Gamete donation and anonymity

Article Abstract:

The Human Fertilization and Embryology Bill, which became law in Britain in 1990, covers a broad range of issues related to embryo research and other aspects of reproductive health care. The Bill states that offspring resulting from the donation of gametes (male and female reproductive cells; sperm and oocytes, or eggs) will be legally considered the children of the recipient couple, but does not fully address issues such as donor secrecy and anonymity or the needs and rights of children resulting from gamete donation. It is generally accepted that oocyte donors should remain anonymous. In oocyte donation, the egg may or may not be fertilized with sperm from the male partner of the couple seeking to have a child. This method of reproduction results in pregnancy as often as in vitro fertilization and embryo transfer techniques (IVF-ET, in which the egg and sperm are joined under laboratory conditions, with subsequent transfer of the embryo to the uterus). Oocyte donation is presently indicated for patients with ovarian failure (spontaneous or following chemotherapy or radiation treatment) or genetic disorders. Improved success in treating lymphoma, a malignant disorder, now results in the survival of more than half the patients, creating considerable demand among these women for oocyte donors. However, maintaining a supply of oocytes remains a problem. Because the techniques for using embryos that have been stored at cold temperatures (cryopreserved) are still under development, couples often need to find oocyte donors, usually women undergoing sterilization. The process of donating eggs is not without hazards, and raises medical, legal and ethical issues. The question of anonymity is of particular concern. Surveys indicate that, while many people believe anonymity is not essential for oocyte donors, it is critical in the case of sperm donation. The attitudes of children produced through gamete donation are of concern, and the law allows these children access to a central donor registry, containing nonidentifiable medical and social information; the identity of the gamete donor will never be revealed. The possibility of nonanonymous gamete donation should be considered, since secrecy may adversely affect parent-child relationships. Public debate should consider the ramifications of this policy. (Consumer Summary produced by Reliance Medical Information, Inc.)

United Kingdom, Great Britain

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Attitudes towards gamete donation among couples undergoing in vitro fertilization

Article Abstract:

The donation of gametes (male and female reproductive cells; sperm and oocytes, or eggs) to infertile couples has become an accepted method of assisted reproduction. To learn more about attitudes concerning gamete donation, a study of 222 infertile couples was carried out in Britain. The couples were interviewed after undergoing in vitro fertilization, a procedure in which oocytes and sperm are joined under laboratory conditions and the resulting embryo is implanted into the uterus. Subjects' demographic characteristics, marital status, ethnic origin, and related factors were recorded, and they were questioned about their attitudes toward sperm and oocyte donation for infertility and for research. Results showed that donation of sperm was considered acceptable for treating infertility by 77 percent of the couples and for the purpose of diagnosing infertility by 90 percent. Seventy-two percent of the couples said they would be willing to donate oocytes anonymously for treatment purposes, and 84 percent would donate eggs to diagnose infertility in another woman. Among potential oocyte donors (160 couples), 41 percent did not require anonymity, while 12 percent expressed interest in meeting the oocyte recipient. Slightly more than one-fourth would prefer a friend or relative as the recipient. Sixty-nine percent of the respondents approved of giving nonidentifying information about the donor to the recipient couple, whereas only 40 percent agreed with the idea of providing the child with similar information. More than half the couples said they would not want information about the donor, if they had been conceived via donated gametes; another one-fourth did want such information. A discussion is presented of the issue of donor anonymity which, in Britain, is absolute. The results testify to the emotional, legal, and ethical complexity of the issues associated with gamete donation. Counseling appears to be in order for couples contemplating this method of reproduction. (Consumer Summary produced by Reliance Medical Information, Inc.)

Social aspects

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Follicular development in spontaneous and stimulated cycles in women with minimal-mild endometriosis

Article Abstract:

Endometriosis is the abnormal development of endometrial tissue, which normally lines the uterus, outside of the uterus in the abdominal wall and various sites in the pelvis. Minimal to mild forms of endometriosis are common among infertile women. However, the relation between endometriosis and reduced fertility is not known, but subfertility may be related to disorders of the menstrual cycle and impaired ovulation. Patients with endometriosis were shown to have a reduced rate of follicular growth; the follicles, situated in the ovaries, contains the eggs and secrete the female hormones estrogen and progesterone. Combined treatment with clomiphene, a drug used to stimulate ovulation, and follicle-stimulating hormone (FSH), which activates the growth of follicles in the ovary, was shown to promote follicular growth in infertile patients. The effects of clomiphene citrate and FSH on follicular growth were assessed in 17 women with minimal to mild endometriosis and 10 infertile women. The rate of follicular growth in the absence of activating factors was similar among all subjects. Combined treatment with FSH and clomiphene caused earlier onset of follicular growth and more rapid growth of the largest follicle than treatment with clomiphene alone. However, the rate of follicular growth was similar for both clomiphene and clomiphene-FSH treatments. These findings suggest that patients with minimal to mild endometriosis do not have impaired follicular growth, and reduced fertility in patients with endometriosis does not appear to be related to impaired follicular growth. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Complications and side effects, Physiological aspects, Endometriosis, Infertility, Female, Female infertility, Follicle-stimulating hormone

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