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Sperm and egg donation: a system of need-adjusted reciprocity

8 July 2005
By Professor Guido Pennings
Professor of Ethics and Bioethics, Ghent University, Belgium
Appeared in BioNews 317
The abolition of gamete donor anonymity has led to a greater shortage of candidate donors (including sperm donors) in several countries. All kinds of solutions have been proposed, including increased payment. Another solution, namely egg sharing, has been criticised by some as morally dubious. In the meantime, as the SEED survey of the HFEA revealed, the majority of egg donors in the UK come from this source. Beside commercialisation, public education campaigns are considered to promote altruistic donation of gametes, but their success remains to be proven.

In a recent article in Human Reproduction, I present a new paradigm as a third way in between pure altruism and payment. In this system, which is called indirect mirror exchange, the partner of the person who needs gametes, donates in exchange for bonus points that are awarded to the infertile person. Simply put, a man donates sperm and his female partner receives bonus points by which she gets priority on the waiting list for donor oocytes. The same applies to the female partner. The system is based on the principle of fairness. According to this principle, a person is obligated to contribute his or her share of the costs when he or she voluntarily accepts the benefits of the system. This implies that people who intend to use donor gametes for their own reproduction are subjected to different moral rules and obligations than other persons. However, the model does not rely exclusively on the principle of reciprocity. Strict reciprocity would mean that people who cannot or want not donate, would not have access to donor gametes. There are several good reasons why this principle should be adjusted with need considerations. People who do not contribute also have a strong desire for a child and this desire demands consideration regardless of the contribution. Moreover, it would not be fair if people who cannot donate for genetic or medical reasons were to be excluded completely.

This system has a number of important advantages: it guarantees an increase of donors; it diminishes the pressure to start payment; the woman is personally involved in the infertility treatment and thus takes a risk partly for her own benefit; the system is compatible with the identifiability of the donor; and, couples who intend to use donor gametes for themselves are better aware than any other group what it is like to separate social and genetic parenthood. The main disadvantage would be the effort demanded of the female partner. However, the same objection can be made against altruistic egg donors (which are encouraged) who have no benefit whatsoever themselves. Moreover, some people believe that, just as for egg sharing, there is coercion involved. This objection, however, turns on a strange interpretation of moral obligation: if the people who intend to use donor gametes themselves have an obligation to contribute, then how can asking them to donate be coercive?

The rules regarding donation of gametes (and body material in general) exclude any benefit for the donor. However, for important social practices like our health insurance, we accept a certain quid pro quo when the benefit is framed in a system of mutually beneficial reciprocity. We should allow the same mechanism for gamete donation.
8 May 2006 - by Dr Kirsty Horsey 
A investigation undertaken by the Scotland on Sunday newspaper has found that some fertility clinics in the country are treating lesbians and single women on the National Health Service. The investigation shows that three Scottish health boards pay for donor insemination and sometimes IVF for lesbian...
11 November 2005 - by BioNews 
The number of potential sperm donors applying to one UK clinic fell sharply after 2000, 'almost certainly' due to growing awareness that changes to the law would remove donors' right to anonymity, a new study shows. The researchers, based at the Newcastle Fertility Centre at LIFE, have called for urgent...
22 October 2005 - by BioNews 
Professor Eric Blyth, speaking at the American Society for Reproductive Medicine (ASRM) conference in Montreal this week, presented an analysis of a UK Department of Health survey of sperm and egg donors, which shows that loss of donor anonymity could potentially halve the number of people donating. In April, a...
10 October 2005 - by BioNews 
Statistics accompanying the UK's Human Fertilisation and Embryology Authority (HFEA)'s publication of the results of its sperm, egg and embryo donation (SEED) review show that the profile of sperm donors in the UK has changed. The statistics show that men who donate sperm are now far less likely to...
10 October 2005 - by Dr Kirsty Horsey 
The Human Fertilisation and Embryology Authority (HFEA)'s recent publication of the results of its review of sperm, egg and embryo donation in the UK was accompanied by a press release detailing the profile of current donors. 'Who are the UK's sperm donors?' it asked, answering that the 'stereotype of...
4 July 2005 - by BioNews 
Critics of a UK campaign to encourage more people to donate eggs and sperm say that each new sperm donor recruited so far has cost the Government £ 6,250, the Daily Telegraph reports. From January to May, the £300,000 'Give Life, Give Hope' campaign has resulted in 486 calls to the...
25 April 2005 - by Professor Brian Lieberman 
In last week's BioNews, Eric Simons and Kamal Ahuja argued that egg sharing should be the only legal solution to donor egg shortages in the UK. This week, Brian Lieberman puts forward his arguments against this practice: Egg sharing is the euphemism used to describe a form of trade in...
18 April 2005 - by Dr Kamal Ahuja and Dr Eric Simons 
Egg-sharing is an arrangement that enables qualifying women to receive subsidised IVF treatment, in return for anonymously donating an agreed proportion of their eggs to paying recipients. In our paper for the Obstetrician and Gynaecologist, published on 19 April 2005, we conclude that egg-sharing is ethically and legally sound, minimises...
4 April 2005 - by BioNews 
British people conceived using donated egg, sperm or embryos will be able to ask for identifying information about the donor when they reach the age of 18, following a law change that came into force on 1 April 2005. Fertility experts have welcomed the move towards openness, but fear that...
29 March 2005 - by BioNews 
British fertility doctors say that a forthcoming law ending anonymity for egg and sperm donors will worsen the current donor shortage in the UK, and will also lead to an increase in patients seeking treatment abroad. The British Fertility Society (BFS) says it 'welcomes steps towards openness in fertility treatment...
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