HEC Forum

, Volume 23, Issue 1, pp 15–30 | Cite as

The Oversight and Practice of Oocyte Donation in the United States, United Kingdom and Canada

  • Aaron D. Levine


In vitro fertilization using donated oocytes is an important medical technique that provides the only option for some infertile patients to have children. The technique remains ethically contentious, however, and, as a result of this controversy, different oversight approaches have been developed in countries around the world. This paper examines the oversight and practice of oocyte donation in Canada, the United Kingdom and the United States to examine how policy choices have influenced the development and use of this medical technology. Examining per capita utilization of oocyte donation in these three countries provides evidence that supply-side policies—specifically policies affecting the compensation of potential oocyte donors—have substantially influenced the use of this technology. These results should provide useful insight for policymakers developing or revising oocyte donation policies.


Assisted reproduction Oocyte donation Infertility 


  1. Ahuja, K. K., Simons, E. G., Fiamanya, W., Dalton, M., Armar, N. A., Kirkpatrick, P., et al. (1996). Egg-sharing in assisted conception: Ethical and practical considerations. Human Reproduction, 11(5), 1126–1131.Google Scholar
  2. Baird, P. (1995). Proceed with care: New reproductive technologies and the need for boundaries. Journal of Assisted Reproduction and Genetics, 12(8), 491–498.CrossRefGoogle Scholar
  3. Baylis, F., & Herder, M. (2009). Policy design for human embryo research in Canada: A history (part 1 of 2). Journal of Bioethical Inquiry, 6(1), 109–122. doi: 10.1007/s11673-009-9135-8.CrossRefGoogle Scholar
  4. Blackwell, T. (2010, April 30). Fertility law leaves us in limbo, doctors say; oversight of burgeoning industry a ‘farce’. National Post.Google Scholar
  5. Bryden, J. (1995, July 28). Reproductive technologies: ban cloning, baby sales, minister asks; Marleau calls sex engineering ‘unacceptable’. Ottawa Citizen, p. A1.Google Scholar
  6. Carlson, K. B. (2010, March 13). Baby by stealth; reproduction law forcing ‘dangerous alternatives’. National Post, p. A1.Google Scholar
  7. Craft, I., Flyckt, S., Heeley, G., Layland, S., Thornhill, A., & Kelada, E. (2005). Will removal of anonymity influence the recruitment of egg donors? A survey of past donors and recipients. Reproductive Biomedicine Online, 10(3), 325–329.CrossRefGoogle Scholar
  8. Donnelly, L. (2010, July 4). IVF couples forced abroad to find eggs: waiting times, not cost, the main reason for trend, say researchers. The Telegraph, p. 9.Google Scholar
  9. Ethics Committee of the American Fertility Society (1986). Ethical considerations of the new reproductive technologies. Fertility and Sterility, 46(3 Suppl 1), 1S–94S.Google Scholar
  10. Ethics Committee of the American Society for Reproductive Medicine (2007). Financial compensation of oocyte donors. Fertility and Sterility, 88(2), 305–309. doi: 10.1016/j.fertnstert.2007.01.104.
  11. Ethics Committee of the American Society for Reproductive Medicine (2009). Interests, obligations, and rights of the donor in gamete donation. Fertility and Sterility, 91(1), 22–27. doi: 10.1016/j.fertnstert.2008.09.062.
  12. Fidelman, C. (2010, March 4). Childless couples waiting for IVF funding. The Gazette, p. A6.Google Scholar
  13. Gagne, L. M. (2006, March 5). Life for sale: Canadian women selling their eggs for up to $10Gs on black market. Toronto Sun, p. 5.Google Scholar
  14. Gleicher, N., Weghofer, A., & Barad, D. (2006). A formal comparison of the practice of assisted reproductive technologies between Europe and the USA. Human Reproduction, 21(8), 1945–1950. doi: 10.1093/humrep/del138.CrossRefGoogle Scholar
  15. Grobstein, C., Flower, M., & Mendeloff, J. (1983). External human fertilization: An evaluation of policy. Science, 222(4620), 127–133.CrossRefGoogle Scholar
  16. Hawkins, J. (2010). Financing fertility. Harvard Journal on Legislation, 47(1), 115–165.Google Scholar
  17. Health Canada. (2008). A chronology of the assisted human reproduction act. Accessed 13 July 2010.
  18. Holland, S. (2001). Contested commodities at both ends of life: Buying and selling gametes, embryos, and body tissues. Kennedy Institute of Ethics Journal, 11(3), 263–284.CrossRefGoogle Scholar
  19. Hope, J. (2006, January 11). Rethink on IVF: Millions spent on multiple births could be used to help more childless couples, say doctors. Daily Mail, p. 35.Google Scholar
  20. Human Fertilisation and Embryology Authority (2005). Seed report: A report on the human fertilisation and embryology authority’s review of sperm, egg and embryo donation in the united kingdom. London: HFEA.Google Scholar
  21. Human Fertilisation and Embryology Authority (1998). Paid egg sharing to be regulated, not banned. London, UK: Human Fertilisation and Embryology Authority.Google Scholar
  22. Human Fertilisation and Embryology Authority (2009). Statement regarding authority decision to review sperm, egg and embryo donation policies. London, UK: Human Fertilisation and Embryology Authority.Google Scholar
  23. Johnson, M. (1997). Payments to gamete donors: Position of the human fertilisation and embryology authority. Human Reproduction, 12(9), 1839–1842.CrossRefGoogle Scholar
  24. Katz, P., Nachtigall, R., & Showstack, J. (2002). The economic impact of the assisted reproductive technologies. Nature Cell Biology, 4(Suppl), s29–s32. doi: 10.1038/ncb-nm-fertilityS29.
  25. Kemp, P. (2007, August 11). NHS failings over IVF treatment. BBC News.Google Scholar
  26. Kondro, W. (1995). Canada calls for moratorium on IVF technologies. Lancet, 346(8971), 367. doi: S0140-6736(95)92239-3.CrossRefGoogle Scholar
  27. Levine, A. D. (2005). A case for government-sponsored monitoring of preimplantation genetic diagnosis in the United States. Journal of Public and International Affairs, 16, 26–45.Google Scholar
  28. Levine, A. D. (2010). Self-regulation, compensation, and the ethical recruitment of oocyte donors. The Hastings Center Report, 40(2), 25–36.CrossRefGoogle Scholar
  29. Lister, S. (2005). Five-year waits in IVF postcode lottery. The Times, p. 13.Google Scholar
  30. Lister, S. (2009, August 6). Infertile couples denied IVF treatment in postcode lottery: Trusts are ignoring eligibility guidelines. The Times, p. 14.Google Scholar
  31. Lovell-Badge, R. (2008). The regulation of human embryo and stem-cell research in the United Kingdom. Nature Reviews. Molecular Cell Biology, 9(12), 998–1003. doi: 10.1038/nrm2550.CrossRefGoogle Scholar
  32. Lutjen, P., Trounson, A., Leeton, J., Findlay, J., Wood, C., & Renou, P. (1984). The establishment and maintenance of pregnancy using in vitro fertilization and embryo donation in a patient with primary ovarian failure. Nature, 307(5947), 174–175.CrossRefGoogle Scholar
  33. Macnaughton, M. (2005). Regulation before the HFEA. Human Fertility (Cambridge), 8(2), 61–62. doi: 10.1080/14647270500030738.CrossRefGoogle Scholar
  34. MacRae, F. (2009, July 28). Fertility chief wants egg donors to be paid. Daily Mail.Google Scholar
  35. McLaren, A. (1990). Research on the human conceptus and its regulation in Britain today. Journal of the Royal Society of Medicine, 83(4), 209–213.Google Scholar
  36. Medical Research International, & Society for Assisted Reproductive Technology (1989). In vitro fertilization/embryo transfer in the United States: 1987 results from the national IVF-ET registry. Fertility and Sterility, 51(1), 13–19.Google Scholar
  37. Motluk, A. (2010, April). The human egg trade. The Walrus. Available at
  38. National Institute for Clinical Excellence. (2004). Assessment and treatment for people with fertility problems. London: National Institute for Clinical Excellence.Google Scholar
  39. Nisker, J. (2008). Distributive justice and infertility treatment in Canada. Journal of Obstetrics and Gynaecology Canada, 30(5), 425–431.Google Scholar
  40. Ogilvie, M. (2009, November 21). The price of eggs: Canada’s fertility laws have created a black market in human ova, leaving donors and recipients vulnerable. Toronto Star, p. A1.Google Scholar
  41. Ouellette, A., Caplan, A., Carroll, K., Fossett, J. W., Bjarnadottir, D., Shickle, D., et al. (2005). Lessons across the pond: Assisted reproductive technology in the United Kingdom and the United States. American Journal of Law and Medicine, 31(4), 419–446.Google Scholar
  42. Practice Committee of the American Society for Reproductive Medicine (2008a). 2008 Guidelines for gamete and embryo donation: A practice committee report. Fertil Steril, 90(5 Suppl), S30–S44. doi: 10.1016/j.fertnstert.2008.08.090.
  43. Practice Committee of the American Society for Reproductive Medicine (2008b). Repetitive oocyte donation. Fertility and Sterility, 90(5 Suppl), S194–S195. doi: 10.1016/j.fertnstert.2008.08.032.
  44. Robertson, J. A. (1988). Technology and motherhood: Legal and ethical issues in human egg donation. Case Western Reserve Law Review, 39(1), 1–38.Google Scholar
  45. Robertson, J. A. (1989). Ethical and legal issues in human egg donation. Fertility and Sterility, 52(3), 353–363.Google Scholar
  46. Royal Commission on New Reproductive Technologies (1993). Proceed with care: Final report of the Royal Commission on new reproductive technologies. Ottawa: Canada Communications Group.Google Scholar
  47. Rubin, R. (2009, October 19). ‘Octomom’ doctor expelled from fertility group. USA Today.Google Scholar
  48. Sauer, M. V., & Kavic, S. M. (2006). Oocyte and embryo donation 2006: Reviewing two decades of innovation and controversy. Reproductive Biomedicine Online, 12(2), 153–162.CrossRefGoogle Scholar
  49. Steinbock, B. (2004). Payment for egg donation and surrogacy. The Mount Sinai Journal of Medicine, 71(4), 255–265.Google Scholar
  50. Steptoe, P. C., & Edwards, R. G. (1978). Birth after reimplantation of a human embryo. Lancet, 2(8085), 366.CrossRefGoogle Scholar
  51. Warnock, M. (1985). A question of life: The Warnock Report on human fertilisation and embryology. Oxford, UK; New York, NY: B. Blackwell.Google Scholar

Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  1. 1.School of Public PolicyGeorgia Institute of TechnologyAtlantaUSA

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