Egg-sharing: an evidence based solution to donor egg shortages

Does egg-sharing negatively impact on the chance of the donor or recipient achieving a live birth?

This study aimed to discover whether egg sharing compromises the chance of donors or recipients achieving a live birth. A descriptive cohort study was performed of 4,545 fertility patients and 5,316 stimulation cycles at a London based fertility clinic between 2010 and 2019. There was no significant difference in clinical pregnancy rate (CPR) or live birth rate (LBR) between egg sharers and standard IVF patients or between egg sharing recipients and non-egg sharing recipients. Both egg sharers and their recipients had fewer oocytes and fewer day 3 embryos available for fresh embryo transfer or cryopreservation than standard IVF patients or non-egg sharing recipients. The cumulative LBR were significantly lower amongst egg sharers than standard IVF patients (p < 0.05), and significantly lower amongst egg sharing recipients than non-egg sharing recipients (p < 0.05). This study demonstrates that egg sharing does not compromise the chances of donors or their recipients achieving a live birth. However, participants may occasionally require additional ovarian stimulation cycles to conceive. With government funding for IVF treatment falling, egg sharing provides a practical option to allow more women access to IVF. Egg sharing is currently the most efficient way of maximising the use of the precious resource of human oocytes.

Oocyte provision as a (quasi) social market: Insights from Spain

The provision of oocytes plays an important role in human fertility treatments. Spain alone performs half of oocyte provision cycles in the European Union whilst all other European countries face an oocyte shortage. How do Spanish fertility clinics manage to match the increasing domestic and foreign demand for female oocytes? Adopting a weak performativity approach and drawing insights from interviews carried out with 20 fertility clinic representatives, this study suggests that Spanish clinics are successful thanks to an egg provision system designed as a (quasi) social market. In the absence of traditional market mechanisms based on price fluctuations, the combination of fixed monetary compensation for providers and altruistic framing of oocyte provision as an act of donation, are used to mobilize relatively high numbers of women. Fertility clinics optimize this supply through a set of supplementary strategies to ensure oocyte supply always meets oocyte demand. Though successful, this market design reinforces gender stereotypes and relies on manipulative notions of altruism. A clear but unacknowledged appropriation of women's bodies and reproductive labour are also operated, which reinforces and reproduces racial and social stratifications. Therefore, we ask whether alternative mechanisms to promote female solidarity across different generations, to raise awareness of the risks of advanced maternal age, and to explore alternative market designs should be considered.

UK guidelines for the medical and laboratory screening of sperm, egg and embryo donors (2008)

This article updates the 1999 British Andrology Society (BAS) guidelines for the screening of sperm donors and the 2000 British Fertility Society (BFS) guidelines for the screening of egg and embryo donors and combines the new recommendations into a single document. This was achieved by a multidisciplinary working group composed of representatives from the Association of Biomedical Andrologists, the Association of Clinical Embryologists, the BAS, the BFS and the Royal College of Obstetricians and Gynecologists. The major changes to the guidelines include a requirement to consider a donor's risk of transmissible spongiform encephalopathies and the recommendation to screen for human T cell lymphotropic viruses 1 and 2. The role of nucleic amplification tests for the detection of blood borne viruses such as HIV is discussed, but it remains the recommendation that this be achieved by serological testing to detect antibody or antigen as appropriate with a quarantine period of 180 days.

Advanced oocyte cryopreservation will not undermine the practice of ethical egg sharing

The fear that the ethics and practice of egg sharing will be undermined by the growing success of oocyte cryopreservation is not based on published evidence. Separate contracts and directed counselling of donors and recipients as required by law in the UK provide protection against potential pitfalls with egg sharing. The cost and waiting time for egg donation might even fall should oocyte cryopreservation become a practicable procedure.