When the Surrogate or Donor is Family

An anonymous comment alerted me to this article (thank you) about intrafamilial medically assisted reproduction (IMAR). It discusses a position paper published 20 January 2011 by the European Society of Human Reproduction and Embryology (ESHRE). The context framing this is when unrelated spouses use a close relative of one of the spouses to assist in reproduction, but the issues are also relevant to those involved in consanguineous spousal relationships (such as, say, first cousins or a mother and son or a sister and brother) who want to have children.

The group advises to evaluate each request for IMAR individually, based on four ethical principles in health care: the respect for autonomy, beneficence and non-maleficence and justice.

That sounds reasonable.

The Task Force explains that the right for individual autonomy is elementary: any individual should have the principle of choice with whom to reproduce. It is understandable that couples wish to preserve some sort of genetic identity with the child, and hence may wish to choose a donor in the family.

I personally know a lesbian couple who had used sperm from a brother of one of the women. It is fairly common for same-sex couples or heterosexual couples experiencing infertility to involve a close relative in some way, whether as a surrogate mother, sperm donor, egg donor, or embryo donor.

In some countries IMAR is illegal and the relevant laws against incest and consanguinity apply to protect the offspring from genetic risks and to avoid possible social disruptions and conflicts.

Ridiculous. How about using genetic testing to avoid risks?

According to the principle of justice, doctors should treat similar cases in the same way. So if sister-to-sister oocyte donation is accepted so should brother-to-brother sperm donation.

This is fair.

The paper gives special attention to (rare) cases of consanguineous IMAR, involving the mixing of gametes of persons that are genetically closely related. "The Task Force considers consanguineous IMAR between up to third degree relatives as acceptable in principle, subject to additional counseling and risk-reduction," says Professor Guido de Wert, coordinator of the ESHRE Task Force. "Here, genetic counseling is appropriate to assess the increased risk of conceiving a child affected by a serious recessive disease."

With genetic counseling, there shouldn’t be any restriction on degree.

First-degree intergenerational IMAR needs special scrutiny, also in view of the increased risk of undermining autonomous choice. First- and second degree consanguineous IMAR is at odds with the spirit of anti-consanguinity and anti-incest legislation in most countries and should not be offered.

The laws should be changed.

In any general population the risk of having a child with a handicap or a major disease is 3%. In third degree consanguinity [such as between cousins], the risk is estimated to be around 5-6%. If the applicant and the intended collaborator carry the same disease, there is a 25% risk of conceiving a child affected with that particular condition.

I encourage anyone, even if they don’t believe they are closely related, to get tested before making children, and that would include testing any donated sperm or egg. Isn’t it good to know the risks ahead of time so that an informed decision can be made? Close relatives can and have had healthy babies together, but it is good to know the possibilities? You don’t have to get tested as a pair. You can get individual tests.

Let Siblings Marry

Someone asked "Why are incestuous marriages illegal? Why can't cousins or siblings marry?"

Actually, there are places where first cousins can marry, and in some of those places where that is encouraged. Not so much for siblings. Prohibitions against consanguineous marriages are vestiges of a narrow-minded and prejudiced past. But it is always interesting to see how people try to defend this denial of the right to marry.

genetics, morals.

Which morality would that be? As far as a genetics, that's not true because there is a difference between marriage and reproduction. Also, we do not criminalize people with genetic diseases who reproduce.

ew why would anyone even be attracted to a cousin or sibling?

Because they're attractive, lovable, dependable, and kind? If your cousins and siblings aren't, too bad for you. And you don't have to marry them anyway. But why deny others what they want?

The same reason people with diabetes or AIDS can't marry; they may pass on ailments to their offspring.

Yes, there is a lot of ignorance out there, folks.

Here's a somewhat intelligent answer...

That was back when the Bible was considered fully legal to use to back laws.

And now that it isn't allowed as much in a court of law, it's still illegal because really no one has challenged it in court.

It's a matter of time. Let's speed that up!

A husband from outside your family was an advantage as it allowed a woman to gain resources from both her birth and husbands family and gave a wider network of family to support her children.

Life is a lot different now. There really isn't a strong enough reason to deny the right to marry to consanguineous lovers. It's mostly ignorance and bigotry keeping this marriage ban in place.

It Is Normal

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Congratulations to Haideri, Aslam, and Qasim

In Pakistan, a man is marring the woman his family picked for him, and another woman with whom he has already fallen in love. Polygyny is not uncommon in Pakistan, but having the weddings so close together is: two weddings in two days.

Azhar Haideri, a 23-year-old herbal medicine practitioner, wanted to marry his maternal cousin Romana Aslam and their engagement was organised a year ago. However, the final rituals were not conducted at that time because his parents wanted his paternal cousin, Humera Qasim, to become their daughter-in-law.

After almost a year of persuasion, it was decided by the elders of the family that “he will have to marry both”, local media reports said.

Haideri, a resident of Multan city in Punjab province, had no option but to go for it to be able to unite with his first love, Romana.

And what do the brides say about this?

Both the women say they think the compromise is a good one and they plan to live as sisters and friends, it was reported.

Congratulations to all!

Incest Laws in Oregon

Law enforcement authorities get all kinds of calls asking if something is legal or illegal, and it doesn’t make the news. But this time it did.

The caller had questions about first cousins “being together.” Turns out while incest is a Class C felony and defined as marriage or sex between an immediate family member (mother/son, sister/brother) or any half-relation such as half-brother. Beyond that, the law is up for interpretation.

The Oregon Revised Statute describes the above as incest, but also “a person whom the person knows to be related to the person ... as an ancestor, descendant.” It is the “ancestor, descendant” section that is ill-defined within the law. The deputy advised the caller that the couple is in the clear as long as they are second cousins or more distant. Anything closer could be referred to the district attorney’s office for interpretation.

It would be a waste for the sheriff or the district attorney or any court to spend resources punishing people for consensual sex, regardless of their relation. Not only should people be free to have such relationships, but they should have the freedom to marry as well. First cousins can marry in some states. Why would Oregon prosecute them for having sex?

A candidate for Kansas Governor has proposed having a person whose job it is to find bad or outdated laws to repeal. Oregon and every other state should have one of those, and one of the things they should do is propose the repealing of any law designed to punish consensual sex. It doesn’t matter if they are the same sex. It doesn’t matter if they are sisters. It doesn’t matter if they are three sisters and a male friend. It should not be something for the law to stop.

I hope the caller wasn't calling from their own number.

Cousin Marriages From a Genetic Perspective

A blog about gene expression at Discover Magazine look at “the individual & social risks of cousin marriage,” and it even has maps.

In the United States there’s a stereotype of cousin marriage being the practice of backward hillbillies or royalty. For typical middle class folk it’s relatively taboo, with different legal regimes by state. The history of cousin marriage in the West has been one of ups & downs. Marriage between close relatives was not unknown in antiquity. The pagan emperor Claudius married his niece Agrippina the Younger, while the Christian emperor Heraclius married his niece Martina. Marriage between cousins were presumably more common.

How did things change?

With the rise in the West of the Roman Catholic Church marriages between cousins were officially more constrained. Adam Bellow argues in In Praise of Nepotism: A Natural History that there’s a material explanation for this: the Roman church used its power over the sacrament of marriage to control the aristocracy.

That’s interesting.

More precisely the coefficient of kinship between two first cousins is 1/8. That means that at any given locus there’s a 1 out of 8 chance that the two individuals will have alleles which are identical by descent, which means that the genetic variant comes down from the same person in the family line.

If the allele is “good,” that is, totally normal/wild type, not associated with any pathology, then we’re in the clear. That’s why most first cousin marriages don’t produce children who are monsters. What a first cousin marriage does is change the odds. How you present these odds matters a great deal in how scary they sound. If I told you than the chance of first cousins having children with a birth defect is 4-7%, vs. 3-4% for a non-consanguineous couple, it might not sound that bad. But if I told you that the odds of having a birth defect is ~50% greater, then it sounds worse.

He gets more technical and moves on to discuss Muslims in Britain.

Consanguineous Marriages in Ancient and Recent History

Katrina Majkut wrote an interesting article that is mostly about cousin marriage, but also deals with other forms.

Laws preventing consanguineous marriages still exist, but more-than-friendly brother-sister relations still occur like out of a V.C. Andrews novel. The latest international news story was about a German couple in 2001: As a result of their amorous affection, they bore 4 children, 2 of whom have disabilities, did hard time, and love still survived.

Yes, and other couples who not related beyond the degree that any of us are related also have children with disabilities. Two of the four children in that case don’t have disabilities.

While today sibling relationships are both taboo and illegal, there was a time when it was widely practiced, and even encouraged in order to prevent the tainting of royal bloodlines. Before Mark Anthony, Cleopatra VII was married to her brother Ptolemy XIII, and she was the offspring of a sibling marriage as well. While technically illegal during Roman times, it is said that Roman Emperor Caligula did the deed with all three of his sisters, Julia Livilla, Drusilla, and Agrippina the Younger. And no story of incest would be complete without the tale of Oedipus, who brought shame and ruin to himself and his city for marrying his mother. These tales were (and still are) told to children to impart lessons on morality, civility and health.

A lot of things are told to children that shouldn’t be. Children are made to feel bad because of their innate feelings and normal activities.

She goes on to write about the concept of the Westermarck effect, Genetic Sexual Attraction, the marriages of European royalty and other people who married cousins, inheritance, and affinity marriages before wrapping it up.

Despite religious condemnation, legal disapproval and social discontent, history has shown that the practice was generally accepted among some of the world’s greatest leaders, thinkers and poets…The question of its morality is not what’s being debated here, this dialogue is to bring attention to the fact that by treating consanguineous marriage as abnormal and taboo, we fail to recognize it as a pervasive component in history, and in doing so only half the story will ever be heard.

How about we stop treating people badly or as second class citizens because of the people they love? Then the full story will be told.

First Cousins

In this blog posting, Danielle writes about what does and does not fit the definition of incest: do first cousins count?

Because really, even if it isn't technically "incest" it's still creepy as hell! Funny on the show... but creepy in real life. Down with flipper babies!

The show to which she refers is “Arrested Development.”

This kind of bigotry and ignorance is all too common. First cousins are able to marry in many parts of the United States and around the world, and while it doesn’t sound like her cup of tea, many people have happy, fulfilled lives married to their cousin and they also have healthy children.

You’re free to call it what you want- I prefer consanguineous to incestuous. But if you want to be respectful, “creepy” isn’t a good word. As you know, I believe in marriage equality, and so not only should first cousins be able to marry everywhere, so should adult sibling, parent-child, and aunt/uncle-niece/nephew couples, trios, etc.