Controversy over rights of children born from oocyte donations, is full disclosure of donor’s identity necessary?

Abstract

In 2003 the Japanese Ministry of Health, Labor and Welfare approved and set the guidelines for egg donation, they established the donor’s right to remain anonymous but also the child born from oocyte donation’s right to know his/her origins. These guidelines contradict each other. As of this date no donors without family or friendly ties have appeared. The main reason for this lack of donors seems to be the fear of the identity disclosure. In Japan, recipients must tell their offspring that the genetic mother is different from the biological mother at an early age. When children are fifteen years old, they can require full disclosure about the donor. That is, donor must be ready to disclose her identity. We report here the current status of oocyte donation in Japan. A retrospective analysis of questionnaire and clinical outcome after oocyte donation at St. Mother Hospital. We gave a questionnaire to 347 ART patients to inquire whether they would consent to give one or two oocytes for free to other woman waiting for an egg donation before their oocyte collection. There were two scenarios, one where they would remain anonymous and the other one where they would permit the disclosure of their identity. The results were that 31% (108/347) in the first group and 0% (0/347) in the second group respectively would agree to a donation. In 2004 the JISART (Japanese Institution for Standardizing Assisted Reproductive Technology) established an ethics committee and loosened the rules to allow the oocyte donation from sisters or friends. Guidelines require that recipients are females who have no chance to become pregnant without oocyte donation. Donors must be married, less than 40 years old and have more than one child. Exchange of money is forbidden. There were 29 cases oocyte donation offers from April 2007 to March 2014. 2 cases canceled the oocyte donation during counseling for fear of the detrimental effect on their children. 26 donors were real sisters, 2 were sisters-in-law and 1 was a close friend. Pregnancy rates, miscarriage rates and birth rates were 29.4% (15/51), 6.7% (1/15) and 17.6% (9/51). 9 were normally delivered and 3 ongoing, including 2 cases of tubal pregnancies. So far, no major problems have been reported. Oocyte donation under the current guidelines is very difficult because the right to anonymity by the donor and right to identity disclosure for the child are basically incompatible. Donor’s disclosure information should be limited to information that does not reveal their identity completely.