Infertility and Assisted Reproduction
Egg Donation for IVF and Stem Cell Research: Time to Weigh the Risks to Womenís Health
QUESTIONS TO CONSIDER BEFORE SERVING AS AN EGG DONOR
- Is counseling (both psychological and legal) provided for the donor and husband (if applicable)?
- When relevant, has the donor told her parents that she is donating eggs?
- If the donor has children, has she discussed the egg donation process with them?
- If she has no children, is she aware that she, like 1 in 12 couples in the US may encounter infertility when she tries to achieve a family of her own?
- Is the donor aware that she will need to take ovulation induction medications, and does she have adequate knowledge of the possible risks and complications from these medications?
- Is the donor aware that she may be tested for sexually transmitted diseases including HIV and her status as a carrier for cystic fibrosis and other genetic conditions?
- Is the donor aware that her medical costs for complications of ovarian stimulation are the responsibility of the couple and not the doctors or medical clinic?
- Is the donor aware of the significant risk of pregnancy during ovulation induction should she not use effective barrier contraception?
- Is the donor comfortable with the degree of choice she may or may not have in selecting the recipient?
- Is the donor aware that her eggs may go to a single woman, lesbian couple, interracial couple, a woman past menopause or be implanted in a gestational carrier, and how does she feel about such possibilities?
- Does the donor understand that she loses all control and ownership rights to the eggs and any resulting embryos and children after retrieval even upon the death of the couple?
- Is the donor aware that her eggs may be used to make extra embryos which may be cryopreserved, used for research or discarded after several years if abandoned by the couple?
- What is the meaning of the compensation fee as a financial incentive for egg donation? How many cycles of donation does the donor intend to volunteer for? Has she been a donor at another clinic?
- If the couple is known or related to the donor, is there any coercion, either subtle or explicit, by the couple to proceed with this option?
- What are the donorís expectations for future contact with the recipient and the child? Is she aware that any future child may never be aware of its biologic origins?
- Is the donor aware that her medical and billing records may be stored indefinitely and are possibly identifiable as an egg donor to her insurance company and others despite special coding procedures?
- Is the donor aware that her right to privacy and anonymity to any offspring cannot be guaranteed should future laws oblige clinics to reveal identifying information to future children?
MINIMUM INFORMATION NEEDED BY INFERTILTY PATIENTS FOR INFORMED CONSENT TO ASSISTED REPRODUCTION
(adapted from New York State Task Force on Life and the Law, Assisted Reproductive Technologies: Analysis and Recommendations for Public Policy (New York: New York State Task Force on Life and the Law April, 1998)
- the likelihood that the patient will become pregnant, based on experience at the particular program with patients of comparable age and comparable medical conditions, including the programís most recent published outcome statistics
- the anticipated price of the procedure, including charges for procedures and medications not covered in the standard fee
- the risks associated with any drugs to be used
- the risks associated with egg retrieval and embryo and/or oocyte transfer
- the risks associated with the transfer of multiple embryos and/or oocytes, including the likelihood of multiple gestation, the possibility that fetal reduction might be recommended as a response to multiple gestation, a clear explanation of the nature of fetal reduction and the associated risks, and the patients right to participate in decisions about the number of embryos and/or oocytes to transfer
- the reasonable foreseeable psychological ramifications of the procedures
- the programís experience performing the particular procedure
- alternatives to the procedure, including the alternative of nontreatment
A new film, "All In One Basket," follows three women who decide to be egg donors, and explores their emotional and physical reactions to the process.
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