Abstract and Introduction
Abstract
As the efficiency of oocyte cryopreservation has increased rapidly in recent years, oocytes are currently being stored either in the course of IVF treatments or as a fertility preservation measure. These practices may have an impact on the number of available donor oocytes due to two different dynamics: first, a certain percentage of women for whom oocytes were cryopreserved will eventually not use their oocytes and may decide to donate them to others; secondly, especially in the practice of social freezing, women may opt to donate a portion of the retrieved oocytes in 'freeze-and-share' schemes in order to reduce the costs. In this article, we aim to sketch the ethical implications of such developments in general and the issue of payment to oocyte donors in particular.
Introduction
In recent years, improvements in the slow freezing technique and especially the development of vitrification have opened up the possibility of efficiently storing human oocytes and using them successfully in an IVF treatment after thawing (Almodin et al., 2010; Grifo and Noyes, 2010; Kim et al., 2010; Rienzi et al., 2010; Trokoudes et al., 2011). Oocytes may be cryopreserved in a number of circumstances: during the course of an IVF treatment, at the request of women whose fertility is threatened by diseases or aggressive medical treatments (the so-called 'medical freezing') or at the request of women who fear infertility due to aging (the so-called 'social freezing'). These practices may have an impact on the number of available donor oocytes due to two different dynamics: first, a certain percentage of women for whom oocytes were cryopreserved for any of the reasons mentioned above will eventually not use all of their oocytes and may decide to donate them to others; secondly, especially in the practice of social freezing, women may opt to donate a portion of the retrieved oocytes in 'freeze-and-share' schemes in order to reduce the costs. In this article, we aim to sketch the ethical implications of such developments in general and the issue of payment to oocyte donors in particular. We start by sketching the situation for donation for reproductive purposes and look into donation for research purposes at the end of the article.
As a preliminary remark, we must point out that the implications of this potential new source of donor oocytes on the practice of oocyte donation will be more pronounced for those countries where patients are currently faced with waiting lists for IVF treatment with donor oocytes, as more oocytes will shorten those waiting lists. In, amongst others, the USA, Spain and some East European countries, this is not an issue. However, as we will show, even in such countries, there may still be a significant impact on certain aspects of the practice of oocyte donation, including the price of oocyte donation cycles.