Abstract
Some pertinent ethical challenges in egg sharing have largely been overlooked. To maximize the number of retrievable oocytes, prospective egg-sharers are often restricted to younger women with indications for either male-factor or mild female-factor sub-fertility. Recently, there is increasing evidence that such group of patients would do better either with natural cycle or minimal ovarian stimulation. The quality of the fewer oocytes retrieved is better and there is also improved endometrial receptivity for embryo implantation. Moreover, high gonadotrophin dosages are associated with increased health risks and expensive medical fees. Hence, there could be an irony because such good prognosis patients may not require a discount if they had instead opted for nil or low dosages of expensive gonadotrophins. Secondly, there is a dire lack of guidelines and regulations specifying the appropriate discounts in medical fees given to egg-sharing patients. Perhaps, only the prescription price of gonadotrophins and medical fees for surgical retrieval of oocytes should be eligible for discount. Other medical fees such as for consultation and ART laboratory procedures should be borne separately by the egg-sharing and recipient patient. Thirdly, there must be rigorous auditing to ensure that the amount of financial subsidy given to the egg-sharing patient is exactly equal to the surplus medical fees billed to the recipient patient, or this might lead to profiteering by fertility clinics and doctors. Lastly, the abolishment of donor anonymity in many countries has potentially more ramifications for prospective egg-sharing patients, as compared to non-patient donors.
References
Ahuja KK, Simons EG, Fiamanya W, Dalton M, Armar NA, Kirkpatrick P, et al. Egg-sharing in assisted conception: ethical and practical considerations. Hum Reprod. 1996;11(5):1126–31. May.
Ahuja KK, Simons EG, Rimington MR, Nair S, Gill A, Evbuomwan I, et al. One hundred and three concurrent IVF successes for donors and recipients who shared eggs: ethical and practical benefits of egg sharing to society. Reprod Biomed Online. 2000;1(3):101–5.
Blyth E, Crawshaw M, Daniels K. Policy formation in gamete donation and egg sharing in the UK—a critical appraisal. Soc Sci Med. 2004;59(12):2617–26. Dec.
Pennings G, Devroey P. Subsidized in-vitro fertilization treatment and the effect on the number of egg sharers. Reprod Biomed Online. 2006;13(1):8–10. Jul.
Heng BC, Zhang X. Perspectives on compensated egg-sharing in the People’s Republic of China. Reprod Biomed Online. 2007;14(5):664–5. May.
Edwards RG. IVF, IVM, natural cycle IVF, minimal stimulation IVF—time for a rethink. Reprod Biomed Online. 2007;15(1):106–19. Jul.
Heng BC. Reluctance of medical professionals in adopting natural-cycle and minimal ovarian stimulation protocols in human clinical assisted reproduction. Reprod Biomed Online. 2007;15(1):9–11. Jul.
Ubaldi F, Rienzi L, Baroni E, Ferrero S, Iacobelli M, Minasi MG, et al. Hopes and facts about mild ovarian stimulation. Reprod Biomed Online. 2007;14(6):675–81. Jun.
Fauser BC, Devroey P, Yen SS, et al. Minimal ovarian stimulation for IVF: appraisal of potential benefits and drawbacks. Hum Reprod. 1999;14:2681–6.
Devroey P, Bourgain C, Macklon NS, et al. Reproductive biology and IVF: ovarian stimulation and endometrial receptivity. Trends Endocrinol Metab. 2004;15:84–90.
Lindhard A, Ravn V, Bentin-Ley U, et al. Ultrasound characteristics and histological dating of the endometrium in a natural cycle in infertile women compared with fertile controls. Fertil Steril. 2006;86:1344–55.
Budev MM, Arroliga AC, Falcone T. Ovarian hyperstimulation syndrome. Crit Care Med. 2005;33(10 Suppl):S301–6. Oct.
Pearson H. Health effects of egg donation may take decades to emerge. Nature. 2006;442(7103):607–8. Aug 10.
Gleicher N, Vietzke M, Vidali A. Bye-bye urinary gonadotrophins? Recombinant FSH: a real progress in ovulation induction and IVF? Hum Reprod. 2003;18(3):476–82. Mar.
De Jonge C, Barratt CL. Gamete donation: a question of anonymity. Fertil Steril. 2006;85(2):500–1. Feb.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Heng, B.C. Egg sharing in return for subsidized fertility treatment—ethical challenges and pitfalls. J Assist Reprod Genet 25, 159–161 (2008). https://doi.org/10.1007/s10815-008-9207-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10815-008-9207-4