P-342 Improving consent procedures to increase oocyte donation rates

Abstract

Abstract Study question Can consent procedures for donation of surplus frozen oocytes be changed to improve donation rates? Summary answer Obtaining informed consent for donation of oocytes after freezing could be improved by adapting new consent procedures used in genomic biomedical research for ART contexts. What is known already The widespread adoption of oocyte cryopreservation has led to a rapid accumulation of oocytes in cryostorage, since the number of people who return to use their eggs remains low. Previous studies show that many people intend to donate their surplus cryopreserved oocytes, but few people actually donate them. Increased rates of donation are required to address chronic shortages of eggs available for both reproductive and research purposes. Study design, size, duration This paper examines whether advances in consent procedures in genomic research and biobanking, such as Dynamic Consent interfaces, could be utilised within the ART context to improve patient experience and oocyte donation rates. Ethical issues with dynamic consent are considered as well as the possible benefits of such a system for potential donors and recipients of oocytes. Participants/materials, setting, methods This paper undertakes ethical analysis of the procedures used for obtaining informed consent in egg freezing for donation of surplus eggs. We consider whether these could be improved and argue that adapting advances in consent procedures, such as dynamic consent interfaces, may help to facilitate donation, with benefits to both donors and recipients. Main results and the role of chance While people freezing eggs often express an intent to donate eggs surplus to their own needs at the start of the freezing process, in few cases does this translate to actual donation. Current processes seek consent for donation at limited times throughout the cryostorage period. Further, some countries such as Australia require that eggs be donated to specific active research projects at the time that eggs are to be relinquished from storage. Factors such as these impede donation and fail to facilitate the initial expressed intent to donate surplus eggs. We hypothesise that consent processes can be improved in ways that may boost rates of donation while still satisfying the requirements of informed consent. Dynamic consent allows continuous review of consent decisions through an online interface. Adaptation of this approach to the context of egg cryopreservation and donation may have several benefits, as continuous communication and review opportunities encourage patient engagement. It may enhance understanding of the need for eggs and increase knowledge of opportunities to donate surplus eggs. While dynamic consent may benefit both potential donors and recipients, careful implementation would be required to ensure compatibility with counselling requirements and other ethical standards for reproductive donation in particular. Limitations, reasons for caution We consider the potential benefits to donors and recipients but do not analyse the costs of implementing such a system of consent for clinics. Further, specific clinics may have consent procedures that differ from the model we use here and may be constrained by regulatory contexts Wider implications of the findings Recent research suggests that cryopreserved oocytes are rarely used or donated. Improving procedures for obtaining informed consent promises to increase rates of donation and improve patient experience. Dynamic consent tools have been widely used in biobanking and genomics research to positive effect but would be novel within the ART context. Trial registration number Not Applicable