Latest Dutch fertility clinic scandal may only be the tip of the iceberg

There are growing demands this weekend for a nationwide investigation into the supervision of Dutch fertility clinics since the 1970s – amid claims that the latest scandal, in which a gynaecologist used his own sperm to father “at least” 21 children, is just “the tip of the iceberg”.

Leading those demands is the Donor Child Foundation, a voluntary organisation that has provided counselling for children born in similar circumstances in the Netherlands’ two previous fertility scandals, one of which emerged in 2019 and the other in 2020, involving over 60 children in total.

The foundation says it is already aware of two other unpublicised cases where doctors used their own sperm – one at a public hospital and another at a private clinic.

“These are very sensitive matters,” says Ties van der Mier, chairman of the foundation. “First there’s one match, then another. That’s how it starts. Many people decide they don’t want their involvement known. You have to hope for openness from everyone involved. But it’s not up to us.”

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The latest revelation that a doctor who worked for 25 years at a Leiden hospital treated women using his own sperm while telling them it came from anonymous donors has reopened many unanswered questions, not least why there has been no urgent review of practices long before now.

Dr Jos Beek worked at the Elizabeth Hospital in Leiderdorp, since amalgamated with the Alrijne Hospital in Leiden, between 1973 and 1998, and the 21 children whose paternity has been established are known to have been conceived between 1973 and 1986.

In 2019, it emerged that Jan Karbaat, from Rotterdam, had fathered at least 49 children and perhaps as many as 80

The hospital went public this week with an appeal to mothers treated by Dr Beek at his clinic to contact a special helpline. It was unable to instigate that difficult contact itself because, it emerged, its own internal records had been destroyed.

The scandal came to light when Fiom, an organisation that helps people to trace their biological parents, found DNA matches last June between children whose mothers had each had fertility treatment supervised by Dr Beek, who died in 2019.

Fiom contacted the Alrijne hospital which set up an independent investigation chaired by Dr Didi Braat, a retired professor of reproductive medicine at Radboud University Medical Centre, which began in January and is due to report by the summer.

Given where the evidence appeared to be leading, further investigation was tightly focused and quickly established that the DNA also matched one of Dr Beek’s own children. The priority then became to contact the families involved.

Acknowledging the worst possible scenario, Peter Jue, a spokesman for the Alrijne management board, conceded it could not exclude the possibility that “dozens more” children fathered by Beek may yet be discovered as more former patients come forward.

He said the hospital board had been “very shocked” by the evidence of Dr Beek’s “unacceptable behaviour”, adding: “We were shocked for the children directly affected, and, of course, shocked for their parents as well.”

In the background to this latest scandal is the fact that in 2004, Dutch law changed to give children the right to know the identities of their biological parents once they reach the age of 16.

Giving effect to that change means that, since 2004, fertility clinics have had to keep donors’ personal details on record, while never, of course, divulging them in inappropriate circumstances.

However, in the period from the 1970s when fertility treatment was still in its infancy up to that legal cut-off point in 2004, after which the identities of donors had to be registered and anonymous donation was banned, there was little or no regulation.

Exactly how what was then cutting-edge treatment was delivered and regulated was in the hands of the treating physicians themselves – and thus wide open to abuse by rogue doctors, with little or no external supervision, especially compared to the protocols and audits required today.

That’s why this is the period the Donor Child Foundation now – belatedly, it says – wants to see it forensically investigated to establish how many other gynaecologists like Jos Beek may have been running their clinics like private fiefdoms.

After all, Beek was not the first. They were two other cases before him, and – to the fury of some survivors – nobody has ever been called to account.

In all three cases, the numbers for children fathered are wildly imprecise because they’re based only on already-established DNA matches in an investigatory procedure that is still continuing.

In 2019, it emerged that Jan Karbaat, from Rotterdam, had fathered at least 49 children and perhaps as many as 80, during the 1970s,19 80s and 1990s.

'How big is the group to whom we're related? Should we think of the others like us as half-brothers or half-sisters?'

In October 2020, it emerged that Dr Jan Wildschut had used his own sperm to father at least 17 children between 1980 and 1993. That figure may well be “dozens”. He died in 2009.

On that basis, Jan Beek’s figure of “at least” 21 is little more than a starting point in an unfolding tale that engulfs more and more families every year.

“Jelmer”, now in his late 30s, is one such victim, a “donor child” fathered by his mother’s attending physician, Dr Jan Wildschut. He says Jos Beek’s victims will be full of questions and, in the absence of answers, deeply confused.

“A lot of what we need is information. How big is the group to whom we’re related? Should we think of the others like us as half-brothers or half-sisters? How will this affect our ability or willingness to have relationships? Should we tell other people? How will it affect how others see us?”

With such painful questions in mind, the Dutch Association of Obstetricians and Gynaecologists, while it supports demands for a thorough national investigation, admits it can’t yet see how one can be carried out within the bounds of confidentiality regulations.

“Doctors are bound by all kinds of confidentiality rules,” said a spokesperson. “Those involved in these cases have a right to privacy as well, even if others in the same cases are looking for information. It will be difficult to conduct reliable research in those circumstances.”