to the spatial dispersal of half-siblings across discrete families, to say nothing of how the donor herself imagines

Recipients IT 181 her particular acts as relations of transilience [cf. Chapter 5, Donors III]. But transilience can also be approached as the process of a projective kinship. When donor-conceived children reach maturity and want to know more, or suspect they should know more about their genetic origins, their enquiries set in train the relations that make their persons ‘transilient’. Transilience here is activated by known ‘half-knowns’ or by what is sim-

ply imagined and not yet known. Its cultural space is the occupancy between concealment and revelation — nobody and nothing can be transilient when it is directly encountered.

Policy Link When we transpose such reflections to the arena of policy, we see that cultural recognition of the creation of transilient kinship with its irrelational and effaced dimensions is flattened from view by a somewhat wayward pragmatics. This is somewhat surprising since the bioeconomics of intra-clinical ova allocation and circulation between [non-IVF] ova donor and ova recipient has been imported already into the clinical practice of ‘egg-sharing’. Sourcing a lucrative profit as hidden return may run in tandem with the purported beneficence of the friendly-faced clinician administering the helping hand of ‘high-tech’ reproduction to women outside of donation schemes (see Chapter 6, Recipients J). Egg-sharing programmes are yet another means whereby genetically related and anonymously distanced half-siblings are effected through women’s donation to another recipient(s). As mentioned in Chapter 6, the policy debate to date has been dominated by various technical and ethical questions. Attention has been paid to the quality of ‘donor’ eggs, whether or not a recipient’s treatment is compromised and protections

against undue coercion by clinics, especially in the case of women who would prefer not to share their eggs. I do not mean to imply that these are not extremely important issues. Clearly they are. Nor would it be judicious to say that the concern of a possible incestuous union between half- or full sib-

lings does not deserve debate and heightened critical awareness or even social regulation. I only mean that in terms of the way that the legal interest has framed its own bias, other interests have been precluded from view. Thus current British law on assisted conception has built into its codification a limit to what could otherwise be a potentially infinite number of

successful donations. As the non-departmental Government body that monitors the activities of all U.K. licensed infertility clinics offering IVF/donor treatments, the HFEA ensures that a donor is automatically struck off its central records once her or his donated gametes (eggs or sperm) have resulted in the births of ten children. Now it is on the premise that a donor-conceived child might wish to check the status of a prospective matriage partner that the Human Fertilisation and Embryology Act (1990: 31)

originally mandated that a list of ‘non-identifying information’ should be kept for each donor. This reflects the cultural anxiety that donor children with shared genetic parentage might one day meet and conceive offspring

182 Nameless Relations without the knowledge that they would be committing incest (after Warnock 1984: 26-27). The collection and provision of non-identifying information for assisted-conception births thus came to be recognised as an important policy agenda from the late 1980s because it was seen to uphold

State-sanctioned norms about the appropriate way to arrange social and sexual relations (see Wolfram 1987: 212-13). One set of needs (donor chil-

dren) was pressed into service to support another set of perceived needs (donors, clinics and the State).'° This way ‘culture’ could be seen to be at work: its effects could be known for the way certain types of blood manipulations could be said to be prevented from becoming socially evident. Peggy is one recipient who questions the basis of such perceived needs.

In the context of emerging fears about a pandemic of sibling incest she wonders why assisted conception complicates what is probably already well-known as secret knowledge amongst the general populace, namely the prevalence of attributions of false paternity. Do these children ever meet each other and marry half-brothers and halfsisters without knowing? I don’t know how much I worry about that anyway. I gather there was a survey in the 1980's with DNA testing and it found that one in twenty children were not their father’s child and that it’s never

been mentioned. So obviously there is already a mixed gene pool where people probably do meet and marry relatives without knowing. I don’t really have very strong feelings about incest in that very occasionally you hear of brothers and sisters who marry because perhaps they didn’t live together and they’ve met later and fallen in love. Apart from the genetic wotries about their children I can’t see why there is this massive taboo about that either. I think if they love each other, and want to be together, what harm apart from worry about the children? I don’t understand how this massive interference in other people’s lives takes place. Obviously the incest between parents and children is damaging to children, but this business about brothers and sisters who are adults who wish to be together. J find it strange but J don’t find it perturbing. The only problems I would have would be about problems with genetics. (Peggy, mid-forties, mother of four birth children from first marriage who wants to start second family)

In fact the issue is not simply whether or not sibling incest is seen as a breach of accepted conventions about relational proximity. The cultural remit is far wider. It is whether or not we permit ourselves to ‘see’ the invisible underside of anonymous sociality. It is about how we make known the nexus that implicates the gift in kinship that implicates in turn the extensional and imaginary field of transilience. The cultural remit means investigation of the ‘relatedness’ that makes relations of non-rela-

tions evident within an explicitly temporal reckoning. How, in other words, we navigate all the work that for some becomes the continuous process of searching, tracing, mediating, pre-contacting of the ‘halfknown’. Across and between the generations occupancy of the ‘unnamed’ is the more enduring problem of knowing how to attribute cultural meaning to the discriminations that mark the classificatory orders of ‘non-identifying’ and ‘identifying’ information.

Recipients I] 183 Summary Link When free-circulating reproductive body parts set up multi-directional flows whose extensional pathways are activated simultaneously, it is impossible to see the gift as a succession of exchanges between transactors who make their returns as the particularistic ties of ‘face-to-face’ relations.

Anonymously mediated gifts, in their extra-corporeal and reproductive form, have the extensile capacity to flow simultaneously in multiple direc-

tions. In other words the ‘opening’ gift is not unilaterally motivated: it does not travel in just one direction, from donor to recipient, from the fertile to the infertile. Further, we have seen how the ideal of matching at the clinic has been ‘defaced’ by the contingency of non-correspondence. There is no necessarily pre-given relation of exclusivity between donor and recipient. The possibility for simultaneous donation to multiple recipients — activated as multiple pathways — means a donor does not necessarily receive the gift of ova from ‘her’ exclusive donor. A donor-recipient pairing, as a field of inscribed activity, may entail multiple diversions from its intended pathway. Should a donor’s cycle ‘go wrong’ due to ovulation prior to egg recovery, insufficient eggs at ovum pick-up, the donor’s voluntary withdrawal or medical complications for example, then the treatment cycle with that particular donor must be abandoned. This contingency means re-incorporating the fact the recipient has already been artificially stimulated and is now

hormonally-primed ready to receive the donor’s donation.'! For the prospective recipient or recipients concerned, such loss will always be a personal blow. For the clinic, the loss is mercenary. Whilst it is true that the gift and the commodity converge through such losses, yet another conclusion can be drawn from this series of converging facts. The extensiveness of the ‘gap’ between donor and recipient is now no longer simply about the interval of time between the opening gift and its

obligatory return, nor can it be flattened to the discrete and linear sequences of circulation that characterise the Lévi-Straussian rubric of generalised exchange. Rather, the extensiveness of the gap between donor and recipient has spread to the diffuseness of transilience. Clinical Strategies of ova allocation, the cultural origins of ova pathways, the creation of multiple sets of ‘lined-up’ prospective recipients, the dispersal of half-sibling donor-conceived children across extended families provide the first clue to this re-spatialisation of manipulated blood relations. Transilience ‘catches’ anonymous relatedness as the active not-know-

ing between spatially stratified sets of un-nameable parents, recipients and children. The ova recipient not only does not know the identity of the donor, she does not know the identities of other recipients who may have been assisted by the same donor. Unconcealing these relations is the continuous work of transilience, the form of the gift’s ‘return’ (see Chapter 8, Recipients II and Part I). Thus, however much an individual social parent

may favour the approach of openness, the issue of the right to know about one’s conceptive origins and gain access to ‘origins data’ cannot be

184 Nameless Relations contained within, nor properly theorised as, the dilemmas of single- recip-

ient households. In subsequent chapters we will glimpse further how transilient persons de-conceive ‘bounded’ individuals.

Notes 1. Among the wide literature, essential to consult initially are: Baran and Pannor 1989; Blyth 1999 and Blyth et al. 1998; Daniels 1988; Haimes 1992; Imber-Black 1993, 1998; Lasker and Borg 1989; Lorbach 2003; McWhinnie 1996, 2000; Nachtigall 1993; Rowland 1985; Snowden et al. 1983. 2. A vast amount of literature by social workers (and some social scientists) reinforces particular normative ideals: one of the guiding premises informing such work is the desirability of establishing a connection between genealogical information and the development of a positive sense of identity. Commentators tend to deliberate over ‘best interests’ and present welfare principles in terms of the achievements of a ‘whole’ self (e.g., Erikson 1968; Haimes and Timms 1985; Black 1990). In the context of adoption, John Triseliotis for example has written of a ‘psychological need’ in ‘the formation of a positive concept of self for personal history material’. Such information is seen to be a ‘fundamental right’ in ‘the quest for roots, origins and reunions where adoptees are seeking to “complete” themselves’ (Triseliotis 1984: 38-42). I quote verbatim so as to underline the significance of the point for furthering cross-disciplinary analysis and indeed the future of public engagement amongst key stakeholders. Poststructuralist accounts as well as psychoanalytic readings and anthropologically informed interpretations of personal identity would be inclined to take a rather different line. Such positions may question the very starting point of projects that seek to recover ‘properly’ re-constituted selves in terms of the pre-given rubric of ‘full’ identity.

3. The response of Swedish recipient couples, and findings from a comparative study of donor insemination families in the U.K., Italy, the Netherlands and Spain are analysed respectively by Gottlieb et al. (2000) and Golombok et al. (1996). See also Nachtigall et al. (1998) and The Children’s Society 2002 MORI poll. Research data from these studies typically identify different parental sub-populations. On the one hand there are couples who inform friends and immediate family but not the donor-conceived child. Around half of the subjects informing the studies by Gottlieb’s research colleagues and Golombok’s team fall into this category. Another subgroup intends to make disclosure to the child at some later date (Gottlieb N= 41%; Golombok N = 12%), and a further sub-group have decided against disclosure. Three quarters of respondents from Golombok’s study indicate that they have no intentions to tell the child. Lindblad et al. (2000) considers the responses of Swedish DI-recipient parents who have not yet informed their children. 4. Anthropologists will also recognise in this the theoretical speculations of an earlier generation of kinship theorists who upheld what they took to be vital distinctions between the biological and the social as propounded through the classificatory terminology of ‘real’ versus ‘fictive’ kin. An excursus of the theoretical genealogy characterising this kinship project would begin with Maine’s (1931) classification of adoption as a legal fiction and continue with various mid-twentieth century kinship theorists, inter alia, Jack Goody 1969;

Recipients II 185 Pitt-Rivers 1973; Davila 1971; Forde 1963; Keesing 1975. [Maine had referred to the operative procedures of (legal) concealment and the fiction that he was concerned with produced the ‘factitious creation of a bloodrelationship’ within and between families (1931: 161).] 5. A viewpoint articulated strongly by recipient Yasmin with her notion of ‘payback’: ‘As you don’t know the donor, you can’t say thank you, so the payback is that you do a proper and good job and hope that’s what you are going to do. I’m sure a donor would be mortified if she found out that someone whom she had donated to had had a child and beaten it up. That would be just terrible, wouldn’t it. So they must believe that you yourself as a recipient are well-motivated’. 6. Mauss (1990: 24) envisions the ‘third person’ as ‘distant partner’, the murimuri as noted in Seligman’s translation of the ‘remote partner’. See Mauss 1990: LO2ff.

7. Since conducting my fieldwork, the HFEA has amended its embryo transfer policy. Since 2001, no more than two embryos may be transferred to a women in any one treatment cycle, bar exceptional circumstances where a three-embryo transfer may be performed (HFEA 2002a: 17). ‘Exceptional circumstances’ include clinical and laboratory criteria and need to be recorded in the patient records for future possible inspection by the HFEA. Prior to this, in cases where a single egg collection is not neatly divisible into equal units of three, clinic staff would always scale up a unit to make it in excess of three. For example had ten eggs been collected, these would not be divided into three units of three plus one unit of one (total four units), but into two units of three and one unit of four (total three units). Likewise, eleven eggs would make two units of four and one unit of three. 8. In the first example, how then to justify the restriction in the allocatory dispersal of ten ova to just one person? Ten harvested ova may end up being allocated to only one recipient (as the products of non-divisible batches) should only one ‘match’ be considered a suitable fit. Supposing the physical characteristics of the recipient were deemed matchable with one recipient only, then this recipient would reap the full amount of ‘her’ donor’s production. This type of one-to-one correspondence may arise because a characteristic or set of characteristics are considered in statistical terms to be relatively unusual, or else because no recipients’ characteristics matched the characteristics of a particular donor at that particular time in the chronology of the treatment queue. 9. Note, however, that multiply dispersed ova travel along pathways whose flow stagnates once ova entities are transformed into embryo entities and thus taken out of the field of social circulation. The re-donation of embryos by recipients to other infertile recipients does however re-activate or ‘mend’ these pathways as discussed in Chapter 8, Recipients III. 10. See Marilyn Strathern (1992a: 118-38). 11. A cancelled donation explains why it is that a recipient will sometimes be ‘re-matched’ and offered another donor’s eggs as a fresh or ‘frozen’ treatment. (This in turn is dependent on the clinic having at their disposal a supply of pre-deposited and frozen sperm from the male partner of that particular recipient and offers another example of how the system incorporates contingency into its operations.) Alternatively the recipient may have to begin from scratch the hormonal preparation of the drug regime with all the attendant health risks this involves.

CHAPTER &

RECIPIENTS IIT

C hapter 5 outlined some the features that make up an extensional field of transilience andof noted the particular convergence of the transilient relation with anonymously mediated sociality. Amongst donors, this field is discernible from the way (1) women’s body parts flow as relations that circulate in time and across space as metonymical extensions of their persons; (2) subjects embody imagined relations of non-relations as forms of ‘irrelational kinship’; (3) anonymised exchanges block reciprocal return and relate to the productions donors make as social agents. It was argued transilience is suggestive of a multidimensional symbolic order and process wherein social relations may be projected as actively present forms of absence. It may be helpful to backtrack momentarily and insert a reflective pause. For if intersubjective spacetime is manifest as a feature of anonymously mediated sociality and if everything is so extensile within intersubjective spacetime, could one by-effect be the problem of knowing how precisely to restrict the range of social transilience? Could possibly too much be said to be running away with itself, part-symptom of a ‘magic of plenty’ (see Malinowski [1922] on vilamalya)? Fertility specialists, med-

ically trained practitioners, bioethicists and others might care to observe that the question — familiar to them as the rhetoric of limits, accountability and ‘slippery slopes’ — reflects a concern already familiar to other contexts and societies. In thinking about issues of generativity one might for instance point to the Manambu of the Sepik River area in Papua New Guinea. For them, as indeed with other regional neighbours, sociality can be defined as integral

interrelationship, a fact reflected in the very constitution of being that is the human person. Resort to homicide and warfare with outsiders is one legitimate and limiting device for defining and inhibiting the extensiveness that is Manambu ‘being-with-others’. Ceremonial exchange and marriage are other established and respected devices. As Simon Harrison observes, Manambu sociality can be defined as the way people direct their energies so as to create and preserve ‘distinct polities for these ties to exist between ...

Recipients III 187 What creates conflict within groups is the ever present sociality between groups. It is this that is conceived as threatening their existence and requiring continued negation’ (Harrison 1993: 46,23). Similarly in the context of donor-assisted conception, mechanisms of delimitation are a vital strategy for the ‘containment’ of certain perceived excess. The danger of ‘too much relationality’ is evident foremost as the phenomenon of ‘spare’ IVF-generated embryos and the counterpart to this problem — its hidden and importantly imagined underside — is the diffluence of extensional transilience. Taking the three-year period from 1998 to 2001, there were altogether in the U.K. some 576 treatment cycles using donated embryos (with frozen embryo replacement) with approximately forty-two babies born by this conception method during 1998 and 1999. Though the HFEA recorded figures for 1999 to 2001 do not distinguish between the number of live births resulting from donor egg and donor embryo treatments, there were 877 live births combining both forms of treatment during just this two-year

span. This chapter on ‘re-donation’ explores some of the ways that prospective recipients-as-donors are transformed from ‘donee-into-donor’. It asks how recipients act to obviate the effects of run-away generativity instantiated originally through donative superovulation (see Chapter 3, Donors I) while others agree to donate embryos to other infertile recipients or to the experimental research enterprise.!

Hyper-kinship within a Remaindered World Eliciting Hyper-embryo

After any given treatment cycle, it is not unusual for recipient couples to learn they have an extra number of fertilised embryos left over that were not implanted as part of the embryo transfer procedure. These so-called ‘spares’, also referred to as ‘surplus’ embryos, derive in part from the fact that the upper limit of embryos that may be transferred at any one time is set by British law at a maximum of three. Increasingly, however, medical practitioners are encouraged to follow revised guidelines and transfer only two embryos at a time as standard clinical practice. This reduction in the legal limit of transferable embryos, as stipulated currently by the HFEA, is perceived by some experts as the correct way to ensure the reduced likelihood of multiple births. As we will see such restriction may serve other, less visible, less publicly declared interests as well. Most clinics have storage facilities enabling spare embryos to be frozen for up to five to ten years by means of cryopreservation technology (see Figure 6). This gives the would-be recipient couple the option to return at a later date for another treatment cycle. While cryopreservation technology may mean that patients avoid the need for repeated drug stimulation, sperm collection and fertilisation, not all embryos survive the freeze-thaw process and in any case the live birth rate per cycle from frozen embryos is usually lower than with fresh embryo transfers. Frozen embryos, which

188 Nameless Relations are currently used in about five thousand IVF treatments each year in Britain, effect a live birth rate of around 12 per cent, whereas the live birth

rate for IVF with fresh eggs and sperm is around 21 per cent.? Despite these eventualities, recipients may have to face other challenging problems. What patient information leaflets do not publicise to their readers is

that having remaindered ‘spare embryos’ at one’s disposal may set up unanticipated and, in some cases, unwelcome prospects. HFEA (00)7 FORM FOR CONSENT TO STORAGE AND USE OF EGGS AND EMBRYOS

N.B. Do not sign this form unless you have received information about these matters and have been offered counselling. You may vary the terms of this consent or withdraw this consent at any time except in relation to eggs or embryos which have already been used. Please insert numbers or tick boxes as appropriate. Patiants wishing to store their eggs should note that egg freezing and the use of frozen eggs in treatment are experimental techniques. Not ail eqgs will survive the freezing and thawing process, and sometimes no embryo will be created using frozen eggs. There have not yet been enough treatments to be able accurately to predict the chance of a baby being born using frozen eggs. You are strongly advised to read the HFEA’s information feafiat on egg freezing before giving your consent.

Lip} fj | tt bt tt et Looped | ft tt tp if tt Full Name (block capitals):

use: pi

Any other name by which you have been known: 1. USE

a. | hereby consent to the use of my eggs for the following purposes:

i. in my own treatment YES|_} Nol_]

ii. in treating others YEs|_| Nol_! lii. In any project of research YES L_j| NOL_]

Please state any particular conditions as to

b. | hereby consent to my egg(s) being fertilised in vitro to develop embryo(s) and to the use of those embryo(s) for the following purposes:

i. in the treatment of myself YES(_} NOL_lor in the treatment of myself YESL_} NOL_J

Lttt it tt i ttt pp tt ft i |

with a named partner Full name of partner:

ii. in treating others YESL_| NOL_! iii. in any project of research YesL_J| NoL_]

ERY MONT Signature: Dbate:|_ | JL t ILL JYEAR Please state any other conditions as to use (eg on the use of particular embryos):

li. STORAGE a. | hereby consent to the storage of my eggs:

Storage period in years Maximum (10 years)" YES| | NoL_J if less please state YEARS L_J * Centres are allowed to store eggs for longer periods for limited uses only.

b. | hereby consent to the storage of embryo(s) developed in vitro fram my egg(s): Storage period in years:

Five years YES |__INO |_| Ten years YES|__INO |_| More than10 years YES L_|NOL_J if less than five years or some other period please state the number of years: YEARS |__| | understand that consent to storage of more than five years must be accompanied by a completed HFEA(96)8 form which has been signed by a registered medical practitioner.** ** his does not apply to donors

c. If | die or become meniaily incapacitated my eggs or the embryo(s) developed in vitro from my egg(s) should:

EGGS EMBRYOS

i. be allowed to perish Yes|_JNOLJ yest} Nol_} ii. continue in storage for the purposes given in

1a (for eggs) and 1b (for embryos) above*** YESL_INOL_] YESL_J] NOL_J *** This in only valid for te i and iil and & U end tH

ili. continue in storage for other purposes YES|_|NOL_| YESL_| NOL_J (please specify below) d. Any other conditions of storage (eg for particular embryos).

Please state ere nen nr etre nt ree nr

{ understand that unless they are used beforehand embryo{s) developed in vitro from my egg{s) will have to be allowed to perish at the end of the storage period specified at jib.

Signature: Cates LL EL LL DAY MONTH YEAR

Figure 6 Form for consent to storage and use of eggs and embryos. Reproduced by kind permission of the Human Fertilisation and Embryology Authority.

Recipients III 189 Sometimes recipients would be required to make hasty decisions about what they wanted to do with the spares.* Unlike donors who have no knowledge of the ‘outcomes’ of their actions (see Chapter 4, Donors II),

clinic staff are quick to impress upon ova recipients the need to take responsibility for these ‘outcomes’. From the perspective of the donation system at the clinic, an embryo that is not going to be frozen for the designated couple could become — at least in theory — an embryo for someone

else’s immediate treatment. Alternatively it could be directed towards experimental medical research (e.g., to further knowledge about the causes of miscarriage and congenital disease; to conduct embryonic stem cell research). Either way, the factor of timing is seen to be crucial to the embryo’s future trajectory and journeying pathways.

It is important to understand that these outcomes, in being made explicit to recipients as the predicament of kinship futures yet-to-be-activated, are relations that are implicated in the utterly contingent past productions of the clinically instigated superovulation procedures.* In this regard, recipients with ‘spares’ are quite powerless: they cannot stipulate in advance for instance how many embryos ideally they would like to receive nor are they able to co-ordinate this aspect of their treatment with the prolificity of their superovulating donor. In this regard, each donation may be seen not only as yielding the hope of ‘new life’ but also as the conStant indeterminacy of knowing exactly what kinds of ‘chances’ these donations will be (cf. Anmed 1995). Since nobody can ever predict how extensive potential will be, the contingencies are ‘wild’.’ It is precisely this indeterminacy that sets up the pre-conditions for the awkward emergence of the reified kinship figure of ‘hyper-embryo’. The hyper-embryo thus stands for the collectivity otherwise known as ‘spare embryos’.°®

When recipients decide they no longer wish to have cryopreserved embryos stored for subsequent transfer — most typically after the birth of donor-assisted child(ren) — they are faced with the additional dilemma of how to ‘de-activate’ these chances. De-activation implies a refusal and cir-

cumscription of sorts. How to refuse the hope that these embryos once engendered for prospective parents as potential children-to-be? How to circumscribe and draw to a close the kinship enacted by hyper-embryo that would otherwise run on relationally as extensions of themselves and others within anonymously mediated intersubjective spacetime?

What choices there are, appear already limited. As patients of the assisted conception clinic, recipients are invited to give their consent to one of the following possible options: (1) the re-donation of unwanted

spares to other infertile recipients (2) their donation to experimental research or (3) their so-called ‘humane’ disposal: allowing the embryo to perish. But prospecting the future of ‘spares’ was a burden of choice many said they would rather not have to make. To confront the existence of the hyper-embryo was not a ‘choice’ at all; it was rather a prolonged equivocation that might never be resolved. From out of many eggs and many embryos came many unwanted dilemmas.

190 Nameless Relations Re-donation, Refusal and ‘Disowning Decisions’

One commonly stated objection against re-donation was the view that the embryo now contained the added substance of the recipient’s partner and could not, as such, be passed on to others since it ‘belonged’ to the couple.

This conventional re-entrenchment of genetic inheritance ideology, primed by its commitment to possessive individualism and foundational in its assumption of the individual as symbol of the enduring relevance of the gene as relational link, was common to women and men informants alike.

Peggy donates blood regularly and has her name listed on the U.K. national bone marrow register. When it comes to the donation of embryos, however, she would prefer to re-donate any ‘spares’ to people she knows rather than to anonymous strangers. Paul, her husband, agrees and refers

to the temporally unbounded dimension of the donation. The link to embryo-donated children cannot be severed and would be imagined to go on forever: the problem, he says, would be one of ‘un-doing’ a tie between genetically related full-siblings. Thus the choice about giving another couple a procreative chance is partially one about whether or not to activate a

particular relation and relationship. In this figuring the ‘spare’ hyperembryo is necessarily already implicated in a conventional kinship order. Paul: The difficult points are if you have a child in front of you as a result of those embryos, you’re giving away a brother or a sister to another family and it’s very difficult not to think of it like that. You think what if it’s unhappy? Peggy: And you picture an identikit of this baby being unhappy somewhere else.

Paul: You don’t mind if it’s happy and flourishes.

Peggy. If it was friends of ours who we know and like and would bring up a child well, we would probably say yes. Because although that child wouldn’t be our child because it would be brought up by them and it would be very different to ours, nevertheless it would be a happy child because we know they’re good parents. So there’s this fright of dropping your child into the wild yonder and not knowing where they’re going. Paul: It’s all mental anguish and thinking ‘what ifs’. It’s limitless, you can be worrying about it and because it’s different people you could be worrying about it for years what happened to that ... (Peggy, mother of four birth children from first marriage

who wants to start second family with Paul, her second partner, who has not fathered any children)

Others, such as sisters Hattie and Vera, a donor-recipient sibling pair, try to circumscribe some of these troubling ‘what ifs’. When Hattie donated to help her sister conceive a second child and sibling for her existing daughter Charlie, she produced eight eggs, seven of which fertilised as grade 1 embryos (see Chapter 6, Recipients I). The batch was split into two sets: the

Recipients ITI 19] first set of three embryos was transferred together after Vera persuaded the consultant during the actual treatment transfer not to replace only two of the embryos. The treatment was successful and Vera ended up giving birth to triplets. But the resulting problem is that there are now four cryopreserved ‘spares’ that neither sister wishes to have implanted. Disagreements ensue between the sisters. Unable to decide how best to deactivate these ‘chances’, it can only be agreed the ideal solution would be to blame a ‘natural’ spontaneous process. If only the decision were to be taken out of their hands. Vera: I just wish one day I could wake up and they’re not there any longer and J haven’t got to make a decision. If they didn’t survive the thawing-out process, in some ways it would be like a natural release from making a decision or having to live with the decision that you’ve made. Hattie: A natural release ...

Vera: ... of making a decision or having to live with the decision that you’ve made.

Hattie: And it would be like a miscarriage, wouldn't it? Vera: Yes, you'd think of it the same as a miscarriage.

Contemplating the alternatives Vera says it would be hard to give the embryos to others anonymously, and possibly a little easier to help another known recipient such as a woman she had met at the clinic. But it would be important, she adds, not to have any continuing relationship with that couple. She would want to ‘cut off’. Her husband, Owen, disagrees. He is against re-donation because he would always be wondering, like prospec-

tive recipients Peggy and Paul, whether a child had been born. ‘All the wondering that you’d go through all the time — no, I don’t want that’ (Owen). Vera agrees and says she would always wonder whether a baby girl had been born since her donor IVF triplets are boys. Hattie, the donor sister, intervenes to say she is not keen on donating to research or for any

other cause involving embryo destruction. ‘To destroy them would be worse than a termination because they’ve been created deliberately’, she explains. Confiding in me that she had not wanted to go ahead with the donation in the first place but felt obliged not to let down her sister, this was not exactly a gift given begrudgingly, nor however was it one made completely willingly. Her ambivalence towards the entire donation project and its unforeseen difficulties prompt her to draw a parallel with the liber-

ating possibility presented by re-donation. She reasons it should be her brother-in-law, Vera’s husband, who should now give the concession. Owen says he doesn’t want to give them away and I said to him: ‘If we all looked on it like that, where would we be? I wasn’t keen in the first place to give you the eggs so therefore if I hadn’t have done that, you wouldn’t

have had these three children and you wouldn't be having to make the choice whether to give them up’. And so he’s got to look on it more or less

192 Nameless Relations in the same way that he’s doing what I originally did by donating them to somebody else that really wants them. By him agreeing to let somebody else have those four [frozen embryos implanted as a treatment transfer attempt], he’s giving someone else the same chance that he was given be me. (Hattie, birth mother of three children, genetic mother and aunt to Vera’s triplet sons)

Vera ultimately comes down on the side of her husband and the sisters are caught in a circle of ‘non-decisions’. While Hattie remains disconnected from the eggs she donated and is ready to extend the relational chain of activation beyond herself, for Vera the collectivised figure of the hyper-

embryo elicits potential kin relations whom she is reluctant to make releasable to others. To re-donate is not therefore simply a repeat act of the initial donation. Vera, the recipient of eggs and potential donor of ‘spares’ does not enact the inventiveness characteristic of those ova donors’ who make social value from the free circulations set up by anonymised spacetime. There is no instant of effraction enacted here as creative non-linkage, no connection enlisted between the creativity of dispossession, non-naming and non-traceability (see Chapter 5, Donors ITI).

Now as Hattie has signed away her rights to the eggs and passed the final decision on to Vera in her capacity as social mother, it would not be in her legal power to enforce the option of re-donation without her sister’s

consent. Likewise, Vera and Owen could not put up the embryos for ‘humane disposal’ without Hattie’s prior approval. Resolution is seen as a joint process because ‘neither one of us could act without the other ... Vera couldn’t give them away if I hadn’t given them to her and I can’t give them away if she doesn’t want to. So really and truly, it’s both of us’, Hattie explains. The irony is that Vera insists it should be her sister who provides release from the responsibility of making the final decision on the grounds that the eggs, as the opening chances, originated from her body. | She thus appeals to a biogenetic logic to excuse her from the burden of the choice. ‘I feel it’s more Hattie’s decision than it is mine actually’. Such intra-familial disputes over the future trajectory of life as ‘de-activated’ chances comprise the less well known, less articulated ‘underside’ of the

more public, legally contested cases between divorcees over claims to rights in cryopreserved ‘spare’ embryos.’ Sacrificial Keeping-while-giving and Donation to Research

Similarly disinclined towards the prospect of re-donation, other recipients do however find ‘resolutions’ of a kind. As Owen recognised, donation to research is one possible strategy for delimiting excess potential relationality: for acting to foreclose unwanted transilience. This mechanism of narrowing down the scope of possible social relations depends on restricting the flow of donation as ‘continuous gifting’ (cf. Delia and Fay in Chapter 5, Donors III). Spare embryos that are taken out of the field of circulation are at the same time given over to research for temporary keeps as ‘sacrificial’ experimental objects.®

Recipients ILI 193 Anthropologist Annette Weiner (1992) once suggested that the practice

she called ‘keeping-while-giving’ amounts to a ‘universal paradox’. Weiner’s associated thesis about inalienability evolved out of her critique of western assumptions about authority, power, and the political domain, and challenged the role that the norm of reciprocity has played tradition-

ally in Western history. Drawing on examples from several Australian Aboriginal groups, as well as the Bimin-Kuskusmin and Melpa peoples of Papua New Guinea, Weiner asserts that the paradox consists in the way that specific products come to be endowed with such high value that they cannot be relinquished for purposes of social circulation. By keeping on the one hand the oldest and rarest wealth objects imbued with mana spirit while giving at the same time less valuable goods as replacement gifts, attention is drawn paradoxically to those non-exchangeable objects that validate the donor’s authority. Polynesian chiefs thus are able to give away items while preserving their most precious heirlooms; their gifts become valuable as substitutive replacements that demarcate what it is they actually wish to keep and do in fact keep safe.

The voluntary surrender of anonymised embryos as gifts to medical research in Western settings sets up a similar field of restricted non-circulation. However in the British case considered here, that which is kept out of exchange does not necessarily remain inalienable. It may become per-

ishable. Whereas ritual objects in several Melanesian societies may become ‘symbolic repositories of genealogies and historical events’ that can be identified with ‘a particular series of owners through time’ (Weiner 1992: 33), the custodians of much prized embryonic research material may wish to ensure more than simply the survival of their possessions. The handing over of the onerous task of embryo destruction to a third party in the name of research experimentation is precisely what ‘releases’ prospective parents from their sensibility of enduring inalienability. In

turning over human embryonic life forms to the project of scientific advance, the power of the individual parent to act as continued potential

life-giver is de-activated. There is radical severance, another form of detachability. Embryonic objects in turn are endowed with ‘special’ research value precisely on account of their imputed instrumentality: they are precious because they can be put to the service of scientific knowledge production. They are thus only ‘kept’ temporarily because in the moment

of their diversion away from free-circulation they are committed to a pathway of annihilation.”? Only those embryos that are permanently suspended in time as ‘fixed’ entities for the purposes of secondary research

‘live on’ through time, possibly being exchanged through successive research teams or bequeathed as ‘inherited collections’. Here we see another enactment of the labile ‘career’ of the gift as it crosses within the same moment between spheres of ‘singularisation’ and ‘commoditisation’ (see Chapter 3, Donors I and Chapter 6, Recipients I).

Sian who is currently pregnant after her second treatment attempt by anonymous donor and has four cryopreserved ‘spares’, says she has no intention of having these de-thawed for her own subsequent use. She

194 Nameless Relations would prefer that they be given to research and thereby destroyed, ‘taken away’ as she says, ‘once and for all’. The decision to re-donate to another

couple would by contrast involve the genetic father and, as she pronounces emphatically, this has nothing to do with her. ‘He would be making a ‘full donation’ (eggs and sperm), whereas I have only received eggs from a donor’, she says. Like Vera she distances herself from the moral obligation of making a decision through her conventional appeal to a biogenetic logic of proprietorial possession. ‘It would be his choice, it’s his part, it’s not a part of me. I’m not the donor. He’s the one helping her. I haven’t got anything to do with it’. MK: If they said that they would leave it up to you and it’s your decision, what would you really prefer to happen — yourself? Sian: Well, I’m not ... well, possibly to destroy them. MK: Do you think that’s easier to do? Does this finalise things for you? Sian: It’s easier I think to get rid of them if you’re a bit unsure about it. You’d

have that at the back of your mind wondering whether it had worked, or hadn’t worked. MK: Would it be something uncompleted in your mind? Sian: Yes, I think the easiest thing is just to get rid of them. (Sian, late twenties, currently expectant, fell pregnant on second treatment attempt)

It is significant that, throughout our conversations, Sian refrains from projecting ahead to future scenarios. Deflecting my questions about the long-term kinship impacts of re-donation with rebulfs such as ‘we’ll deal with that when it comes up’ or ‘that’s still a long way to go yet’, her prognostication obviates what she sees as the problem of ‘too much related-

ness’. She forecloses transilient ties through repeated strategies of obviation. Obviating a Compounded Life

Vanessa, on the other hand, has already converted her ‘spares’ into perishables. Unlike the majority of ova recipients I met, she had entered the donation programme with a view to extending her ‘second’ family and had made the decision to give consent for the disposal of her remaindered embryos about one year after completing her treatment. The mother of

one teenage daughter conceived from her first marriage and a son fathered by a different man, she explains why the birth of Nathan, her two-year-old donor-conceived child by her current partner, led her to divert the flow of spare embryos from further anonymised circulation. In a way I wanted to donate them because somebody had been generous to me. But life is complicated enough without. I mean it would have been a complete brother and I thought Nathan would have enough to worry about

Recipients III 195 as it is. It would not have been a half-sibling but an actual exact brother or sister to Nathan wandering somewhere around that he’ll never meet. I wish you could do it so that it was unrelated eggs and sperm and not an embryo of somebody’s that you were giving. If they could put together one woman’s eggs and not her husband’s sperm. But do it separately so that you'd be giving in the abstract. (Vanessa, mid-forties, mother to donor-conceived son and to two birth children each with different genetic fathers)

Different composites can be made as much from the matter of separable bio-substance as they can from the convergence of different life problems. Vanessa runs together the two orders and eliminates the distinctions. It is

the problem of the non-separability of reproductive substance that led her to believe re-donation would represent an added difficulty for her donor-conceived son in years to come. What Vanessa implies is that it is hard enough in the first place for a child to learn about his unusual conceptive origins. To have to include within an explanation the additional story about a potential full sibling who was re-donated to another set of parents might elicit knowledge that is too difficult, too immense in its implications, she thinks. But this is also a decision Vanessa has made on the assumption there could never be any backward identification through non-anonymous tracing. Her ‘choice’ not to re-donate is informed by the expectation she will never be able to know the identity of either her own donor, the un-named woman who helped her, nor that of the recipient couple who could have received assistance from her. Were the re-donated

embryo ever to materialise, the ‘shadow child’, to borrow Vanessa’s euphemism, would be a full genetic sibling to Nathan and yet a relative whom he would never meet. Vanessa decided she did not want to take a part in the creation of such a prospective kinship. She obviates the temporalised impacts of irrelational kinship: to refuse help to others by giving away potential chances for life seems more of a moral action to her. The ‘sacrifice’ is seen as beneficent for existing kin — and for ego.!° KE *

How many recipient couples may have made comparable decisions through similar forms of reasoning? Had there been the possibility of a retrospective link with the donor, might fewer unwanted spare embryos have been donated to research in the past? On a different though related note, the non-attribution of biological parentage has justified in the past the mass destruction of so-called ‘orphan embryos’. In retrospect it is possible to see how these orphaned ‘spares’ could have been converted into a relation of transilience. They could have been ‘supportive’ as a derivative source for the extraction of stem cells intended for therapeutically oriented research (see Chapter 9). All these questions, and the decisions that could have arisen but were precluded from deliberation, are instructive in

the light of current policy considerations about anonymity and the prospective release of non-identifying information by consenting donors.

196 Nameless Relations Vanessa plans to tell her donor-conceived son about his genetic mother, the egg donor. By means of what language, though, does one tell a child that his social mother also decided to abort his potential full sibling, the spare remaindered embryos? And from Nathan’s perspective, how would such knowledge come to be translated in later years as a form of ‘cancelled’ kinship? Would his biogenetic ‘lost sibling’ be replaced through enacted relations of transilience? Might the curiosity activate Nathan’s search to trace any genetically related half-siblings? Or might contact with his genetic mother’s children (half-siblings) stand in for the full sibling(s)

he never knew? Alternatively, and again from a future vantage point, Vanessa’s past decision not to re-donate may get lost in the telling. It

might be averted from becoming a fact as another instantiation of sequenced obviation. Donor children might then claim that they know the truth about their conceptive origins, but do they necessarily know everything there is to know? Unconcealing as exposure is not always the same as letting things be known through revelation, as we saw beforehand in the earlier discussion on the cultural elusiveness and persistent murkiness of the ‘half-known’ (see Chapter 6, Recipients I). Liquidating the Third Party

For other recipients, donation to research and re-donation to infertile recipients seem equally unpalatable prospects. Some reason that by undertaking a final course of treatment they obviate the necessity of a choice between similarly impossible ‘solutions’. In such cases remaindered embryos would be ‘used up’ by recipients as a type of clearance measure

despite the fact that couples are usually emotionally exhausted, financially depleted and probably reluctant to embark on yet another cycle of treatment, which they are convinced will not, in any case, work. ‘Treatment for treatment’s sake’ means one ‘kills off’ chance, thereby arresting the ‘growth’ of the hyper-embryo -— restricting its potential span of relational activation — by keeping treatment options exclusively for oneself. The hyper-embryo becomes reinforced here as endogenous hyper-link. Over the course of the past sixteen years Tess and Max had undergone

ten IVF treatment cycles, initially with Tess’s own eggs and then by anonymous donor. After their tenth attempt, planned as their last, they finally decided to use up the last batch of remaindered frozen embryos held in their name so as to eschew what they would have regarded as the obligation to pass them on anonymously to another infertile recipient. Using up these spares for their eleventh treatment attempt represented the least worst alternative, a reproductive ‘choice’ made begrudgingly. Since only one embryo from the remaindered batch happened to survive the freeze-thaw process, nobody had expected any positive result. It was treatment for treatment’s sake and a costly expenditure to boot. Against all the odds, it was in fact this one-embryo transfer that became the making of Tess and Max’s donor-conceived daughter, Francesca.

Recipients IIT 197 I had to have them [transferred] because they were my husband’s so I couldn’t give them to anybody else. They were already fertilised by my husband. I thought: ‘well I can’t just leave them there’. So we thought we’ll go for the following month and basically get it over and done with. We had just

completely had enough, both of us. So we went the following month not expecting anything. We didn’t think it would work. Why should it? None of

the others had worked. So let’s just get it over and done with. It sounds really awful but that is how I felt. (Tess, 39-years-old, mother of one donor-conceived daughter)

Zoe has just undergone her fourth unsuccessful egg donation. She likewise reasons that the best way ‘out of the decision’ would be to have another treatment attempt! To disregard it and say we don’t want it anymore, that’s no good. Throwing it away I would feel that I am not rejecting the person that helped us but I would feel that I haven’t done her justice. I would feel that she’s done what

she’s done for me and then I’m throwing it away. I wouldn’t feel that it would be right. And then on the other hand you wouldn’t know what to do for the best. With research, they’re mucking about with an embryo but then that’s how these advances are made anyway. ... [just think it would be like I say disrespectful to think that if it worked and I was pregnant or I had had a child. To think that I’ve left those there. It’s disrespectful to think I’ve got what I want and now I don’t want these. I think the best way out of that would be to just have another go! (laughing). And think well, if we get another one so be it (laughing) ...

(Zoe, 38-years-old, has undergone four treatment attempts) Re-donation as Continuous Gifting

By contrast, willingness to re-donate to other infertile recipients may often be marked by a non-possessive modelling of biosubstance whereby cryopreserved embryos are given value not simply in terms of rights to

ownership. There are those who insist that ownership claims can be waived whilst those who would rather put emphasis on idioms of collectivity are more likely to activate relations of transilience. Yvonne, whose second egg donation treatment led to the birth of her daughter two years ago, would be willing to donate her ‘spares’ if and when she would have completed her family. Embryos represent designated social property, but her notion of possessive modelling is more flexible than that of Tess, based on a view of passing ‘chances’ across to others. Yvonne: If I had five children and I decided I didn’t want anymore, I would say, well, give the other fertilised eggs to the woman that would need them.

That would be that situation because even though it’s earmarked and booked for me and that is mine, if I decided not to, that’s my choice, and then I'll let somebody else have the option of receiving the eggs. Because to me even though it was my husband's sperm it’s not his children because they’re not living as yet. It’s only until they implant them ... it’s not living until the woman has got it in here.

198 Nameless Relations MK: Would this then be like you would be donating? Yvonne: I suppose in retrospect it might well be. Probably because it’s gone through from one to me and then from me to the recipient the third time. MK: Would you see the act of giving your frozen embryos to other recipients as a type of gift? Yvonne: Yes I think it’s a gift of life whatever. Even the donor giving me is a gift. Because she’s given me something. And anything in that field is a gift. It’s the same gift — it’s just going down the line like a conveyor belt really: it goes from one down to the other.

MK: Just taking that image of the conveyor belt. What would that be exactly? Do you mean that people are on the conveyor belt?

Yvonne: No, it wouldn’t be a person or people because I don’t think you could class it as living. It’s the giving that is the conveyor belt. (Yvonne, mid-thirties, second ova donation resulted in birth of daughter)

Yvonne softens a proprietorial model of biogenetic ownership with her claim to autonomy of choice. She is emphatic she can act to take a decision about re-donation, and unlike some of the recipients already men-

tioned, this is something not to be conferred on somebody else: if necessary, she is prepared to override the views of her husband.'! Winnie, contrariwise would be prepared to concede the right of a final decision to

her husband but insists that she would nonetheless be ‘related’ to the potential child through her decision to let the embryo live on. In her account transmission is not just the substance of biogenetic property (the

addition of her husband’s sperm to the egg), it is about her agency as recipient to choose to let the frozen embryo be passed on. In a way, it’s similar to the lady that donated the eggs because if she didn’t donate them they would only go down the pan. It’s like a second-hand gift.

It’s like having something that you’ve used to your best advantage, and you’ve had all you want from that but it’s not used up. It’s not spent, therefore it’s still of use, of help, of significance to somebody else. And I’m sure the person that donated that in the first place would be pleased it was being used to advantage ... I’ve just really agreed for it to be used further on with

my husband. There’s nothing of me in it. Obviously my husband would have to have the casting vote on that because it’s his sperm. It’s just I’ve got the choice to say whether it’s thrown away or give it to somebody else who can use it. (Winnie, mother of donor-conceived daughter after fifth treatment attempt)

Winnie would ‘wonder whether there’s another little being not dissimilar to my daughter somewhere’. But the ‘kinship’ that makes these multiple flows of relatedness imaginable as transilient relations extends also backwards in time to the donor, to whom Winnie says she feels the strongest link, as well as forwards to the recipient and any of her resultant offspring.

Recipients [II 199 Ella is seventeen weeks pregnant, expecting twins. She similarly would be keen to ‘give to somebody else the opportunity that I’ve been able to

have’ and looks upon embryo re-donation as an ‘achievement’. Six embryos materialised from her second donor treatment and these were split into two sets of three. After fertilisation of the first set produced only one viable embryo for transfer, Ella elected not to ‘break into’ the second already frozen set at the same time. So only one embryo from the first set was implanted which subsequently cleaved during gestation. Ella reflects

here on the way she went about activating her relation to the three remaining embryos. Ella: Sylvia [egg donation co-ordinator] asked me when only one started to divide whether I would like her to go ahead and defrost the others? And I said not to. J might want those later on. But in the back of my mind I was thinking to myself no. If you defrost the others and then we’ll have four and

you can only implant three, we’re throwing one away which someone could use, so I said no. But at the back of my mind it wasn’t because of that. I was thinking irrespective of what happens I don’t think I will probably go through it again. I would like to donate those. They are all ready for donating, I didn’t want them wasted. They could be used for someone else.

MK: When the embryos are frozen and when people have the option to decide whether to donate them or to use them themselves, do you feel that these embryos are yours? Is there not any sense that the embryos are there, that they are yours?

Ella: No, never crossed my mind actually. No, I mentioned it to people at work because they all know there’s three waiting. They said: ‘what are you going to do?’ And I said: ‘I'll donate them’. If it helps someone else, I will have achieved something. I will have thanked her [donor] in another way. People express gratitude in different ways. I mean you could also say that the way they bring the child up is a way of expressing gratitude. (Ella, aged fifty-one at time of conceiving with second donation attempt)

Yasmin also thinks of her yet-to-be implanted embryos in terms of the potential activation of conception chances. However unlike Ella, these chances do represent potential kinship as her ‘frozen family’. Not only can these relations be imagined as the future activation of persons, Yasmin is already projecting forward to the work of ‘unconcealing’. She anticipates the day her whole family will gather around the Christmas tree to hear her narration of a non-traditional procreation story. This will be the context for the donor children learning about their assisted conception origins. Oh yes, they were individuals but definitely brother and sisters. I think I probably thought of them as two girls and a boy. I used to talk about them as well. I used to talk to people about my ‘frozen family’, that’s what I called them. And I also used to think about what I would tell them if they became

born. I always thought it would be a very amusing Christmas time story when we’d sit around the Christmas tree and I’d say: ‘T’ll tell you all about you’. I thought it was mildly amusing that they would find it amusing to

200 Nameless Relations think that they’d been in the freezer for a year, at two cells big. I always thought that would make a good story for them, a good way to approach it. I used to think about them as being some form of potential. I wasn’t really attached to them but IJ certainly thought about them. I knew they were there and that they were my family or could be my family.

This variant of a traditional procreation story is also the template for other possible stories. Once her family is complete, Yasmin would be willing to relinquish these chances for others’ potential activation. Embryo donation is envisaged in terms of the allocatory flows of donated substance as redirected chances. Furthermore, such activation is essentially redistributive in nature. Embryos are no longer imagined as potential ‘individuals’ but are part of a collectivity mediated by anonymous sociality. Here Yasmin introduces the notion of the recipient pool and her understanding of the ethics informing the intra-pool ‘donation’. You would be doing it for the recipient pool because you’re increasing the donor pool. Obviously you're taking somebody out of the recipient pool that

then releases somebody as a donor for another person to have a donor. Obviously I wouldn’t have gone through the pain and the actual physical process of actually having to have them removed, but it would still be the same thing in principle. (Yasmin, mid-thirties, mother of one donor-conceived daughter)

In other words, the collectivised recipient pool is served by similarly positioned anonymous ‘participants’. Infertile women who remain unknown to each other can help one another through acts of re-donation that might help them all.!? Unlike Winnie, though, the extensions set up by multiple

persons within an anonymised pool are not assimilated as relations that can be imagined within a wider social collectivity. When it comes to redonation, transilience for Yasmin is less multi-directional in its range of

activation. She says that to imagine connections extending between anonymised donor and recipient and again onwards to a successive recipient(s) represents ‘too big a chain, too long a chain’ and that ‘the donor who helped me would have faded out of the picture’. Thea also activates relations of transilience in her capacity as prospective recipient-as-donor. Like Winnie she keeps the donor in mind as the person who originally helped her when she extends help to others. But it is the figure of the imagined recipient to whom she donates that she feels the strongest link, contrary to both Yasmin and Winnie. Thea: I know that everybody has a different reason for donating eggs, but this is like a bond between recipients I should think because they understand how you feel. And then the donors, they are a little group on their

own. Perhaps she has donated for one reason and somebody else has donated for a different reason but it’s like a type of kinship really. They know what it’s like to donate and we know what it’s like to receive, so ina way there’s a knowing between us, between all the donors and between all the recipients.

Recipients [I 201 MK: Would you feel curious about the other unknown recipients who had received eggs from the woman donor you had shared between yourselves? The other recipients and what had happened to them? Thea: Yes I would. I would probably like to know how they feel. (Thea, 26-years-old, mother of non-identical donor twins)

Summary Link These vignettes detailing embryo re-donation decision-making have considered some of the strategies recipient couples deploy to delimit or open

up the potential field of extensional anonymous relatedness. The commentary has spanned a range of infertility experiences, juxtaposing both recipients’ views as future intended action with those decisions some couples already have made. We have seen that more relations can always be made from out of the kinship figure of the ‘hyper-embryo’: all the ‘spares’ it encompasses as remaindered form create the possibility of extending life as renewed gifts. Alternatively, donation to research and the uptake of ‘treatment for treatment’s sake’ are both ways of keeping frozen embryos out of circulation. Exposed here is a prospective kinship order predicated on the perceived danger of ‘too much relatedness’. The de-activation of ‘life’, its delimitation as potential excess and run-away generativity, can be circumscribed

through manoeuvres that convert embryos into ‘sacrificial’ gifts to research. On the face of it, embryonic destruction is made anodyne through its spatialised estrangement from the social parents-to-be, those persons who may or may not be the original providers of the gametes. When extensional flow is thus withheld within anonymously mediated sociality, loss can be converted into requisite social distance (cf. Mosko’s example of mixing and un-mixing blood for the Bush Mekeo in Chapter 7, Recipients IT) and relations of transilience can be obviated. Both possibilities may evoke an appeal to a biogenetic logic, reinforcing in a very literal way the familiar Euro-American belief about the significance of genes for establishing claims of relatedness and for modelling claims to possessive ownership as prior rights in biosubstance. However, whilst difficult

decisions about the future of unwanted spares can be ‘disowned’ by prospective parents, these pragmatic manipulations may never in practice fully resolve the problems they were intended to overcome. If an aesthetics of excess unravels itself in these contexts through ‘remaindered form’, every action may afford a generational impulse that spills over as the further activation of a past relation. It is the form and implications of these less apparent generations that Part HI considers.

202 Nameless Relations Notes 1. A note about precision of use with the term ‘recipients-as-donors’. It is important to distinguish between infertile recipients who ‘donate’ to other infertile recipients as part of an ‘egg-sharing’ scheme, as discussed in Chapter 6, and ‘recipients-as-donors’ who may be called upon to donate because their previous treatments have been successful. Usually the latter group of women is in a position to pass on ‘spare’ embryos that are not needed for their own further treatment attempts because they are already parents to donor-conceived children. 2. Despite the lower success rate for frozen embryo transfer, recipient couples can expect also to save considerable financial expense: importantly, they will not need to generate a set of freshly produced ova with the assistance of another superovulated donor. 3. This pressure to make quick decisions, although not always a consistent feature of clinical practice, is not unlike the way some women told me they had been asked by their consultant half-way through the embryo transfer procedure how many embryos they wanted to have transferred. ‘Would it be two or three?’ 4. On the enhanced prolificity of the superovulating donor as an example of

‘run-away generativity’, see Chapter 3, Donors I. } 5. As discussed in Chapter 7, Recipients II, the contingencies associated with the donor’s treatment can directly affect which particular ova and embryo pathways are set in motion, and therefore whose eggs and embryos are allocated to whom as a consequence of cycles ‘going wrong’. 6. The indeterminacy attributable to the kinship figure of the ‘hyper-embryo’ builds upon Becker’s (2000) ethnography of the ‘elusive embryo’. 7. In the U.K., Natalie Evans and Lorraine Hadley, two divorcees and sufferers of infertility, instigated a landmark legal battle during 2003 at the High Court to prevent their frozen ‘spare’ embryos from being destroyed after their former partners withdrew permission for their use. (British law currently states that unless both parties consent to storage and use, the embryos must be destroyed. See HFEA [1990: 37-38], in particular Schedule 3, Sections 4,6,8.) The women argued that their former partners’ power to withdraw consent constituted an unwarranted ‘male veto’ which would infringe their rights under the European Convention on human rights. With his ruling, the presiding judge, Mr. Justice Wall, denied the claimants the legal right to implant the embryos on the ground that these same rights (respect for family and private life) apply equally to the women’s former partners. See ‘Infertile women fight for embryos’, Daily Telegraph, 1 July 2003, p. 9.; ‘Women lose right to use their “own” embryos’, Guardian, 2 October, 2003, p. 3. 8. It is worth noting that cryopreservation technology in itself ensures embryos will be kept out of general circulation. That which is designated as spare substance will always be set aside for the exclusive use of one particular recipient who has prior rights in the ‘completed’ embryo(s). As one recipient put it, her frozen embyros are ‘earmarked’ for her subsequent use. 9. According to British statute (HFEA 1990 Act) an embryo donated to research must perish before, or no later than, 14 days of development and prior to the formation of the neuronally determined ‘primitive streak’.

Recipients III 203 10. As Malinowski (1922: 178) noted for the Trobrianders ‘many a man [sic] will carefully conceal any surplus so as to avoid the obligation of sharing ... and yet escape the opprobrium attaching to meanness’. 11. Note how parallels are evident in this instance between Yvonne’s conveyor belt imagery and the continuous gifting envisioned by ova donors Delia and Fay (see Donors II): both are mediations through others to ‘someone’. 12. See further Konrad (1996: 235-38).

Blank Page

PART II APPLICATIONS

Blank Page

CHAPTER 9

UNCONCEALING EXTENSIONAL TRANSILIENCE

HH”social mightscientists donor families, makers, fertility practitioners and begin to policy talk together in the language of extensional transilience? This chapter re-examines the question of re-donation (Chapter 8, Recipients III) in the light of two ‘applied’ problems. Firstly, the impli-

cations of the growing nexus between treatment and research-based therapies, and secondly the kinship impacts of transilience from the perspective of adults known to be conceived from a re-donated embryo.

Hyper-embryo into Infinite Partibility and the Sourcing of Embryonic Stem Cells Recognition of the value of innovative regenerative medical therapies has

ushered into recent British statute and public consciousness a new pseudo-legal entity: the human stem cell. In February 2002, a House of Lords Select Committee approved scientific research on human embryos created by IVE or ‘cell nuclear replacement’ technique (CNR) as legitimate

methods for the derivation of embryonic stem cells (ES cells).! Undertaken as therapeutically oriented research, the generation of ES cells — in conjunction with experiments on adult stem cells — is thought to offer the

enticing and lucrative prospect of novel cell-based treatments.? These therapies, it is envisaged, would both repair or replace damaged tissues and treat a wide range of currently incurable degenerative conditions such as Parkinson’s disease, diabetes, cardiac failure and Alzheimer’s. Stem cells do not have any rights as such, but they are unique biological and cultural entities (see Franklin n.d.). Interestingly, scientists have

been quick to borrow in rather a loose fashion a language of kinship to describe some of these special features. Unique for their distinctive capabilities as generative and regenerative matter, the property of the stem cell lies in the power of divisibility: in generating one specialised descendant, a so-called ‘daughter’ cell, it will reproduce a version of itself as its own

208 Nameless Relations identical replacement. Able thus to reproduce indefinitely, stem cells have the capacity to develop into various different more ‘specialised’ cell types, also known as ‘parent’ cells. Unlike any other type of stem cell yet identified, embryonic stem cells have the innate capacity or ‘potential’ to differentiate into each of the two hundred or so cell types that comprise the

human body. This makes them what developmental biologists call ‘pluripotent’, an attribute Roger Pedersen, professor of regenerative medicine at Cambridge University, summons up with the symbolic icon of ‘the ‘Rosetta stone’ — the so-called key of life for translating the event of biological regeneration.’ Now with the isolation and culturing of stem cells in laboratory space, and the generation thereby of so-called stem cell ‘lines’

or ‘colonies’, so it becomes possible to reproduce infinitely a person’s genetic identity. The figure of hyper-embryo evolves thus into the promise of infinite partibility. Implicated is an extensional field whereby the person, through his of her donation of ‘spare’ embryos to stem cell research, may enact relational reproducibility ‘beyond’ oneself. In the U.K., the Medical Research Council together with the Biotechnology and Biological Sciences Research Council and the HFEA have been

involved in a delimitation exercise of a kind. One could say they have been attempting to pre-empt how to restrict the range of social transilience. J am referring specifically to the inter-institutional consultation that took place over the design of new consent forms for the derivation of

stem cells from human embryos. This design initiative links up to the wider research objective for the accessioning and storage of stem cell lines that is currently taking shape as the establishment of a national Stem Cell Bank. Run by the National Institute for Biological Standards and Control] (NIBSC) at South Mimms in Hertfordshire, the U.K. Stem Cell Bank is charged to manage and supply quality controlled stem cell ‘lines’ for basic research and potential applications. Acting as a centralised resource for researchers, the bank will hold existing and new adult, foetal and embryonic stem cell lines. It is hailed as the first bank of its kind in the world.4 In the case of stem cell lines derived from embryonic human tissue, the assisted conception clinic is a key strategic site for procurement. Indeed

the first human embryonic stem cell line to be cultured by a team of British researchers from King’s College London was derived from one of a number of IVF-generated ‘spare’ embryos that had been donated to stem cell research by the prospective parents.’ As further research licenses are granted by the HFEA, so in the future counsellors at fertility centres will ask those who go for donor or non-donor IVF treatment whether they are

willing to donate any of their spare embryos or eggs to this or related experimental fields.° Now, in the process of designing new consent forms, one prevalent concern has been the issue of possible coercion. Specifically,

reassurance was sought that implicit pressure will not be placed on patients through the request to donate-to-research. In similar vein, the House of Lords Select Committee (2002: 42) made a point of stressing in its Report the importance of keeping clinical and research roles separate in the procurement of donated eggs and embryos. Meanwhile, outside the

Unconcealing Extensional Transilience 209 clinic, findings from a MORI poll conducted with a cross section of the British public in February 2003 suggest that around seven in ten persons would support the use of human embryos for therapeutically orientated medical research, both for ‘serious’ diseases and for fertility research.’

Despite the apparent enthusiasm and the intended safeguards for ensuring genuine informed consent, the appropriation of biosubstance and associated techniques for procuring consent can be very subtle. This is especially so when one is talking to a population as ‘desperate’ as the infertile. Consider a few possibilities. A kind of supplication as ‘user-friendly consent’ that assuages feelings of patient inferiority and desperation ... ..We are helping you to create new life, wouldn’t you like to help research for the common good? Why not have your part in working to eliminate neurological diseases such as Parkinson’s?’ This appeal to the prospective ‘recipient-as-donor’ plays on notions of beneficence and solidarity that may appear uncannily similar to the sentiments expressed by certain ova donors (see Chapter 5, Donors III). Playing off a present possibility against a future anticipated hope, and indeed one allegedly dedicated to the welfare of future generations, the relative immediacy of treatment for ‘someone’ is pitted against the long-

term scientific quest for cure. Help directed towards a specific but unknown ‘other’ is not unlike the abstract rendition of a service in the ‘name’ of all mankind. Intended suggestive technique: Who but the mean-spirited could refuse? There is also the possibility of imposing, albeit subtly, the expectation of a certain type of reciprocation: in this way donation is no longer a spon-

taneous gesture but part of a much more explicitly normative and biopolitical discourse. In order to receive one might be construed as impelled

to incur the obligation to give, that is, to re-donate (back to research). Now since this obligation is not necessarily part of the donated gift of ova as originally given, could this transform the nature of the original gift? I will come back to this in a moment. Refusal to comply on the part of the recipient (potential donor) may arouse feelings of selfishness or worry

that one’s infertility treatment may be compromised in some way. Worse still, one may wrestle with feelings of guilt or anxiety fearing perhaps that because one had not agreed to (re) donate anything for the greater good of research, one’s treatment therefore had failed as though this were some

kind of retributive ‘punishment’. There is the danger here that ideas of misfortune become that much more implicated in one’s own causal agency, just as the geneticisation of the individual which characterises much of the new predictive genetics increasingly directs moral blame back to the actions of the afflicted. Such unarticulated culpability is additionally

a convenient manipulative tool from the standpoint of the clinic since recipient failure (poor conception rates) occludes the non-efficacy of med-

ical technology itself. Intended suggestive technique: the technology is Superhuman so treatment failure can be directly attributable to others: “It’s your fault!” The implicit moral coding is that successful assisted pro-

creation means virtue of character and generosity of spirit. Remember

210 Nameless Relations Quentin Anderson’s open-evening presentation: God, he impugned, is watching over you! (See Chapter 3, Donors I.)

Policy Link ‘Under the HFE Act donors must give ‘informed consent’ to the use and storage of their eggs, and of the embryos produced using their eggs. The consent to use may relate specifically to particular eggs or embryos if the donor wishes. For example, she may wish some eggs or embryos to be used for treatment and some for research, or all to be used for treating a particular woman. Before she gives consent the donor must have received adequate information about egg donation, and must have been offered counselling’

(‘Egg Donation’, HFEA Patient Information Leaflet)

Since ES cell lines are potentially ‘immortal’, obtaining informed consent from potential embryo donors raises distinctive problems, one such being the desirability or otherwise of communicating back to the donor (gamete and embryo) many years later research results that could reveal personal health implications. The issue of patient information and subsequent feedback of adverse genetic familial data to the embryo/stem-cells donor adds another layer of indeterminacy to what it means to make a ‘gift of life’ in such reproductive contexts.® We do not yet know what are the cross-generational and kinship impacts of a post-donation retrospective release of genetic information for relatives of the original donor(s). But in the light of recent interest to explore new models of benefit sharing between the public and private sectors, we can, however, ask a number of questions.’ Even with full counselling, can donors realistically be expected to appreciate in advance of their donation what information they might want to know before the implications of such information have imploded directly within their lives? This is similar to the quandary that appears in ‘nondirective’ genetic counselling for pre-symptomatic genetic testing. Find-

ings from research with Huntington’s Disease-affected families, for example, indicate that local decision-making dilemmas over how much genetic information is good to know and good to tell others cannot be easily resolved either before or after adult predictive genetic testing.'® Is it not possible that considerable burdens and unrealistic expectations will be placed upon patients without their full awareness of all possible implications? Consent forms and information can look pretty on paper but how will the terms of consent be explained in practice, how will they be made palatable in the real day-to-day exigencies of the assisted conception clinic as ‘full information’? Since counselling at the assisted con-

ception unit is all so confidential, ostensibly so in the patient’s best interest, who oversees the mannerisms and facial gestures, the unspoken and maybe unintended hints of disapproval or approval emanating from these secret chambers? As we. saw in the previous chapter, the ethnographic evidence suggests that donation to research presents many Ova recipients with a ‘resolution’ to choices that they find particularly bur-

Unconcealing Extensional Transilience 211 densome as courses of action. In the light of stem cell research initiatives, will these ‘choices’ mutate into further strains of indecision and ambivalence? Is there not the danger that practising infertility specialists will exploit the underlying biogenetic logic of some patients (see Chapters 6-7, Recipients I to II) so as to serve their own vested interests in increased embryo donation recruitment? Despite well-intended cautions about the desirability of keeping treatment and research-based initiatives separate when it comes to matters of donor recruitment, to what extent can these aims be enforced in the light of commercial pressures for inter-institu-

tional collaboration? Flows of information are part of the ‘exchange’ between different medical communities, and indeed have become increasingly vital to the professional survival of researchers, practitioners and their own institutions. Are donors ever informed about these ‘needs’ when they read through consent forms? In any case, clinicians tend to present cryopreservation techniques as

an option entailing diminished chances of success and increased risk. Practitioners often stress to patients that frozen embryos are less likely than fresh embryos to survive the freeze/thaw cycle, that they are more likely to fail to implant, with pregnancy rates statistically lower than those following fresh embryo transfer. Patients were reminded too that insuffi-

cient research had been conducted to rule out an increased chance of congenital malformation. In the light of these considerations, how will the option of re-donation preferred by some ova recipients, as discussed in Chapter 8, contend with future ‘donation to research’ recruitment initiatives? How will IVF patients see themselves as partners in human tissue

procurement in the future? Until the sourcing of stem cells from adults becomes a standardised technique with equal if not superior therapeutic effects to those promised for embryonically derived tissue, how will the cultural politics of stem cell acquisition be presented as ‘options’ by counsellors and other clinic staff? The question deserves prolonged attention since we have already seen how subtle the manipulative techniques of cooptation can be within clinic space (see Chapter 3, Donors I). The debate about tissue sourcing and stem cell extraction thus deserves to be opened up more fully in terms of its ‘hidden’ aesthetics of excess. Namely, recognition need be given to the fact that these embryonic life forms are derived additionally from complex culturally laden dilemmas: they originate from the often anguished and unresolved decision-making of gamete recipients, as they do from the past productive efforts of gamete

donors. Furthermore those would-be embryo donors, whose potential gifts are conditional upon their previous recipiency of donated gametes (e.g., from ova donors), may have very different views about re-donation

compared to those who acted as the original gift facilitators, their anonymised donor ‘partners’. Many of the women ova donors, whom I interviewed, specifically wanted their ‘gifts’ to be directed to other persons

for fertility treatment, even if such persons remained unknown as nonidentifiable recipients. This sub-group of donors was not happy with the prospect of their donated ova being used experimentally for medical

212 Nameless Relations research purposes and said they would not have donated to such ends.'! In what sense then can we say that the past intentions of ova donors who have assisted ova recipients comprise part of the continued or thwarted life of the potentially re-directed gift? An ova donor may not have given her prior informed consent to the use and storage of her donated eggs for the purposes of research. But her anonymised ova recipient/male partner, as a couple burdened by ‘spares’, may feel rather differently. Or vice versa: an ova donor might be willing to donate to research, the recipients less so.

These more ‘hidden’ dilemmas incite a more subtle cultural politics of acquisition and sourcing that does not currently inform the scientific agendas of stem cell researchers. Were a National Donor Service ever to be implemented for example, how might notions of altruism be extended?!” Could these be stretched to include the ways that future donors and recipients ought to be ‘matched up’ on the grounds of their shared views about

tissue and research resourcing? Might this ever become part of the standardised protocol of treatment eligibility at clinics, part of the definition of what it is to be a voluntary ‘donor’? All such questions show why it would be misleading for the scientific community to continue to claim, as it currently does, that human embryonic stem cells are extracted simply from the biological matter of surplusto-required pre-’primitive-streaked’ human embryo — those aged less than

fourteen days. Human generativity is linked intimately to the cultural recognition of complexly generated subjective dilemmas. In other words, biological donors are always social donors too.

Transilient Kinship and Embryo Donor-conceived Children ‘The termination of the development of a human embryo and the disposal of the remaining material are sensitive and delicate issues. [Licensed] centres should take full account of this when considering how the development of an embryo ts to be brought to an end, and what is to happen thereafter’

HFEA Code of Practice (2001: 42)

Let us turn now to consider the perspective of embryo-donor-conceived children. For them, past ‘parental’ choices are likely to augur a different set of emotional responses. Those children who are made aware of their

conceptive origins may feel gratitude toward their ‘a-genetic custodian(s)’, the first set of recipients who made procreative decisions in

their capacity as prospective social parents. In an anonymous donation system embryo donor offspring may never get to say to them the following words of gratitude. ‘Thank you for not donating me — in my former embryonic form — to the research sluice’. Since this category of children owe their existence to the fact that they were kept out of the sacrificial field of ‘keeping-while-giving’, as explained in Chapter 8, Recipients III, will they display a heightened sensibility and appreciation of what it

Unconcealing Extensional Transilience 213 means to be ‘given’ life? For the donor-embryo-conceived child, part of one’s ‘conception portfolio’, as some recipient parents describe them, consists in having the knowledge of what could have been different conceptive life trajectories. One’s sense of being a human person might be framed by the knowledge ‘I was not a stem-cell-donated research embryo’.’? In

other words, embryo-donor offspring carry the unusual genealogical knowledge that one is not part of a lost generation of vanquished ‘children-that-might-have-been’.'* What are the implications of knowledge of one’s genetic origins and biological parentage? For those offspring who wish to trace their genetic parents it would be necessary to trace two sets of genetic parents across different, unrelated families. In the case of egg donation, the embryodonor child’s genetic father is the ova recipient’s male reproductive partner and the genetic mother is the woman who originally donated ova, obviously one conceptive step backwards in time to the first recipient would-be social mother. We can schematise simply as follows: When the

donation stems from the actions of a progenetrix (the ova donor), the field of transilience simply in terms of parentage alone would be back-traced with reference to:

The original donor — genetic mother [figure A] The first recipient couple — genetic father [figure B]

The second recipient couple (social parents with no genetic tie to child) [figure C]

As we have seen in Chapter 4, the anonymised progenetrix does not necessarily know the allocatory range and therefore the breadth of extensional field generated by her corporeal donation. Very many women identified lack of knowledge about the outcome of their donation as a problem

precisely because it thwarted the perception of one’s efficacy as social agent (see Chapters 4 and 5, Donors ll & IJ). Even were a donor to know how many eggs and embryos were subsequently allocated to one or more Ova recipients, and indeed the consequence of the ‘donation outcome’ as live birth, she cannot herself know the identity of the genetic co-parent.

The biological father with whom her reproductive substance has been mixed remains an unknown, untraceable, non-attributable identity. Now in order for the embryo-donated child to trace his or her genetic mother [A], the clinic that performed the assisted conception and the HFEA or other mediatory oversight body would need to keep records of which batches of transferred embryos had been successfully implanted by the female partner of [B]. Moreover these records would need to be accessible as information for interested children, since in the case of ‘re-donation’ it is impossible for either genetic parent to reveal the identity of the

other genetic parent. In other words neither parent can facilitate the other’s ‘coming into being’ for the donor child since neither knows who the other is. This is analogous to the way that Yasmin, one potential recip-

214 Nameless Relations ient-as-donor, finds it difficult to figure the past donor and prospective recipient. ‘The chain is too big, too long’, she says (see Chapter 8, Recipients III). As for practicalities, one genetic parent is positioned as mediator,

the mid-referent, to the other genetic parent, since the child must first pass ‘through’ the set of relations that revelation of this knowledge would

activate before hoping to gain knowledge of the identity of the other genetic parent. It is therefore the child, if it is anyone at all, who may be said to bring the parents together. It is the already existing child who effects a post-donation ‘conjugation’. S/he is the link, the ‘feeder’ that not only ‘adds’ to the chain but keeps it in place as an interlinking connexion (see Strathern 1971: 122). A further word about practicalities. It is far likelier that the ‘first’ traced genetic parent [B] would be willing to meet the child conceived from the embryo he and his partner re-donated all those years ago if he has already told his own donor-conceived children about their own conceptive origins. Upon finding out they have a genetically related sibling by virtue of the fact they share the same genetic mother — the anonymous woman who donated her eggs — the respective sets of children will be in a position

to activate their kinship relations by way of past subjunctives. Knowing about or meeting the other sibling(s) means the realisation that ‘I could have been a spare donated embryo too’, and by inference ‘I could have had your father as my biological parent instead’. Things could have been so very different were it not for the past decision of ‘your parents’ to give me away! An additional consideration is that the embryo-donated child may have other ‘spare-embryo siblings’ who were donated to a different prospective recipient couple other than his or her own social parents. The ‘returns’ of knowledge effected by transilience set up therefore additional Strata of subjunctive kinship. In all these cases transilience arises from the dispersal of genetic relatives and is made evident as the multiple combinations of relational activation that are possible between hitherto unknown, un-traced relations. At any one time, there may be more than one activational source of transilience that is being effected: this implicates a ‘field of extensional transilience’ (see Figure 7).!° Most minimally, these sources can be classified by: (1) the direction of initiation, namely the agent who sets the chain of transilience in action through strategies of search and trace; and (2) the nature of transilience as temporalised cross-flows within and across the generations. To schematise, the desire to ‘link up’ and establish contact implicates multiple relational sources including both donor-conceived and embryo donor-conceived children. Note that the relation remains transilient up until the time it is no longer purely imaginary. Physical encounters enacted through re-union cancel out or ‘kill off’ transilience, although one may remain transilient should more information come to light about other presently unknown, genetically related kin in the process of reconnection.

Unconcealing Extensional Transilience 215 TRANSILIENT KINSHIP: HOW THE KNOWLEDGE OF HITHERTO UNKNOWN RELATIONS IMPLICATES MULTIPLE COMBINATIONS OF ACTIVATIONAL SOURCES Cross-generational linkage

Activational source of transilience: FROM CHILD TO PARENT

Donor-conceived offspring wants to find donor (note: within one recipient family, different donors may have been used for each conceived child). Activational source of transilience: FROM PARENT TO CHILD

Donors want to find genetic offspring (indeterminate/weak anonymity). Dependent on the prior consent of child in question (e.g. Contact Register). Same-generational linkage

Activational source of transilience: SEARCH INITIATED BY DONOR-CONCEIVED OFFSPRING Donor-conceived offspring wants to find possible half-siblings (by

gamete donation) or full siblings (by embryo redonation/adoption). Activational source of transilience: SEARCH INITIATED BY NON-DONOR CONCEIVED OFFSPRING Donors’ birth children want to find genetically related donor siblings.

Figure 7 Anonymous sociality characterised by field of extensional transilience.

The scenario of searching set into motion by non-donor conceived offspring is portrayed in the radio drama-documentary ‘The Donor’s Daughter’ by British playwright Sally Festing.'° The play opens with a deathbed scene in a hospital ward as an elderly father discloses to his natural chil-

dren the fact that he used to donate sperm in his days of youth. The drama goes on to explore the emotional and kinship ramifications faced

by the dead man’s adult children as they grapple with the decision whether or not to follow their father’s last wishes. He had wanted them to

find the children, their genetic half-siblings, born from his donations many decades ago. In the 1950s, the time when he donated, there were only a few so-called ‘champion donors’ who seeded bottles weekly. ‘Do you want one hundred half-siblings?’, asks one sister to the other. Disagreeing about the importance for them of embarking on the work of a post-donation search and finding perhaps ‘long-lost relatives’, one sister resolves to take up the challenge. Through her search process there are many ‘false reunions’ with non-genetic relatives, a process in itself that sets up a trail of unforeseen kinship ‘connections’. This class of people are ‘my not-halt sibs’, she announces, as she tells her sister why she wants to continue to meet up with these new friends. As transilient relations they are all engaged in similar searches for their as yet-unknown kin.

216 Nameless Relations From the other perspective, that of the donor-conceived offspring, many testimonies of the process of search are beginning to emerge. These are almost all based on the viewpoints of DI-conceived offspring and do

not presently encompass the female donor perspective. Janice Stevens Botsford, an activist member of the Donor Conception Network, found out six months after the death of her social father that she was conceived with the help of an anonymous sperm donor from the United States. As an adult she chanced to meet her half-sibling brother and they were able to work out that they must be genetically related since both knew the name of their donor. It was the same person! Both now want to find out if they have other siblings ‘somewhere’. Janice has kept a diary of all the snippets of information she has been able to accumulate over the years about the facts relevant to her conception. This is the material evidence of her search. I keep adding to my stork file as each new piece of the puzzle falls into place.

I know that some parts of it may never be finished. But I’m willing to be open to wherever the quest takes me. (cited in Lorbach 2003: 191)

Updating the file and discovering how the different elements of knowledge may fit together is the work of imagining a future realisable kinship.

Janice’s ‘quest’ is the enactment of prospective transilience. Living through the emotions of one’s search, transilient relations take shape as

one builds networks around the non-traceable, as one seeks out and meets up with donor-conceived offspring driven by similar kinship desires. Conception-related ‘detective work’ may be an ongoing and elusive trajectory but there will always be the curiosity and determination to

know more, the disappointments of ‘dead ends’ and thwarted non reunions. There will always be the relational space of the ‘non-link’.

Summary Link Consent to ‘donate-to-research’ always depends on a relational chain: activating the source — of potentiation and chances — through previous and

future anticipated relations. In the case of embryos made from donated gametes, these will pass with the infertile patient’s prior consent from one recipient (couple) to the next recipient (couple). But if data records have

been kept as centralised donor information, in theory at least the redonated embryo is an entity whose journeying pathway leaves an affective trail for the retrospectively activated identification of genetic parentage. Even within anonymously-mediated sociality, the embryo-donor-conceived adult has a history whose genealogical lineage ultimately can be traceable to the identity of the ‘healthy’ non-IVF ova donor. In the case of ‘spare’ embryos from infertile couples using their own genetic material (with IVF or ICSI procedures for example), the provenance of embryos can be short-circuited to the original gene providers:

Unconcealing Extensional Transilience 217 there is no third party to whom one could trace back. Embryos simply move forward, as it were, travelling onwards in space and time to the next awaiting recipient couple. Whether sourced from donated or endogenous substance, the donor’s ‘choice’ will be whether the embryo is ‘re-donated’

to research ends rather than to another anonymous, similarly unknown infertile pair. In Chapter 8, Recipients II, we saw how tumultuous these choices can be, as well as how these decisions may have long-lasting ram-

ifications for the kinship of transilience, both imagined and enacted. Based on the observation that the spatio-temporal activation of ova and embryo pathways effect simultaneous multi-directional flows, these effects

are both intra-generational and inter-generational, and may have multiple instigators. Donor offspring, parents, genetically related half- or full siblings are all unique kinship players in their own right as they traverse the field of extensional transilience.

Notes 1. House of Lords (2002). 2. Stem cells are found in the early embryo, in the foetus, placenta and umbilical cord, and in many tissues of the body. Although adult stem cells are found in many parts of the human body, embryonic stem cells have proven to be more flexible in terms of their development potential. Recent research, however, suggests that adult stem cells may have greater therapeutic potential than had previously been thought, although no conclusive evidence exists as yet within the scientific literature to indicate research on ES cells therefore would be extraneous. See House of Lords (2002: 17-18).

3. Pluripotent as opposed to ‘multipotent’ cells: the latter give rise to multiple | but not all cell types, for example haematopoietic (blood) stem cells from the bone marrow. The ‘Key of life’ metaphor, a cellular-based analogy that depicts cells and their specialisation as organised systems, is a descendent of the ‘code of life’ symbolisation of gene-based sequences. See Pedersen (2003). 4, For institutional governance and regulation issues within the U.K. Stem Cell Bank, see details at . The protocols for validation and screening of stem cell lines and procedures for deposition and accession are detailed in Medical Research Council (2003). 5. A team of scientists led by Dr Stephen Minger at King’s College London produced three stem cell populations from fifty-eight embryos. ‘British lab hails stem cells first’, Guardian, 13 August 2003, p. 10. 6. Following publication of a government commissioned report on Stem Cell Research (Department of Health [2000]) based on the deliberations of an expert group chaired by the Chief Medical Officer, Professor Sir Liam Donaldson, Parliament passed regulations extending the purposes for which research on human embryos could lawfully be undertaken. Under the terms of the Human Fertilisation Embryology (Research Purposes) Regulations 2001, three additional purposes have been added to the original provisions of the HFEA 1990 Act. These are: (1) increasing knowledge about the

218 Nameless Relations development of embryos (2) increasing knowledge about serious diseases (3) enabling any such knowledge to be applied in developing treatments for serious disease. 7. The MORI survey was commissioned by a coalition of organisations with a common interest in stem cell research. Note that it was not targeted towards the views of infertile recipient couples with experience of repeated donor/IVF treatment attempts. 8. In all cases a master sample of the original cell line is to be stored by the U-K. Stem Cell Bank in perpetuity against the need for future testing. The intention is to be able to cross-link adverse health data to a specific donor without the need to test the person directly. 9. For example, in the U.K., benefit sharing in the context of the governance of personal genetic information has been considered by the Human Genetics Commission (2002). 10. See Konrad 2003c, Konrad 2005. 11. My donor subjects were asked about medical research in general. For obvious reasons they had not been asked specifically about national databanking programmes such as U.K. BioBank or U.K. Stem Cell Bank. 12. The idea of a National Donor Service was deliberated by the HFE in its 1998 Public Consultation on payment to donors and is linked closely to societal ideas of genetic altruism. Many donor conception-related support groups are keen to extend the parameters of donor recruitment as currently practised by U.K. licensed clinics (see Olivia Montuschi’s comments in Chapter 4, Donors IT). One increasingly prominent player here is The National Gamete Donation Trust (NGDT). A government-funded charity, the NGDT is committed to alleviating the national shortage of gamete and embryo donors and to this end galvanises an active network of recipient parents willing to assist With recruitment and awareness campaigns. 13. Comparing these speculative testimonies of gratitude by donor-conceived children with the testimonies of assistance proffered by ova donors (Chapters 3 to 5, Donors I to III) would be one way of ‘bringing together’ the different parties and thus effecting transilience between them. 14. Levy (1970) makes a related argument for adoption in connection with what he calls the ‘contingency of relationships’ that are forged through choice. Adopted children feel grateful to adoptive parents for having been positively chosen. The contrasting view sees the adoptive carer as a form of surrogate kin created out of necessity (Pitt-Rivers 1973). These views, attributable ultimately to the problematic conceptual legacy of ‘real’ versus ‘fictive’ kinship, relate back to the question of the extent to which adoptive relationships are conceived as equal and therefore substitutive of ‘biological’ relations. Of interest to the anthropologist is the way that these imitative replacements are perceived as endowed with cultural value in different contexts. In donor-assisted conception this category of ‘children-that-mighthave-been’ can be seen to stand in a line of conceptual affiliation to the category of ‘mothers-that-might-have-been’. Both are particular reckonings of irrelational kinship. See Chapter 10. 15.1 am referring to the concept of ‘field’ in much the way that Andrew Strathern (1971) writes of the Hagen exchange system as intersecting ‘fields of warfare’. 16. Broadcast originally on 25 April 2003, BBC Radio 4.

CHAPTER 10

UNCONCEALING REGENERATIVE [TRANSILIENCE

... While culture is a world of the imagination, it is not a fantasy one whose

power lies in the impossibility of realisation ... it has its constraints and its effects on how people act, react and conceptualise what is going on around them: it is the way people imagine things really are. Marilyn Strathern, Reproducing the Future (1992a: 3)

Spotlight on the Final Frontier ‘It is in the nature of human beings to intervene to try to shape their world’. With these words the Human Fertilisation and Embryology Authority opened its Report on assisted conception and donated ovarian tissue in embryo research (HFEA 1994a: 2). The Consultation exercise that had preceded the publication of the Report may be seen as an experimental intervention of its own. The process of public enquiry set in train by the Authority had been initiated above all as the pre-emptive speculations of a future reproductive science, one concerned with the relatively unknown field of maturational oogenesis and the cultivation of immature eggs or oocytes outside of the human body. In mid-1990s Britain nobody actually knew whether and when the requisite technology would materialise as a technically feasible ‘solution’. But within the designs of this particular ‘virgin science’, defeating time was not simply about the quest for innovation by groups of scientists. Defeating time looked as though it was the very name of a novel constellation of reproductive possibilities. The specific occasion for the HFEA deliberation was the possible creation of new donor sources. Under critical social scrutiny was the prospect of the extraction and ex-vivo cultivation of immature eggs or ovarian tis-

sue from the cadavers of women and aborted foetuses. That prospect, in turn, had been driven by the uncompromising commodity logic of greater material procurement and supply. What was needed, fertility specialists

and scientists concurred, was a way of overcoming the shortage of

220 Nameless Relations donated ova from adult donors. A new expansive search was the order: human eggs would have to come from elsewhere. Tools, practices and knowledge would have to be re-sourced. Except that in the scientific imaginary the female egg is the final frontier: an unconquerable entity whose cell structure continues to elude the epistemic cultures of oogenesis knowledge production.'! In vivo, it takes six months for a human egg to mature fully before it is released from the ovarian follicle sac that contained it, journeying henceforth down the passageway ol the Fallopian tube. To date no scientific experiment has been able to replicate successfully this pre-ovulatory developmental process. Despite years of research and repeated attempts at protocol improvement, no scientist has fathomed how to grow to maturity eggs from adult ovarian tissue. But despite the failure, the vision persists. Scientists imagine

the day when immature eggs of anonymous bio-provenance could be erafted into a recipient for infertility treatment or else matured in growth culture inside the laboratory for research and treatment purposes. The gap between present and future possibilities had not escaped the concerns of the legal profession. Since it is only the use of mature eggs from live donors that is subject to current licensing under the terms of the Human Fertilisation and Embryology Act (1990), on this count alone it could

be seen that a critical hiatus had opened up in British fertility legislation. But the HFEA Consultation Paper was intended simply as an initial testing of the waters and to draw together diverse views. After inviting and examining written comments from the general public as well as various professional bodies, the Committee charged with overseeing the Report concluded that only ovarian tissue removed from live donors would be

acceptable for the therapeutic treatment of female infertility. While it decided to reject the use of eggs matured from dead foetuses for fertility

treatment, it did however advise that ovarian tissue taken from living women, cadavers or aborted foetuses would be permissible in the case of

embryo research. At the present time no statutory effect is attached to these pronouncements, nonetheless the gap between the actual and potential continually readjusts itself as the horizon of possibility at once recedes and expands.’ Though the science of immature egg cultivation remains speculative, today it is somewhat further advanced than a decade ago. Do we then ‘see’ things as if they were more visible?

Envisioning the Problem of Ovarian Tissue and the Life-giving Death Given that the HFEA Consultation was supposed to be a national enquiry into public opinion, it is worth mentioning some facts about the exercise.

25,000 copies of the Consultation Document were distributed nationwide by the HFEA. These contained set questions on the use of ovarian tissue for research and fertility treatment and invited comments on a vari-

Unconcealing Regenerative Transilience 221 ety of scientific, ethical and legal issues, among them, definitions of consent and the psychological effects of ‘donation’ for future offspring. Just under 9,000 replies were received from individuals and a range of

groups. There was representation from sixth-form classes, religious groups, women’s groups, village meetings, professional scientific, medical,

and nursing organisations and the education department of one of Her Majesty’s Prisons. Although the final Report does not break down in any significant detail the reasoning behind respondents’ objections, it does nonetheless reveal that one-quarter of replies came from those opposed to abortion and that 16 per cent of responses (1,467 persons) were opposed

to the use of eggs retrieved from foetal tissue. One set of respondents wrote to register their abhorrence for a procedure they perceived would defy respect for the dead. Others raised doubts about the safety of the technique and the perils of ‘foetus farming’ for commercial gain. A number of pro-life representatives projected that ovary graft techniques might

lead to increased numbers of delayed abortions. They feared maternal gestation might be extended until sixteen weeks as a means of overcoming the maturational growth factor problem. Other pro-lifers equated foetal material with the moral opprobrium of a ‘tainted source’.* Also submitted as evidence to the Authority were the findings of three surveys. Carried out independently by unspecified institutions, these studies had

focused exclusively on the views of some 1,500 women. The cohort included those planning to have children and currently attending Family Planning Clinics; pregnant women attending antenatal classes at clinics; women presenting for elective termination, or attending infertility clinics for assisted conception treatment. The significant finding from these surveys, and the one that appears to challenge the other Consultation replies,

is introduced into the final analysis of the Report in somewhat scant terms. It is simply noted that: ‘Between one third and a half of all women approved the use of foetal tissue in infertility treatment’ (HFEA 1994a: 8).

Together with contemporaneous media debate, this dataset provides a record as to how a cross-section of the British public made imaginable to themselves the possibility of assisting the commencement of life outside of human bodies.’ But more specifically, if less overtly, these documents also point to other interventions. They ‘show up’ the potential for intervening to shape new life as the ongoing re-ordering of ‘old’ sets of relations. What becomes evident is how the debate, in its own terms, could be suggestive

for thinking about the ways in which one might activate relations of regenerative transilience. This chapter explores how the possibility of persons acting to shape new life suggests an ethnographic curiosity inasmuch as nobody appeared to be talking about reproduction here as a matter of social regeneration. I suggest the ways in which the re-shaping of social relations might amount to distinctive acts of social intervention, and to the continuous remaking of persons and relations over time, is perhaps best viewed as a subject that could not find its way into the dominant terms constituting public debate. This omission lies, in part, with the prevalent Euro-American concern of

222 Nameless Relations tracing generations through a representational model of continuity privileged as lineal descent, and bears upon the commonly unchallenged perception that certain assisted reproductive practices commit a violation of a rather precise kind. The de-sequencing of chronological time. It is important to underline that Iam not advocating here the legal use of ovarian tissue from aborted foetuses. This is not a legalistic argument. What the exposition attempts to illustrate rather is the cultural logic that

excludes the formulation of such eventuality. What I want to show — through the device of critical juxtaposition and comparative ethnography — is how such issues remain conceptually underdetermined on the one hand, and the implications this presents for future policy formulation on the other. It is as well to add at this point that in the formalist genealogies of mid-twentieth century functional-structuralism, anthropological rep-

resentations of idealised genealogical space-time used the trope and method of the pedigree to depict the temporal passage of the generations. Genealogy was seen to serve as metaphor for the spatial and temporal coordinates of territory and generational age reckoning.® But genealogies, even then, could be drawn upon as devices for the artificial compression of biological relatedness and the seeming preservation of social time. ‘Telescoping genealogies’ was a way of ensuring that the line of descent from

the founding ancestor to the present generation remained a line that could be traced. As anthropologist Alfred Gell observes, the telescoping of family genealogy was about ‘silently revising the content of accepted beliefs

about the identities of ancestors, so that the line of descent from the founding ancestor to presently living individuals does not exceed a certain number of generations’ (Gell 1992: 21, emphasis added). In the case of transplanting ovarian tissue from aborted foetuses, a key ethical objection has centred on the perception of genealogical anomaly: the child’s mother would not only have died before the child would have

been conceived, but ‘she’ herself would never actually have lived. In excluding the possible future use of eggs matured from dead foetuses for fertility treatment, the Authority’s main concerns were not simply pragmatic ones such as the safety of procedures. The ethical storm blustered around the unfamiliar prospect of non-origins, the strangeness of babies generated from ‘unborn mothers’. It was this unprecedented paradox that unleashed a sense of deep cultural malaise (see Figure 8). How could society partake in this experiment and begin to think about the possible effects for resulting children upon learning about their genetic non-origins? The Public Consultation presented this quandary to its readers as a particular cultural elision. It ran together the notion of ‘skipping’ a generation with the act of ‘breaking a natural law of biology’. The Document states: A potential difficulty might be thought to be that a generation of human development would be skipped if fetal ovarian tissue were used in infertility treatment. Ovarian tissue or eggs from an aborted foetus have not been subjected to the pressures that govern survival and norma] development to adulthood. This raises questions about the degree of risk of abnormality, at

Unconcealing Regenerative Transilience 223 present unquantifiable, in embryos produced using such tissue. This might be seen as breaking a natural law of biology. (HFEA 1994b: 6)

When the same debate was to surface nearly ten years later at an international conference in Madrid in 2003, the British press reported this purported breach of kinship with spectacular consistency. The media had been covering events at the annual meeting of the European Society for Human Reproduction and Embryology (ESHRE) where an Israeli-Dutch collaborative research team had just publicised its latest efforts to grow ovarian tissue from seven aborted foetuses aged between twenty-two and thirty-three weeks’ gestation. A doctor from the Meir Hospital-Sapir Medical Centre in Kfar Saba, near Tel Aviv, announced to delegates that ovar-

ian samples had been sliced into thin sections and placed in culture medium containing follicle-stimulating hormone. After four weeks some cells had shown signs of maturing into eggs. The presence of oestradiol secretion in the culture samples, the doctor explained, had been interpreted by the research team as evidence that the follicles had reached the ‘secondary’ stage of growth, the penultimate stage before ovulation. But none of the egg-producing follicles had developed sufficiently to release an egg cell. It was not yet a scientific coup. Headlines from three papers that ran the stories on the same day [July 1, 2003] announced ‘Spectre of babies from the unborn’; ‘Era of “unborn mother” looms as scientists use aborted foetuses to grow human eggs’; ‘Your real mother was aborted baby’.”? Once again the vociferous outcry of ‘womb-robbing’ (see Mihill 1994) could be heard as anti-abortion campaigners condemned the development ‘grotesque’, ‘macabre’, ‘sickening’.

I th d

Connnued trom Page Orie ical questions. There have been sev- uneasy’ abou ea of usin Ahk fs : 10n suen fo —— were about 10 be produced, Chiet Saureemmyaniet eran coups Aborted oetusts te asource of ce Pines SSte ol ttman ese geno oad Blron-Shental said and the fact that Dutch and Israeli wrong. t he said. ‘Partly because it : sit ockiog saw rearaten wae

wileaiahomgne rine they Sebibestewuafintegeaics Rotietemacemeedcraon | 77Aviv, won| |inicscoliaboration otal Kir Sabawith nee | could have produced mature eggs The development adds ow, V4-o 8 eee| Tel

suitable for IVF use PI oByetbato ma ances roll pes E nang rotrertin bcos raay l ag child of thei oe Utrecht Universtty. It Involved Be, claimed it would be ethically modern reproductive medicine. “We need ae aanoaeer the welfare of .* oa tom pg or Reto © rae? pend gh i

Boerne ti Same’ as existing a on car — the child and the impact of finding W fis | Slices of their ovarian tissue | Detalis of the major research birth to an IVF baby genet cally ge Paced matersirar depen dogma ont, ee : ee ee ee eee

Ervest inference Site Hurpens match or hueick Brother “asd ghortign pressure group Lire, | IN fa] | ff | Necks tne fiiiesmaturedio the Souetyof Human Reproduction andTom possialy provide him with acure. managof anecsperments macabre) | | “DE Siroo'snsnar The Embryology in Mad Dr Sbakespesre, director . ening, even by| UgeMest ge ron-Shental said: saa "The The process would be iliegal in the Policy, Ethics and Life Sciences *he low standards of peerage = vifraaed, seg ack sey ere ce ones

Britain, but experts said there isno Researcti Institute at Newcastle beter Who would want to 5 Zager), me Ganael tae oun de a we way this country can escape theeth- University, said he was ‘deeply oe Sout Sones ae. se eof SPX | Sancoe these $e ether cbemiaens |

Bremmupemaniiy | Seo eey Va | watatec dean, would be grotesque. cad = 4 bi und donated eggs already ~ it's ‘They may suffer enormous Wags fri ca mae grea the same. I'm

Papas acntsa wou | CAMMY A | but probably i'ome place ist in medical ethics and infertil- = BH tae Tee esate ucla Gone bed | fy Es ptenpooe | ae re Eee fi , after disabilities and defects by the new technique. ‘Society is a were discovered, but the Israeli | not ready for this,’ she sald “You never know where fe ee es of abaormality |

posinity orang on denis |” Ghesedayat | utroriai nated eee. aborted for genetic malforma. wamen se isfive times Embryology Authority. whieh

— oe — by = time the eauar of atiees. and the eovetas Mrttny ices. bas

2 Ww : ‘nt can more Outlawed th

reserves have fallen naturally than ‘two years. For ae cou- aborted | A lag ania 250.000, possibly because nature Feduces the chanoe of eucoees.” lasue trised MAiticcil soci tonne

But the scientists develoy =| babies ace 0 omens ‘suppiy ot Hie acted: "We decided it woudl oe profiad Gare ne renee pl tha tay sacs called follictes, inside meena Bon, Breaprandan gi pert

sprmmarh iereached 24 weeks feta material some areascana the numberof tion, By a foetus will havegests seven shorted ob. [email protected]

Figure 8 ‘You never know where they get their IVF eggs these days!’, 1 July 2003. Reproduced by kind permission of The Daily Mail.

224 Nameless Relations Attentiveness to the inviolable, near sacred nature of ‘laws of biology’ is nothing new. It is evident in the whole evolutionary paradigm of social Darwinism and the positing of human nature as a continually evolving community of genealogical descent. The ‘community in [its] embryonic structure reveals community of descent’, wrote Darwin in 1859 in The Origin of Species. In this model of filiation by shared blood, to skip a genera-

tion would be tantamount to creating wilfully a missing link between persons and between the generations. The literary theorist Gillian Beer has suggested that the obsession with the missing link in the popular imagination of late Victorian Britain had to do as much with attempts to reinforce degrees of cultural distance as it did with seeking out ties for social connexion. Man, she notes, was still just ‘hypothetical’ and so long as a ‘gap’ could be seen to remain between humans and animals, between races and species and between social classes, the supremacy of the image

of the human could remain intact (Beer 1992: 22). By playing on this paradox of keeping what is cherished both distant and near, the project of man’s hypothetical ‘kinship’ could be kept unfinished. One’s sense of identity within the social order could remain productively unresolved. This Victorian paradox of wanting to locate the missing link in order to refute its very existence would seem to have several parallels more than

a century later in ‘high tech’ Britain as indeed elsewhere. On the one hand, biotechnology is seen to make ‘persons’ publicly visible as agents involved in the potential violation of their own [biological] mechanism of

natural selection.” Whilst on the other, it is held to be part of the very ‘nature’ of human beings to act to make interventions as cited at the beginning of this chapter. It is between these elisions of what counts as human

nature that the notion of ‘skipping’ a generation can be seen to depend foremost on having already equated the value of the entity of the foetus with that of the category of the mother (see Hall 1993). According to this temporal sequencing of relations and events, the presumption of what constitutes the boundaries of the natural and the unnatural rests on the way that the figure of the ‘mother’, as foetus, comes to be defined as assumed non-presence. ‘Her’ identity could only be known — surmised hypothetically — in terms of the establishment of links premised on specifically cultural ideas about genetic continuity. In other words, the cultural

equation of the aborted foetus with ‘mother’ pertains to a way of thinking organised around the privileging of an ideology of biogenetic kinship. If it is thought that a generation is skipped, this is because the category of ‘mother’ breaks the rule of lineal descent reckoning; a reckoning whose prime imperative would be to trace back via genealogy from where this ‘relation’ originated. ‘She’, the foetus/mother symbiosis, is symbolically homologous to the illicit act of having converted the blood tie into the disparity of an evident missing link, namely that which both uncomfortably connects and disconnects mother and offspring from each other. There is no natural selection here, only an ‘organism’ whose biological sequestration shows up a parentage of obviously indeterminate origins. The cul-

Unconcealing Regenerative Transilience 225 tural anxiety, in other words, is one of unconcealing a particular kinship trajectory predicated explicitly on ‘relations of non-relations’. These observations about non-linkage prompt a further set of questions that fan out as critical juxtaposition. Is there anything left of ‘the gift’ in these relations? Could the rationale supporting these claims be

evaluated somewhat differently from the perspective of relations of regenerative transilience?

Reconstituted Persons and the Extensional Imaginary A large body of Melanesian and Oceanic ethnography has explored the symbolic linkages between images of birth, death and rebirth, portraying indigenous conceptions of the creation of social bonds in terms of local procreational idioms. The symbolic dimensions of fertility or conceptions of life-generating potency are regarded as important details of this litera-

ture. Seen as cycles of exchange regulated by cycles of death, a key instancing of this regenerative reproduction of persons are the mortuary transactions marking the rites of the dead (Battaglia 1990; Damon and Wagner 1989; de Coppet 1981; Foster 1990b; Humphreys and King 1981; Weiner 1980). A consistent feature in these accounts concerns the way in which the deceased person is thought to be ‘taken apart’ and reconstituted in new form during and after these transactions. The so-called biological death of a person is seen to entail a redistribution of aspects of the deceased that are then deemed to reside subsequently in others. As Roy Wagner notes ‘the social person of the deceased (the aspect of a person that participates in the personae of others) is not diminished but expanded to the limits of his or her social circle’ (Wagner 1989: 267, emphasis added). In

this way the belief that death brings with it the separation and release of valuable resources for use in new productive contexts is enacted ritually in terms of the cultural attention paid to the deceased as the embodiment and time of reordering new sets of social relations.

One aspect of this belief system has been identified as the analytic theme of commemoration or memory. Memory is that which is definable as intersubjective knowledge (Battaglia 1992, 1993; Munn 1986: 60-67); a ‘productive’ kind of forgetting where being ‘held in mind’ is tantamount to remaining symbolically vital through others’ actions (Battaglia 1990:

12,198). The related notion that the person remains an ongoing social context or trajectory, thereby transmuting the effects of loss, deterioration

and degeneration, relates to the value of death as a mechanism for the long-term regeneration of society as the legitimation of an enduring sociopolitical order (Hertz 1960). It also relates to the belief in regeneration as the simultaneous denial and mastery over the arbitrary nature of biological death and individual distinction (Bloch and Parry 1982).

Conception by posthumous reproduction is now one possible technique for social commemoration afforded by the new life technologies. When Howard and Jean Garbner from California, U.S.A were prede-

226 Nameless Relations ceased by their young daughter, Julie, their wishes received much press attention and the tag of public derision. In the making was a controversial ‘case’ of uncertain cultural resolution and run-away proportion. Although childless, Julie had already acted as a procreative agent of a kind. She had chosen to have her eggs cryopreserved before the commencement of her treatment programme for leukaemia. In her mid-twenties she hoped one day to have children and was concerned her fertility might be compromised by the cancer treatment she needed. In the event it was this deci-

sion to store her eggs for her own future use which enabled Julie’s parents, after her death in 1996, to claim that they wished to ‘recreate’ [the memory of] their late daughter through a surrogate host pregnancy.!°

The press portrayed Julie and the surviving Garbner kinsfolk as giving birth ‘from beyond the grave’. No talk of productive forgetting here! Only an extensional imaginary envisioned in the negative as the troublesome ‘de-conception’ of unique personhood. Yet listening closely to what the family members say about their kinship losses, this attempted reconstitution is not about equating and iden-

tifying one set of detached body parts with the singular body of an autonomous internally bounded self, as is so commonly depicted in medico-legal debate. ‘Julie’ was not being put back together. Surviving kin are talking rather about the potential of reproductive technology to help preserve and distribute social memory of the deceased across multiple persons. Could then the ‘handing over of a vitality which can then be recycled’ be symbolised as a ‘good’ death or birth (cf. Bloch and Parry 1982: 17)? Here is Howard Garbner, Julie’s father, on plans for his grandchild-to-be, whom he hopes will be a girl-child: We will call her Simcha, which was Julie’s Hebrew name. It means happiness. It reflects what Julie’s memory evokes for us ... we [Howard and Jean] have never closed our minds to the idea of having more than one of Julie’s embryos implanted in a surrogate mother. We [parents and Julie’s sisters] would be willing to bring up several of her babies if that were possible ... in a blink I can bring Julie back in my mind’s eye. Within a year I want to hold a grandson or daughter who looks just like her. (Craig and Bourne 1996)?!

The way in which local ideologies of regeneration can be elaborated in terms of a complex folk theory of procreation in Melanesian societies, and the way this might underscore representations of personhood, is evident from Fitz John P. Poole’s analysis of social continuity among the

Bimin-Kuskusmin (West Sepik interior, Papua New Guinea). Poole (1984) describes how much ritual attention is paid to bones as bodily structures during life and to ancestral relics after death, such that a cycle of social and cosmological regeneration underscores the way that male substance is conceived as continuing the symbolic transformation of clan finiik spirit. Death is conceptualised as a (re)birth into a socially bounded collectivity of ancestors and this ancestral collectivity is thought to connect the living and the dead as both a source of the living and yet to be

born. By perpetuating attributes embodied by ancestors who remain

Unconcealing Regenerative Transilience 227 within the social and moral universe of their descendants, it is believed that finiik spirits of the dead pass on into clan collectivities and are able to animate the foetuses of unborn clan members by re-embedding their substance within them. We may see these performances across different bodies and the generations as transilient relations. The relevance of regenerative processes for a reproductive model of ‘replacement’ has been highlighted by Annette Weiner as part of her conceptual critique of ‘the tenacious anthropological belief in the inherent nature of the norm of reciprocity’ (Weiner 1992: 149-50). Reciprocal exchanges are, she claims, ‘only the pawns on the chessboard of culture preserving inalienable possessions and fending off attempts by others to claim them’ (Weiner 1992: xi). Reworking Malinowski’s material on Trobriand exchange relations, Weiner identifies ‘society’ in terms of a ‘reproductive’ system governed by the cyclical transmissions and regenerations of persons, relationships and objects, each mutually bounded by and constituted through the other. But these transmissions, as kinds of recircula-

tions, do not simply happen by themselves. Matrilineal and patrilineal relationships must be made to flow as the exigencies of a system that itself needs to be ‘fed’ as the multiple processes of continuing exchange. ‘... the

transaction must be understood as an aspect of the larger reproductive system in which the accumulation, circulation, and replacement of elements of value, along with the build-up and replacement of individuals, only occurs through constant attention, nurturance, and “feeding”’ (Weiner 1980: 80). We may see how transilience is activated here as relations of support across divergent kin, and as part of a wider sociality or social collectivity of persons. Now the donors who ‘feed’ the Trobriand system are not discrete indi-

viduals. This much is evident from the inter-generational reclamations made by a deceased person’s kin in the case of dala resources.'* Objects and

land given to a deceased member of another dala must be reclaimed by members of the original dala or else risk being lost permanently to them. Dependent on the nature of the item being reclaimed, male or female valuables will be offered as replacements, and will thereby effect some measure of power over other individuals when they take these objects out of the course of others’ prospective exchanges. Since these reclamations are likely to bear upon the resources of individuals who had nothing to do with the initial transaction many years or even decades ago, a field of relations between mutually implicated non-kin is set up as a regenerative network of transilience for the processing of social continuity.

How it is Imagined Breath Circulates between Persons For the ‘Aré ‘Aré society of Malaita in the Solomon Islands, it is the ‘everlasting work of mourning’ (de Coppet 1981: 179) which, as it were, ‘feeds’ the society and simultaneously is the substance of the ‘Aré ‘Aré person.

The social management of death creates both the foundations of norma-

228 Nameless Relations tive social order and is reflected in the internal composition of ‘the person’

as a living substance made up from the three different elements of the ‘body’ (rape), the ‘breath’ (manomano) and the ‘image’ (nunu). This mutual interdependence of the social order in the power of the corporeal element and vice versa, means that ‘the society [‘Aré ‘Aré] builds up its own character of permanence through the repeated dissolution into the ritual and exchange process of the main elements composing each individual’ (de Coppet 1981: 176).

On the one hand this rituology of death is the visible sanctioning of peaceful social relations. On the other, normative meaning resides in the way that the labour of mourning work will be seen to assume different symbolic dimensions according to the status of the deceased. It matters, de Coppet observes, whether somebody has been murdered by the living, for instance by avenging ancestors, or whether death is an affliction by per-

sonal ancestors. But the crucial point is this: the category of ‘murdered persons’ (rdramua) and persons ‘killed’ by their ‘ancestors’ (hi’ona) are to be ‘reconstituted’ as different kinds of regenerative agents on account of

the different symbolic transformations (‘work’) that they and their mourners will effect. In the former case, the replacement of ‘breath’ of an unavenged murder victim requires the exchange of someone else’s life or the ‘return’ of a

corpse from an opposing party, subsequently recompensed by ‘bloodmoney’. The unavenged person’s breath circulates symbolically as a social

part of that person until it has been ‘covered’ with the ‘breath’ of a new victim. In the case of death by ancestor, however, it is not a matter of salvaging ‘breath’ but of transforming successfully the ‘image’ part of the deceased person into the sanctioning power of an ancestor. The ‘image’ is cultivated over time through the constant flow of ‘mourning work’ carried out over several years, facilitated in part by an appointed ‘grave-dig-

ger’ who produces a great number of pigs, coconuts and taros for distribution between his group and the dead person’s family at a subsequent funeral feast. It is now as the transformation of the deceased person’s body parts as circulating food that these two ceremonial groups will exchange piles of cooked food amongst themselves. The three main components of the piles will display ‘body’ (the taros and the coconuts), ‘breath’ (the pork) and ‘image’ (the money on top of

the piles) as the ‘reconstituted’ form of the deceased. But, as noted already, the ‘image’ of the dead person can only be completed as a part of previously sanctioned ancestors. It is by means of the long-term exchange of money between the groups that the ‘image’ enters ancestral life thereby cancelling out, and taking the symbolic form of eating or leaving to rot, the

‘images’ of earlier ancestors and regenerating death as the life of new ‘bodies’ and new ‘breaths’. In this way, the ‘Aré ‘Aré ensure that the complete dead person’s ‘image’ is constituted out of pieces of money whose origins are the ‘images’ of other ancestors that have been displayed at one

time or another at previous feasts. What this cultural imaginary shows, then, is how the circulation of the dead is achieved by the continual trans-

Unconcealing Regenerative Transilience 229 formative replacements of [bodily] parts of the person that become the simultaneous (re)constitution of the person as a ‘self-feeding process where nothing is ever lost’ (de Coppet 1981: 192).

How it is Imagined the Unborn Sibling Blood-donor Child Will Make New Life When Lord Phillips, Master of the Rolls, announced in April 2003 that the British Court of Appeal had decided to grant legal power to the Human Fertilisation and Embryology Authority for the licensing of embryo selection by tissue typing, the ruling gave at least one family fresh hope. The Court had been responding to the case of the Hashmi family from Leeds whose four-year-old son, Zain, suffers from the rare and fatal inherited blood disorder, beta thalassaemia. With the Judges’ decision, Sha-

hana and Raj Hashmi, themselves both a-symptomatic carriers of the disorder, became the first couple in Britain to win the right to pre-select IVF cultured embryos for the purpose of genetic tissue matching. Rights

may sometimes bear the mark of their own contested origins. In this instance it had been with a view to saving the life of their son that Zain’s parents found themselves embroiled in a lengthy public display of love, protest and recalcitrance. ‘Society’ had been present in all of the differences between medicine, law, ethics, theology and technology that culminated in the final victory of appeal and its successful quashing of the two previous rulings by the High Court.!* What had fuelled the long clash of dispute? On the Hashmi side, the motivations were simple to see. A chance to seize the hope of a cure that would end Zain’s gruelling regime of drugs, injections and regular blood transfusions.'4 What however was known to be required was also known to be missing. Namely, a living transplant donor who, as exact genetic match to Zain, could offer bone marrow as a vital source of substance: new cord blood. Shahana and Raj had hoped in vain one of their other healthy offspring might test a correct tissue match and had searched with-

out success the worldwide registry of donors. The situation looked deathly. No curative agent, no life. Except that ... there was one remaining possibility in the offing. Zain’s condition might be cured by a transplant of stem cells with matching tissue supplied in blood taken from the umbilical cord of a newborn child. Shahana and Raj could try to conceive another child as a therapeutic sibling donor support for their existing child. But they would need to summon the presence of this child through novel procreative combinations: besides the eggs and sperm of each of the parents, it would be the joining together of assisted reproductive techniques with genetic testing technology that would hopefully produce the desired effect. With pre-implantation genetic diagnosis, the unborn child as potential donor-to-be would be screened and genetically selected from multiple IVF-cultured embryos. She or he will be made up from various knowledge components, just as

230 Nameless Relations the ‘Aré ‘Aré are wont to pile up the components of the person as the final ‘image’ of the deceased. When the fertilised embryos will have grown to the eight-cell stage, an IVF technician would carefully remove a cell from each embryo for genetic testing. These cells would then be cross-matched

with genetic markers pertaining to members of the Hashmi family that medics previously will have sampled and stored. If any of the cultured embryos show up as non-thalassaemic and are a good tissue match, they would be potential candidates for embryo transfer. If and when Shahana gives birth, blood from will be taken from her new-born baby’s umbilical cord and then frozen for storage and testing. It is the cells from this cord blood that would be injected into Zain’s bone marrow. Screening embryos for genetic characteristics has drawn criticism from the anti-abortion lobby and others who believe that it is wrong to bring a child into the world for the benefit of anyone else, namely, a third party.

This position argues that the donor child is conceived primarily as an instrumental means to an end, rather than as a subject in its own right. Furthermore, since the child has not given its own consent to the donation procedure, the act of blood extraction is regarded as potentially exploitative. It is said that creating babies to provide ‘spare parts’ for children or adults who become sick undermines the notion of the person as a bundle of rights endowed with autonomous free-will. Some opponents go on to frame their objections in commodity terms: this is nothing less than

the manufacturing of the child, they say. Others suggest that embryo selection for donor compatibility creates so-called ‘designer babies’ as part

of a shift towards more overt forms of reproduction by eugenics. This position, sometimes overlapping with the previous objection, is concerned about the effects of a technology that could allow, in principle, the ‘selecting in’ of children with positive traits. One worry has to do with the customised creation of genetically enhanced babies ‘made to order’ and the effects of societal discrimination that accompany the systemic reification of traits such as intelligence, beauty and so on.!° Whatever position protagonists take, the terms of the debate appear to cleave the different societal interests into competing sides. In many ethics deliberations on the new technologies, moderators intervene in formal, stylised ways. Processes of evaluation often come with their own built-in

pretensions: there are the aesthetic devices of measuring up, pitting against and weighing up. In short, judgements are made against an analytic frame of ‘balancing’ various positions and counter positions. How one makes one’s final argument will be a matter of personal predilection. But the terms of the debate are framed consistently as the balancing of rhetorical opposition and counter-opposition.'® To devalue the life of a prospective child or save the life of an existing child? It is one against the

other. With this example of tissue-matched sibling embryos by preimplantation genetic diagnosis testing technology, what I have wanted to present are the outlines of an alternative extensional imaginary. Let me stress again I neither condone nor advocate a particular position. I simply want to suggest that in the context of reproductive medicine the potential

Unconcealing Regenerative Transilience 231 redistribution of body parts/persons over time comprises an aesthetic of regenerative transilience, which, at least for some interested persons (i.e. implicated kin) can be seen to keep local social life (‘relatedness’) orderly and continuous. Let’s go back once more to the sequence of events in the above scenario

and fast-forward to the moment of parturition. In relation to its mother, father and other family members, the resulting donor-sibling child would become the kin support of transilient regeneration. Activated as a relational support upon birth, the child makes new breath for its sick brother. Within the frame of this extensional imaginary, it will have been summoned up as a therapeutic ‘spirit’ child whose curative regenerative relation to its sibling elicits the magic of stem-cell therapy. The donor child enacts transilience because its passage into the world evokes a particular historicised trajectory: it will have straddled already between the realms of the living, the dying and yet-to-be born. It is true that in this particular instancing of irrelational kinship the siblings do not yet know each other when they are implicated, the one as donor, the other as recipient. I broached this point earlier through others’ stated objection about the impossibility for the neonate donor to give its prior consent. I should add here an additional caveat. This concerns the fact that blood, and its therapeutic properties, has been removed from a

mediatory agent rather than from any one particular person: it is the extra-embryonic umbilical cord that unites mother and child that may stave off death as the very symbol of a maternal-foetal lifeline. The siblings are connected through this umbilical ancestor.

Discussion It was mentioned earlier how a key objection to the transplantation to living recipients of ovarian tissue from aborted foetuses and cadavers centred

on the perception that the child’s mother would have died before the child would have been conceived. In other words ‘she’ herself would never actually have lived. I have wanted to show how once the underlying fear of ‘skipping a generation’ is filtered through the multidirectional flows that define persons as the regenerative substance and potential activation of transilience, the related adjunct of ‘a natural law of biology’ ceases to pull any discursive force. Drawing upon Melanesian materials to work over an external comparison we see further how the possibilities for ‘deconceiving’ persons defies a purely biological construction of the individual.!” If in certain Western contexts, people also reorder ‘old’ relations by recourse to similar non-biological idioms, albeit in less explicit ways, then in terms of what precisely does the difference inhere that makes receiving ova from a dead woman or aborted foetuses — as opposed to ova from living women — objectionable? Why is it ostensibly part of the ‘nat-

ural’ order in western society to keep these substances out of a field of exchange?

232 Nameless Relations I have suggested that the question is perhaps one that is best turned around so as to address the difference between live and cadaver donation in terms of the value of actions of relational persons/agents. For the issue is not one of determining the ‘innate’ properties of eggs, cadavers, and aborted foetuses as the substance of self-owning persons whose body parts may or may not serve the functional purpose of providing regenerative potential. Here I must backtrack again. Although the analyses by de Coppet and Weiner see the conversion of loss as a positive resource and are

concerned with the temporal aspect of a regenerative logic, neither account develops a theory of social agency by virtue of these observations. De Coppet obviates the need for a theory of social agency by stressing the

inevitability by which ‘chains [of transformation] are not so much invented as rather blindly and faithfully followed’ (de Coppet 1981: 201). Weiner too leaves unanswered the question of what kinds of persons are capable of enacting processes of regeneration, partly because she pursues her own ‘paradox’ that veers her analysis, however important and subtle, more towards an over-reliance on structural causality than a micropolitics of human agency. Although Weiner’s insistence on the universal and enduring nature of

inalienable possessions stems from a critique of ‘a Western construct of | linear sequences basically concerned with discrete acts of giving and receiving’ (Weiner 1980: 71), in fact the central paradox informing her account turns on the way that the construct of inalienability supports a view of the self as discrete, unitary and inviolable. James Weiner makes

the point deftly: ‘But why do these selves care whether such objects become alienated if the integrity of the self is not affected by their loss?’ (Weiner 1995: 133; see also Howell 1989). Because persons in Annette Weiner’s account are still founded on the axiomatic rubric of self-ownership and the view that they are rightfully the originary owners of their [dala] products, the meanings invested in an accumulated ‘wealth’ kept out of the flow of circulation hang conceptually free from other important connections. I must offer yet another caveat. Of course the discussion so far is skewed analytically inasmuch as it has completely overlooked the fact that the internal constitution of the Melanesian person is not analo-

gous to that of the Western person. Marilyn Strathern has already exchanged [the] perspectives, so to speak, in the theoretical account of social agency informing The Gender of the Gift (1988), in the fractal aesthetic of Partial Connections (1991) and the refiguring of parts and wholes that forms the conceptual backdrop to the comparative exercise in Reproducing the Future (1992a). The Melanesian person is a microcosm of societal forms of organisation. ‘In the way that Melanesians present social life to themselves, it would seem that there are no principles of organisation that are not also found in the constitution of the person. External relations have the same effect

as internal ones. In short, to imagine the person in this manner means that no switch of perspective between persons and relations is required in order to ‘see’ social relations’. Exchanging perspectives only differentiates

Unconcealing Regenerative Transilience 233 one set of relations from another, as it does one kind of person from another’ (Strathern 1992a: 100). This concordance of perspective was apparent in de Coppet’s analysis of the person made up from ‘body’, ‘breath’ and ‘image’; the same compo-

nents that make up the piles of exchanged food as the ‘reconstituted’ form of the deceased at the mortuary feasts. It was also evident in Mosko’s analysis of the homologies between the respective ‘openings’ and ‘closings’ of women’s bodies and patrilineal clans (Chapter 6, Recipients I). But what Strathern’s detailed conception of Melanesian agents shows more-

over is how one is enabled to act and thus capable of making an action because of the way that a ‘person’ stands for a ‘locus of relationships’. In

the sense that persons’ capabilities reveal the social relations of which they are composed, social relations reveal the persons they produce (Strathern 1988: 173). Further, every relation contains within it or anticipates, as its ‘capacity’, its own outcome, this being nothing less than the previous relationship in a transformed state. Actions therefore are the substitution of one relationship by another. For the Hageners, argues Strathern, power does not equal exerting control over others, but refers instead to the drawing out of internal capacities. What matters is the way that the effect of an interaction on the inner person comes to be registered in or on the body. Thus, the category of the body is thought of as registering the effects of others’ motivations and intentions because it is composed of the specific historical actions of others (ibid., 132). With the problem of consent in mind, my provocation has been to ask whether ‘Western’ bodies/agents are really that different? When ‘linedup’ Ova recipients draw upon the notion of the ova ‘pool’ at the clinic,

they sometimes refer to this as the container of many persons. Women imagine the pool as intersubjective space-time: it is activated as the outcome of the kinds of relations that are made and transferred as the detachable and circulating parts of anonymised persons. The pool holds together

these unknown persons as ‘one body’. It encompasses donors and the prospect of donation. The imagery of Fay’s person as a body constituted of

internal escalators ‘going around’ is another instance of the agent activated as a microcosm of social relations of exchange (see Chapter 5, Donors ITI). As the container of several persons’ actions, we saw how the

multiply divisible body is the recursivity of continuous cycles that the internalised ‘steps’ — the bodies of agents — activate. In the account of her

interiorly active body and her person as someone involved in ‘the world [as] made up of people giving and receiving’, there is absolutely no switch of perspective. What is imagined as internal and external is co-equivalent since social relations are ‘seen’ for the way that the body is composed of the (historical) actions of others.

Although seemingly proximate to the figure of the Melanesian agent, the examples discussed at length here do not provide a perfect reflection of the person as the embodied form of societal organisation at large. These

agents cannot be said to carry all of ‘society’ inside them, nevertheless they do, as modes of transilience, have social relations integral to them.

234 Nameless Relations Rather than viewing the social circulation of intercorporealised body parts

as the ‘infringe[ment] [of] the dead’ (see Palmer 1994) or as a form of ‘essence rape’, J have argued that regenerative transilience creates reconstituted persons as different sets of relationships over time. Indeed it is precisely in ‘the nature of human beings to intervene to try to shape their world’, to borrow the words of the HFEA, when they express the desire to extend themselves as the redistributive potential of ‘many’ persons. By bringing life and death together as the potentially seamless meeting point of different cultures, such ‘(re)mobilisations’ of substance are shown to be valid as the aesthetic of the social expansion of the person — both in the sense of moving beyond the trajectory of individuals’ own lifetime as well as beyond persons’ identifiable presence. We see that persons’ bodies need not be fixed necessarily as a physical source of identity, nor that the transilient relation need be founded upon the requisite of a unique and unrepeatable biography. It is not then the case, as Rosi Braidotti suggests in a commentary on the nature of discourses of ‘bio-power’, that the boundaries between life and death collapse imperceptibly because of a ‘freezing out of time’ (1989: 153). Rather it is the case that life and death comprise each other’s imaginative counterparts: this is made evident as the social agent’s capacity to initiate the multiple dispersals of ‘self’ that she or he engenders as the play

of time. The commonly held perception then that the child’s mother would not only have died before the child would have been conceived, and that ‘she’ herself would never actually have lived, is not to be seen as necessarily symptomatic of the violation of time. Generations are not necessarily pregiven as sequences of relations that can be ‘skipped’. This is what we can ‘see’ when we juxtapose examples in unexpected ways, both

as the event of internal and external comparison. Namely children with unborn mothers set against unborn children as therapeutic donor-sib-

lings-to-be as well as children conceived with the sex gamete of a deceased parent. The ‘foetal mother’ figure is perhaps one of the most graphic examples of the ‘silent’ reconfiguration of genealogy. ‘She’ shows how temporal relationships can no longer be expressed in the traditional genealogical idiom of natural biology. It is evident, at least in the contexts noted here, that genealogical time can no longer be taken to ‘stand in’ for the succession of generations. Nor is it possible to address the ‘becoming’ of the human simply as a matter of the ‘evolution’ of an individuated biological organism. For the future, this means being conceptually open to how persons with different interests — families, scientists, activists and so on — imagine they may reconstitute social relations from out of themselves (and others) through new telescoping time-frames. kK*kK*

When the amendment to the Criminal Justice and Public Order Bill was passed into law in 1994 banning the use of foetal ova or embryos derived

Unconcealing Regenerative Transilience 235 from foetal ova for fertility treatment, Dame Jill Knight as proposer of the motion had addressed the House of Commons with the following plea: ‘It is totally repugnant that an unborn child — a child deliberately prevented from being born — should be plundered to facilitate the birth of another child ... [want to send a message to scientists that there is no point spending any more time on research in that area, or in messing about with aborted mouse

eggs, rat eggs or anything similar. The end product from using aborted | human eggs for fertilisation purposes will simply not be allowed to be used.’!8

The House concurred when the vote was taken in the dead of night. The ‘Aye’ lobby filled with at least three hundred MPs and only fifteen or so parliamentarians in the opposing lobby. There was no point in even sending in the tellers.

Notes 1. As noted in Chapter 1, the figure of ‘cosmic egg’ encompasses the final frontier in its symbolic fusion of micro- and macro-cosmos. A historiography of the sexual politics of the conquest would tell, among other things, the story of inter-institutional processes of encroachment. It is not by chance alone that male scientists in this area continue to outnumber female gynaecological researchers. 2. In 1994, an amendment to the Criminal Justice and Public Order Bill proposed by Dame Jill Knight was passed into British law banning the use of foetal ova, or embryos derived from foetal ova, in fertility treatment. In turn this revised Public Order Bill can be seen to amend the HFE Act. However the main provisions of the HFEA Act cover only the use of human eggs or sperm that are mature or capable of fertilisation. The point to note therefore is that the possible future use of immature human eggs cultivated from stored ovarian tissue is not at the present time part of the HFEA regulatory licence remit. 3. Note that under the terms of the Polkinghorne guidelines adopted by the Department of Health in 1989 [Review of the Guidance on the Research Use of Foetuses and Foetal Material Cm 762 HMSO], medical professionals are

permitted to use foetal tissue in research or in treatment. The guidelines are however shrouded in operational secrecy. They state that consent to the use of foetal tissue obtained from a woman undergoing an abortion need only be general in nature. There is no obligation on the part of medical staff to inform the woman of the intended use of foetal tissue, nor indeed whether or not any such tissue has been put to any use. The lack of any precise accountability here again paves the way for the possible use of immature eggs from aborted foetal tissue. 4. See HFEA (1994a: 11). 5. See for example ‘Ban in using foetal ovaries to treat the childless’, The Times, 21 July 1994, p. 6; ‘Fertility team wants to use eggs from aborted foetuses’, The Independent, 3 January 1994; ‘A “mad” foetal position’ [Letters], The

236 Nameless Relations Sunday Times, 9 January 1994, p. 8; ‘Foetal eggs as a fertile ground for debate’ [Letters], The Guardian, 6 January 1994. 6. See Bouquet (1993) on the limitations of genealogy as bourgeois scientific methodology. Needham (1974) was another early voice wary of the synthesising pretensions of mid-century British kinship theory. The theoretical inflexibility of the concept of human generation to incorporate categories of change informed his particular scepticism. 7. Reported respectively in The Daily Telegraph, p. 1, The Independent, p. 3, The SUN, p. 22.

8. See Darwin (1985: 427). 9. An outlawed vision typically depicted in press and policy reports as the ‘monster’ thesis of unnatural human deviation. On the ‘unnatural’ life of monsters, see Turney (1998). See also Daston and Park (1998) in the light of Latour’s (1993: 12) observation that we need ‘to regulate the proliferation of monsters by representing their existence officially’. 10. See Usborne (1997) and Craig and Bourne (1996). Note that there are differences between British and US law here. In the U.K., a woman intending to have ‘her’ embryos frozen must forward written instructions on their intended use in the event of death. There were no such provisions in the Garber case. 11. In February 1997, the U.K. Court of Appeal finally ruled in the favour of Diane Blood, decreeing it legal for her to be inseminated with her late husband’s cryopreserved sperm. Blood was now allowed to receive IVF treatment in a fertility clinic outside of the U.K. where contravention of the terms of the 1990 Human Fertilisation and Embryology Act would not apply (see Simpson 2001). Upon hearing the ruling, Blood evoked a chain of links

as social memory that connected her late husband to the prospect of her embodiment of new procreative life. ‘It’s Stephen’s birthday today and I think it would have been a very nice birthday present for him and it’s certainly very nice for me’ (Wynn Davies 1997). 12. Dala refers to the complex of identities connected by matrilineal blood and to plots of land, hamlet sites or other transmissable objects such as body and house decorations, names, magic decorations, dances and distinctions of rank. 13. Besides the Hashmi family, the ruling gave fresh hope to many other parents with seriously ill children. The HFEA is licensed to approve embryo selection by tissue typing in certain medical circumstances only. Genetic tissue typing of IVF embryos by pre-implantation genetic diagnosis (PGD) is to be made available, currently at the time of writing as a private treatment only, for the parents of children suffering from life-threatening blood disorders (e.g., thalassaemia, fanconi anaemia or leukaemia) whose only hope of cure is by bone marrow transplants. Prior to the ruling, couples from Britain had evaded the ban by travelling overseas to North America as reproductive fertility tourists. 14. Thalassaemia beta is caused by a genetic defect that disrupts the formation of haemoglobin. Symptoms begin within a few months of birth. Without regular blood transfusions, the child does not grow properly and dies in early childhood. Even with treatment, many sufferers die in adulthood. 15. A representative from the anti-abortion group, LIFE, combined both positions in his objection. ‘Should we allow a child to be manufactured in order to serve the medical needs of an older brother? Whilst the term

Unconcealing Regenerative Transilience 237 “designer baby” is often overused, it is all too appropriate in this case’. Much of the press has been complicit in promotion of the eugenic association. The front-page headline that run the report from which the above citation is extracted speaks for itself. ‘Designer baby gets go-ahead’, The Guardian, 23 February 2002, p. 1. 16. Epitomised by the bioethical principle of beneficence in which the formulaic ideal is to ‘balance benefits against the risk of harm’. 17. Note that in some Melanesian societies the procreative capacity of the deceased are continued in the living through post-mortem transformations of bodily substance by ritual anthropophagy. Female substance may be transformed into male substance by men and vice versa. See Gillison (1980), Lindenbaum (1987), Andrew Strathern (1982). 18. Dame Jill Knight, Parliamentary Debates (Hansard), House of Commons, Criminal Justice and Public Order Bill, vol. 241, 12 April 1994, cols. 158-9.

CHAPTER I1 CONCLUSION: RELATIONS OF NON-RELATIONS

D onor-assisted conception anonymous donation is the a novel contemporary ‘test case’byfor rethinkinggamete what we mean by term ‘kinship with strangers’. Understanding the new reproductive technologies as the enactment of ‘intimacy-at-a-distance’, we see that the British and their Euro-American neighbours are perfectly capable of doing relationality in astoundingly variable, if unusual ways. It is, then, against a rich performative repertoire of kinship practices that we can tap into one of the more hidden features marking the beginning of the twenty-first century. The relational non-relation. To think of configuring ties of relatedness through the substance of anonymity, kin must make themselves into active mediators, confounding traditional symbols of consubstantiality, the blood tie, in the very moment that they become meaningfully non-identifiable to each other, the one non-relation evident as such to the other. Xeno-gamete is one facilitator of these transformations. As an exte-

riorised extra-corporeal entity detached from its original productive source, the xeno-gamete as its various affiliate incarnations (e.g., cosmic

egg, hyper-embryo, donated embryo, stem-cell line) may circulate between strangers via the mediations of anonymous sociality. Whether as

live ova donors in their capacity as extensional supports, or whether as ova recipients in their capacity as assisted birth mothers, relations of nonrelations go beyond any one singular kinship form. In one sense what I have analysed here as irrelational kinship becomes evident as the multiple possibilities whereby extensional persons can be activated as the forms

of the trace/non-trace — as the investments of bio-governmentality in traceability and non-traceability. Further, the anonymisation of persons in these contexts brings with it surprises. Anonymity may confound expectations and exceed convention. Making the non-relation arrive as nameless relations is itself a form of excess, and just like the Lacanian ‘objet petit

gap.’ ,

a’, we can enter through the oblique and through the structure of the

Conclusion 239 ‘Women urged to donate eggs’; ‘Call to pay sperm and egg donors’; ‘Are

you the kind of woman who could make another woman pregnant?’. What is behind the media reportage and recruitment campaigns that remind us so reliably of the perpetual gap between consumer demand and

market supply? Behind and beyond the commodity logic that divides demand from supply are lamentations. And with the lamentations we can see revealed many different types of donor and recipient, just as we may glimpse the coming together of many different faces of anonymity. The cultural politics of ova and embryo procurement reveal the parame-

ters of a changing ‘technoscape of non-proximity’ where the rush to superovulate women’s bodies, an unabashed concession to global biocapitalism — especially amidst the growing international trade in gametes — collides with indigenous narratives about the wonders of prolificity, the knowledge of generativity, the pleasures of female empowerment. It is true that anonymity beguiles as much as it conceals. Anonymisation may stand for the commodification of persons just as much as it may evince the surprise of the free gift, the donation freely ventured.

As the scientific search for new donor sources becomes more pronounced and explicit in its acquisitive aims, so the need for public ques-

tioning about the different types of ‘donor’ and concepts of donor availability becomes that much more critical. The truth is that different publics are already engaged in such questioning, paradoxically directly so. We are not just witnesses to unfolding debates. We have become part of the very substance of the re-modernised ‘cosmic egg’, signifier of every-

thing and nothing, the spherical body and circle of zero that gets caught up in the infinity of ‘all potentialities’. As such, we do well to be prepared for contradiction and ambivalence. Let me press the point with a brief detour. Already, live donation and the ‘gifts of life’ proferred by non-IVF altruistic donors have given way to multiple possibilities. On technical grounds alone, as some commentators remind us, there is no reason why human eggs could not be sourced by posthumous cadaver donation from young pubescent girls. Or take the case of immature oocytes and the evolving science of ex-vivo oogenesis production; there is mounting interest on the part of scientists to culture eggs from ovarian tissue and aborted foetuses, or to re-locate the site of primordial substance to the new nature of ‘artificial gametes’. Or what about enucleated human eggs and associ-

ated developments in cell nuclear replacement technology. Enucleated human eggs are a rare example of ‘pure anonymity’ because they are ulti-

mately a-genetic and origin-less entities with dubious, if indeed any, traceability-to-source. As anonymised receptacles for others genetic material, these hollow ‘support sacs’ carry no innate set of genetic markers. Of

course, the possibility of harvesting ova from, say, poor women in the South for research use in therapeutic cloning raises vexing questions about global health inequities and the status of cultured stem cells as ‘universal donors’ (Konrad 2003d). Do not forget either the polyvalent ambiguity of that term and its own etymological origins. To enucleate is to: (1) explain; (2) clear up; and (3) extract from shell (OED). As one is extract-

240 Nameless Relations ing the kernel from, taking the nucleus out, so one is making plain, laying open, clearing, explaining. Let me turn around this version of scientific reductionism here, just briefly. The cultural politics of enucleation may be symptomatic of the auto-replication of ‘run-away’ generativity where prolificity and productivity cannot be traced back to a known, locatable, visible source: the original anonymous donor. If a donor’s geno-

typic identity can be effaced without cultural attribution (namely recog-

nition of racial, ethnic and sex markers), what systems of ethical regulation are required to make such kinds of ‘donation’ practice humane, acceptable and non-exploitative? In such a nexus of power, the infinity that is the creation of limitless cloned ‘stock’ for research experimentation is ‘enhanced’ by way of the ready availability of human biomaterials — preserved in this case through the relatively new techniques of egg freezing. Such non-traceability, en masse, is the bio-ancestry of the ‘universal donor’. But how precisely do we trace her lineage?

I am projecting forwards for good reason. We have seen how these newly emerging ‘donor’ candidates, shorn of subjectivity and the human subject herself, have a historical genesis in the discursive conflation that eradicates, to all intents and purposes, distinctions between egg donating,

egg-sharing and egg-giving (Chapter 6, Recipients I). In practice, the arrangements pertaining to the treatment schemes may all be different, but we have seen how the category of gamete ‘donor’ is run together, a discursive elision held together by an elastic ‘gift’ rubric. Medical practitioners and others are experts at the craft of persuasive flex: stretching one thing to cover all. Egg donors, egg sharers, egg givers, are all making the same kind of reproductive ‘gifts’, we are told. Seamless connections: there is no clear discrimination between the acts of gift giving nor between the social agents who produce these possibilities. Just the fetishised gift, the

remaindered leftover from multiple re-sourcing. In the light of all such developments, I have argued that we need to be that much more aware of how women donors bring with them to the donation experience different interests, motivations, aspirations and desires. In fact I have insisted that these multivocal narratives, replete with ambivalence and contradiction, cannot be ignored (Chapters 3 to 5, 8). On the one hand these narratives enable us to give cultural value to subjects’ experiences of donating, to appreciate the distinctive voices that speak through testimonies of assistance. Indeed, the testimonies open the way to helping us understand why some women choose to make reproductive gifts with strangers from out of the most intimate of body parts, why they choose to make more of themselves through the extensile capacities of xeno-egg. These moving testimonies let us discriminate, in other words, between different donating agencies and different donation forms. They give us the tools to inter dangerous conflation: they help us to hear both the power and powerlessness implicated in moments of experiential ambivalence.

This important testimonial work may assist us too in documenting what is perhaps another emerging paradox. Auto-grafting techniques in the service of regenerative medicine potentially render the donor a super-

Conclusion 24] fluous figure. To bank parts of oneself in anticipation of a future illness or in advance of a declining fertility, to stave off the female menopause, to envision the ‘egg bank’ for everyone; should such possibilities materialise then they bring with them a reinvention of the self so radical that it makes the donor seem archaic. One is reminded of Lévi-Strauss’s final rejoinder in Elementary Structures that ‘... mankind has always dreamed of seizing and fixing that fleeting moment when it was permissible to believe that the law of exchange could be evaded, that one could gain without losing, enjoy without sharing’ (1969: 496-97). But just as the figure of the donor would appear to recede from view, to fade from public imagination, so we become witness to a timely revival of the gift, one that announces itself

through invigorated appeals to social solidarity, much in the manner Mauss had hoped. Increasingly, genetic donation invokes a discursive shift towards acts of intergenerational altruism as new forms of communitarianism. The idea of banking a body part is linked to the immortalisation of biosubstance as relational act. One reproduces oneself through the knowledge that one effects beneficence for anonymous others, however short or

long, immediate or abstract, that chain of relational activation may be. Truly, as Roy Wagner (1989: 267) notes of cultural practices for an altogether different context, ‘[the] entailed expansion of the individual into a generalised social significance becomes the point of origin of society’. We are not talking only about symbols now; this is all literal stuff! From the donated egg to the spare embryo to the stem-cell line, each the kinship affiliates of ‘hyper-embryo’, one is part of a new collective pooling exercise, a chain of interdependencies, what I have sought to expose as the unconcealing of regenerative transilience, itself an offshoot of extensional transilience (Chapters 9 to 10). Opening up anonymity to appreciate the power of its plural trajectories in the donor conception context — to envision its fundamental paradox — has been central to this cultural exploration of namelessness. On the one

hand, anonymity enforces the rule of taboo. This is the most familiar, public ‘face’ of anonymity. Some may not approve or like it. Conversely others may support it. Either way those of us directly involved in donor

conception issues immediately know what donor anonymity means. Donor anonymity is synonymous with prohibition. It is about the impossibility of certain social relations. It is about severing links between different partners involved in or arising from the donation experience through the cultural device of the non-name. It is about public and private secrecy, about the dilemma of disclosure, about how to give cultural form to the

preservation of past biological truths. Now as the face of convention, anonymity upholds certain fears and pushes them away to safe distance. There is the anxiety associated with the perceived threat of conjugal chaos as represented by the ‘interventions’ of the third party; the fear of recognition, of identifiability, of involvement, the fear of being held to account. It is at this juncture that the anonymisation of donor information becomes overtly political as a technology of biopower. Should prospective recipi-

ents and donors be given more information about each other, should

242 Nameless Relations donor offspring be able to find out more than non-identifying information about their biological parent? As our analysis has illuminated, these issues make themselves known in terms of the different strengths or degrees of

anonymisation, the shading in of ‘strong’, ‘indeterminate’ and ‘weak’

forms of anonymity by proponents and opponents alike (Chapter 4, Donors IT). J mentioned that this particular instancing of anonymity is synonymous to the face of convention. This is to say that whether one is proor anti-anonymity, the logic of the appeal stems from a common ideolog-

ical root whose source of reasoning goes back to notions of the self grounded in biological personhood. Those who say they have a right to know their genetic origins, who rally forces against anonymity, often argue in such a way as to reinforce these claims through appeals to bio-

logical essentialism. They need to know about their biological mother/father, the provisioner of female/male gametes, originating source

of xeno-gamete. Those who defend non-disclosure, who rally forces against openness, commit the same reification of biology: many fear that the revelation of a discontinuous genetic heritage will alienate the children they have raised, that this may lead to further fission, and in moral terms, make good relations bad. I argue instead what has been overlooked so far in these debates is the sheer inventiveness of anonymity. There is an underside to anonymity’s public face, its own hidden non-revelations. The time of objectification that is the act of naming, the encapsulation of one’s identity within fixed

denotative brackets — what Westerners customarily like to pin down through the defined certainties of the bounded individual, company or corporation — all this can be ‘undone’ in the instant of effraction that recognises the non-name as the creativity of non-linkage (see Chapter 5, p. 125). Irrelational kinship is the vanguard of collectivised dispossession. It is the time of multiple being, the time of multiple co-existence and coproduction. Enacting relations of non-relations, do we really do this, the sceptic will ask? Yes! The non-relation is the animation of an ethos whose spirit is induced to life through the mediations of ‘someone’. You will appreciate by now that I am not talking about the synthesising pretensions of anonymity as taboo. This is not the story of sanctioned prohibi-

tion. It is about other negatives. It is about how the exchange of the non-name sets in train a series of productive negations, in this case nega-

tions that may be seen to converge centrally upon the territory of the gift/commodity. Where once the central mechanism of the gift was once held to be reciprocity — the movements of return — in anonymous sociality relations of non-relations are mediated by the [non] knowledge of transilience. Norms of reciprocity premised on individual or group relationships as ‘ego-centred linkages’ give way to non-lineal transactional processes that ‘embed’ the value of transilient relations in multiple others across space and over time. We have learned how the value of someone's actions are transmuted successively into new relations/generations that can only be made apparent as the intersubjective relations that are someone else’s actions. This is a

Conclusion 243 feature of many donors’ narratives. Here we have the beginnings of local idioms of a-geneticism, ones that express a declension from forms of ownership. Moreover I have wanted to show that the extensional and regenerative field of transilience elicited by these idioms, as well as by certain professional aspirations, is applicable to different mediation contexts. The preceding ethnographic analysis has helped to sharpen our understanding therefore about the range of mediatory interactions that may be set up between (1) donor-researcher-recipient; (2) donor-practitioner-recipient; (3) donor-recipient-donor-conceived offspring. Now contrary to assumptions informing a specifically western approach

to the concept of property, the circulation of reproductive body parts between persons does not necessarily entail the question of determining or resolving the issue of ‘whose’ body parts are being transferred in intercorporealised space. This is because a radical disjunction between ‘persons’ and ‘things’ cannot provide an appropriate conceptual framework for theorising the socially reproductive circulation of parts of transilient persons (cf: Hirschon 1984). Nor can it theorise adequately the forms such

reproductions assume. We have seen that a notion of persons as ‘transilient’ draws upon the elements of extension, dispersal, circulation and multidirectional flows. Transilience sets up an altogether different rationale of identity to the property assumptions underscoring the notions of alienability and inalienability because it anticipates a disinvestment of the ego. While we may see the project of refining ourselves to become ‘sufficiently anonymous conducting bodies’ as a turn away from the ‘closed voluminous body’ that is homologous with ego and property, the libidinal bodies to which Lyotard refers here presuppose that anonymity is simply synonymous with passivity (Lyotard 1993: 258). Post-structuralist semiotics tell us nothing about what subjects do or feel, the ambivalence we

breathe. By contrast, this anthropological investigation into the human reproductive technologies introduces the notion of transilience to denote a non-possessive modelling of personhood in which non-relations, rather surprisingly, are shown to be integral to social agents, as well as central to a subject’s sense of her or his own core ambivalence. Working through the inventiveness of anonymised engagement we can illuminate at the same

time, through various exemplars, the manner in which persons’ bodies need not be fixed necessarily as a physical source of self-identity. I have not kept these observations distant. They are not recoverable only as the time of the past or as pre-emptions of the future. When anonymised ova donors and anonymised ova recipients talk about their non-traceability, they are recording how the non-link already makes them — and their children — into real, embodied non-relations. For some people this can be lib-

erating, for others less so. Either way, this is one out of many ways of doing relatedness, of combining different ideas and practices of what it means to be a relation constituted in and through active not-knowing. Anonymity, and the practice of converting persons into de-identified, non-identifiable and non-nameable entities, belongs to a complex of prac-

tices that are at once innovative and conventional in their effects. We

244 Nameless Relations need to understand how the concept can be operationalised often simultaneously as plural and differentiated registers of meaning. This set of observations ought to be a beginning and not an endpoint for thinking through future policy on assisted conception, donor anonymity and the law.

Notes 1. The concept ‘object petit a’ has no precise translation from the French. The ‘a’ in question stands for ‘autre’ (other), a concept developed out of the Freudian ‘object’ and Lacan’s psychoanalytic rendition of constructs of ‘otherness’. The ‘petit a’ (small a) differentiates the object from the ‘Autre’ (the capitalised ‘Other’). 2. A modification of Appadurai’s (1996) notion of ‘technoscape’.

APPENDIX I DONOR BIOGRAPHICAL PROFILES

ADELE, mother of two, in mid-twenties with history of miscarriage, and a close friend to an involuntarily childless couple. Intends to donate a second time. Employed in retail trade. London. AGGIE, Irish-born mother of two who donated indirectly to her sister as anonymous ‘cross-over’. London. ALICE, 38-year-old mother of three who has donated five times over the course of the past three years, producing a total of forty-eight eggs. Selfrefers as ‘normal, average every-day kind of woman’. Had a hysterectomy five years ago alter being diagnosed with uterine endometriosis, and prior to this had been diagnosed with pre-cancer of the vulva. Southampton.

AMILY, single, early thirties, went on to donate twice after being diagnosed with blocked fallopian tubes. Has not wanted to undergo IVF herself. Professional sector employment. Somerset. AMY, experienced unplanned conception the month following her donation. Newcastle-upon-Tyne.

ANITA, mother of two, works as part-time assistant for creative design company. Surrey. BETTY, early thirties, mother of two, Church of England. Kent.

BUKI, 32-year-old West African Ghanaian (Ewe ethnic affiliation), mother of one daughter, who read an article about an African couple experiencing infertility and wanted to donate a ‘non-white egg’ to help the black community. Essex.

CATHY, early thirties, single, two unsuccessful attempts at sister-to-sister donation. Previously underwent two terminations in her twenties. Plans to start own family soon with partner. Carries donor card. Sales travel executive. Hampshire.

246 Appendix I CHANTAL, Australian-born nurse who experienced delayed conceptions with each of her two birth children, and is a friend to several involuntarily childless couples. Slough. |

CINDY, mother of three who had hysterectomy three years prior to her donating. Employed as mature trainee hospital nurse. Hampshire. CLARICE, mid-thirties, single parent mother of one and close friends with

couple diagnosed with ‘unexplained infertility’. Employed as domestic cleaner. Ipswich.

CYNTHIA, tried without success to help younger sister conceive. Hertfordshire. DAVINA, mother of three, Church of England. Aberdeen. DEA, single parent mother willing to donate ova a second time. Church of England. Ipswich. DEE, full-time mother of two who decided to donate after reading an article on infertility in a woman’s weekly feature magazine. Middlesex.

DELIA, mother of three in early thirties, previously underwent four miscarriages and has donated ova three times (her first donation attempt was cancelled due to ovarian hyperstimulation). Plans to continue donating until the age of thirty-five. Active fundraiser, involved in charity appeals for children. Carries organ donor card. Practising Christian. Surrey. DILPHA, 25-year-old married Anglo-Indian Hindu who donated to twin

sister and plans to start her own family in next few years. Kept fact of donation secret from their mother, only some very close friends know of it. London. DONNA, sister-to-sister donor and mother of three birth children. Surrey Coast.

EDWINA, full-time mother of three. Church of England. Essex. EILEEN, unmarried mother of one, donated indirectly on behalf of her sister as anonymous ‘cross-over’. Surrey.

EMMA, Anglo-Hungarian college student in her mid-twenties and single mother of one. Bedfordshire. FAY, 23-year-old full-time mother of two, self-describes as ‘working-class mum’, had difficulty conceiving after the birth of first child. Has donated

twice and plans to donate for at least a third time. Arranges occasional home-based linen parties as independent source of finance. Middlesex.

FELICE, mother of two, donated ova three times and is regular blood donor. Church of England. Kent. FIONA, mother of three. Occasional temporary employment. Surrey. GILL, mid-thirties, mother of one. Hampshire.

Appendix I 247 HATTIE, mid-thirties, mother of three whose direct donation to her sister (see Appendix I: Vera) resulted in birth of triplet boys. Church of England. SuSSeX.

HEATHER, 27-year-old mother of six who has donated once: ‘they had to

try and find extra people quickly as they collected about twenty-seven eggs from me’. Essex.

HELENA, full-time mother of two in regular touch with childless friends experiencing infertility. Church of England. Surrey. HOLLY, donated six months after the birth of her first child as an anonymous ‘cross-over’ to try to help a friend who has been trying to fall pregnant for the past eighteen years. Ex-nursery school worker. Kent.

IMOGEN, mother of two, self-describes as ‘ordinary housewife’, employed as part-time nurse. Channel Islands. IVY, mid-twenties mother of two, has donated twice. Initially prompted to

donate after reading story about infertile woman in a local newspaper. Occasionally employed as part-time librarian. Somerset. JEAN, full-time mother of two, previously experienced four miscarriages and a complicated second pregnancy requiring over more than six months hospitalisation. Intends to donate ova a second time. Regular six-monthly blood donor. Greater London.

JONI, single, mid-twenties, donated directly to help friend who had previously tried GIFT over four-year period. ‘It just made me realise what an

incredible thing procreation is and confirmed to me that I do want to have children myself at some point in the future’. London. JUNE, mid-twenties, single and no children of own, donated indirectly for her mother and stepfather as anonymous ‘cross-over’. Public Relations executive. London.

KATE, mother of three and non-anonymous donor to a friend. London.

KIRSTY, mid-twenties, divorcee and non-anonymous donor to aunt (mother’s half-sister) whose donation resulted in birth of baby boy. Had no children of own prior to donation but has become accidentally pregnant in the month after her donating. Currently considering a termination. Employed as finance market trader. London. LAUREN, has donated twice, knows many involuntarily childless friends. Computer analyst. Hertfordshire.

LEILA, self-describes as ‘white British working class’, has donated three times. Gateshead.

LUCY, 34-year-old mother of two, acts as informal telephone egg donation counsellor linked to clinic where she donated. Otherwise employed as professional childminder. Church of England. Guildford.

248 Appendix I MAEV and her husband had undergone medical investigations, treatments and counselling for infertility for ten years before conceiving DI twins (insemination by sperm donor). Berkshire. MARGUERITA, unmarried 20-year-old Portuguese-born Catholic college student who donated as anonymous ‘cross-over’ for her sister. London.

MEENA, Punjabi-born Sikh Indian, mother of three in her late thirties who experienced difficulty conceiving her first child. Suffered adverse physical effects continuously for six months after her donation. Works as part-time shop assistant. Kent. MIRIAM, mother of two, plans to donate a second time. Walsall.

MOIRA, 33-year-old Australian-born married woman, voluntarily childless and willing to donate ova second time. Employed in human resources for public sector. London. MURIEL, early twenties, full-time mother of two. Leicestershire.

NANCY, mature student and divorcee, single mother of two whose ova donation attempt was aborted after ultrasound scanning showed risk of ovarian hyper-stimulation. Hertfordshire.

NAOMI, married full-time mother of donor-conceived child (by DJ). Church of England. Kent. NINA, mother of four in her late twenties with a history of repeat miscar-

riages: ‘too many to remember how many’. Donated to a nurse couple whom she befriended in response to advertisement in local newspaper. The donation took place three years later but was unsuccessful. The month after her donation, Nina had an unplanned twin pregnancy and endured a miscarriage (one baby in second trimester). The would-berecipient couple cut off all contact. Nina works as a volunteer local organiser for a national charity. Sussex.

ODELLE, 35-year-old unattached single woman. Employed as hospitalbased senior registrar. Stoke-on-Trent.

PENNY, unmarried 34-year-old, has donated ova twice and currently plans to donate again. Has donated blood on a three-monthly basis since the age of eighteen. Bedfordshire.

PHOEBE, unmarried Australian-born Catholic whose sister underwent IVF by the egg-share scheme for five years before conceiving. Donates blood regularly. London.

POLLY, donated indirectly on behalf of her sister as anonymous ‘crossover’. Church of England. Sheffield. RITA, donated as anonymous ‘cross-over’ for a close friend. Mid-twenties,

unmarried full-time mother of two, currently cohabiting with male partner. Carries a donor card and regularly donates blood. Greater London.

Appendix I 249 ROSEMARY, divorcee and currently single, mother of two, acted as a ‘cross-over’ anonymous donor to help her friend. Yorkshire. SADIE, married with two children, donated as an anonymous ‘cross-over’ to help a friend. Mid-thirties schoolteacher. Cornwall. SALLY, divorcee and single mother of 16-year-old daughter. Eastbourne.

SHENA, unable to conceive naturally due to damaged Fallopian tubes but was prompted to donate after seeing a feature on egg donation in Bella magazine. Bristol. STEPHANIE, single unmarried mother of two, currently cohabiting with partner. Greater London. SUZANNA, practising Christian, mother of one. Leicestershire.

UTE, donated indirectly as anonymous ‘cross-over’ for close infertile friends. London. VALERIE, full-time mother of four. Guildford.

APPENDIX IT RECIPIENT BIOGRAPHICAL PROFILES

CLARA, early fifties, divorcee and mother of one teenage daughter. Resorts to egg donation to start a second family after experiencing five miscarriages over the course of the past thirteen years. Currently five weeks pregnant. Norfolk. ELLA, 51-years-old, currently expecting donor-conceived twins with second husband as a result of second treatment attempt. Hampshire.

FERN, 39-years-old, currently pregnant in second trimester by her third egg donation attempt. Has had tubal surgery and suffers from fluctuating hormone levels that have not been stabilised with conventional medicine. Most recent diagnosis is ‘unexplained infertility’. Three previous pregnancies from ‘straight IVF’ (using her own eggs) have each resulted in miscarriages. Buckinghamshire. HILARY, 43-years-old, second ova donation resulted in birth of daughter. Gynaecological history of endometriosis and premature menopause. Surrey.

LUISHA, 43-years-old Afro-Caribbean woman whose partner is white; together they have undergone eight attempts at IVF using Luisha’s own

eggs (first treatment commenced when she was thirty-five) and one unsuccessful attempt using an anonymous black donor’s eggs. Refuses to use her sister’s eggs for fear of future familial claims by kin upon resultant donor child. Currently trying to recruit a black donor by placing advertisements in black women’s press. London.

NITA, 37-years-old, sixth ova donation resulted in birth of son. Her first two treatment attempts had been with sister’s donated eggs. Affected by symptoms of premature menopause from the age of sixteen. Surrey. PEGGY, 45-year-old mother of four birth children from first marriage who

wants to start second family with second partner of sixteen years. Has undergone two unsuccessful donor treatments and four unsuccessful IVF

Appendix II 251 treatments (with own eggs), and experienced five miscarriages from nonassisted conceptions. Works as business executive. Bedfordshire. SARITA, early thirties, has undergone one unsuccessful donor treatment. Saving up finances to try another treatment cycle. Affected by onset of premature menopause since early twenties. London.

SIAN, in her mid-twenties and currently pregnant from an anonymous donor; this treatment was made possible through her sister-in-law’s anonymous ‘cross-over’ donation. Essex.

SINEAD, mid-thirties, currently pregnant expecting twins by third donation, has one adopted son. Suffers from primary amenorrhoea. Buckinghamshire.

SUSIE, 36-years-old, second ova donation resulted in birth of daughter. Affected by onset of premature menopause, aged sixteen. London.

TESS, 39-years-old, whose eleventh treatment attempt resulted in the birth of her donor-conceived daughter. Has been trying to start a family for the past sixteen years. Has infertility history of ovarian cysts, blocked

fallopian tubes and premature menopause. Has undergone three tubal surgery operations. Luton.

THEA, 26-year-old mother of non-identical twins born eight weeks prematurely as a result of her third donation attempt. Was diagnosed with premature menopause at eighteen. Lives in Northamptonshire.

ULRIKE, 28-years-old, two unsuccessful donor treatments (one anonymous and one non-anonymous). Was diagnosed with onset of premature menopause in late teens. Cheltenham.

UNA, late forties, her second ova donation resulted in the birth of her daughter. Affected by onset of premature menopause since her early thirties. Employed as secondary school teacher. London. VAL, late thirties, fifth treatment attempt resulted in birth of donor-con-

ceived daughter. Suffers from blocked fallopian tubes and premature menopause. Reading. VANESSA, mother of one adult son from her first marriage and a teenage daughter from her current relationship. Resorted to egg donation in her mid-forties with a view to extending her second family. Conceived and gave birth to her third child two years ago. London.

VERA, 33-year-old mother of one who has recently been diagnosed with resistant ovary syndrome, partial blockage of both Fallopian tubes and the onset of premature menopause. Since this diagnosis Vera conceived and gave birth to triplet boys using her sister’s donated eggs (see Appendix I: Hattie). Sussex.

WENDY, late thirties, second ova donation resulted in the birth of her daughter. Suffers from ‘unexplained infertility’. London.

252 Appendix IT WINNIE, 34-years-old, fifth ova donation resulted in the birth of her daughter. Natural ovulation ceased when she turned twenty. Essex. YASMIN, 33-years-old, second ova donation resulted in birth of daughter. Had both her ovaries and Fallopian tubes removed surgically at sixteen alter a diagnosis of ovarian cysts and suspected ovarian cancer. Northamptonshire.

YVONNE, mid-thirties, second ova donation resulted in the birth of her daughter. Has suffered from onset of premature menopause since early twenties. London. ZETA, late thirties, numerous unsuccessful donor treatments for diagnosis of ‘complete ovarian failure’. Surrey. ZOE, 38-years-old, four unsuccessful donor treatments. Diagnosed, aged nineteen, with ‘resistant ovary syndrome and complete ovarian failure’. Kent.

APPENDIX LIT

TREATMENT PROTOCOL

()” donation entails and an extensive therapy of is complex drug regimes, surgery anaesthesia,medical the nature of which often downplayed in the standard medical accounts produced by clinics or pharmaceutical drug companies (see for example Sampson 1993). The following description is only a basic outline of the main treatment procedure for donors and recipients.!

Ova that are donated need to be combined with the sperm of the genetic father in a process known as in-vitro fertilisation or IVF (in-vitro meaning in glass, as opposed to in-vivo, in the body). As usually only one ovum becomes fully mature in a woman’s monthly cycle, part of the aim of IVF treatments, besides the actual technique of extra-corporeal fertilisation, is the artificial induction of an extra growth of ova. This is achieved by stimulation of follicles in the ovary with fertility drugs, a technique known as ‘superovulation’. Practitioners explain this to be in the interests of women since the greater the number of mature ova removed from the body, the greater the likelihood of a successful fertilisation, and hence of establishing a pregnancy. One way that clinicians convey to women their understandings of the production of such growth is by recourse to explanations that emphasise how the (donating) body both overrides and mimics the course of ‘nature’.

Donors On the assumption a donor’s natural cycle is normally twenty-eight days, beginning on day twenty-three of the preceding menstrual cycle women

commence a ten to fourteen day course of Buserelin/Suprefact, to be sniffed at regular intervals each day. This drug suppresses the production of the reproductive hormones FSH (follicle stimulating hormone) and LH (luteinising hormone) that are triggered by the pituitary gland at the base of the brain and which would otherwise stimulate the ovaries to develop

254 Appendix III follicles. Medical staff refer to this course of sniffing as the ‘switching off’

of women’s ‘spontaneous ovulation’, or else to ‘pituitary down-regulation’ (see Brinsden 1992; Davies 1992; Lewis 1992). In effect, the process puts the donor into a temporary state of premature menopause.

Following this, donors are injected for ten days with concentrated amounts of follicle stimulating hormone (FSH), colloquially termed ‘fertility injections’, so as to promote rapid ovarian follicular growth. During this time the rate of ovarian follicular growth is monitored by ultrasound scans (at least one on day twelve of the donating cycle) and by the analysis of oestrogen levels in blood samples. In non-assisted reproduction,

these hormones would stimulate the ovary to produce a single follicle each month. By suppressing the natural activity of the pituitary gland, however, fertility medication ‘tricks’ the ovaries into developing multiple follicles and hence multiple eggs.

The most recent FSH preparations known as ‘recombinant’ gonadotrophrins are produced synthetically and can be administered by subcutaneous injections rather than the deeper intramuscular injections required with the earlier preparations (for instance Pergonal/Humagon which were derived from human urine). It is important that the eggs are collected when they have reached a critical stage of maturity, yet before follicle rupture and egg dispersal. Information leaflets given to donors inform them of the possible side effects of the medication: hot flushes, weight gain and the possibility of developing ovarian cysts or ovarian hyperstimulation syndrome (OHSS) as a result of the simultaneous over-swelling of too many ova. Symptoms may include nausea, vomiting, pain, abdominal swelling and shortness of breath. For the minority of women who do suffer OHSS, urgent hospitalisation is necessary. Between twenty-four and thirty-eight hours after the last Pergonal injec-

tion, a final intramuscular injection of human chorionic gonadotrophin (nCG — e.g., Profasi) is administered which mimics the expected onset of what would otherwise be the ‘natural’ surge of luteinising hormone. By first ‘switching off’ and then controlling very precisely the superovulatory phase of ‘hyperstimulation’, the collection of the eggs (known also as egg retrieval or ovum ‘pick-up’) can be timed to coincide just before they would be released ‘spontaneously’ from the ovarian follicles.

Between thirty-six to thirty-eight hours after the hGC injection, the follicles are expected to rupture and release the eggs. Once in theatre, donors are put to sleep with a general anaesthetic (or given heavy sedation) and prepared for the egg collection operation. Ova are removed by transvaginal ultrasound guided aspiration, or by the older method of laparoscopic [transabdominal] retrieval. Pioneered by the British gynaecologist Dr Patrick Steptoe in the late 1960s, laparoscopies are now almost universally superseded in clinical practice by the technique of transvaginal ovum pick-up.

Appendix III 255 With both techniques — transvaginal and transabdominal ultrasounddirected recovery — the eggs are collected by passing an ultrasound probe (required for the visualising of the ovaries) through the patient’s vagina or abdominal wall and then through the bladder to the ovary. Each ovum is carefully drawn up by the use of an attached aspiration needle. The average number of eggs collected is ten to twelve per donor (or IVF patient).

Retrieval by laparoscopy is commonly held to be more invasive. It entails making an incision just below the woman’s navel into which a telescope is passed for visualisation of the pelvic organs. Another incision

is made into which a probe is inserted in order to ‘clamp’ the ovaries whilst the ova are collected with the egg aspiration needle inserted from a third incision. Once the ova have been collected, they are incubated for a short time before a sample of the recipient partner’s sperm is added. This will have

been specially prepared beforehand from a fresh or frozen specimen. There follows a further incubation period in the clinic laboratory of twenty-four to forty-eight hours during which time fertilisation should hopefully take place. This is confirmed as the embryologist examines each

entity under the microscope. The resulting fertilised ova, referred to as pre-embryos (zygotes) or embryos — dependent on the stage of development and time at which they are re-implanted — are then transferred to the recipient according to the method best suited to her particular medical requirements. To ensure any remaining ovarian follicles subside and to maintain their reproductive systems in a ‘suppressed’ condition so as to

prevent subsequent unwanted conceptions, donors continue taking the Buserelin sniff post-operatively until the time of their next non-induced ovulation, theoretically fourteen days after the egg collection operation.

Recipients Recipients must also undergo treatment to ‘prepare’ their bodies. Women whose ovaries do not function ‘spontaneously’ need to have their bodies ‘switched on’ by so-called ‘exogenous hormone therapy’. In such cases the form of medical intervention turns on the way that recipients bodies need to be synchronised with that of their ‘matched’ donor. Each recipient’s body needs to follow as closely as possible the speed at

which the ovarian follicles are becoming active and mature inside the superovulated body of their donor. Based on the prior mimicking of the physiological phases of ovulation with hormone supplements, recipients’ ovaries are stimulated to react as though fertilisation has taken place. Progesterone injections or pessaries (e.g., Gestone) are administered daily to ensure that the lining of the recipient’s womb grows thicker (to at least

6mm endometrium thickness) in anticipation for the zygote/embryo transfer, and implantation of the embryo to the uterine wall.

256 Appendix III On the other hand, a recipient who has regular menstrual cycles (‘nor-

mal ovarian function’) may receive donated eggs if her ‘spontaneous’ cycle can be intermitted. A luteinising hormone releasing hormone (LHRH) analogue will desensitize the pituitary prior to hormone replace-

ment and then the recipient will follow much the same regime as the donor with regards to being ‘switched off’.

Those recipients who achieve pregnancy are administered increased levels of hormone replacements so as to mimic the rise in oestrogen and progesterone that would occur spontaneously after implantation. This is usually continued for three to four months until the placenta continues to support the pregnancy.

Embryo Transfers to the Recipient Due to the number of eggs produced during IVF donor treatment cycles, many embryos may be created. In the United Kingdom it is illegal for clinics to transfer more than three embryos to the recipient’s uterus during any one cycle of treatment. This reduces the incidence of multiple pregnancies and indeed in many clinics it is usual to counsel couples to have only two embryos replaced (three embryos may be transferred in cases that can be justified as ‘exceptional’ circumstances). Though there are different methods of transfer, there are just two basic

forms of transfer: embryos that are ‘fresh’ and those that are ‘frozen’. Fresh transfers involve the immediate transfer of the zygote (the fertilised egg and sperm) and are medically preferable to frozen transfers because

they have a higher success rate of implantation. Developed from cryopreservation technology, frozen transfers involve a freeze-thaw process for embryos that cannot be transferred immediately. This may be because the recipient has ‘spares’ left over from one treatment cycle (see Chapters 8 and 9). The transfer of frozen embryos is also used when it has not been possible to achieve a synchronisation between the donor and the recipient. This might occur because ova have been donated unexpectedly, for

example, from patients themselves undergoing IVF or GIFT who have produced more ova than they need for their own treatment, and have consented to ‘donate’ them for the treatment of others (e.g., egg sharing schemes [see Chapter 6, Recipients I]). In such cases the recipient’s body will not have been prepared temporally so that the donated ova will need to be fertilised with the recipient’s partner’s frozen sperm and resulting embryos will need to be frozen for later transfer. Another contingency factor may be the cancellation of a cycle due to OHSS or donor withdrawal from the programme. Should the ova recipient’s endometrium begin to shed unexpectedly at the proposed time of transfer, this may also be cause for the delay of the transfer. Over the years different methods of embryo transfer (ET) have been developed.

Appendix ITI 257 GIFT: Gamete intra-fallopian transfer is similar to IVF except that the ova

and sperm are not mixed together outside the woman’s body but are injected into one or both of the recipient’s Fallopian tubes. As the procedure is closer to the ‘natural’ events of fertilisation and pregnancy (the embryos travel along the Fallopian tube in the normal way to reach the uterus after four to five days), it has a higher success rate than IVF by uterine transfer. GIFT is thus only suitable for recipients with healthy Fallopian tube(s). ZIFT: Zygote intra-fallopian transfer involves the surgical transfer of fertilised ova (zygotes) prior to cell division into the recipient’s Fallopian tubes. TET: Tubal embryo transfer involves the same medical procedure as ZIFT, except that the embryos are transferred at a more advanced stage, usually two to three days after fertilisation.

Notes 1. Fora bibliographic overview and description of individual technologies and procedures, see Birke et al. 1990; Cirasole and Seager 1987.

Blank Page

BIBLIOGRAPHY

Abdalla, H., F. Shenfield, and L. Latarche. 1998. ‘Statutory information for the children born of oocyte donation in the UK: what will they be told in 2008?’, Human Reproduction 13: 1106-109. Abercrombie, M., C.J. Hickman, and M.L. Johnson. 1955. A Dictionary of Biology. Harmondsworth, Middlesex: Penguin Books. Abrahams, R. G. 1992. ‘Comment to Chris Shore’s “Virgin births and sterile debates”’, Current Anthropology 33(3): 302. Ahmed, Zenab. 1995. ‘Babies on ice’, Guardian, 14 March 1995, p. 11. Ahuja, K., B. Mostyn, and E. Simons. 1997. ‘Egg sharing and egg donation: attitudes of British egg donors and recipients’, Human Reproduction 12(12): 2845-52. Andrews, Lori B. 1988. ‘My body, my property’, Hastings Center Report, 16 (October) 28-38. Appadurai, Arjun. 1986. ‘Introduction: commodities and the politics of value’. In A. Appadurai (ed.) The Social Life of Things. Commodities in Cultural Perspective,

pp. 3-63. Cambridge: Cambridge University Press. _____ 1996. Modernity at Large: Cultural Dimensions of Globalization. Minneapolis:

University of Minnesota Press. Arditti, R., R.D. Klein, and S. Minden (eds). 1984. Test-Tube Women. What Future for Motherhood? London: Pandora Press. Baal, Jan van. 1975. Reciprocity and the Position of Women. Amsterdam: van Gorcum. Baran, A. and R. Pannor. 1989. Lethal Secrets. New York: HarperTrade.

Barlow, Kathleen. 1995. ‘Achieving womanhood and the achievements of woman in Murik society’. In N.C. Lutkehaus and P.B. Roscoe (eds) Gender Rituals: Female Initiation in Melanesia, pp. 85-112. New York: Routledge. Barnes, John A. 1961. ‘Physical and social kinship’, Philosophy of Science 28:

296-99. ______ 1973. ‘Genetrix: genitor: nature: culture?’ In J. Goody (ed.) The Character of Kinship. Cambridge: Cambridge University Press.

Bateman Novaes, S. 1998. ‘The medical management of donor insemination’. In K. Daniels and E. Haimes (eds) Donor Insemination: International Social Science Perspectives, pp. 105-30. Cambridge: Cambridge University Press. Battaglia, Debbora. 1990. On the Bones of the Serpent. Person, Memory, and Mortality in Sabarl Island Society. Chicago: University of Chicago Press. —______ 1992.’The body in the gift: memory and forgetting in Sabarl mortuary exchange’, American Ethnologist, 19(1): 3-18.

260 Bibliography ______ 1993. ‘At play in the fields (and borders) of the imaginary: Melanesian transformations of forgetting’, Cultural Anthropology 8(4): 430-42. Beauvoir, Simone de. 1953. The Second Sex. London: Jonathan Cape. Becker, Gay. 2000. The Elusive Embryo: How Women and Men Approach New Reproductive Technologies. Berkeley: University of California Press. Bell, D., P. Caplan, and W.J. Karim (eds). 1992. Gendered Fields. Women, Men and

Ethnography. London: Routledge. Beer, Gillian. 1992. Forging the Missing Link. Interdisciplinary Stories. Inaugural Lecture, University of Cambridge, 18 November 1991, Cambridge University Press. Birke, Lynda, Susan Himmelweit, and Gail Vines. 1990. Tomorrow’s Child. Reproductive Technologies in the 90s. London: Virago.

Black, D. 1990. ‘What do children need from parents?’, Adoption and Fostering 14(1): 43-52. Bleier, Ruth. 1984. Science and Gender. New York: Pergamon Press. Bloch, M. and J. Parry (eds). 1982. Death and the Regeneration of Life. Cambridge: Cambridge University Press. Bloch, M. and J. Parry. 1989. ‘Introduction: money and the morality of exchange’. In J. Parry and M. Bloch (eds) Money and the Morality of Exchange, pp. 1-32. Cambridge: Cambridge University Press. Blyth, Eric. 1999. ‘Secrets and lies: barriers to the exchange of genetic origins information following donor assisted conception’, Adoption and Fostering

23(1): 1-10. _____. 2000. ‘Sharing genetic origins information in third party assisted conception: a case for Victorian family values?’ Children and Society 14: 11~22. Blyth, E., M. Crawshaw, and J. Speirs (eds). 1998. Truth and the Child 10 Years On: Information Exchange in Donor Assisted Conception. Birmingham: British Association of Social Workers. Bock, Monika and Aparna Rao (eds). 2000. Culture, Creation and Procreation: Concepts of Kinship in South Asian Practice. Oxford: Berghahn Books.

Boden, Jane. 2003. ‘Sharing is different from donating: a counselling perspective’. Paper presented to First International Egg Donation Conference, Global Egg Donation Resource (GEDR), London. 8 February 2003. Boling, Patricia (ed.). 1995. Expecting Trouble: Surrogacy, Fetal Abuse and New Reproductive Technologies. Boulder: Westview Press. Bourdieu, Pierre. 1977. Outline of a Theory of Practice. Cambridge: Cambridge University Press. Bouquet, Mary. 1993. Reclaiming English Kinship: Portuguese Refractions of British Kinship Theory. Manchester: Manchester University Press. Braidotti, Rosi. 1989. ‘Organs without bodies’, Differences: A Journal of Feminist Cultural Studies 1: 147-61. Brady, Ivan. 1976. Transactions in Kinship. Honolulu: University Press of Hawaii.

Brecher, Bob. 1994. ‘Organs for transplant: donation or payment?’. In Raanan Gillon (ed.) Principles of Health Care Ethics, pp. 993-1002. Chichester: John Wiley and Sons Ltd. Brinsden, Peter R. 1992. ‘Oocyte recovery and embryo transfer techniques for in vitro fertilisation’. In P. Brinsden and P. Rainsbury (eds) A Textbook of In Vitro Fertilisation and Assisted Reproduction. pp. 139-53. Lancaster: Parthenon Publishing Group Ltd. Buckley, Thomas and Alma Gottlieb (eds) 1988. Blood Magic: The Anthropology of Menstruation. Berkeley: University of California Press.

Bibliography 261 Butler, Judith. 1993. Bodies that Matter. London: Routledge. Callahan, Joan C. 1995. ‘Procreative liberty: whose procreation, whose liberty?’, Stanford Law and Policy Review 6(2): 121-25. Campbell, Shirley. 1983. ‘Kula in Vakuta: the mechanics of keda’. In J. Leach and E. Leach (eds) The Kula: New Perspectives on Massim Exchange, pp. 201-227. Cambridge: Cambridge University Press. Carp, E. Wayne. 1998. Family Matters: Secrecy and Disclosure in the History of

Adoption. Cambridge, MA: Harvard University Press. Carrier, James G. 1995. Gifts and Commodities. Exchange and Western Capitalism since

1700. London: Routledge. Carroll, V. (ed.). 1970. Adoption in Eastern Oceania. Honolulu: University of Hawaii Press. Carsten, Janet. 2004. After Kinship. Cambridge: Cambridge University Press. Casper, Monica. 1998. The Making of the Unborn Patient: A Social Anatomy of Fetal Surgery. New Brunswick: Rutgers University Press. Cheal, David. 1988. The Gift Economy. London: Routledge. The Children’s Society. 2002. ‘A child’s right to identity’. Available at

Cirasole, Donna M. and Joni Seager. 1987. ‘Women and reproductive technologies: a partially annotated bibliography’, Women and Health 13(1/2): 237-59. Cohen, Cynthia (ed.). 1996. New Ways of Making Babies: The Case of Egg Donation.

Bloomington: Indiana University Press. Collier, J. and C. Delaney. 1992. ‘Comment to Cris Shore’s “Virgin Births and Sterile Debates”’, Current Anthropology 33(3): 302-303. Collier, J.F and S.J. Yanagisako (eds). 1987. Gender and Kinship. Essays Toward a Unified Analysis. Stanford: Stanford University Press. Coppet, Daniel de. 1981. ‘The life giving death’. In Humphreys, S.C. and H. King (eds) Mortality and Immortality. The Anthropology and Archaeology of Death, pp.

175-204. London: Academic Press. Corea, Gena. 1987. Man-Made Women: How the New Reproductive Technologies Affect

Women. Indianapolis: Indiana University Press. _______. 1988a. The Mother Machine. Reproductive Technologies from Artificial

Insemination to Artificial Wombs. London: The Women’s Press. _______ 1988b. ‘What the King cannot see’. In E. Barcuh, A. D’Adamo and J. Seager (eds) Embryos, Ethics and Women’s Rights: Exploring the New Reproductive Technologies, pp. 77-93. London: Harrington Park Press. Craig, O. and B. Bourne. 1996. ‘Baby love’, The Sunday Times, 29 December 1996, p. 10.

Crowe, Christine. 1985. ‘Women want it: in vitro fertilisation and women’s motivations for participation’, Women’s Studies International Forum 8(6): 547-52. Cussins, Charis. 1998. ‘Quit snivelling, cryo-baby. We’ll work out which one’s your mama!’ In R. Davis-Floyd and J. Dumit (eds) Cyborg Babies: From TechnoSex to Techno-Tots, pp. 40-66. New York: Routledge. Damon, F. and R. Wagner (eds). 1989. Death Rituals and Life in the Societies of the Kula Ring. DeKalb: Northern Illinois University Press. Daniels, K. and E. Haimes (eds). 1998. Donor Insemination: International Social Science Perspectives. Cambridge: Cambridge University Press.

262 Bibliography Daniels, Ken. 1988. ‘Artificial insemination using donor semen and the issue of secrecy: the views of donors and recipient couples’, Social Science and Medicine

27: 377-83. Darwin, Charles. [1859] 1985. The Origin of Species. Harmondsworth, Middlesex: Penguin. Daston, Lorraine and Park, Katherine. 1998. Wonders and the Order of Nature 1150-1750. New York: Zone Books. Davies, M.C. 1992. ‘Oocyte donation’. In P. Brinsden and P. Rainsbury (eds) A Textbook of In Vitro Fertilisation and Assisted Reproduction, pp. 385-97. Lancaster:

Parthenon Publishing Group Ltd. Davila, M. 1971. ‘Compadrazgo: fictive kinship in Latin America’. In N.H. Graburn (ed.) Readings in Kinship and Social Structure, pp. 396-406. New York: Harper and Row. Davis-Floyd, Robbie E. and Carolyn F. Sargent (eds). 1997. Childbirth and Authoritative Knowledge: Cross-Cultural Perspectives. Berkeley: University of

California Press. Davis-Floyd, Robbie E. and Joseph Dumit (eds). 1998. Cyborg Babies: From TechnoSex to Techno-Tots. New York: Routledge. Delaney, Carol. 1991. The Seed and the Soil: Gender and Cosmology in Turkish Village Society. Berkeley: University of California Press. Department of Health. 1989. Review of the Guidance on the Research Use of Foetuses and Foetal Material. London: HMSO. —______ 2000. Stem Cell Research. Medical Progress with Responsibility. London:

Department of Health. —____ 2001. Donor Information Consultation: Providing Information about Sperm, Egg

and Embryo Donors. London: Department of Health. Available at

. _____. 2003. ‘Donor-conceived children to get more information about donors’ (Press Release 2003/0037, 28 January). London: HMSO. Derrida, Jacques. 1976. Of Grammatology. Translated by G.C. Spivak. Baltimore: Johns Hopkins University Press. ______ 1992. Given Time: 1. Counterfeit Money. Translated by P. Kamuf. Chicago: University of Chicago Press. _____. 1995. The Gift of Death. Translated by David Wills. Chicago: University of Chicago Press. Douglas, Mary. 1990. ‘No Free Gifts’. Foreword to Marcel Mauss The Gift. The Form and Reason for Exchange in Archaic Societies. Translated by W.D. Halls pp.

vii-xvili. London: Routledge. Dyke, José van. 1995. Manufacturing Babies and Public Consent. Debating the New Reproductive Technologies. London: Macmillan. Ebeling, Richard. 1987. ‘Co-operation in anonymity’, Critical Review. Fall: 50-61. Edwards, Jeanette. 2000. Born and Bred: Idioms of Kinship and New Reproductive Technologies in England. Oxford: Oxford University Press. Edwards, J., S. Franklin, E. Hirsch, F. Price, and M. Strathern. 1999. Technologies of Procreation: Kinship in the Age of Assisted Conception. 2nd edn, London: Routledge. Erikson, E.H. 1968. Identity, Youth and Crisis. New York: W.W. Norton and Company.

Errington, S. 1990. ‘Recasting sex, gender, and power. A theoretical and regional overview’. In J.M. Atkinson and S. Errington (eds) Power and Difference: Gender in Island Southeast Asia, pp.1—58. Stanford: Stanford University Press.

Bibliography 263 Feil, Daryl. 1984. Ways of Exchange. The Enga ‘tee’ of Papua New Guinea.

Queensland, Australia: University of Queensland Press. Finkler, Kaja. 2000. Experiencing the New Genetics: Family and Kinship on the Medical

Frontier. Philadelphia: University of Pennsylvania Press. Firth, Raymond. 1951. Elements of Social Organisation. C.A. Watts and Co. Ltd. Fischel, S. and P. Jackson. 1989. ‘Follicular stimulation and high tech pregnancies: are we playing it safe?’ British Medical Journal 299: 309-311. Forde, Darryl. 1963. ‘Unilineal fact or fiction: an analysis of the composition of kin groups among the Yako’. In I. Schapera (ed.) Studies in Kinship and Marriage. London: Royal Anthropological Institute. Forster, E.M. 1925. Anonymity: An Enquiry. London: Hogarth. Fortes, Meyer. 1969. Kinship and the Social Order. London: Routledge and Kegan Paul. Foster, Robert J. 1990a. ‘Value without equivalence: exchange and replacement in a Melanesian society’, Man (n.s.) 25(1): 54-69. _______ 1990b. ‘Nurture and force-feeding: mortuary feasting and the construction of collective individuals in a New Ireland society’, American Ethnologist 17(3): 431-48. Fox; Robin. 1993. Reproduction and Succession. Studies in Anthropology, Law and

Society. New Brunswick, New Jersey: Transaction Publishers. Franklin, Sarah. 1997. Embodied Progress: A Cultural Account of Assisted Conception.

London: Routledge. Franklin, Sarah. n.d. ‘Culturing biology: cell lines for the Second Millennium’. Published by the Department of Sociology, Lancaster University. . Franklin, Sarah and Helena Ragoné (eds). 1998. Reproducing Reproduction: Kinship, Power, and Technological Invention. Philadelphia: University of

Pennsylvania. Gasché, Rodolphe. 1997. ‘Heliocentric exchange’. In Alan D. Schrift (ed.) The Logic of the Gift: Toward an Ethic of Generosity, pp. 100-117. London: Routledge. Gell, Alfred. 1992. The Anthropology of Time: Cultural Constructions of Temporal Maps and Images. Oxford: Berg. Giddens, Anthony. 1979. Central Problems in Social Theory. London: Macmillan.

Gillison, Gillian. 1980. ‘Images of nature in Gimi thought’. In Carol P. MacCormack and Marilyn Strathern (eds), Nature, Culture and Gender, pp. 143-73. Cambridge: Cambridge University Press. _____ 1991. ‘The flute myth and the law of equivalence: origins of a principle of exchange’. In Maurice Godelier and Marilyn Strathern (eds), Big Men and Great Men: Personifications of Power in Melanesia, pp. 174-96. Cambridge: Cambridge University Press. ______. 1993. Between Culture and Fantasy: A New Guinea Highlands Mythology. Chicago: University of Chicago Press. Gingrich, A. and R.G. Fox (eds). 2002. Anthropology, By Comparison. London: Routledge.

Ginsburg, Faye and Rayna Rapp. 1991. ‘The politics of reproduction’. Annual Review of Anthropology 20: 311-43. Glover, Jonathan. 1989. Fertility and the Family. The Glover Report on Reproductive Technologies to the European Commission. London: Fourth Estate. Godelier, Maurice. 1977. Perspectives in Marxist Anthropology. Translated by R.

Brain. Cambridge: Cambridge University Press.

264 Bibliography ______ 1999. The Enigma of the Gift. Translated by Nora Scott. Cambridge: Polity Press. Goffman, Erving. 1971. Relations in Public. New York: Basic Books. Golombok, S., A. Brewaeys, and R. Cook. 1996. ‘The European study of assisted reproduction families’, Human Reproduction 11: 2324-31. Goodenough, Ward. 1970. ‘Epilogue: transactions in parenthood’. In V. Carroll (ed.) Adoption in Eastern Oceania. Honolulu: University of Hawaii Press. Goody, Esther. 1982. Parenthood and Social Reproduction. Cambridge: Cambridge University Press. Goody, Jack. 1969. ‘Adoption in cross-cultural perspective’, Comparative Studies in Society and History 2(1): 55-78. Gottlieb, C., O. Lalos, and F. Lindblad. 2000. ‘Disclosure of donor insemination

to the child: the impact of Swedish legislation on couples’ attitudes’, Human Reproduction 15(9): 2052-56. Gouldner, Alvin W. 1960. ‘The norm of reciprocity: a preliminary statement’. American Sociological Review 25(2): 161-78. Greenhalgh, Susan (ed.). 1995. Situating Fertility. Anthropology and Demographic

Inquiry. Cambridge: Cambridge University Press. Greer, Germaine. 1992. The Change: Women, Ageing and the Menopause. London: Penguin. Gregory, Christopher A. 1982a. Gifts and Commodities. London: Academic Press. _______ 1982b ‘Alienating the inalienable’. Man (n.s.) 17(2): 340-45 [Correspondence]. Haimes, Erica. 1992. ‘Gamete donation and the social management of genetic origins’. In M. Stacey (ed.) Changing Human Reproduction: Social Science Perspectives, pp. 119-47. London: Sage. Haimes, E. and N. Timms. 1985. Adoption, Identity and Social Policy. Aldershot: Gower. Hall, Celia. 1993. ‘Clinic defends offer of free IVF treatment’, Independent, 29 March 1993, p. 4. Harrison, Simon. 1993. The Mask of War. Manchester: Manchester University Press. Hart, Keith. 1982. ‘On commoditisation’. In E. Goody (ed.) From Craft to Industry, pp. 38-49. Cambridge: Cambridge University Press. Hartouni, Valerie. 1997. Cultural Conceptions: On Reproductive Technologies and the

Remaking of Life. Minneapolis: University of Minnesota Press. Hauser-Schaublin, B., V. Kalitzkus, I. Petersen, and I. Schroder. 2001. Der Geteilte Leib: Die kulturelle Dimension von Organtransplantation und Reproduktionsmedizin in Deutschland. Frankfurt: Campus Verlag.

Helman, Cecil. 1988. ‘Dr Frankenstein and the industrial body: reflections on ‘spare part’ surgery’. Anthropology Today 4: 14-16. Herdt, Gilbert. 1981. Guardians of the Flute: Idioms of Masculinity. New York: McGraw Hill. ______ 1984. ‘Semen transactions in Sambia culture’. In G. Herdt (ed.) Ritualised Homosexuality in Melanesia, pp. 167-210. Berkeley: University of California Press.

____ 1994. ‘Introduction: third sexes and third genders’. In G. Herdt (ed.) Third Sex, Third Gender: Beyond Sexual Dimorphism in Culture and History, pp.

21-81. New York: Zone Books.

Bibliography 265 Hertz, Robert. 1960. ‘A contribution to the collective representation of death’. In R. Hertz (ed.) Death and the Right Hand. Translation by R. and C. Needham, pp. 27-86. London: Cohen and West. Hirschon, Renée (ed.). 1984. Women and Property — Women as Property.

London/Canberra: Croom Helm. Hornby, Derek and Patrick Hennessy. 1994. ‘Exposed: trade in human eggs’. Daily Express, 18 February 1994, pp. 1-2. House of Commons. 1994. Criminal Justice and Public Order Bill. London. HMSO. House of Commons Science and Technology Committee. 2002. Developments in Human Genetics and Embryology. London: HMSO. House of Lords Select Committee on Science and Technology. 2001. Human Genetic Databases: Challenges and Opportunities. Fourth Report. London: HMSO. House of Lords. 2002. Stem Cell Research. Report from the Select Committee. London: HMSO. Howe, David and Julia Feast. 2000. Adoption, Search and Reunion: The Long Term Experience of Adopted Adults. The Children’s Society.

Howell, Signe. 1989. ‘Of persons and things: exchange among the Lio of Eastern Indonesia’, Man (n.s.) 24: 419-38. Hubbard, Ruth. 1990. The Politics of Women’s Biology. New Brunswick: Rutgers University Press. Human Fertilisation and Embryology Act. 1990. London: HMSO. Human Fertilisation and Embryology Authority. 1994a. Donated Ovarian Tissue in Embryo Research and Assisted Conception. Report. HFEA: London. _______ 1994b. Donated Ovarian Tissue in Embryo Research and Assisted Conception. Public Consultation Document. HFEA: London. ______ 1998. Public Consultation on the Compensation of Gamete Donors. London: HFEA.

______ 2000. Ninth Annual Report. London: HFEA. ______. 2001. Code of Practice. 5th edn, London: HFEA. _______ 2002a. Eleventh Annual Report. London: HFEA. ______ 2002b. HFEA Response to the Department of Health’s Consultation on ‘Donor Information: Providing Information about Sperm, Egg and Embryo Donors’. London: HFEA. ______. 2002c. Tenth Annual Report. London: HFEA.

____ 2003. ‘Egg Donation’, HFEA Patient Information Leaflet. London: HFEA. Human Genetics Commission. 2002. Inside Information. Balancing Interests in the Use of Personal Genetic Data. London: Department of Health. Humphreys, S.C. and H. King (eds). 1981. Mortality and Immortality. London: Academic Press. Imber-Black, Evan (ed.). 1993. Secrets in Families and Family Therapy, New York: Norton. Imber-Black, Evan. 1998. The Secret Life of Families: Making Decisions about Secrets. Bantam Books. James, Wendy and Nick Allen (eds). 1998. Marcel Mauss: A Centenary Tribute. Oxford: Berghahn Books. Jacobus, M., E.F. Keller, and S. Shuttleworth (eds). 1990. Body/Politics. Women and the Discourses of Science. London: Routledge. Jordan, Brigitte. 1978. Birth in Four Cultures. Montreal: Eden Women’s Press Publications. Kahn, Susan Martha. 2000. Reproducing Jews: A Cultural Account of Assisted Conception in Israel. Durham, N.C: Duke University Press.

266 Bibliography Kass, Amy (ed.). 2002. The Perfect Gift: The Philanthropic Imagination in Poetry and

Prose. Bloomington: Indiana Press. Keesing, Roger M. 1975. Kin Groups and Social Structure. New York: Holt, Rinehart and Winston. Komter, Aafke (ed.). 1996. The Gift: An Interdisciplinary Perspective. Amsterdam: Amsterdam University Press. Konrad, Monica. 1996. ‘Anonymous Exchange Relations: Assisted Conception Between Ova Donors and Recipients in the United Kingdom’. Ph.D. thesis. The London School of Economics and Political Science. _______ 1998. ‘Ova donation and symbols of substance: some variations on the theme of sex, gender and the partible person’. The Journal of the Royal Anthropological Institute 4(4): 643-67. ____ 2003a. ‘Gifts of life in absentia: regenerative fertility and the puzzle of the “missing genetrix”’. In J. Haynes and J. Miler (eds) Inconceivable Conceptions: Psychotherapy, Fertility and the New Reproductive Technologies, pp. 120-42.

London: Routledge. ,

_______ 2003b. ‘From secrets of life to the life of secrets: tracing genetic knowledge as genealogical ethics in biomedical Britain’. The Journal of the Royal Anthropological Institute 9(2): 339-58. ______ 2003c. ‘Predictive genetic testing and the making of the pre-symptomatic person: prognostic moralities amongst Huntington’s affected families. Anthropology and Medicine 10(1): 23-49. ______ 2003d. ‘Egg donation in cultural context: the relevance of anthropological approaches for policy and regulatory development in the UK’. Paper presented to the First International Egg Donation Conference, Global Egg Donation Resource (GEDR), University of London, 7-9 February 2003. ______ 2004. ‘Offspring, being and wellbeing: parental decision-making’. Paper presented to the Cambridge University Government Policy Programme (CUGPOP) Seminar on Human Reproduction. Selecting for Life: Scientific Basis and Policy Implications. Cambridge, 23 April 2004. _______ 2005. Narrating the New Predictive Genetics: Ethics, Ethnography and Science.

Cambridge: Cambridge University Press. Kopytoff, Igor. 1986. ‘The cultural biography of things: commoditisation as process’. In A. Appadurai (ed.). The Social Life of Things. Commodities in Cultural Perspective, pp. 64-91. Cambridge: Cambridge University Press. Lacan, Jacques. 1977a. Ecrits. A Selection. Translated by Alan Sheridan. London: Tavistock/Routledge. ______—«i1977b. The Four Fundamental Concepts of Psychoanalysis. Translated by Alan

Sheridan. London: Penguin Books. Laidlaw, James. 2002. ‘A free gift makes no friends’. In Mark Osteen (ed.) The Question of the Gift: Essays Across Disciplines, pp. 45-66. London: Routledge. Laqueur, Thomas. 1990. Making Sex. Body and Gender from the Greeks to Freud.

Cambridge, MA: Harvard University Press. Lasker, Judith and Susan Borg. 1989. ‘Secrecy and the new reproductive technologies’. In L.M. Whiteford and M.L. Poland (eds) New Approaches to Human Reproduction: Social and Ethical Dimensions. London: Westview Press. Latour, Bruno. 1993. We Have Never Been Modern. Hemel Hempstead: Harvester Wheatsheaf. Layne, Linda. (ed.). 1999. Transformative Motherhood: On Giving and Getting in a Consumer Culture. New York: New York University Press.

Bibliography 267 Leach, Jerry and Edmund Leach (eds). 1983. The Kula: New Perspectives on Massim Exchange. Cambridge: Cambridge University Press. Lepowsky, Maria. 1990. ‘Gender in an egalitarian society: a case study from the Coral Sea’. In PR. Sanday and R.G. Goodenough (eds) Beyond the Second Sex: New Directions in the Anthropology of Gender, pp. 169-223. Philadelphia: University of Pennsylvania Press. Lévi-Strauss, Claude. 1969. The Elementary Structures of Kinship. Boston: Beacon Press. Levy, R. 1970. ‘Tahitian adoption as psychological message’. In V. Carroll (ed.) Adoption in Eastern Oceania. Honolulu: University of Hawaii Press. Lewis, Ioan. 1999. Arguments with Ethnography. Comparative Approaches to History, Politics and Religion. London: Athlone Press. Lewis, P.M. 1992. ‘Patient selection and management’. In P. Brinsden and P. Rainsbury (eds) A Textbook of In Vitro Fertilisation and Assisted Reproduction,

pp.27-38. Lancaster: Parthenon Publishing Group Ltd. Lindblad, F, C. Gottlieb, and O. Lalos. 2000. “To tell or not to tell - what parents think about telling their children that they were born following donor insemination’, Journal of Psychosomatic Obstetrics and Gynaecology 21: 193-203.

Lindenbaum, Shirley. 1987. ‘The mystification of female labors’. In J.F.Collier and S.J. Yanagisako (eds) Gender and Kinship: Essays Toward Unified Analysis,

pp. 221-43. Stanford: Stanford University Press. Lock, Margaret. 1993. Encounters with Ageing: Mythologies of Menopause in Japan and North America. Berkeley: University of California Press.

Lock, Margaret, Allan Young, and Alberto Cambrosio (eds). 2000. Living and Working with the New Medical Technologies: Intersections of Inquiry. Cambridge:

Cambridge University Press. Loizos, P. and P. Heady (eds). 1999. Conceiving Persons: Ethnographies of Procreation, Fertility and Growth. London: Athlone Press. Lorbach, Caroline. 2003. Experiences of Donor Conception. Parents, Offspring and Donors Through the Years. London: Jessica Kingsley Publishers. Lundin, S. and L. Akesson (eds). 1999. Amalgamations: Fusing Technology and Culture. Sweden: Nordic Academic Press.

Lutjen, Peter, Alan Trounson, John Leeton, Jock Findlay, Carl Wood, and Peter Renou. 1984. ‘The establishment and maintenance of pregnancy using in vitro fertilisation and embryo donation in a patient with primary ovarian failure’, Nature 307: 174-75. Lyotard, Jean-Francois. 1993. Libidinal Economy. Translated by Iain Hamilton Grant. London: The Athlone Press. MacCormack, Carol and Marilyn Strathern (eds). 1980. Nature, Culture and Gender. Cambridge: Cambridge University Press. Maine, H.L. [1876] 1931. Ancient Law. London: Spottiswoode and Company. Malinowski, Bronislaw. 1922. Argonauts of the Western Pacific. London: Routledge and Kegan Paul. _____ 1926. Crime and Custom in Savage Society. London: Kegan Paul. Mantel, Hilary. 2004. Giving Up the Ghost. London: Harper Perennial. Marriott, McKim. 1976. ‘Hindu transactions: diversity without dualism’. In B. Kapferer (ed.) Transaction and Meaning: Directions in Anthropology of Exchange and Symbolic Behaviour. A.S.A Essays in Social Anthropology, 1. pp. 109-42. London: Tavistock Publications. Martin, Emily. 1987. The Woman in the Body: A Cultural Analysis of Reproduction. Milton Keynes: Open University Press.

268 Bibliography __—s«4A: 99]. ‘The egg and the sperm: how science has constructed a romance based on stereotypical male-female roles’, Signs 16(3): 485-501. Matthews, Paul. 1983. ‘Whose body? People as property’. Current Legal Problems 36: 193-239. Mauss, Marcel. [1925] 1990. The Gift. The Form and Reason for Exchange in Archaic Societies. Translated by W.D. Halls. London: Routledge. McWhinnie, Alexina. 1996. Families Following Assisted Conception — What Do We Tell Our Child? University of Dundee.

____ «2000. ‘Families from assisted conception: ethical and psychological issues’. Human Fertility 3(1): 13-19. Medical Research Council. 2001. Human Tissue and Biological Samples for Use in Research. London: MRC Ethics Series.

2003. Code of Practice for the UK Stem Cell Bank. London: MRC [Consultation Document]. Melosh, Barbara. 2002. Strangers and Kin: The American Way of Adoption.

Cambridge, MA: Harvard University Press. Merleau-Ponty, Maurice. 1968. The Visible and the Invisible. Evanston: Northwestern University Press. Mihill, Chris. 1994. ‘MPs denounce ‘womb robbing’. Guardian, 3 January 1994, p. 3. Mimica, Jadran. 1988. Intimations of Infinity. The Mythopoetia of the Igwaye Counting System and Number. Oxiord: Berg. Modell, Judith. 1994. Kinship with Strangers: Adoption and Interpretations of Kinship

in American Culture. Berkeley: University of California Press. _______ 2002. A Sealed and Secret Kinship: The Culture of Policies and Practices in

American Adoption. New York: Berghahn Books. Moore, Henrietta. 1988. Feminism and Anthropology. Cambridge: Polity Press.

Mosko, Mark. 1983. ‘Conception, de-conception and social structure in Bush Mekeo culture’, Mankind 14(1): 24-32. Munn, Nancy. 1983. ‘Gawan kula: spatiotemporal control and the symbolism of influence’. In J. Leach and E. Leach (eds) The Kula: New Perspectives on Massim Exchange, pp. 277-308. Cambridge: Cambridge University Press. _______ [1986] 1992. The Fame of Gawa. A Symbolic Study of Value Transformation in a Massim (Papua New Guinea) Society. Durham and London: Duke University Press.

Nachtigall, R. 1993 ‘Secrecy: an unresolved issue in the practice of donor insemination’, American Journal of Obstetrics and Gynaecology 168: 1846-51. Nachtigall, R., G. Becker, S. Quiroga and J. Tschann. 1998. ‘The disclosure

decision: concerns and issues of parents and children conceived through donor insemination’, American Journal of Obstetrics and Gynaecology 199:

1165-68. Natanson, Maurice. 1979. ‘Phenomenology, anonymity, and alienation’. New Literary History 10(3): 533-46. ____ 1986. Anonymity. A Study in the Philosophy of Alfred Schutz. Bloomington: Indiana University Press. Needham, Rodney. 1974. Remarks and Inventions: Skeptical Essays about Kinship. London: Tavistock Publications. Nuffield Council on Bioethics. 1995. Human Tissue: Ethical and Legal Issues. London: NCB.

Bibliography 269 Oakley, Ann. 1987. ‘From walking wombs to test tube babies’. In M. Stanworth (ed.) Reproductive Technologies: Gender, Motherhood and Medicine. pp. 36-56.

Cambridge: Polity Press. Ortner, S., and H. Whitehead. 1981. Sexual Meanings: The Cultural Construction of Gender and Sexuality. Cambridge: Cambridge University Press. Osteen, Mark (ed.). 2002. The Question of the Gift: Essays Across Disciplines. New York: Routledge. Palmer, Jill. 1994. ‘The gift we must refuse?’, Daily Mirror, 6 July 1994, p. 6.

Parry, Jonathan. 1986. ‘The gift, the Indian gift, and the “Indian gift”’, Man (n.s.) 21(3): 453-73. Pedersen, Roger. 2003.’Cellular songs in the key of life’, Times Higher Educational Supplement. 29 August 2003, pp. 20-21. Petchesky, Rosalind Pollack. 1987. ‘Foetal Images: the Power of Visual Culture in the Politics of Reproduction’. In Michelle Stanworth (ed.) Reproductive Technologies. Gender, Motherhood and Medicine, pp. 57-80. Cambridge: Polity Press. Pinto-Correia, Clara. 1997. The Ovary of Eve: Egg and Sperm and Preformation. Chicago: University of Chicago Press.

Pitt-Rivers, Julian. 1973. ‘The kith and the kin’. In J. Goody (ed.) The Character of Kinship. Cambridge: Cambridge University Press. Poole, Fitz John P. 1984. ‘Symbols of Substance: Bimin-Kuskusmin models of procreation, death and personhood’, Mankind 14: 191-216. Power, M., R. Baber, H. Abdalla, A. Kirkland, T. Leonard, and J. Studd. 1990. ‘A comparison of the attitudes of volunteer donors and infertile patient donors on an ovum donation programme’. Human Reproduction 5: 352-57. Ragoné, Helena. 1994. Surrogate Motherhood: Conception in the Heart. Boulder, Colorado: Westview Press. Raheja, Gloria Goodwin. 1988. The Poison in the Gift: Ritual, Prestation and the Dominant Caste in a North Indian Village. Chicago: University of Chicago Press.

Rapp, Rayna. 1991. ‘Moral pioneers: women, men and fetuses on a frontier of reproductive technology’. In Micaela di Leonardo (ed.) Gender at the Crossroads of Knowledge: Feminist Anthropology in the Postmodern Era, pp. 383-95. Berkeley: University of California Press. ______ 1995. ‘Heredity, or: revising the facts of life’. In S.J. Yanagisako and C. Delaney (eds) Naturalising Power: Essays in Feminist Cultural Analysis, pp.

383-95. New York: Routledge. ______ 1999. Testing Women, Testing the Fetus: The Social Impact of Amniocentesis in

America. New York: Routledge. Raymond, Janice G. 1994. Women as Wombs. Reproductive Technologies and the Battle over Women's Freedom. New York: Harper Collins. Resnik, David. 2001. ‘Regulating the market for human eggs’. Bioethics 15(1): 1-25. Riviere, P. 1985. ‘Unscrambling parenthood: the Warnock Report’. Anthropology Today 4: 2-7. Robertson, John. 1994. Children of Choice: Freedom and the New Reproductive Technologies. Princeton: Princeton University Press. Rogers, Lois. 1993. ‘Row over human eggs “for sale”’, The Sunday Times, 28

March 1993, pp. 1,3. Rothman, Barbara Katz. 1986. The Tentative Pregnancy, Prenatal Diagnosis and the Future of Motherhood. New York: W.W. Norton.

270 Bibliography Rothstein, Mark (ed.). 1997. Genetic Secrets: Protecting Privacy and Confidentiality in the Genetic Era. New Haven: Yale University Press. Rotman, Brian. 1987. Signifying Nothing: The Semiotics of Zero. New York: St. Martin’s Press.

Rowland, Robyn. 1985. ‘The social and psychological consequences of secrecy in AID programmes’, Social Science and Medicine 21: 391-96. —____— 1993. Living Laboratories: Women and Reproductive Technology. London: Cedar.

Rubin Gayle. 1975. ‘The traffic in women: notes on the ‘political economy’ of sex’. In Rayna Reiter (ed.), Toward an Anthropology of Women. pp. 157-210. New York: Monthly Review Press. Rubinstein, Robert L. 1981. ‘Knowledge and political process in Malo’. In M.R. Allen (ed.) Vanuatu. Politics, Economics and Ritual in Island Melanesia. Sydney: Academic Press. Sahlins, Marshall. 1965. ‘On the sociology of primitive exchange’. In Michael Banton (ed.) The Relevance of Models for Social Anthropology, ASA Monographs

No.1. pp. 139-236. London: Tavistock. Sampson, Val. 1993. ‘Good eggs’, Guardian, 10 May 1993, pp. 10-11. Sandelowski, Margarete. 1991. ‘Compelled to try: the never enough quality of conceptive technology’. Medical Anthropology Quarterly. 5, 29-47. Scheffler, Harold. 1991.’Sexism and naturalism in the study of kinship’. In M. di Leonardo (ed.) Gender at the Crossroads of Knowledge: Feminist Anthropology in the

Postmodern Era. Berkeley: University of California Press. Schieffelin, Edward L. 1980. ‘Reciprocity and the construction of reality’, Man (n.s.) 15(3): 502-17. Schneider, David. 1968. American Kinship: A Cultural Account. Englewood Cliffs, NJ: Prentice Hall. Schover, L., R. Collins, M. Quigley, J. Blankenstein, and G. Kanoti. 1991. ‘Psychological follow-up of women evaluated as oocyte donors’. Human Reproduction 6: 1497-91. Schrift, Alan. 1997. The Logic of the Gift: Toward an Ethic of Generosity. London:

Routledge. Schutz, Alfred. 1976. The Phenomenology of the Social World. Translated by G.

Walsh and F. Lehnert. Evanston, IL: Northwestern University Press. Schwimmer, Eric. 1979. ‘Reciprocity and structure: a semiotic analysis of some Orokaiva exchange data’, Man (n.s.) 14(2): 271-85. Seibel, M. and S. Crockin (eds). 1996. Family Building Through Egg and Sperm Donation: Medical, Legal and Ethical Issues, Boston: Jones and Bartlett. Sexton, Lorraine. 1992. ‘“Wok Meri”: a women’s savings and exchange system in Highland Papua New Guinea’, Oceania 52: 167-98. Simmons, Roberta G., Susan Klein Marine, and Richard L. Simmons. 1987. Gift of Life: The Effect of Organ Transplantation on Individual, Family and Societal

Dynamics. New Brunswick, NJ: Transaction Books. Simpson, Robert. 2001. ‘Making “bad” deaths “good”: the kinship consequences of posthumous reproduction’, The Journal of the Royal Anthropological Institute

7(1): 1-18. _____ in press. ‘Localising a brave new world: new reproductive technologies and the politics of infertility in contemporary Sri Lanka’. In M. UnnithanKumar (ed.) Reproductive Agency, Medicine and the State: Cultural Transformations

in Childbearing. Oxford: Berghahn Books.

Bibliography 271 Smith, David Eugene. 1958. History of Mathematics. Vol. Il. New York: Dover Publications. Snowden, Robert and Geoffrey Mitchell. 1981. The Artificial Family: A Consideration of Artificial Insemination by Donor. London: Allen and Unwin. Snowden, R., G. Mitchell, and E. Snowden. 1983. Artificial Reproduction: A Social Investigation. London: George Allen and Unwin. Spallone, Patricia. 1989. Beyond Conception: The New Politics of Reproduction. London: Macmillan Education. Spallone, P. and D. Steinberg. 1987. Made to Order: The Myth of Reproductive and Genetic Progress. Oxford: Pergamon Press. Stabile, Carol A. 1994. Feminism and the Technological Fix. Manchester: Manchester University Press.

Stanworth, Michelle. 1987. ‘Reproductive Technologies and the Deconstruction of Motherhood’. In Michelle Stanworth (ed.) Reproductive Technologies. Gender, Motherhood and Medicine, pp. 10-35. Cambridge: Polity Press. _____._ (ed.) 1987. Reproductive Technologies. Gender, Motherhood and Medicine.

Cambridge: Polity Press. Strathern, Andrew. 1971. The Rope of Moka: Big-Men and Ceremonial Exchange in Mount Hagen, New Guinea. Cambridge: Cambridge University Press.

______ 1982. ‘Witchcraft, greed, cannibalism and death: some related themes from the New Guinea Highlands’. In M. Bloch and J. Parry (eds) Death and the Regeneration of Life, pp. 111-33. Cambridge: Cambridge University Press. Strathern, Marilyn. 1988. The Gender of the Gift: Problems with Women and Problems with Society in Melanesia. Berkeley: California University Press. ______ 199]. Partial Connections. Savage, Maryland: Rowman and Littlefield Publishers. ______ 1992a. Reproducing the Future. Essays on Anthropology, Kinship and the New Reproductive Technologies. Manchester: Manchester University Press. —_____ 1992b. After Nature: English Kinship in the Late Twentieth Century. Cambridge University Press. Sutkamp-Friedman, Joyce. 1996. Building Your Family Through Egg Donation. Fort Thomas, KY: Jolance Press. Taussig, Michael. 1999. Defacement: Public Secrecy and the Labor of the Negative.

Stanford, CA: Stanford University Press. Thomas, Nicholas. 1991. Entangled Objects. Cambridge, MA: Harvard University Press. Titmuss, Richard M. [1970] 1997. The Gift Relationship. From Human Blood to Social Policy. London: George Allen and Unwin. Tong, R., G. Anderson, and A. Santos (eds). 2001. Globalising Feminist Bioethics: Cross-Cultural Perspectives. Boulder, Colorado: Westview Press. Tremayne, Soraya (ed.) 2001. Managing Reproductive Life: Cross-Cultural Themes in Fertility and Sexuality. Oxford: Berghahn Books. Triseliotis, John. 1973. In Search of Origins. London: Routledge and Kegan Paul. _____. 1984. ‘Obtaining birth certificates’. In P. Bean (ed.) Adoption: Essays in Social Policy, Law and Sociology. London: Tavistock.

Trounson, Alan, John Leeton, Mandy Besanko, Carl Wood, and Angelo Conti. 1983. ‘Pregnancy established in an infertile patient after transfer of a donated

embryo fertilised in vitro’. British Medical Journal 286: 835-38.

Turney, Jon. 1998. Frankenstein’s Footsteps: Science, Genetics and Popular Culture.

New Haven: Yale University Press.

272 Bibliography Usborne, David. 1997. ‘Unease grows about baby from beyond the grave’. Independent, 2 December 1997, p. 5. Valle, Teresa del. (ed.). 1993. Gendered Anthropology. London: Routledge.

Vidal, John and John Carvel. 1994. ‘Lambs to the gene market’, Guardian. 12-13 November 1994, p. 25. Wagner, Roy. 1986 Asiwarong: Ethos, Image and Social Power among the Usen Barok of New Ireland. Princeton: Princeton University Press.

____— 1989. ‘Conclusion: the exchange context of the Kula’. In F. Damon and R. Wagner (eds) Death Rituals and Life in the Societies of the Kula Ring. pp.

254-274. DeKalb: Northern Illinois University Press. ______ 1991 ‘The fractal person’. In Maurice Godelier and Marilyn Strathern (eds) Big Men and Great Men: Personifications of Power in Melanesia, pp. 159-73.

Cambridge: Cambridge University Press. Warnock, Mary. 1984. Report of the Committee of Inquiry into Human Fertilisation and Embryology. London: HMSO. ______ 2002. Making Babies: Is There a Right to Have Children? Oxford: Oxford University Press.

Weiner, Annette. 1980. ‘Reproduction: a replacement for reciprocity’, American Ethnologist, 7(1): 71-85. ______ 1992. Inalienable Possessions. The Paradox of Keeping-While-Giving. Berkeley:

University of California Press. Weiner, James. 1985. ‘Beyond the possession principle: an energetics of Massim exchange’. Pacific Studies 18(1): 128-37. _____ 1988. The Heart of the Pearl Shell: The Mythological Dimension of Foti Sociality.

Berkeley: University of California Press. _______ 2001. Tree Leaf Talk: A Heideggerian Anthropology. Oxford: Berg.

Whitehead, Harriet. 1987. ‘Fertility and exchange in New Guinea’. In J.F. Collier and S.J. Yanagisako (eds) Gender and Kinship. Essays Toward a Unified Analysis,

pp. 244-67. Stanford: Stanford University Press. Wilmut, Ian, Keith Campbell, and Colin Tudge. 2000. The Second Creation: The Age of Biological Control by the Scientists who Cloned Dolly. London: Headline. Wolfram, Sybil. 1987. In-Laws and Outlaws: Kinship and Marriage in England. London: Croom Helm.

Wynn Davies, Patricia. 1997. ‘Widow wins right to have baby from her dead husband’, The Independent, 7 February 1997, p. 3. Yanagisako, S.J. and C. Delaney (eds). 1995. Naturalising Power: Essays in Feminist Cultural Analysis. New York: Routledge.

Newspaper Articles ‘Women lose right to use their “own” embryos’, The Guardian, 2 October, 2003, p. 3. ‘Winston warns of risks to test-tube babies in later life’, The Independent, 1] September 2003, p.11. ‘British lab hails stem cells first’, The Guardian, 13 August 2003, p. 10. ‘Ovulation revolution’, New Scientist, 19 July 2003, p. 16. ‘Your real mother was aborted baby’, The Sun, 1 July 2003, p. 22. ‘Spectre of babies from the unborn’, The Daily Telegraph, 1 July 2003, p. 1. ‘Era of “unborn mother” looms as scientists use aborted foetuses to grow human eggs’, The Independent, 1 July 2003, p. 3. ‘Infertile women fight for embryos’, Daily Telegraph, 1 July 2003, p. 9. ‘Brave new IVF’ [Editorial], New Scientist, 10 May 2003, p. 3.

Bibliography 273 ‘Mother of newborn child says she is 65’, The Times, 10 April 2003, p. 28. ‘The IVF deal that nearly killed me’, Evening Standard [London], 2 December 2002, pp. 16-18. ‘IVF doctor is accused of “egg trading”’, Evening Standard [London], 2 December 2002, pp. 1-2. Lockwood, Gillian. 2002. ‘Frozen egg baby hailed as fertility milestone’, The Guardian, 11 October 2002, p. 1. ‘Designer baby gets go-ahead’, The Guardian, 23 February 2002, p. 1. ‘Clinic criticised over IVF twins for mother, 56’, The Daily Telegraph, 23 January 2002, p. 5. ‘Call to identify sperm donor in human rights test case’, The Guardian, 11 September 2000, p. 1. ‘Ovary the Moon’, The Mirror, 26 January 2000, p. 1. ‘Ban lifted on use of frozen eggs to delay conception’, The Independent, 26

January 2000, p. I. ‘Ovarian banks raise questions for medical law’, The Daily Telegraph, 24 September 1999, p. 5. ‘The menopause is reversed’, The Daily Telegraph, 23 September 1999, pp. 1-3. ‘Career women get a baby ‘deadline’, The Sunday Times, 11 July 1999, p. 5. ‘To Britain’s “most dangerous feminist” ... a daughter’, The Guardian, 2 September 1997, p. 7. ‘Donor eggs fuel baby boom for over-50s’, The Sunday Times, 13 July 1997, p. 6. ‘Test-tube twins for woman of 54’, The Daily Telegraph, 5 June 1997, p. 1. ‘Ban in using foetal ovaries to treat the childless’, The Times, 21 July 1994, p. 6. ‘Doctors approve “egg donor cards”’, The Independent, 6 July 1994, p. 6. ‘Baby donors aged 12’, Daily Mirror, 6 July 1994, p. 1. ‘Baby drug kills test tube mum’. Daily Mirror, 24 February 1994, p. 1. ‘A “mad” foetal position’ [Letters], The Sunday Times, 9 January 1994, p. 8. ‘Foetal eggs as a fertile ground for debate’ [Letters], The Guardian, 6 January 1994, ‘Fertility team wants to use eggs from aborted foetuses’, The Independent, 3

January 1994. ‘300 women warned of risk 30 years after infertility treatment’, The Times, 2 September 1993, p. 2. Winston, Robert. 1993. ‘Menopause for thought’, The Guardian, 21 July 1993, p. 4.

Websites All the following websites were accessed in June 2003. AceBabes . British Fertility Society . British Infertility Counselling Association . CHILD (The National Infertility Support Network) . Daisy Premature Menopause Support Group Network . The Donor Conception Network . The Donor Conception Support Group of Australia Inc . European Infertility Network . Global Egg Donation Resource . Human Fertilisation and Embryology Authority .

274 Bibliography Independent Fertility Concerns . International Federation of Infertility Patient Associations. Contact via CHILD. Issue (The National Fertility Association) . The National Gamete Donation Trust . National Infertility Awareness Campaign . People Conceived Via Artificial Insemination . The Progress Educational Trust . Project Group on Assisted Reproduction of the British Association of Social Workers (PROGAR). Contact Eric Blyth: [email protected]

INDEX

NOTE: Italicised page numbers refer to illustrations.

The terms ‘ova’ and ‘eggs’ have both been used in the text, but all related index entries have been gathered under ‘ova’ to assist the reader.

A cultural exploration of aborted foetuses, eggs from ovarian namelessness 93, 241-44

tissue 119-20 DC Network Anonymity Statement AceBabes 38, 162 84-85

adoption 10 de-anonymisation 102

contrasted with ova donation 156 degrees of anonymisation

information disclosure 167-69 indeterminate 87-90, 118, 242 ova donor’s own adoption 118-20 strong 86-87, 120, 242 adult ovarian tissue, research to grow weak 90-92, 115-16, 242

eggs 119-20 and disclosure issues 161-73, research 207-9 egg sharing 133-34 age, pregnancy, childbearing and enucleated eggs as ‘pure parenthood 11-12 anonymity’ 239-40 adult stem cells, embryonic stem cell 178-84

AID (artificial insemination by donor) free gifts and anonymous

7 relationships 6-7, 39, 138

altruism and irrelational kinship 238 blood donation 39 legal principle 34

embryo donation for research 212 non—anonymous ova donation 135

and gift relationship 41-42, 44 non-identifying information 146,

ova donors 20, 8] 242

ova and sperm donation 60 non-reciprocity 42

anonymity 5 ova recipients’ preference 138

anonymisation of DNA data 85 removal of donor anonymity 36 anonymous helpfulness 40, 66 reversible and irreversible

anonymous mediation 129 anonymisation 85, 90

anthropological approach xii-xiv, serving pragmatic ends 35

162 shifts in opinion 36-39, 92, 102

assumed permanence of donor sperm donation 9, 35, 162

anonymity 165 transilience and anonymous

concealing and severing social sociality 49-50, 180-82, 200,

relations 35 214, 227, 242

276 Index un-doing gift-relations 41 procurement site for embryonic and unfulfilled reciprocity 40-41 stem cells 208 and Western denomination recipient’s ‘complex of obligation’

systems Xlil—xIV. 15]

See also donor information provision assisted reproductive technologies.

anthropology See ARTs on anonymity and disclosure Australian Aboriginals 193

xii—xiv, 162 auto-grafting techniques 240-41

on ARTs 25-27

cross-regional and thematic B

comparisons 25-27 banking

inter-articulation on gamete body parts 240-41

donation 3-27 DNA samples 85

inter-articulation with medical Barnes, John 103-4

orthodoxy 3-4 Battaglia, Debbora 124, 175

kula ring and ‘free gifts’ xi-xili BICA (British Infertility Counselling

new reproductive technologies Association) 38

10-11 Bimin-Kuskusmin 193

parenthood 104-6 BioBank (U.K.), collection of DNA

anti-abortion lobby 223, 230 samples 85 Argonauts of the Western Pacific xii, 40-41 bioethics, cross-cultural 25 artificial gametes 17 bioethics experts 25

artificial insemination by donor. See biogenetic ownership, ova donor’s

AID denial of parentage 86-87 technologies) 103, 201 anthropological focus 25-27 biological regeneration, embryonic

ARTs (assisted reproductive biogenetic substance of parenthood

ethical, legal and social stem cell research 208 implications 26 biological ties, egg and sperm

feminist issues 7-15, 18, 43 donations 8-9, 10

intimacy at a distance 238 Biotechnology and Biological Sciences

manipulation of blood ties 163 Research Council 208

preserving social memory 226 black market in human eggs 17-18

scientific advances and Bloch, Maurice and Jonathan Parry 6

implications 239-44 blood donation 6, 39

assisted conception clinics 133 blood identities, manipulation 163-64 bioeconomics of clinical practice blood imagery, recipient’s gestation

174, 175, 181 role 153-55, 159 contact with successful recipients blood ties. See biological ties 169-70 bodily ‘integrity’ 44-45 ‘cross-over’ donation system 135, body as ‘partible’ 45-46

138, 166 body parts

lack of transparency 134 cross-transferable relations 46

176 as property 47. open evenings for donors and See also extensional transilience;

maximising recipients per donor extracorporeal value 112

recipients 57—59 regenerative transilience pressure to accept recommended Bourdieu, Pierre 42, 130, 131 nll, 151 donor 144-45 British Infertility Counselling procedures on ‘surplus’ embryos Association. See BICA

189 Buserelin/Suprefact 253, 255

Index 277 Bush Mekeo 201 cultural politics ‘manipulating’ blood ties 163-64 corporeal extraction and surplus 58 Butler, Judith xiv enucleation 240

C 71, 86, 96

‘cutting off’ from eggs, donors’ idiom

cadaver egg donation 16

campaign groups 36, 38, 84, 102 D and disclosure issues 162 Daisy Network 38

cardiac disease 17 Darwin, Charles 224

cell nuclear replacement. See CNR data ‘champion donor’ legend 7, 215 ‘linked anonymised’ 85

child by proxy 114 ‘unlinked anonymised’ 85 childbearing age, extended by ova DC Network 38, 84 donation 11-12 Anonymity Statement 84-85

children and disclosure issues 162

conceptive origins 116, 118, de-identification, categories 86—92

167-69, 173, 196 death

donor conceived, statutory rights 36 cultural imagery of Aré’Aré 227-29

embryo-donor-conceived 212-16 release of valuable resources

Children’s Society (U.K.) 36 225-27

Church of England, condemnation of degenerative conditions, embryonic

AID 7 stem cell research 207-9

clinics. See assisted conception clinics Department of Health, Donor

cloning research 17 Information Consultation 36, CNR (cell nuclear replacement) 207, 37, 85, 145

239 depersonalisation

Committee of Inquiry into Human ‘cutting off’ link 86, 96

Fertilisation, Report. See ova donation 69-71

Warnock Report Derrida, Jacques 6, 73, 128, 130

conception, by posthumous ‘designer babies’ 230

reproduction 225-27, 234, 239 DI (donor insemination) 7

‘conception portfolio’ 213 diabetes 17

confidentiality, biobanking of DNA disclosure debate, and new genetic

samples 85 initiatives 85 consent to donate to research 208, divisibility, stem cells 207-8

209, 210-12, 216 DNA samples, traceability 85

Contact Register, traceability of donor Dolly the sheep 17

identity 92 donation, live and cadaver 232

corporeal extraction, cultural politics donor anonymity. See anonymity

of surplus 58 Donor Conception Network. See DC

corporeal parts, donations 41, 43 Network

‘cosmic egg’, symbolism 18 Donor Conception Support Group of

cost of IVF Australia 102 hidden costs in United States 151 donor information

reduced by egg sharing 133 Department of Health consultation

Credo Clinic 141, 177 36, 37, 85, 145

cryopreservation technology 187-89, donor genetic parent xiii

188, 21] ‘donor release’ 9 189 egg donor database 147

cryopreserved embryos, de-activation donor to recipient 144-47, 148 identifying knowledge 88

278 Index informational gaps 144-47 embryo donor interviews, renon-identifying 145-47, 181-82, donating spare embryos 190-92

242 embryo donor offspring 212-16

quality of profiling 146 embryo donors, embryos for stem cell recipient’s need for 149-50 research 208, 209, 210-12, 216 risk of ‘selectionism’ 149-50 embryo procurement 239 shifts in public opinion 36-39, 92 embryo recipient interviews, dilemma

and traceability issues 84-96 of ‘spare’ embryos 189, 194-201 United States IVF industry 147-50 embryo storage 187-89 withholding donor’s ‘pen-portrait’ cryopreservation technology

92. 187-89, 188, 21]

See also search; traceability issues embryo transfer procedure, surplus

donor insemination. See DI embryos 187-89, 158 donor interviews. See embryo donor embryo transfer. See ET

interviews; ova donor embryonic stem cells. See ES cells

interviews embryos

donor offspring, traceability issues de-activation 189

99-100 dilemma of surplus 186-201

donor recruitment donation to research 192-95 ova donation 57-60, 135, 138 ‘elusive embryo’ 19

valuing donors 77, 84 ES cell research 207-9

donor sources hyper-embryo 189, 196, 201,

HFEA search 219-20 207-12

scientific search 239 re-donation 190-92. See also donor-assisted conception. See assisted extensional transilience;

conception regenerative transilience

donor-recipient ties endogenous techniques, eggs from donor interviews 86-92 embryonic stem cells 17 as explicit kinship linkages 86-87 enucleated human eggs 239-40

‘The Donor’s Daughter’ 215 epidemiological surveillance 85 donors. See embryo donors; ova equivalent matching 141-44

donors; sperm donors ES cells (embryonic stem cells) 17, Douglas, Mary 6 207-9 ‘Dream Donations’ 147-48 extensional transilience 241

E Stem Cell Bank 208 ED, Inc. (Egg Donation Inc.) for therapuetically oriented from umbilical cord 229

donor/recipient information flow research 195

148 ESHRE (European Society for Human

egg donor database 147 Reproduction and Embryology)

Edwards, Jeanette 11 223 Egg Donation Inc. See ED, Inc ET (embryo transfer) eggs. See ova fresh transfers 256

EIN (Electronic Infertility Network) 38 number of embryos permitted 256 Electronic Infertility Network. See EIN process 256

129 ethical issues embryo donation embryo selection by tissue typing elicitation strategies 5, 27 nl, 112, use of frozen embryos 256

full siblings 92 230 Statistics 9 genealogical disclosure dilemmas 118

Index 279 genotype identity effacement 240 free gilts

new technologies 26 and anonymous relationships 6-7, Nuffield Council on Bioethics 47 39, 138

16, 222-23 risk 66 sister-sister ova donation 137-38 ova donor disinterest 87

ovarian tissue from dead foetuses discounting pain, discomfort and

Euro-Americans, concepts of kinship receding 73-80

1] theoretical anthropology xii, 20.

European Convention on Human See also gifts

Rights 36 FSH (follicle stimulating hormone)

European Society for Human 253, 254

See ESHRE G exogenous hormone therapy 255 gamete donation 3-27, 240 Reproduction and Embryology.

extensional transilience 214, 215, disclosure to offspring 37

217, 243 and other corporeal donations 41

exteriorisation, of ova 8, 42 Statistics 9

externalisation, of self beyond the self traceability issues 84-96

F gametes

111-12 gamete intra-fallopian transfer. See GIFT

facelessness, forms of 7-11, 41 artificial 17 family planning, delayed childbearing ‘gifts of life’ 19

by egg freezing 13, 13 international trade 17-18

family tension risk, ova recipient’s See also artificial gametes; xeno-

family 138, 140 gamete

fatherhood categories 103-4 Gasché, Rodolphe 128

feminism Gawan people 111-12, 124 and ova donation 11-15, 18 GEDR (Global Egg Donation

politics of fertility 14-15 Resource) 38

women’s objectification 43 Gender of the Gift 45-46, 232

fertility genealogical amnesia 163

politics 14 genealogical ethics, disclosure technologically enhanced 61, 254 dilemmas 118, 169

unexplained 21 genealogy, passage of generations 222 Festing, Sally 215 generativity 186-87, 201, 240 fieldwork, access to donors and genes, establishing relatedness 201

recipients 22-24 genetic counselling dilemmas 210-11

Firth, Raymond 6 genetic father 104

‘foetal-centered’ therapy, feminist genetic information

perceptions 43 HFEA information hiatus 93-94

tissues 119-20 92 follicle stimulating hormone. See FSH traceability 85, 213-14, 216

foetuses, aborted, eggs from ovarian siblings through embryo donation

food transmission genetic mother 103-4, 108

11] 107, 108

and symbolic dimensions of value genetic [non-social] parent donors

temple ceremonies linked to genetic pre-selection, to provide stem

conception 121-24 cell donor 229 Franklin, Sarah 19 genetrix 103-4, 108 genitor 104

280 Index

gestation hCG (human chorionic

ova recipients’ emphasis on gonadotrophin) 254

152-58 health risks ‘real’ kinship proponent 103 attitudes of donors 62-65, 79

Gestone 255 ova/sperm donation contrasted 60 The Gift 39, 42, 128, 174 superovulatory drugs 62-65

gilt See also side effects. altruism/self-interest 41-42, 44 HFE Act (Human Fertilisation and and anonymous sociality 125 Embryology Act) 34, 36

‘biographical career’ of the gift 60, ‘carrying mother’ definition 103

80, 193 donor information provision 37,

donor perceptions of ‘giving’ 67-73 181

and duplicity 42 property assumptions 47

elasticity of the gift 134, 137, 240 HFEA (Human Fertilisation and

gift/secret relationship 169 Embryology Authority) xx, 9 hazard of ‘toxic’ diffusion 139, 173 central register 118, 120

temporality 129-30 clinic audits by Licence gilt exchange Committees 93 continuous circle 127-28 consent to donate to research 208, double-edged relationship 42-43 209, 210-12, 216

‘keeping-while-giving’ 192-94, 212 Consultation exercise and Report

and reciprocity 40-41, 128 219, 220, 221, 222 and non-reciprocity 42 derivation of stem cells 208

theoretical anthropology xii Donor Consent Form 142, 165 GIFT (gamete intra-fallopian transfer) Donor Information Form 92, 93

257 donor/biological parent

gift relations information 84, 93, 102, 165

actions and interactions 65-73 embryo selection by tissue typing

corporeal parts as gifts 43 229

in donor assisted contexts 138-39 licensed clinic centres 133, 134 paradoxes in ova donation 80-82 limiting number of successful

sense of debt 132, 140 donations 18]

un-done by anonymity 41 limiting transferable embryos 187 The Gift Relationship 6, 39-40 ‘SEED Review’ xiii ‘gifts of life’, ova donation 19-20 Statistics 9, 187, 188 gifts. See also free gifts; reproductive ‘holo-egg’ 17, 18

gifts hormone treatment, egg induction

Global Egg Donation Resource. See process 61-65

GEDR House of Commons Science and Glover Report 34, 103 Technology Committee, public Godelier, Maurice 42 consultation xiii Goodenough, Ward 104-5 House of Lords Select Committee,

Goody, Esther 105 stem cell research 207, 208

Greer, Germaine 15 human chorionic gonadotrophin. See hCG

H Human Fertilisation (Committee of Harmony Clinic 135 Inquiry). See Warnock Report

Harrison, Simon 186 Human Fertilisation and Embryology Act,

Hashmi family, pre-selection of IVF 1990. See HFE Act

cultured embryos 229 Human Fertilisation and Embryology Authority. See HFEA

Index 281

Human Genetics Commission 85 K

Human Reproductive Technologies and keda pathways 174

the Law, public consultation xili kinship

Human Rights Act 36 categories redefinition 12-13, 85 human-egg industry 17-18 formation 10-11] hyper-embryo 189, 196, 201, 207-210 genetic half-siblings 116, 118, extensional transilience 241 120-21, 178-81] infinite partibility 207, 208 hazard of toxic diffusion 139, 173 ‘hyperstimulation’, superovulatory intimacy-at-a-distance 98

phase 254 irrelational kinship 115-16, 118, 120, 129, 195, 231, 238, 242

I linkages, donor-recipient ties 86—87

identity, notion of the person 44, 46 manipulating blood ties 163 | impersonality, underlying giving 66 polymaternal genetics 17

in vitro fertilisation. See IVF and transilience 118, 119, 166,

India, gift sacrifice 139 173, 198.

Information. See knowledge See also relatedness

information release ‘kinship with strangers’, relations

children’s conceptive origins 116, with non-relations 9-10, 49-50,

118, 167-69, 173 98, LOO, 113-20, 238-44

donor need for information 94-96 knowledge donor/recipient information flow donor-identifying 88, 181-82

148 embryo-donated child’s genetic

kinship ramifications 120-21 origin 213-14

ova donors/outcome of donation transilient, and irrelational kinship

92-96, 116 118, 119. past egg donations 118, 120 See also information; non-

social management of AID knowledge; transilience;

information 161-66 transilient kinship

intergenerational relations, kula ring, ceremonial exchange

redefinition 12-13 XxI-xxii, 175

internet-driven resources

donor information on U.S. sites 147 L Electronic Infertility Network 38 Lacan, Jacques xiv

recruitment of ova donors 135 Laidlaw, James 66

IVF laparoscopic retrieval 254, 255 clinic open evenings 57-59 Layne, Linda 19

egg sharing 133-34 legislation

embryonic stem cell research 207 British fertility legislation 220 generation of ‘spare’ embryos Human Fertilisation and Embryology

187-89, 188 Act, 1990 34, 36, 37, 47, 103

hidden costs in America 15] Human Rights Act 36 induction of extra ova 253 limit to number of successful

parallels with adoption 10 donations 181

Statistics xx, 9 Lévi-Strauss, Claude 42, 174

IVF industry, United States 147-50 LH (luteinising hormone) 253, 256 Liberty (civil rights organisation) 36 Jjural luteinising hormone. See LH parenthood 104—6 : M Malinowski, Bronislaw xii, 40-41

282 Index

Manambu 186 National Infertility Awareness

Massim region, kula ring xx—xxi Campaign. See NIAC

matching ova donor and recipient National Institute for Biological

141-53, 176 Standards and Control. See

informational gaps 144-47 , NIBSC

or mismatching 150-51 NCT (National Childbirth Trust) 38

United States IVF industry 147-50 New Guinea, Bush Mekeo kin 163-64

viewed as irrelevant 152 New Reproductive Technologies

mater 104 (Glover Report) 34, 103 107, 108, 114 Campaign) 38

maternity, biogenetic/gestational roles NIAC (National Infertility Awareness

Mauss, Marcel xii, 6, 39, 40, 41-43, NIBSC (National Institute for

128, 151, 174 Biological Standards and

mediation, in donor-assisted Control) 208 conception 23 non-knowledge 9, 94, 115-16, Medical Research Council 161-62, 166, 170, 243 derivation of stem cells 208 non-relatedness, degree of

‘unlinked anonymised’ data 85 anonymisation 85

Melanesia non-social parent donors 103, 107, 108 links and parallels 24-25, 233 by progenetrix 107 Melanesian societies 193 nuclear transfer cloning techniques 17 Melanesians as corporeal persons Nuffield Council on Bioethics 47

Melpa 193 O 45-46

membrane fusion technology 17 oocytes, cultivation 219, 239

menopause oogenesis 219, 220, 239

hormonally induced in egg donors ooplasmic transplantation 17

62, 254 The Origin of Species 224

reversed by ovarian grafts 12 ‘origins data’ 183

‘mero-egg’ 17, 18 ova

Miscarriage Association 38 enucleated human eggs 239-40

missing link 224-25 search for new sources of human MORI poll, research use of human eggs 220-23, 223 embryos 209 ova cells, woman’s reproductive life

Mosko, Mark 163, 233 15

motherhood categories 19, 104 ova donation 135-37, 240, 253

negotiated maternity and the altruism 60

ambiguous progenetrix 102-9 anonymity. See anonymity multiple egg stimulation 58-59 associated with gifts to God 121

Munn, Nancy 11-112, 124 cadaver egg donation 16

compared with sperm donation 7, 9 N contrasted with adoption 156 nameless relations, mediating ‘cross-over system’ 135, 138, 166

agencies 23 donor recruitment 57-60, 135, 138 namelessness donor’s relational connexion 46 cultural exploration 241-44. donor’s statutory protection 34

See also anonymity egg harvesting 8, 80

National Childbirth Trust. See NCT egg induction process 61-65 National Gamete Donation Trust 38 egg life-span and freezing 8, 13, 15 donor recruitment posters 135, 136 exteriorisation 8, 42 feminist issue 11-15, 18, 44

Index 283 form of pseudo-procreation 117 ova freezing 8, 13, 15

‘gifts of life’ 19-20 regenerative medicine 14, 15

international black market 17-18 ova giving knowledge of treatment outcomes akin to ‘egg pawning’ 134

92-96, 116 euphemistic variant of ‘donation’

known/related donors 137-4] 134, 240

matching recipients and donors IVF candidates giving eggs 134.

141-53, 176 See also ova donation

multiple egg stimulation 58-59 ova harvesting. See ova retrieval non-anonymous donation 135 ova induction process 61-65 profiles of donors and recipients ova procurement 239

20-22 Ova recipient interviews

reasons and motives 113 anonymity and disclosure 162-66 simultaneous donation to multiple emphasis on gestation role 152-58

recipients 174~—84 feelings towards donors 170-72, 173

133-37 157-58

strategies and their nomenclatures generational lines of continuity symbolic ‘returns’ to donor 73-80 information disclosure to children

traceability issues 84—96. 116, 118, 167-69, 173

See also ova giving; ova sharing known/related donors 137-41

ova donor interviews on matching recipients and donors attitudes to health risks 62-65 141-53 changes to their physiology 62-65 ova donation contrasted with

collectivised spatio-temporal adoption 156

linkages 112 post natal ambivalence 172

on degrees of anonymisation ranking recipients 178-8]

86-92 sibling incest concern 182

donor viewed as ‘special’ 77-78 ova recipients donor/recipient relationship 86-92 biological tie 8-9, 10 ex-donors life members of a club information about donor 144-47

96-100 non-reciprocation 132 100-102 preparation 255-56

gradations of disconnection ongoing life of secrets 170 knowledge of ova donation ranking and prioritising 176-78

outcomes 92-96, 116 recipient indebtedness 132, 140

perceptions of ‘giving’ 67-73 recruiting ova donors 135, 138 reasons for volunteering 59-61] ova retrieval 8, 254

relations of non-relations 113-24 ova pathways and directing flow

symbolic ‘returns’ to donor 73-80 174-76, 175

ova donors preparation of donors and avoiding parental involvement recipients 177

86-87, 100-2 quantification unpredictability 176

‘cut off’ from eggs 71, 86, 96 ranking between recipients 176-78 not socially recognised agents ova sharing 153-54, 181, 240

69-73, 94 ova storage, ‘egg banks’ 241]

prepared for superovulation 253-54 ova-related technologies 15-20

as progenetrix 50, 102-9 ovarian tissue

question of lower age limit 16, 16 from aborted foetuses 16, 220, 231

reactions to traceability 84-85 from live donors 220 on use of ova for research 211-12 research to grow eggs from tissue

ova exteriorisation, and lifespan 8 219-20, 239

284 Index ovary graft techniques, reversal of proxy child 114

menopause 12 psychic parenthood 104-6

ovulation, multiple egg stimulation public opinion

58-59 research use of foetal tissue 22]

ownership research use of human embryos 209 creativity of dispossession 192

‘disowning decisions’ 190 Q

making children one’s ‘own’ 152-58 Quintavalle, Josephine 15 non-proprietorial 48, 123, 125,

197, 243 R reconceptualised 48 Raymond, Janice 43-44

re-donation of embryos 186-201, 211 Pp recipients. See ova recipients Papua New Guinea 111-12, 124, 186, reciprocity

193 anonymity as non-reciprocity 42

195 gift giving 40

parentage, biological non attribution an imperative obligation 41, 128

parenthood symmetry between exchange anthropological debates 104-6 partners 140

flexible concepts 103, 108 ‘recombinant gonadotrophrins’ 254

negotiability 108-9 recruitment of ova donors 57-60 parental roles 103-9 by would-be recipients 135, 138 Parenthood and Social Reproduction 105 regeneration 225-27

Parkinson’s disease 17 regenerative medicine, and egg

Parry, Jonathan 6, 66, 139 freezing 14, 15

Partial Connections 232 regenerative transilience 221, 223,

103 relatedness pater 104 between recipient families 179-80

parturition, ‘real’ kinship proponent 225, 227, 231

paternity, false paternity 182 extensional anonymous patient information, genetic data relatedness 201

210-11 and gestation 156. Pergonal/Humagon 254 See also kinship

person, notion of the person 44, 46 ‘relational’ knowledge, irrelational

physical parenthood 104-6 kinship 118 posthumous cadaver donation relationships 225-27, 234, 239 imagined relations 115

pregnancy, surrogate host 226 intergenerational 12-13 privacy, biobanking of DNA samples 85 and kinship formation 10-11 PROGAR (Project Group on Assisted non-blood relationships 10-11

Reproduction) 36 ova donors and recipients 46, progenetrix 107, 213 49-50, 113-15 ambiguous 102-9 relations of non-relations 9-10,

Progesterone 255 49-50, 98, 100, 113-30, 238-44

Project Group on Assisted relatives, post donation search for Reproduction. See PROGAR relatives 215-16

property replacement stem cells 208. body parts 47 See also ES cells ‘ownership’ as relationship of non- reproducibility of women,

relations between persons 48, technologically enhanced 61 123, 243. See also ownership Reproducing the Future 232

Index 285 reproductive gifts 115 intersubjective 111-12, 113 creating symbolic value 112. value parameter 111-12 See also gifts of life Spare embryos, extensional reproductive technologies. See ARTs transilience 241 ‘right to know’ 183 spatio-temporal transformations 112 ‘ripple effect’ of ova donation 117, sperm donation

S 35, 162

124, 129 altruism 60

anonymity and disclosure issues 9,

Sabarl Islanders 124 compared with ova donation 7-8, 9 ‘sacred surplus’, of the anonymised donor’s statutory protection 34

donation 166 drama presentation 215

Sahlins, Marshall xiii sperm donor interview, relatedness

Sambia culture 124 between recipient families

Schneider, David 11 179-80

search Stem Cell Bank 208 post donation search for relatives stem cells (embryonic). See ES cells

215-16. Strathern, Andrew xvinl, 175

See also donor information; Strathern, Marilyn 10, 45-46, 76,

traceability issues 232-33 secrecy superovulation 58-59, 253-54 donor-conceived families 161-62, egg sharing 133-34 167-69 surplus embryos 187-89 manipulating blood ties 163 superovulatory drugs secret revealed/exposed 166 egg induction process 61-65 selectionism, release of donor health risks 62-65, 133

information 149 support groups 36, 38, 84, 102

siblings and disclosure issues 162

embryo donated child’s siblings 214 surrogate host pregnancy 226

genetic half-siblings 116, 118, symbolism

120-21, 178-81 birth, death and re-birth 225-27

hazard of toxic diffusion 139, 173 cosmic egg 18

‘lost’ 196 T side effects TAMBA (Twins and Multiple Births incest concern 182

superovulatory drugs 62-65, 254. Association) 38

See also health risks Taussig, Michael xiv, 161, 173 sister-sister ova donation 137-38 temporality, of the gift 129-30 ‘skipping a generation’ 224-25, 231 TET (tubal embryo transfer) 257

social anthropology therapeutic cloning research 17 anonymity and disclosure xii—xiv, Titmuss, Richard 6, 39-40, 66

162. traceability issues

See also anthropology Contact Register 92 social exchange, and reciprocity 40-4] DNA samples 85 social parent donors 103 donor offspring 99-100

social pressures, achievement of full disclosure of information 36, 92

motherhood 22 gamete donation 84—96

201 ova donation 84-96 ‘space-time’ strong anonymity 86-87

sociality, anonymously mediated 186, ‘indeterminate’ anonymity 87-90 extensional 118

286 Index weak anonymity and elicitation WwW

90-92 Warnock, Dame Mary 36

See also donor information; search ‘Warnock’ Report 34, 35

transabdominal ultrasound-directed health risks to women donors 60

recovery 255 identifiable donor information 149, transilience 182 activation 112-13, 124 web-based resources and anonymity 47-49 donor information on U.S. sites

anonymous sociality 49-50, 147 180-81, 182, 200 Electronic Infertility Network 38 diffuseness 183 recruitment of ova donors 135 irrelational kinship 118, 119 Weiner, Annette 193, 227, 232

regenerative 223, 231] Weiner, James xiv, 175

relations of support 227 women through images of donor child 115 depersonalised by ARTs 43-44 transilient kinship ova donation unique to women embryo donor-conceived children 74, 98

212-16 ova donations and exchange

from redonated embryos 198 relations 19-20 ramifications 166, 173 prolificity technologically ‘transitional donors’, statistics 9 enhanced 61 transvaginal ultrasound guided Women as Wombs 43-44 aspiration 254, 255

treatment protocol 253-57 »,4

triadic kinship formation 10-11 ‘xeno-egg’ 18, 240 tubal embryo transfer. See TET xeno-gamete 238, 242

U 257

Twins and Multiple Births

Association. See TAMBA Z

ZIFT (zygote intra-fallopian transfer)

ultrasound imaging, feminist zygote intra-fallopian transfer. See

perceptions 43 ZIFT

UN Convention on the Rights of the zygotes (pre-embryos) 255 Child 36 United States of America, IVF

industry 147-50 ‘universal donors’ 240 cultured stem cells 239 user groups 36, 38, 84, 102 and disclosure issues 162 Vv

value gilt as value 129-30 and intersubjective spacetime 111-12, 130 symbolic dimensions 111, 124 van Baal, Jan 5

voluntarism 39-40