Louise Brown, the world's first in vitro fertilization baby, was born in 1978 in Oldham, England. Five years later, the world's first birth using a donated egg occurred in Monash, Australia. Since then, egg donation--which separates the roles of birth mother and genetic mother--has been adopted worldwide, although its full impact on family and society is still debated.
Emotional
Donation of eggs raises emotional issues for the egg donor, the recipient and other family members. Psychological counseling can help the egg donor and the recipient couple fully explore the feelings and concerns that may arise from egg donation. Egg donors who don't have children may regret donating eggs if they experience infertility later in life. If egg donors are family members, egg donation may impact family dynamics.
Whether to disclose to the child or the extended family that the child was conceived using an egg donor can be a difficult decision. The American Society for Reproductive Medicine recommends that parents inform children about egg donation.
Legal
Legal contracts are recommended before egg donation occurs to clarify the duties and obligations of the egg donor and recipient. Contracts between the donor and recipient usually clarify that the donor gives up all rights to the donated eggs and to any offspring that may result from the donation. Financial compensation of the donor is usually described in a legal contract.
According to the Uniform Parentage Act, an egg donor is not considered the mother of children born from her eggs. Because the egg recipient is usually also the birth mother, the recipient birth mother is designated as the mother on the child's birth certificate. In cases in which a gestational surrogate is used, the recipient may have to formally adopt the child because she did not give birth to him.
Ethical
Paying donors for their eggs raises two ethical concerns, according to ASRM's ethics committee in its publication, "Financial compensation of oocyte donors." First, the interests and rights of egg donors must be protected when they are being recruited to donate their eggs. The donor must be fully informed of all foreseeable medical and emotional risks so she can give full and informed consent.
A second concern is that paying for egg donation devalues human life by treating eggs as property. According to the ASRM ethics committee, as long is the payment is not unreasonably large and covers reasonable expenses in consideration of time, inconvenience and discomfort from egg retrieval, payment for the donation service and not the eggs themselves is ethical and comparable to paying sperm donors for their donation.
Egg donation without compensation can also raise ethical concerns. Within a family, younger relatives may feel emotionally pressured or even intimidated to donate eggs for older relatives.
Religious
Religious opinions about egg donation vary widely, even within a religious tradition. Traditional rabbinical doctrine is that Jewish identity arises from the birth mother. At a January 2010 meeting of Orthodox Jews at the Puah Institute in Jerusalem, Rabbi Mordechai Halperin said that religious rabbinical opinion was moving toward the concept that the source of the genetics--the egg--determines the religious identity of the offspring, not the birth mother. This revised opinion has raised concerns among some Orthodox Jews who have used non-Jewish egg donors that their children would not be considered Jewish.
Christians also hold various opinions regarding egg donation according to Agneta Sutton in "Three Christian Views on Assisted Conception and Marriage: The Roman Catholic Church, Church of England and Presbyterian Church of Scotland." The Roman Catholic Church does not approve of egg donation under any conditions, whereas Protestant Christian groups may be more tolerant of egg donation to married couples.
References
- New York State Task Force on LIfe and Law: Thinking of Becoming an Egg Donor
- Wall Street Journal: Fertility Treatment gets more complicated
- ASRM: Family members as gamete donors and surrogates
- ASRM: Financial compensation of oocyte donors
- ASRM: Informing offspring of their conception by gamete donation
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