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Third Party Reproduction in Recurrent Pregnancy Loss
Published in Howard J.A. Carp, Recurrent Pregnancy Loss, 2020
Gautam Nand Allahbadia, Rubina Merchant, Akanksha Allahbadia Gupta, A.H. Maham
Embryo donation may be medically indicated in couples where both sperm and oocyte donation are mandatory to achieve a normal conception, as in unexplained genetic disease and failure of ART due to poor fertilization or poor embryo quality. The embryos may be obtained from couples consenting to donate surplus embryos following self-use or specifically created by using a chosen sperm and oocyte donor [8]. Embryo donation may be offered as a viable treatment option in the event that all embryos are chromosomally abnormal following PGT-A. If pregnancies are miscarried despite the transfer of genetically normal embryos following PGT-A, there may be a role for embryo donation, but embryo donation should only be advised if all the therapies for maternal causes of RPL have been exhausted.
Assisted Conception
Published in Jane M. Ussher, Joan C. Chrisler, Janette Perz, Routledge International Handbook of Women’s Sexual and Reproductive Health, 2019
In embryo donation, a woman receives an embryo from another source, often from another infertile couple who had surplus embryos following their own successful treatment, and provides the epigenetic gestational environment herself. Embryo donation is not a popular option for donors because it means relinquishing a fully genetically related child, or full sibling to their existing children (de Lacey, 2005, 2007), but less is known about recipients of donated embryos. Australia reported its first successful embryo donation in the early 1980s (Trounson et al., 1983), which was, as in most countries, practiced under the laws of anonymity, with few exceptions (International Federation of Fertility Societies, 2016). Recent research on the relationships and boundaries proposed between embryo providers and their recipients (Frith et al., 2017) shows that early contact between donor and recipient families is favoured by both parties and allows for more open interpretations of parenthood and family belonging. This contact is based upon trust (similar to surrogacy), and, when broken, can lead to significant harm to the child(ren) concerned and the donors (The New Daily, 2017).
The Role of Biomedical Technology
Published in Kant Patel, Mark Rushefsky, Healthcare Politics and Policy in America, 2019
Embryo donation is also often referred to as embryo adoption. Couples who have undergone IVF successfully and have had children often choose to donate their remaining embryos. The donated embryo is transferred to the recipient woman’s uterus, allowing her to experience pregnancy and give birth to her adopted child.
Motherhood through medically assisted reproduction – characteristics and motivations of Swedish single mothers by choice
Published in Human Fertility, 2021
An increasing number of women from high-income countries are deciding to become single mothers by choice through the use of medically assisted reproduction (MAR) and donated semen (Golombok, 2017). In Sweden, new legislation in April 2016 made it possible for single women to be accepted for MAR, such as donor insemination (DI) and/or assisted reproductive technology (ART). Before this, single women in Sweden had to go abroad, for example to Denmark, for such treatment. In the new legislation, ‘single woman’ refers to any woman who is not married, or without a registered or cohabiting partner, and has no previous children. Because there has to be a genetic link associated with ART in Sweden, treatment using both donor sperm and donor eggs is not permitted (National Board of Health and Welfare, 2009; Sveriges Riksdag SoU, 2015). However, a new legislation will permit embryo donation from 2019, according to a decision by the parliament in June 2018 (Sveriges Riksdag SoU, 2017). In Sweden, the donor is non-anonymous to the prospective child, who will have access to the donor’s identity from the age of 18 years. While there has been a decrease in the number of children available for adoption and many countries do not permit adoption by single women, and as norms and values have changed in Swedish society, there has been an increased acceptance of alternative parenting, such as single motherhood by MAR (Wennberg, Rodriguez-Wallberg, Milsom, & Brännström, 2016).
Disclosure of Genetic Risk: When Genetic Relatives Are Not Family Members
Published in The American Journal of Bioethics, 2018
Jazmine L. Gabriel, Jane Jankowski
There is also precedent for disclosing genetic information to families rearing genetically unrelated children in adoption practices. In cases of adoption, many states require a child-placing agency or biological parents to compile a family history and disclose hereditary conditions, and at least one state requires an agency to notify adoptive parents if they receive information about a genetic disease (ASHG Social Issues Subcommittee on Familial Disclosure 1998). Embryo donation appears analogous to adoption in the relevant ways: Neither the embryo nor the adopted child necessarily has the genetic condition, but both are at risk and could benefit from the opportunity for prevention or early treatment. In both cases there is an intermediary facilitating the nongenetic familial relationships, an adoption agency or an IVF center.
Duty to Warn in the Era of Next Generation Sequencing
Published in The American Journal of Bioethics, 2018
Alicia Latham Schwark, Michael F. Walsh
Considering that the “at-risk” family member(s) may be embryo donation in vitro fertilization (IVF) recipients who are anonymous to the donor family, the reproductive center in this case must act as the intermediary to receive the updated diagnosis and share this information with any donation recipient(s). This assumes the parents came forward to willingly share this information with the reproductive center. If that were not the case, we believe the preceding conditions would be met to impose a duty on clinicians to disclose the information to the center. Because there is a 50% risk for each embryo to also carry the known mutation, significant harm could befall genetic offspring. Recently, there is evidence supporting the efficacy of whole-body magnetic resonance imaging (MRI) screening in individuals with Li–Fraumeni syndrome (Villani et al. 2016), but official guidelines have yet to be established. If the reproductive center is warned prior to implantation of these embryos, it could consider preimplantation genetic diagnosis (PGD). Currently, in the United States, the Federal Drug Administration (FDA) oversees legal regulation with regards to the use and disposal of human tissue, including frozen embryos. This organization is also responsible for establishing guidelines for testing of said embryos prior to donation (FDA 2016). However, current FDA regulations and guidelines from the American Society of Reproductive Medicine (ASRM 2013) do not require the screening of donated embryos for cancer predisposition syndromes, as centers are only legally required to either test donated embryos and tissue for certain infectious diseases or to explicitly label these tissues as “not evaluated for infectious substances” prior to tissue donation (ASRM 2013; FDA 2016).