Abstract
Since the successful introduction of in vitro fertilization in 1978, medically assisted reproduction (MAR) has proliferated in multiple clinical innovations. Consequently, egg cells have become an object of demand for both infertility treatment and stem cell research, and this raises complex legal, ethical, social and economic issues.In this paper we compare how the procurement and use of human egg cells is regulated in two countries: Israel and Austria. Israel is known for its scientific leadership, generous public funding, high utilization and liberal regulation of assisted reproductive technology (ART). Austria lies at the other extreme of the regulatory spectrum in terms of restrictions on reproductive interventions.In both countries, however, there is a constant increase in the use of the technology, and recent legal developments make egg cells more accessible. Also, in both countries the scarcity of egg cells in concert with the rising demand for donations has led to the emergence of cross-border markets and global 'reproductive tourism' practices. In Israel, in particular, a scandal known as the 'eggs affair' was followed by regulation that allowed egg cell donations from outside the country under certain conditions.Cross-border markets are developed by medical entrepreneurs, driven by global economic gaps, made possible by trans-national regulatory lacunae and find expression as consumer demand. The transnational practice of egg cell donations indicates the emergence of a global public health issue, but there is a general lack of medical and epidemiological data on its efficacy and safety. We conclude that there is need for harmonisation of domestic laws and formulation of new instruments for international governance.
Highlights
Since the successful introduction of in vitro fertilization in 1978, medically assisted reproduction (MAR) has proliferated in multiple clinical innovations
First we provide a general background on the medical practice of egg cell donations for infertility therapy, the commercialization of reproductive medicine and the concerns about the commodification of women’s body parts, given the intrinsic scarcity of egg cells and the growing
Third-party reproduction Since the birth of the first in vitro fertilisation (IVF) baby, Louise Brown, in 1978, it is estimated that 3.75 million babies have been born world wide with the assistance of medical reproductive technologies [1]
Summary
Since the successful introduction of in vitro fertilization in 1978, medically assisted reproduction (MAR) has proliferated in multiple clinical innovations. The essence of the Eggs Donation Law, 2010 is to allow donations from healthy volunteers, primarily for infertility treatment, but the donor may designate up to 2 egg cells (or 20% of the total number of those retrieved in any given cycle) either for research or to be frozen for her own future use In this respect the Law is permissive, but at the same time it subjects the practice of egg cell donation to detailed regulation. In Austria, the issue is less visible, but women there use cross-border services, and private fertility clinics offer egg cell donation to their clients in cooperation with partner clinics in other European countries, e.g. Spain and the Czech Republic These practices are part of a flourishing global market for egg cells, where transnational IVF clinics broker sales between generally poor, female vendors and wealthy purchasers, beyond the borders of national regulation and with little clinical or bioethical scrutiny [7]. When cross-border IVF is practiced, the question of public funding gains an additional moral dimension
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