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Lesbian shared biological motherhood: the ethics of IVF with reception of oocytes from partner

Abstract

In vitro fertilization (IVF) with reception of oocytes from partners (ROPA) allows lesbian mothers to share biological motherhood. The gestational mother receives an egg from her partner who becomes the genetic mother. This article examines the ethics of IVF with ROPA with a focus on the welfare of the woman and the resulting child, on whether ROPA qualifies as a “legitimate” medical therapy that falls within the goals of medicine, and on the meaning and value attributed to a biologically shared bond between parents and child. We also contrast IVF with ROPA with egg donor IVF for heterosexual couples and intrafamilial live uterus transplantation with IVF, and show how Swedish legislation makes certain ways of sharing biological bonds out of place. In Sweden, IVF with ROPA is illegal, egg donor IVF for heterosexual couples is allowed and practiced as is sperm donor IVF for lesbians, and live uterus transplantation is performed within a research project (though not allowed in regular health care). But is ROPA really ethically more problematic than these other cases? The article argues that IVF with ROPA gives rise to fewer ethical questions than does live uterus transplantation with IVF and, in some cases, egg donor IVF.

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Notes

  1. 1.

    Reception of Oocytes from Partner is the term used by Marina et al. (2010). We use their terminology because this is accepted practice, at least in the Spanish clinical context. However, another way of framing this treatment is as biological co-mothering or egg sharing. In contrast to the notion of egg sharing used in the UK (where the term denotes the practice of offering IVF at a subsidized cost to women who donate eggs to research), egg sharing in this context implies sharing eggs with one’s partner. Furthermore, some see ROPA as a form of embryo donation, which currently is available at some IVF clinics in for instance the UK, the US, Canada and Russia (Statens medicinetiska råd [The Swedish National Council on Medical Ethics] 2013:1).

  2. 2.

    ROPA could also offer a possibility for a transsexual man who has undergone female to male treatment and surgery and who has kept his oocytes. If such a man has a female partner she may carry their child, and the embryo may be the result of one of his oocytes being fertilized with donor sperm.

  3. 3.

    The parental couple was interviewed by Malmquist for a research project on lesbian parenting. Their names have been replaced by pseudonyms. Other publications from this project are Malmquist submitted; Malmquist et al. 2013a, b; Rozental and Malmquist, accepted.

  4. 4.

    Furthermore, assisted reproduction technologies both promote and undermine the idea that biological relationships have great significance for parent–child relations: Whereas IVF without a donor is a route to a child with genetic bonds to two parents, IVF with gamete donation for heterosexuals separates social from genetic parenthood, and IVF with ROPA allows for genetic motherhood without pregnancy and gestational motherhood without genetic bonds.

  5. 5.

    See http://www.eggsharing.com/. See also Haimes 2013.

  6. 6.

    The original text in Swedish reads:”Ett befruktat ägg får föras in i en kvinnas kropp endast om kvinnan är gift eller sambo och maken eller sambon skriftligen samtyckt till detta. Om ägget inte är kvinnans eget skall ägget ha befruktats av makens eller sambons spermier.”

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Acknowledgments

The article is part of Malmquist’s work within the project Swedish Lesbigay Families in the Twentieth Century—Parenthood in a Time of Legislative Changes, financed by the Swedish Research Council for Health, Working-life, and Welfare, and of Zeiler’s work on bodily giving and sharing in medicine as a Pro Futura Scientia Fellow. The Pro Futura Scientia Program is a collaboration between the Swedish Collegium for Advanced Study, Uppsala University and Riksbankens Jubileumsfond. We thank all these for financial support for this research.

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Correspondence to Kristin Zeiler.

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Zeiler, K., Malmquist, A. Lesbian shared biological motherhood: the ethics of IVF with reception of oocytes from partner. Med Health Care and Philos 17, 347–355 (2014). https://doi.org/10.1007/s11019-013-9538-5

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Keywords

  • Ethics
  • Reception of oocytes from partner
  • Oocyte donation
  • Shared biological motherhood
  • Lesbian
  • Live uterus transplantation
  • Egg donor IVF