O-219 Surplus Frozen Eggs Lay to Waste Opportunities for Research and Treatment

Abstract

Abstract Study question Is there a moral duty to donate surplus frozen eggs (SFEs)? Summary answer SFEs are a valuable resource with the potential to mitigate harm and improve well-being and should be donated where the costs to donors are small. What is known already In Victoria, Australia, eggs can be stored for up to 10 years, after which SFEs must be discarded, donated to research or to others. Our research shows that many people do not return to use their frozen eggs, many are left in storage and most SFEs are then discarded. At the same time, there is a serious shortage of donated gametes and a high demand for eggs for both research and reproductive treatments. The recent legalisation of mitochondrial donation in Australia has added to the demand for eggs for training, research, and clinical purposes. Study design, size, duration This paper considers whether donation of SFEs can be grounded on ‘the duty of easy rescue’, broadly defined as a moral duty to help others when the harm that might be averted is sufficiently great, and the costs are sufficiently small. Participants/materials, setting, methods We present an ethical analysis of the harms that could be mitigated by egg donation and the costs to donors associated with donation to both research and to others. Main results and the role of chance The harms associated with prolonged infertility, long waiting lists for donor eggs, and gamete donation in less regulated settings are well known. In addition, the use of donated eggs for mitochondrial replacement offers the possibility of avoiding the transmission of serious disease. Our research shows that many SFEs are abandoned or discarded but little is known about why people discard SFEs. Among the ‘costs’ to donors, there are logistical barriers such as the time needed, and the physical and emotional demands associated with donor eligibility screening. There may be additional emotional and ethical costs associated with donation to others; concerns about donor anonymity, the parental status of donors, and the meaning of genetic relationships have been cited as barriers to embryo donation and may also factor in egg donation. We suggest that while donation of SFEs to others may have costs, there are opportunities to facilitate this option, such as offering donor screening at the time of egg freezing, providing education about the current demand for SFEs, and greater discussion and critical reflection about the moral status of donors. We reason that donating to research does not incur the same ‘costs’ and in most cases, represents an ‘easy rescue’. Limitations, reasons for caution This analysis considers ‘costs’ to donors and ‘harms’ relating to the shortfall of donor eggs. However, donors and recipients are not the only actors involved in egg donation. There may be other morally relevant considerations, such as the experience of donor-conceived people, that complicate assessments of costs, harms, and benefits. Wider implications of the findings The large number of SFEs abandoned and discarded suggests the need for more serious consideration about the disposition of SFEs, prior to egg freezing. In addition, more information should be provided to would-be users about the current fate of and demand for eggs. Trial registration number n/a