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Explore chapters and articles related to this topic
‘A Precipice in Time’ – Reproductive Biotechnology
Published in Rosa Maria Quatraro, Pietro Grussu, Handbook of Perinatal Clinical Psychology, 2020
As many sceptical feminists have pointed out, over the decades the scientific establishment has remained preponderantly male, white, upper-middle class and corporate. Sperm donation is painless, and sometimes lucrative. Egg donation is painful and possibly dangerous. ART offers new hope to infertile people, but also has a potential for exploitation of less fortunate women as egg donors, or womb providers, in exchange for medical care. Ethical concerns arise when wealthy clients and celebrities travel to less privileged places to purchase babies, embryos, eggs or sperm. Or when women who are unable to conceive, or who prefer to avoid pregnancy borrow a womb. Even legitimate reproductive tourism is emotionally fraught – unregulated, commercialised and unpredictable.10
California Cloning
Published in Tina Stevens, Stuart Newman, Biotech Juggernaut, 2019
The law became the first of its kind and set a precedent signaling the importance of establishing full disclosure before a truly informed consent is possible. But it did not, in itself, establish that full disclosure. This was in large measure owing to lobbying efforts on the part of ASRM which secured an exemption for its members. (During a legislative hearing on the bill, the lobbyist for ASRM asserted that the organization favored the idea of a registry. There is, however, no public evidence of ASRM seriously working toward establishing a mandatory, long-term, rigorously controlled, independent, donor health registry, then or now.) Moreover, instead of requiring strong language indicating that the long-term health risks associated with egg donation were unknown, ads need state only that, “As with any medical procedure, there may be risks associated with human egg donation.” An additional clause required notice that, “Before an egg donor agrees to begin the egg donation process, and signs a legally binding contract, she is required to receive specific information on the known risks of egg donation.” This references only known risks, thereby skirting the enormous problem that there are few studies and no health registries tracking long-term risks of egg harvesting.1 (Enforcement of AB 1317 presents an additional limitation. For a while, AHB collected ads not in compliance and sent them to the California Attorney General’s office. But lack of funds to continue such watchdog effort limited this strategy.)
Two Decades as an Infertility Therapist
Published in Allison Rosen, Jay Rosen, Frozen Dreams, 2015
The first baby born as a result of oocyte donation was in 1983 in Australia. The case involved a 29-year-old patient who, while going through an IVF cycle, donated one of her eggs to a 25-year-old woman with premature ovarian failure (Lutjen, Trounson, and Leeton, 1984). While the original effort was to treat a particularly devastating diagnosis for young women, egg donation has become a treatment for women with a variety of diagnoses, including repeated failed cycles of IVF, genetic disorders, recurring pregnancy loss, and advanced reproductive age. In the early years of oocyte donation, eggs were retrieved through the laparoscope, a surgical procedure requiring anesthesia. For that reason, women already scheduled for that procedure—tubal ligation patients and women going through IVF—were thought to be ideal candidates. However, the number of tubal ligation patients willing to donate eggs was limited, and the number of IVF patients willing to donate their “extra eggs” dwindled with the advent of embryo cryopreservation.
Does egg-sharing negatively impact on the chance of the donor or recipient achieving a live birth?
Published in Human Fertility, 2023
Timothy Bracewell-Milnes, Aleena Hossain, Benjamin P. Jones, Raef Faris, Jaya Parikh, James Nicopoullos, Mark Johnson, Meen-Yau Thum
The demand for donor eggs has been rising globally, with a 49% increase in DEPS cycles since 2011 in the UK (HFEA, 2018); however the annual numbers of newly registered oocyte donors has plateaued and remained stable at 1,600 (HFEA, 2019b). In contrast to the straight-forward process of sperm donation, egg donation involves high dose ovarian stimulation and invasive procedures, such as transvaginal oocyte retrieval under sedation, or general anaesthesia. Additionally, the donor must endure the inconvenience of multiple appointments at the fertility clinic to plan the IVF cycle, ultrasound scans and counselling sessions, resulting in missing work and significant travel time. Understandably, few women are willing to donate their eggs on a purely altruistic basis, and therefore supply is falling short of demand in many countries worldwide, including the UK (Dyer, 2011). This has resulted in long waiting lists and limited choices, especially among ethnic groups seeking egg donation (Brulliard, 2006). This has driven some patients abroad to destinations where donor eggs are more readily available, but where regulations may be less strict (Culley et al., 2011), a process known as cross-border reproductive care (CBRC). Identifying this, the HFEA implemented changes aimed at improving the numbers of new donors registering and maximising the use of their gametes (BIONEWS, 2011). A significant change was providing £750 as a compensatory payment per cycle, replacing the previous payment of £250 (Bracewell-Milnes et al., 2018).
A systematic review investigating psychosocial aspects of egg sharing in the United Kingdom and their potential effects on egg donation numbers
Published in Human Fertility, 2018
Timothy Bracewell-Milnes, Srdjan Saso, Hossam Abdalla, Meen-Yau Thum
Approximately 2% of all babies born in the UK are conceived through in vitro fertilization (IVF) [Human Fertilisation and Embryology Authority (HFEA), 2013]. Egg donation is a technique that started in the early 1980s (Trounson, Leeton, Besanko, Wood, & Conti, 1983), and has been made possible because of IVF. Egg donation offers an option for infertile women with conditions such as primary ovarian insufficiency. Many fertility clinics will ask women over a certain age to consider using donor eggs, because of the poor success rates of treatment with their own oocytes. Demand for egg donors has been on the rise globally, with couples increasingly using it to overcome their infertility (Pennings, 2007). More recently, an increasing number of gay couples and single women have been using egg donation to found their families (HFEA, 2013). Of the fresh embryo cycles in the UK in 2013, 5% used donated sperm, 4% used donated oocytes, and less than 1% used both donated sperm and oocytes, meaning just under 10% of patients used donated gametes during their fertility treatment (HFEA, 2013).
The futile case of the aging ovary: is it mission impossible? A focused review
Published in Climacteric, 2018
For women aged 42 and above, 49.7% of cycles utilized egg donation, and for women up to 42 years old, only 10.2% of cycles were donor-egg cycles6. The chances of a live birth with IVF using self-eggs of women older than 42 years are termed futile. Futility is described as live birth chances of <1% by the American Society for Reproductive Medicine (ASRM). However, Gleicher and colleagues reported that IVF outcomes in women older than 40 years were still better than ‘futile’, as described by the ASRM. However, the age of 43 years demarks a clear cutoff between better and poorer clinical pregnancy and live birth rates6. Some women are denied insurance coverage and even treatments based on advanced age7.