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Iranifard E, Ebrahimzadeh Zagami S, Amirian M, Ebrahimipour H, Latifnejad Roudsari R. A systematic review of assisted and third-party reproduction guidelines regarding management and care of donors. Reprod Health 2024; 21:75. [PMID: 38824591 PMCID: PMC11143578 DOI: 10.1186/s12978-024-01804-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/01/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND Gamete and embryo donors face complex challenges affecting their health and quality of life. Healthcare providers need access to well-structured, evidence-based, and needs-based guidance to care for gamete and embryo donors. Therefore, this systematic review aimed to synthesize current assisted and third-party reproduction guidelines regarding management and care of donors. METHODS The databases of ISI, PubMed, Scopus, and websites of organizations related to the assisted reproduction were searched using the keywords of "third party reproduction", "gamete donation", "embryo donation", "guidelines", "committee opinion", and "best practice", without time limit up to July 2023. All the clinical or ethical guidelines and best practice statements regarding management and care for gamete and embryo donors written in the English language were included in the study. Quality assessment was carried using AGREE II tool. Included documents were reviewed and extracted data were narratively synthesized. RESULTS In this systematic review 14 related documents were reviewed of which eight were guidelines, three were practice codes and three were committee opinions. Five documents were developed in the United States, three in Canada, two in the United Kingdom, one in Australia, and one in Australia and New Zealand. Also, two guidelines developed by the European Society of Human Reproduction and Embryology were found. Management and care provided for donors were classified into four categories including screening, counseling, information provision, and ethical considerations. CONCLUSION While the current guidelines include some recommendations regarding the management and care of gamete/embryo donors in screening, counseling, information provision, and ethical considerations, nevertheless some shortcomings need to be addressed including donors' psychosocial needs, long-term effects of donation, donors' follow-up cares, and legal and human rights aspects of donation. Therefore, it is needed to conduct robust and well-designed research studies to fill the knowledge gap about gamete and embryo donors' needs, to inform current practices by developing evidence-based guidelines.
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Affiliation(s)
- Elnaz Iranifard
- Student Research Committee, Mashhad University of Medical Sciences, 9137913199, Mashhad, Iran
| | - Samira Ebrahimzadeh Zagami
- Nursing and Midwifery Care Research Center, Mashad University of Medical Sciences, 9177949025, Mashhad, Iran
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, 9137913199, Iran, Mashhad
| | - Malihe Amirian
- Department of Obstetrics and Gynecology, Fellowship of Infertility, School of Medicine, Milad Infertility Treatment Center of Mashhad, University of Medical Sciences, Mashhad, 9137913316, Iran
| | - Hossein Ebrahimipour
- Department of Health Economics and Management, School of Health, Mashhad University of Medical Sciences, 9196773113, Mashhad, Iran
- Health Sciences Research Center, Torbat Heydarieh University of Medical Sciences, 9519633787, Torbat heydarieh, Iran
| | - Robab Latifnejad Roudsari
- Nursing and Midwifery Care Research Center, Mashad University of Medical Sciences, 9177949025, Mashhad, Iran.
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, 9137913199, Iran, Mashhad.
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Cornthwaite K, Goedeke S, Shepherd D, Rodino I. Student views on recognition and payment options for gamete donation in New Zealand. Aust N Z J Obstet Gynaecol 2023; 63:753-759. [PMID: 37221091 DOI: 10.1111/ajo.13702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 05/01/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND Demand for donor gametes in New Zealand significantly outweighs the number of willing donors. Payment for donation has been suggested as a viable solution to increase the supply and attract more donors in acknowledging the time, effort and inconvenience associated with donation. AIMS Internationally, university students are a commonly targeted group for paid gamete donation. This study aims to explore the views of university students in New Zealand to gauge their support and concerns relating to a range of options to recognise donors, including payment. METHODS Two hundred and three tertiary students completed a questionnaire exploring their views on various forms of recognition for donation and concerns relating to payment. RESULTS Participants indicated the greatest support for reimbursement for expenses directly related to the donation process. Payment constituting explicit financial advantage was regarded least favourably. Participants held concerns that payment would attract people donating for the 'wrong' reasons and lead to donors concealing relevant histories. Further concerns included payment increasing costs for recipients and causing disparities in access to gametes. CONCLUSIONS The findings of this study suggest that within a New Zealand context a culture of gift-giving and altruism are strongly held principles towards reproductive donation, including among the student population. This highlights the need to consider alternative strategies to commercial models to overcome donor shortages which are in line with the cultural and legislative context of New Zealand.
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Affiliation(s)
- Kelsey Cornthwaite
- Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand
| | - Sonja Goedeke
- Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand
| | - Daniel Shepherd
- Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand
| | - Iolanda Rodino
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
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Molas A. Recentering Labor in the Egg Donation Bioeconomy: Egg Donors' (Re)productive Work and Subjectification in Spain. Med Anthropol 2023:1-14. [PMID: 37796880 DOI: 10.1080/01459740.2023.2263806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
In 2019, Spanish fertility clinics reached a historical record of ova extractions. A total of 14,521 surgeries were performed to serve the growing egg demand internationally. Here I show how bringing a cycle to completion is not an easy task for egg donors. Selecting a clinic, understanding their own biocapital in the industry and how to invest it, fitting the cycle into their lives, and managing pain and emotions become crucial parts of their work. I argue that these activities constitute a vast amount of labor that, although essential for the generation of value in reproductive bioeconomies, remains invisible and undertheorized.
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Affiliation(s)
- Anna Molas
- Social and Cultural Anthropology, Autonomous University of Barcelona, Barcelona, Spain
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Tober D, Pavone V, Lafuente-Funes S, Konvalinka N. Eggonomics: Vitrification and bioeconomies of egg donation in the United States and Spain. Med Anthropol Q 2023; 37:248-263. [PMID: 37229598 DOI: 10.1111/maq.12767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/13/2023] [Indexed: 05/27/2023]
Abstract
Regulations governing assisted reproduction control the degree to which gamete donation is legal and how people providing genetic material are selected and compensated. The United States and Spain are both global leaders in fertility treatment with donor oocytes. Yet both countries take different approaches to how egg donation is regulated. The US model reveals a hierarchically organized form of gendered eugenics. In Spain, the eugenic aspects of donor selection are more subtle. Drawing upon fieldwork in the United States and Spain, this article examines (1) how compensated egg donation operates under two regulatory settings, (2) the implications for egg donors as providers of bioproducts, and (3) how advances in oocyte vitrification enhances the commodity quality of human eggs. By comparing these two reproductive bioeconomies we gain insight into how different cultural, medical, and ethical frameworks intersect with egg donor embodied experiences.
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Affiliation(s)
- Diane Tober
- Department of Anthropology and Institute for Social Science Research, University of Alabama, 19 Ten Hoor Hall, Tuscaloosa, AL, 35487, United States
- Affiliate faculty, Social and Behavioral Sciences University of California, San Francisco
| | - Vincenzo Pavone
- Institute of Public Goods and Policies, Spanish National Research Council, Calle Albesanz, 26-28, Madrid, 28037, Spain
| | - Sara Lafuente-Funes
- Goethe University Frankfurt, Frankfurt, Germany, Theodor-W.-Adorno-Platz 6, 60323, Frankfurt am Main, Frankfurt, Germany
| | - Nancy Konvalinka
- Departamento Antropología Social y Cultural, Universidad Nacional de Educación a Distancia, Calle Senda del Rey, 7, 28040, Madrid, Spain
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Tober DM, Richter K, Zubizarreta D, Daneshmand S. Egg donor self-reports of ovarian hyperstimulation syndrome: severity by trigger type, oocytes retrieved, and prior history. J Assist Reprod Genet 2023:10.1007/s10815-023-02855-3. [PMID: 37347350 DOI: 10.1007/s10815-023-02855-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/03/2023] [Indexed: 06/23/2023] Open
Abstract
PURPOSE To evaluate self-reported survey data provided by US oocyte donors on their experiences with ovarian hyperstimulation syndrome and possible correlations between OHSS severity and number of oocytes retrieved, trigger type, and prior OHSS history. METHODS An 85-question retrospective survey was administered online. Survey questions included demographic information, reasons for donating, immediate per-cycle experiences and outcomes, perceptions of informed consent, and perceived impact of donation on long-term health. Quantitative Data for this study was collected between February 2019 and September 2020 via QualtricsXM (January 2019), an online survey platform. Follow-up interviews were also conducted. Participants were recruited via fertility clinics, egg donation agencies, and online forum. The research was approved by the University of California, San Francisco Institutional Review Board (#14-14765). RESULTS Of 420 initiated US oocyte donor online surveys, 289 (68%) respondents provided detailed information on per cycle experiences with ovarian hyperstimulation syndrome, number of oocytes retrieved, and trigger type over a total of 801 cycles. On cycles where donors reported receiving GnRH agonist triggers (n = 337), they reported milder OHSS compared to cycles with hCG or dual triggers. Among donors undergoing multiple retrieval cycles, the severity of OHSS in second cycles was strongly associated with OHSS severity in first cycles. CONCLUSION Self-reported OHSS in oocyte donors is lower in GnRH antagonist stimulation protocols combined with GnRHa trigger and in cycles where donors reported fewer than 30 oocytes retrieved. Donors who reported severe OHSS on a prior cycle were significantly more likely to experience severe OHSS on a subsequent cycle.
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Affiliation(s)
- Diane M Tober
- Department of Anthropology/Institute for Social Science Research, University of Alabama, 24b Ten Hoor Hall, Tuscaloosa, AL, 35487, USA.
- Institute for Health and Aging, University of California, San Francisco, 490 Illinois St, Box 0646, San Francisco, CA, 94158, USA.
| | - Kevin Richter
- The Fertility Scientist, Silver Spring, MD, 20910, USA
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Lafuente‐Funes S, Weis C, Hudson N, Provoost V. Egg donation in the age of vitrification: A study of egg providers' perceptions and experiences in the UK, Belgium and Spain. SOCIOLOGY OF HEALTH & ILLNESS 2023; 45:259-278. [PMID: 36444136 PMCID: PMC10100196 DOI: 10.1111/1467-9566.13590] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 11/07/2022] [Indexed: 05/31/2023]
Abstract
IVF treatment involving donated eggs increases yearly. Numerous technical and commercial transformations have reshaped how eggs are retrieved, stored and managed. A key transformation is vitrification; a 'fast freezing' method that allows efficient preservation of eggs, and therefore more flexibility in use, giving rise to new commercial possibilities. There has been limited focus on egg providers' experiences in the context of vitrification and related commercialisation. We report findings from a study in the UK, Spain and Belgium, where we interviewed 75 egg providers. Comparing experiences within different donation 'regimes' allows an exploration of how varying national practices and policies shape information-giving and women's experiences. In the UK, a system of 'informed gift-giving' was described, where egg providers saw their actions as not-for-profit and felt relatively well informed. In Belgium, the system was presented as 'trusted tissue exchange': with less information-giving than in the UK, but clinics were trusted to act responsibly. In Spain, a 'closed-door, market-driven' system was described, whereby egg providers received little information and expressed concerns about generation of excess profit. Our findings extend understandings of how egg donation is managed at the national level and how donation regimes produce specific experiences, expectations and subjectivities amongst tissue providers.
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The experience of counselling for UK egg providers. COUNSELLING & PSYCHOTHERAPY RESEARCH 2023. [DOI: 10.1002/capr.12613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Combs A, Kimes MJ, Jaslow CR, Hayes H, O'Leary LB, Levy MJ, Kutteh WH. Perception of pain and the oocyte donor experience: A retrospective analysis of commercial U.S. donors. Reprod Biomed Online 2022; 45:906-912. [DOI: 10.1016/j.rbmo.2022.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 11/16/2022]
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Tober D, Kroløkke C. Emotion, embodiment, and reproductive colonialism in the global human egg trade. GENDER WORK AND ORGANIZATION 2021. [DOI: 10.1111/gwao.12637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Diane Tober
- Assistant Professor at University of California, Department of Social and Behavioral Sciences Institute for Health and Aging, Bixby Center for Global Reproductive Health, and Department of Anthropology, History and Social Medicine. University of California San Francisco San Francisco California USA
| | - Charlotte Kroløkke
- Associate Professor at the Institute for the Study of Culture University of Southern Denmark Odense Denmark
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Oocyte Biobanks: Old Assumptions and New Challenges. BIOTECH 2021; 10:biotech10010004. [PMID: 35822776 PMCID: PMC9245479 DOI: 10.3390/biotech10010004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 11/19/2022] Open
Abstract
The preservation of fertility is a clinical issue that has been emerging considerably in recent decades, as the number of patients of childbearing age who risk becoming infertile for many reasons is increasing. The cryopreservation technique of oocytes has been developed for many years and nowadays constitutes a method of safe storage with impressive efficacy and high rates of successful thawing. The storage and use for research of oocytes taken for medical or non-medical can be carried out by both public and private structures, through egg sharing, voluntary egg donation and so-called “social freezing” for autologous use. This paper focuses on the oocyte bank as an emerging cryopreservation facility, in which a collaboration between public and private and the creation of a network of these biobanks can be useful in enhancing both their implementation and their functions. Good oocyte biobank practice would require that they be collected, stored, and used according to appropriate bioethical and bio-law criteria, collected and stored according to procedures that guarantee the best preservation of their structural components and a high level of safety, connected with appropriate procedures to protect the rights and privacy of the parties involved and associated with the results of the bio-molecular investigations that will be carried out gradually.
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