Cross Generational Egg Donation and Beyond

A recent case in Canada raises some very interesting ethical questions. A women with a young daughter with Turner Syndrome wished to undergo IVF with cryopreservation of the unfertilized eggs so that her daughter could use them later in her life in order to conceive rather than rely on another egg donor to provide her this opportunity for parenting.

http://www.associatedcontent.com/article/221699/medical_first_mother_to_daughter_egg.html

Never a dull moment in the world of reproductive medicine! In the above situation the girl would give birth to her 1/2 sister and raise her as her daughter. Well, I must admit that is a new one on me although I have been asked whether we could use a patient's daughter from her first marriage as an egg donor for her and her new partner. In this case, the patient's ex-husband would be the genetic grandfather of the child born to her and her new partner. Try that question out on the cocktail party circuit.

So would we do the daughter to mother egg donation? We elected not to...as the issue of consent was problematic given the unmeasurable issue of coercion between parent and child. We used to discuss such cases at UCSF with Dr. Mary Martin who served on the Ethics Committee of the American Society of Reproductive Medicine. Dr. Martin described such cases as having a high "yuck factor." The "yuck factor" was that intangible aspect of a case that simply causes a visceral negative reaction.

So what about screening tests for egg donors (and their recipients)? That is the topic of today's question of the day from 100 Questions and Answers about Infertility, the book that has yet to crack the 500,000 mark on Amazon.com.

84. What screening tests are performed on donors?


Both the ASRM and the FDA have issued clear screening guidelines and regulations for egg and sperm donors; the guidelines are available on these organizations’ respective websites. A typical evaluation involves a comprehensive history of the donor’s health and his or her family. A physical examination and comprehensive laboratory screening tests for communicable diseases are also performed. Many centers add genetic testing of the donors. A psychological assessment of all ova donors is routinely performed. Although the anonymous donor’s anonymity is preserved, the results of his or her laboratory tests, psychological profile, physical characteristics, and historical information are shared with the infertile couple. This information allows couples to carefully choose their donor and provides a certain level of comfort in knowing that proper screening was performed. Some clinics provide adult photos of their donors, but in our practice we have limited photos to those from childhood to preserve the donors’ anonymity