Cost effectiveness of utilizing cryo-bank oocytes versus fresh donor oocytes in an anonymous oocyte donation program

ABSTRACT A growing number of people desire ART with cryopreserved donor oocytes. The allocation of these oocytes to couples and mothers to be is a 2-fold process. The first step is to select a pool of recipients. The second step is to decide who should be treated first. Prioritizing recipients is critical in settings where demand outstrips supply. So far, the issue of how to fairly allocate cryopreserved donor oocytes has been poorly addressed. Our ethical analysis aims to support clinics involved in allocation decisions by formulating criteria for recipient selection irrespective of supply (Part I) and recipient prioritization in case supply is limited (Part II). Relevant criteria for recipient selection are: a need for treatment to experience parenthood; a reasonable chance for successful treatment; the ability to safely undergo an oocyte donation pregnancy; and the ability to establish a stable and loving relationship with the child. Recipients eligible for priority include those who: have limited time left for treatment; have not yet experienced parenthood; did not undergo previous treatment with cryopreserved donor oocytes; and contributed to the supply of donor oocytes by bringing a donor to the bank. While selection criteria function as a threshold principle, we argue that the different prioritization criteria should be carefully balanced. Since specifying and balancing the allocation criteria undoubtedly raises a moral dispute, a fair and legitimate allocation process is warranted (Part III). We argue that allocation decisions should be made by a multidisciplinary committee, staffed by relevant experts with a variety of perspectives. Furthermore, the committees’ reasoning behind decisions should be transparent and accessible to those affected: clinicians, donors, recipients and children born from treatment. Insight into the reasons that underpin allocation decisions allows these stakeholders to understand, review and challenge decisions, which is also known as accountability for reasonableness.

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Social egg freezing and donation: waste not, want not

Journal of Medical Ethics ◽

10.1136/medethics-2020-106607 ◽

2021 ◽

pp. medethics-2020-106607

Author(s):

Alex Polyakov ◽

Genia Rozen

Keyword(s):

Cost Effectiveness ◽

Unmet Need ◽

Psychological Sequelae ◽

Compensatory Mechanisms ◽

Ethical Implications ◽

Donor Oocytes ◽

Low Rate ◽

Egg Freezing ◽

Social Egg Freezing

The trend towards postponement of childbearing has seen increasing numbers of women turning towards oocyte banking for anticipated gamete exhaustion (AGE banking), which offers a realistic chance of achieving genetically connected offspring. However, there are concerns around the use of this technology, including social/ethical implications, low rate of utilisation and its cost-effectiveness. The same societal trends have also resulted in an increased demand and unmet need for donor oocytes, with many women choosing to travel overseas for treatment. This has its own inherent social, medical, financial and psychological sequelae. We propose a possible pathway to address these dual realities. The donation of oocytes originally stored in the context of AGE banking, with appropriate compensatory mechanisms, would ameliorate AGE banking concerns, while simultaneously improving the supply of donor oocytes. This proposed arrangement will result in tangible benefits for prospective donors, recipients and society at large.

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The possibility of using selective embryo transfer in the oocyte donation programmes

Journal of obstetrics and women s diseases ◽

10.17816/jowd64115-22 ◽

2015 ◽

Vol 64 (1) ◽

pp. 15-22

Author(s):

Victoria Vladislavovna Gabaraeva ◽

Alla Stanislavovna Kalugina

Keyword(s):

Embryo Transfer ◽

Oocyte Donation ◽

Donor Oocytes ◽

Double Embryo Transfer

The aim of the study was to analyze the outcomes of donation programmes with selective embryo transfer and double embryo transfer using native and vitrified donor oocytes.

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