Gamete Donation Research Articles

Payment to gamete donors: equality, gender equity, or solidarity?

Regulation of payment to gamete donors varies substantially across countries. The development of an ethically sustainable governance system of payments in gamete donation demands that the preferences of different stakeholders be heard. This study intends to contribute to improving the understanding of payment to gamete donors by analysing the views of donors and recipients about the preferred form of payment and its associations with their sociodemographic characteristics. This cross-sectional study included 70 donors and 172 recipients recruited at the Portuguese Public Bank of Gametes (July 2017-June 2018). Participants completed a self-reported questionnaire. Views about the preferred form of payment were collected through a multiple-choice question and an open-ended item. Associations were quantified through χ2 tests; content analysis was conducted with the open-ended answers. Both donors (48.6%) and recipients (40.7%) considered that reimbursement is the preferred form of payment to ensure solidarity-based motivations to donate. This option was followed by compensation for non-financial losses (41.4% of donors; 33.7% of recipients) based on gender equity. Preference for a fixed reward (22.7% of recipients; 8.6% of donors) was less frequent among younger donors and married/living with a partner or employed recipients, being based on the promotion of equality. In the context of the search for cross-border reproductive care and gamete circulation across countries, the findings from this study claim for the need to create solutions for payment to gamete donors that take into account gender equity and are simultaneously sensitive to donor's actual expenses and further health complications.

Who Counts as Family? Gamete donation and the construction of family forms in medical markets

This paper examines how gender beliefs are embedded in the organizational practices of the reproductive market. Third party reproduction blurs boundaries between familial and non-familial members, making gamete banks and donation agencies important sites for studying the construction of family. Cultural beliefs about gender are implicated in the discourses and practices of these organizations, which shape and constrain the experiences and options for both gamete donors and recipient families. To evaluate this process, I conducted qualitative analyses on the recruitment materials of all of sperm banks, egg banks, and egg donation agencies in the United States. My analysis demonstrates that the reproductive market still relies on heteronormative assumptions of family. However, the extent to which these organizations facilitate participation in new, non-normative family forms breaks down along gendered lines, where sperm donors have more freedom, status, and potential to create relationships with recipient families than egg donors.

Solidarity and reciprocity in data governance: information sharing among gamete donors and recipients

Abstract Background Decreasing fertility rates have spiralled a growth in demand for assisted reproduction technologies, including reproduction through donated gametes. Gamete donation is grounded on solidaristic practices traditionally focused on the gift of gametes. However, solidarity and reciprocity between donors and recipients may also be enacted through the sharing of other types of information (e.g. donation outcomes, medical and identifying information). Little is known, however, about these stakeholders’ preferences regarding information sharing, which is crucial to promoting people-centred policy for data governance in gamete donation. Methods A self-report structured questionnaire was completed by 69 donors and 161 recipients (participation rate: 77.4%) between July 2017 and April 2018 at the Portuguese Public Bank of Gametes. Opinions about access to donation outcomes and medical, extended profile and identifying information about recipients, donors and children were analysed using descriptive statistics. Results Most participants considered that recipients should not have access to donors’ identifying (92%) and extended profile (79%) information, but that they should access donors’ medical information (58%). Donors stated more frequently that they should receive information about the outcomes of donation (e.g. pregnancies and births) than recipients (32% vs. 12%). Participants also disagreed with donors’ access to recipients’ medical (83%) and extended profile information (92%) and children’s identifying information (98%). Conclusions People-centred policy on data governance in gamete donation should be informed by donor and recipients’ preferences. Sharing donation outcomes with donors and medical information from donors with recipients can foster solidarity and reciprocity between them. This requires the development of a matching mechanism (via consent) to accommodate their preferences. Key messages Policy on data governance should be informed by gamete donors and recipients’ preferences. Sharing desired information with donors and recipients can foster solidarity and reciprocity between them.

Changing criteria of access to gamete donation: the views of donors and recipients

Abstract Background Differences on the use of sexual orientation and marital status as criteria to define access to gamete donation persist in Europe, contributing to the search of cross border reproductive care (CBRC). The lack of international policy and norms on CBRC highlight the need for surveillance to ensure quality and equitable access to reproductive care, namely by assessing donors’ and recipients’ views. This study aims to analyze the opinion of donors and recipients about the use of marital status and sexual orientation as priority criteria for accessing gamete donation, and its associated factors. Methods Between July 2017 and June 2018, 72 donors and 171 recipients completed a self-report questionnaire at the Portuguese Public Bank of Gametes. Opinion about the use of marital status and sexual orientation as priority criteria was assessed through a 5-point Likert scale of agreement, ranging from “totally disagree” to “totally agree”. Descriptive statistics and multinomial logistic regression were used. Results Most participants disagreed with a priority of access to gamete donation for heterosexual couples (61%) and married women (60%). Participants who agreed with priority to heterosexual couples were more likely to be males (OR = 2.5, CI95% 1.2-5.3) and married or living with a partner (OR = 3.5, CI95% 1.1-10.8). Males (OR = 3.18, CI95% 1.5-6.9) and those with lower white collar (OR = 3.0, CI95% 1.2-7.4) or blue collar occupations (OR = 4.3, CI95% 1.4-13.1) were more likely to agree with priority for married women. Conclusions Donors and recipients agree with equitable access to gamete donation, independently of sexual orientation and marital status. However, a heterosexual marriage hierarchy is particularly observed on male, married/living with a partner, and with lower white or blue collar occupations participants. Policy on reproductive care needs to be especially mindful of equity in access to gamete donation. Key messages Donors and recipients agree with access to gamete donation independent of sexual orientation and marital status. Policy on reproductive care needs to be mindful of equity in access to gamete donation.

Revisiting the use of ‘counselling’ as a means of preparing prospective parents to meet the emerging psychosocial needs of families that have used gamete donation

Third party reproduction is an increasingly important part of family building but also challenges societal understanding of family and ‘kin’ relationships as being primarily hetero-normative and based on genetic connection. At the same time, understanding of the longer-term psycho-social implications of gamete donation is changing as knowledge grows. Research, professional and personal experiences demonstrate that a range of meanings can be triggered regarding relationships, identity and health matters that challenge normative views. This raises questions of how best to assist those contemplating this route to parenthood. With knowledge gained from research and practice over many years, we argue this requires a shift from focusing on assessment/evaluation of prospective parents and/or therapeutic work to a psycho-educational partnership approach offering help with managing relationships, thoughts and feelings and building strategies for healthy family functioning alongside sharing knowledge from research and experiences. Such approaches can also be appropriate for later professional interventions.

Gamete donation and parenthood

Today many heterosexual couples, as well as single women and lesbian couples, use gamete donation in France or abroad in order to fulfil their desire for a child. The construction of parenthood in these conditions raises many questions and requires specific psychological work in order to reflect on issues surrounding genetic transmission, the establishment of the bond and the appropriation of parenthood. Furthermore, what is the future of the children conceived by donation?

MAR: current and future practices with the review of the law on bioethics

Medically assisted reproduction techniques are aimed at heterosexual couples, when both members are living, of reproductive age, consenting to acts of insemination or the transfer of embryos and presenting medically diagnosed infertility. The review of the law on bioethics could offer new perspectives for reproduction notably by allowing access to medically assisted reproduction (MAR) to all women, elective egg freezing, the lifting of gamete donor anonymity and the authorisation of post-mortem MAR.

Old consent and new developments: health professionals should ask and not presume

We thank Lucy Frith for her thought-provoking response1 to our paper, where we argued that it would be ethically acceptable to contact an anonymous egg donor to help facilitate diagnostic...

Dilemmatic tensions around parenthood: the ambiguous third-party role in Assisted Reproductive Technologies and Surrogacy in France and Portugal

This article analyzes couples’ attitudes towards the third-party role in Assisted Reproductive Technologies with gamete donation, and problematizes parenthood and kinship. I base my analysis on 66 in-depth interviews with different ART actors (from beneficiaries to professionals) in France and Portugal, conducted as part of a research project already completed. Special focus is given to 19 interviews with heterosexual and homosexual couples who used third-party reproduction in Europe and the United States. I found a physical and moral detachment operation among heterosexual and lesbian couples vis-a-vis the donor of reproductive potential, who is depersonalized and reduced to a functionality. The objective is to preserve the intimacy of the couple and the autonomy of the parental project. This contrasts with innovative and enlarged family dynamics developed by gay couples, who integrate both female figures (surrogate and oocyte donor) in their children’s family history, through bonding efforts in a logic of reciprocity (gift and counter-gift). The purpose is to reject the negative image of a woman’s body being commodified while preserving the natural appearance of procreation. I conclude that a naturalist conception of kinship persists —one based on shared biogenetic substances that bind together one parent and the donor-conceived child— along with the centrality of biological processes such as pregnancy and childbirth. There are different ways of easing tensions inherent to the contractual intervention of third parties in the reproductive process. ART re-elaborates the line of demarcation between commodities and gifts and between living things and human beings, while reconfiguring family concepts.

ПОПОЛНЕНИЕ ГЕНЕТИЧЕСКОЙ КОЛЛЕКЦИИ ЯБЛОНИ ФГБНУ ВНИИСПК ДЛЯ ИСПОЛЬЗОВАНИЯ В СЕЛЕКЦИИ

A brief description of genetic collection of apple in the Russian Research Institute of Fruit Crop Breeding (VNIISPK) is given in this article. The collection is annually saved and replenished with the introduced apple varieties from various breeding institutions of Russia, CIS, Europe, America and Australia as well as varieties and hybrids of VNIISPK breeding. At the Institute in 01.01.2019, the apple gene pool consisted of 830 accessions and 350 selected seedlings for further study and selection of new source material for breeding. In the genetic collection of the Institute there are sources and donors for apple breeding for columnar habit, winter hardiness, precocity and high productivity, long shelf life of fruit, high resistance and immunity to scab as well as donors of diploid gametes for breeding on a polyploidy level, sources and donors of high content of sugars, titrate acids and biologically active substances (ascorbic acid and P-active substances). Creation, preservation, study and replenishment of the gene pool are a priority and actual direction of research.

Optimizing clinical exome design and parallel gene-testing for recessive genetic conditions in preconception carrier screening: Translational research genomic data from 14,125 exomes

Limited translational genomic research data have been reported on the application of exome sequencing and parallel gene testing for preconception carrier screening (PCS). Here, we present individual-level data from a large PCS program in which exome sequencing was routinely performed on either gamete donors (5,845) or infertile patients (8,280) undergoing in vitro fertilization (IVF) treatment without any known family history of inheritable genetic conditions. Individual-level data on pathogenic variants were used to define conditions for PCS based on criteria for severity, penetrance, inheritance pattern, and age of onset. Fetal risk was defined based on actual carrier frequency data accounting for the specific inheritance pattern (fetal disease risk, FDR). In addition, large-scale application of exome sequencing for PCS allowed a deep investigation of the incidence of medically actionable secondary findings in this population. Exome sequencing achieved remarkable clinical sensitivity for reproductive risk of highly penetrant childhood-onset disorders (1/337 conceptions) through analysis of 114 selected gene-condition pairs. A significant contribution to fetal disease risk was observed for rare (carrier rate < 1:100) and X-linked conditions (16.7% and 41.2% of total FDR, respectively). Subgroup analysis of 776 IVF couples identified 37 at increased reproductive risk (4.8%; 95% CI = 3.4–6.5). Further, two additional couples had increased risk for very rare conditions when both members of a parental pair were treated as a unit and the search was extended to the entire exome. About 2.3% of participants showed at least one pathogenic variant for genes included in the updated American College of Medical Genetics and Genomics v2.0 list of secondary findings. Gamete donors and IVF couples showed similar carrier burden for both carrier screening and secondary findings, indicating no causal relationship to fertility. These translational research data will facilitate development of more effective PCS strategies that maximize clinical sensitivity with minimal counterproductive effects.

Birthweight difference of singletons conceived through in vitro fertilization with frozen versus fresh embryo transfer: An analysis of 5406 embryo transfers in a retrospective study 2013–2018

IntroductionPerinatal risks after frozen embro transfer (FET) have been reassuring but some authors suggest that birthweights are higher after FET than after fresh embryo transfer (ET). The primary objective of this retrospective study, conducted in Clinique de la Sagesse, Rennes (France) from December 2013 to March 2017, was to determine whether a difference in birthweight exists between children conceived through in vitro fertilization (IVF) with frozen versus fresh ET. The secondary objective was to compare live birth rates after frozen versus fresh cycles. Material and methodsAll couples undergoing IVF were included. Cycles with gamete donation and twin pregnancies were excluded. Hormone therapy was used in all embryo transfers. The main outcome measures were the child’s birthweight, mode of delivery, gestation length and sex, maternal characteristics, and IVF characteristics. The primary endpoint was birthweight. ResultsWe studied 5406 embryo transfers and the 708 resulting singleton live births on which birthweight data were available. Mean birthweight was 3357g after frozen embryo transfer versus 3183g after fresh embryo transfer (p<0.001). After adjusting for confounding factors, the children born after frozen embryo transfer were 165.2g heavier (95%CI [92.96–237.51]). No difference was found in gestation length. Live birth was obtained after the 1.6th IVF attempt. Live birth rate was higher for fresh cycles (19% versus 12%, p<0.001), and the caesarean rate lower (16% versus 21%). DiscussionBirthweight was higher after frozen embryo transfer for a similar gestational age. Further research is needed to elucidate the mechanisms responsible for this difference.

Genetic Counseling and Assisted Reproductive Technologies.

Despite the ever-increasing number of patients undergoing fertility treatments and the expanded use of genetic testing in this context, there has been limited focus in the literature on the involvement of genetics professionals in the assisted reproductive technology (ART) setting. Here we discuss the importance of genetic counseling within reproductive medicine. We review how genetic testing of embryos is performed, the process of gamete donation, the challenges associated with genetic testing, and the complexities of genetic test result interpretation.

“Doubly Mother”: Heterologous Artificial Insemination Between Biological and Social Parenthood: A Single Case Study

In heterologous artificial insemination, the donation of gametes (either sperm or eggs) from a third person allows infertile and same-sex couples to become parents. Therefore, the child is genetically related to one parent, while the other parent is referred to as the social mother or father. This current single case study aimed at investigating this double access to parenthood in a lesbian couple who had two children after heterologous artificial insemination. In this couple, both women delivered one of the two children, so that each partner is either biological or social mother. The Clinical Generational Interview was used to assess the quality of family relationships, with a specific focus on three dimensions: the origins of each partner, the constitution of the couple, and the generational passage. Paper and pencil textual analysis was conducted following the principles of Interpretative Phenomenological Analysis and led to the identification of six dominant themes (and subthemes): (a) relationship with the family of origin; (b) couple relationship; (c) generational passage; (d) heterologous artificial insemination and “double motherhood”; (e) donor/biological father; and (f) children identity and the disclosure of their origin. This study’s findings revealed the importance of using research techniques aimed at in-depth exploration of this phenomenon consistently with the specificities of the new filiation forms. The adoption of a transgenerational perspective allows articulating conception coordinates with the history of the couple and each partner’s origins.

Tracing pathways of relatedness: how identity-release gamete donors negotiate biological (non-)parenthood

This article draws on an interview study with UK ‘identity-release’ sperm and egg donors, exploring how, in the context of a new ethic of openness around donor conception, they articulate their role in relation to offspring. I show that participants neither dismissed, nor straightforwardly activated, the relational significance of the ‘biological’ substance they donated. Instead, they renegotiated its meaning in ways which do not map straightforwardly on to established kinship roles. Building on a conception of personal lives and selves as fundamentally relational (Mason, 2004; Smart, 2007; May, 2013), I show how donors managed the conflicting demands of identity-release donation by tracing their relatedness to offspring along particular pathways (while diminishing others); the inherent connectedness of their own lives and selves enabled them to construct indirect non-parental connections with offspring as the siblings of their own children or the children of their friends or sisters.

Decriminalizing Payment of Gamete Donors and Surrogates in Canada: An Analysis of Factors Influencing the Public Debate in Light of Bill C-404

On 29 May 2018, the Liberal MP Anthony Housefather tabled Bill C-404 titled An Act to amend the Assisted Human Reproduction Act which seeks to decriminalize the payment of gamete donors and surrogates across Canada. Although Prime Minister Justin Trudeau indicated the importance of having a societal debate on the subject, the bill was read only once by the House of Commons before it died on the Order Paper. Bill C-404 aimed to increase the number of Canadian gamete donors and surrogates to fulfill Canada's domestic needs, which are purportedly not being met because of a lack of economic incentives on the supply side and the existence of a grey market that deters some Canadians in acting as donors or surrogates and causes intending parents to fear being criminally sanctioned if the reimbursement they pay is deemed unrelated or unreasonable. While Bill C-404 has not been adopted by Parliament, this paper seeks to analyze the policy tensions at the heart of the decriminalization of payment of donors and surrogates—tensions that may well resurface in the future. As long as the alleged shortage of donors and surrogates persists, stakeholders are likely to continue to advocate for legislative change. Le 29 mai 2018, le depute liberal Anthony Housefather a depose le projet de loi C-404 intitule Loi modifiant la Loi sur la procreation assistee, qui vise a decriminaliser le paiement des donneurs de gametes et des meres porteuses au Canada. Bien que le premier ministre Justin Trudeau ait souligne l'importance d'avoir un debat de societe sur le sujet, le projet de loi n'a ete lu qu'une seule fois par la Chambre des communes avant de mourir au feuilleton. Le projet de loi C-404 visait a augmenter le nombre de donneurs de gametes et de meres porteuses pour repondre aux besoins interieurs du Canada qui ne seraient pas satisfaits en raison du manque d'incitatifs economiques et de l'existence d'un marche gris qui dissuade certains Canadiens d'agir comme donneurs ou meres porteuses et qui fait en sorte que les parents craignent de possibles sanctions criminelles si le remboursement qu'ils offrent est juge non-relie ou deraisonnable. Bien que le projet de loi C-404 n'ait pas ete adopte par le Parlement, le present document cherche a analyser les tensions politiques qui sont au coeur de la decriminalisation de la remuneration des donneurs et des meres porteuses—tensions qui pourraient bien reapparaitre dans l'avenir, car la penurie alleguee de donneurs et de meres porteuses est susceptible de persister et il est probable que les intervenants continueront a plaider pour un changement legislatif.

Decriminalizing Payment of Gamete Donors and Surrogates in Canada: An Analysis of Factors Influencing the Public Debate in Light of Bill C-404

English abstract: On 29 May 2018, the Liberal MP Anthony Housefather tabled Bill C-404 titled An Act to amend the Assisted Human Reproduction Act which seeks to decriminalize the payment of gamete donors and surrogates across Canada. Although Prime Minister Justin Trudeau indicated the importance of having a societal debate on the subject, the bill was read only once by the House of Commons before it died on the Order Paper. Bill C404 aimed to increase the number of Canadian gamete donors and surrogates to fulfill Canada’s domestic needs, which are purportedly not being met because of a lack of economic incentives on the supply side and the existence of a grey market that deters some Canadians in acting as donors or surrogates and causes intending parents to fear being criminally sanctioned if the reimbursement they pay is deemed unrelated or unreasonable. While Bill C-404 has not been adopted by Parliament, this paper seeks to analyze the policy tensions at the heart of the decriminalization of payment of donors and surrogates — tensions that may well resurface in the future. As long as the alleged shortage of donors and surrogates persists, stakeholders are likely to continue to advocate for legislative change. French abstract: Le 29 mai 2018, le depute liberal Anthony Housefather a depose le projet de loi C-404 intitule Loi modifiant la Loi sur la procreation assistee, qui vise a decriminaliser le paiement des donneurs de gametes et des meres porteuses au Canada. Bien que le premier ministre Justin Trudeau ait souligne l’importance d’avoir un debat de societe sur le sujet, le projet de loi n’a ete lu qu’une seule fois par la Chambre des communes avant de mourir au feuilleton. Le projet de loi C-404 visait a augmenter le nombre de donneurs de gametes et de meres porteuses pour repondre aux besoins interieurs du Canada qui ne seraient pas satisfaits en raison du manque d’incitatifs economiques et de l’existence d’un marche gris qui dissuade certains Canadiens d’agir comme donneurs ou meres porteuses et qui fait en sorte que les parents craignent de possibles sanctions criminelles si le remboursement qu’ils offrent est juge non-relie ou deraisonnable. Bien que le projet de loi C-404 n’ait pas ete adopte par le Parlement, le present document cherche a analyser les tensions politiques qui sont au cœur de la decriminalisation de la remuneration des donneurs et des meres porteuses—tensions qui pourraient bien reapparaitre dans l’avenir, car la penurie alleguee de donneurs et de meres porteuses est susceptible de persister et il est probable que les intervenants continueront a plaider pour un changement legislatif.

Contacting gamete donors to facilitate diagnostic genetic testing for the donor-conceived child: what are the rights and obligations of gamete donors in these cases? A response to Horton et al

In their paper Horton et al argue that it is acceptable to contact an anonymous egg-donor to facilitate diagnostic genetic testing for the donor conceived child, despite the donor, ‘indicating...

Right to health: the situation of assisted reproduction techniques with gametes donation in Italy

Right to health: the situation of assisted reproduction techniques with gametes donation in Italy

Informed consent for genetic testing on gamete donors

Informed consent for genetic testing on gamete donors