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Egg sharing and reimbursement of IVF

21 August 2006
By Professor Guido Pennings
Professor of Ethics and Bioethics, Ghent University, Belgium
Appeared in BioNews 372
Egg sharing remains a highly controversial procedure. The discussion on whether or not egg sharing in return for a free or reduced IVF cycle constitutes a kind of payment has been going on since the very beginning of the practice. However, from an ethical point of view, it might be more important to answer the question of whether it constitutes an inducement that may jeopardize the validity of the patient's consent, as stated by the chairman of the Ethics Committee of the British Medical Association last year. It is very difficult to find a definitive answer to that question. Still, some evidence may shed some light on this point. There has been evidence reported by Rapport in 2003 that women are reluctant to part with their eggs but still go ahead because of a desire to have a baby.

In a recent article by Pennings and Devroey (2006) in Reproductive Biomedicine Online, a different route was followed to find out about the influence of the offer of a reduced or free IVF cycle on the patients' decision to donate. On 1 July 1 2003, Belgium began providing full reimbursement for six IVF cycles. The authors compared the numbers of egg sharers before and after this date. The main finding was a drop of approximately 70 per cent. This finding seems to confirm the fear that the majority of the egg sharers donate because of restricted financial means. However, since the motivation to donate is multidimensional, one should be careful in interpreting this result. The data show that the financial incentive is the main motivation for a large majority of egg sharers. It does not show how large the group is in which there is also an altruistic motive present, be it insufficiently strong to bring the women to donate without financial return. This indirectly shows a degree of coercion. More positively, it also shows that about one in four women were prepared to donate without any incentive beside the wish to help others.

The next question obviously is how one should react to this finding: should one stop compensated egg sharing to prevent this from happening? This solution would not help anyone. Instead of shooting at the piano player, one should take away the cause of the phenomenon. The real solution lies in providing more extended funding of infertility treatment for the financially needy.

Subsidized in-vitro fertilization treatment and the effect on the number of egg sharers
Reproductive Biomedicine Online |  1 July 2006
22 September 2008 - by Dr Nataly Atalla 
The removal of anonymity in 2005 led to a reduction in the already-insufficient number of altruistic egg donors coming forward in the UK. This, combined with a strong trend towards parenthood at an older age, leads hundreds of British women to go abroad each year for treatment with donor eggs...
7 October 2005 - by Veronica English 
On 7 October, the UK's Human Fertilisation and Embryology Authority (HFEA) published the results of its sperm, egg and embryo donation (SEED) review. The British Medical Association (BMA) welcomes the majority of the conclusions in the report and particularly the principle that donation of gametes should be 'cost neutral' - that...
7 October 2005 - by BioNews 
The UK's Human Fertilisation and Embryology Authority (HFEA) has published the results of its sperm, egg and embryo donation (SEED) review, which included a survey of UK clinics and a review of current scientific and clinical evidence in this area. An accompanying public consultation, which closed in February 2005, sought...
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...
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