Differences between sperm sharing and egg sharing are morally relevant

Sperm sharing arrangements involve a man (‘the sharer’) allowing his sperm to be used by people seeking donor sperm (‘the recipients’) in exchange for reduced price in vitro fertilisation. Clinics in the UK have offered egg sharing since the 1990s and the arrangement has been subjected to regulatory oversight and significant ethical analysis. By contrast, until now no published ethical or empirical research has analysed sperm sharing. Moreover the Human Fertilisation and Embryology Authority (HFEA) does not record the number of sperm sharing arrangements taking place.This paper describes the sperm sharing process providing an analysis of all the UK clinics advertising sperm sharing services. The ethical rationale for egg sharing is described: reducing the number of women exposed to the risks of stimulation and retrieval. This advantage is absent in sperm sharing where donation has no physical drawbacks. The key adverse social and emotional outcome of gamete sharing arises when the sharer’s own treatment is unsuccessful and the recipient’s is successful. This outcome is more likely in sperm sharing than in egg sharing given sperm from sharers can be used by up to 10 families whereas shared eggs only go to one other family.Given its morally relevant differences from egg sharing, sperm sharing requires its own ethical analysis. The HFEA should begin recording sperm sharing arrangements in order to enable meaningful ethical and policy scrutiny.

Human Fertilisation and Embryology Act 1990

This chapter covers the Human Fertilisation and Embryology Act 1990 and includes topics on Activities involving embryos, Prohibition on germline cells, Prohibitions on Storage and Use of Gametes, The Definition of Mother, and Definition of a Father.

6. Assisted reproduction

This chapter deals with the statutory provisions governing assisted reproduction, with particular reference to the Human Fertilisation and Embryology Act 1990 (as amended) and the Human Fertilisation and Embryology Authority. It also explores the issue of access to services and whether these are available on the National Health Service, together with the ethical and legal issues surrounding the use and storage of gametes and embryos, surrogacy arrangements, and screening of embryos. Relevant cases are considered, where appropriate.

Live birth and perinatal outcomes using cryopreserved oocytes: an analysis of the Human Fertilisation and Embryology Authority database from 2000 to 2016 using three clinical models

STUDY QUESTION Are live birth (LB) and perinatal outcomes affected by the use of frozen own versus frozen donor oocytes? SUMMARY ANSWER Treatment cycles using frozen own oocytes have a lower LB rate but a lower risk of low birth weight (LBW) as compared with frozen donor oocytes. WHAT IS KNOWN ALREADY A rising trend of oocyte cryopreservation has been noted internationally in the creation of donor oocyte banks and in freezing own oocytes for later use in settings of fertility preservation and social egg freezing. Published literature on birth outcomes with frozen oocytes has primarily utilised data from donor oocyte banks due to the relative paucity of outcome data from cycles using frozen own oocytes. STUDY DESIGN, SIZE, DURATION This was a retrospective cohort study utilising the anonymised database of the Human Fertilisation and Embryology Authority, which is the statutory regulator of fertility treatment in the UK. We analysed 988 015 IVF cycles from the Human Fertilisation and Embryology Authority (HFEA) register from 2000 to 2016. Perinatal outcomes were assessed from singleton births only. PARTICIPANTS/MATERIALS, SETTING, METHODS Three clinical models were used to assess LB and perinatal outcomes: Model 1 compared frozen own oocytes (n = 632) with frozen donor oocytes (n = 922); Model 2 compared frozen donor oocytes (n = 922) with fresh donor oocytes (n = 24 706); Model 3 compared first cycle of fresh embryo transfer from frozen donor oocytes (n = 917) with first cycle of frozen embryo transfer created with own oocytes and no prior fresh transfer (n = 326). Preterm birth (PTB) was defined as LB before 37 weeks and LBW as birth weight <2500 g. Adjustment was performed for confounding variables such as maternal age, number of embryos transferred and decade of treatment MAIN RESULTS AND THE ROLE OF CHANCE The LB rate (18.0% versus 30.7%; adjusted odds ratio (aOR) 0.61, 95% CI 0.43–0.85) and the incidence of LBW (5.3% versus 14.0%; aOR 0.29, 95% CI 0.13–0.90) was significantly lower with frozen own oocytes as compared with frozen donor oocytes with no significant difference in PTB (9.5% versus 15.7%; aOR 0.56, 95% CI 0.26–1.21). A lower LB rate was noted in frozen donor oocyte cycles (30.7% versus 34.7%; aOR 0.69, 95% CI 0.59–0.80) when compared with fresh donor oocyte cycles. First cycle frozen donor oocytes did not show any significant difference in LB rate (30.1% versus 19.3%; aOR 1.26, 95% CI 0.86–1.83) or PTB, but a higher incidence of LBW (17.7% versus 5.4%; aOR 3.77, 95% CI 1.51–9.43) as compared with first cycle frozen embryos using own oocytes. LIMITATIONS, REASONS FOR CAUTION The indication for oocyte freezing, method of freezing used (whether slow-freezing or vitrification) and age at which eggs where frozen were unavailable. We report a subgroup analysis of women using their own frozen oocytes prior to 37 years. Cumulative LB rate could not be assessed due to the anonymous nature of the dataset. WIDER IMPLICATIONS OF THE FINDINGS Women planning to freeze their own eggs for fertility preservation or social egg freezing need to be counselled that the results from frozen donor egg banks may not completely apply to them. However, they can be reassured that oocyte cryopreservation does not appear to have a deleterious effect on perinatal outcomes. STUDY FUNDING/COMPETING INTEREST(S) No specific funding was sought for the study. The authors have no relevant conflicts of interest. TRIAL REGISTRATION NUMBER N/A

Peculiarities of Legal Regulation of the Use of Genomic Technologies in Embryology and Artificial Fertilization in the UK

The development of modern medicine is based on the development of high-tech treatment methods. One of such methods includes the application of genomic research that in Russia is not inferior, but in many ways superior to the achievements of Western scientists. However, legal regulation, or rather lack of such regulation in our state prevents comprehensive application of advanced techniques in practice. In order to solve this issue, it becomes relevant to study the experience of foreign countries in order to take into account their flaws and gaps in legal regulation to deal with the debate over problems that may be associated with the application of advanced techniques. The paper considers the use of genomic technologies in the UK in the field of embryology and artificial fertilization as one of the most open areas for genomic editing in modern medicine. The paper elucidates the issue of obtaining and withdrawal (revoking or suspending) of the license by organizations that provide medical services in the field of embryology and artificial human fertilization. The authors also deal with the issue of the formation of specialized bodies, e.g. appeals committees in the Human Fertilisation and Embryology Department, dealing with narrow issues. The authors have chosen legal regulation of the issue under consideration in Britain because it appears to be the most liberal regulation as compared with the regulation applied in the other States and even under international law. This, in turn, creates grounds for fears, disputes and discussions in the expert community, which is also of particular interest to the forthcoming Russian law-making and law enforcement. For the purposes of the study, the authors analyze the provisions of the Human Fertilisation and Embryology Act in terms of their applicability both in the UK and in Russia and examine expert opinions regarding the issues under consideration. Based on the work done, the authors propose to implement the model of legal regulation under which both children who appeared as a result of genomic editing and donors are to be informed of the application of this method.

8. Reproduction

This chapter examines legal and ethical aspects of assisted reproduction. Topics discussed include infertility; the concept of reproductive autonomy; criticisms of assisted reproduction; regulation of assisted reproductive technologies; criticisms of the Human Fertilisation and Embryology Act 1990; gamete donation; surrogacy; cloning; and genetic enhancement and eugenics. The chapter explores the extent to which the state should regulate decisions around reproduction or whether they should be left to the decision of the individuals concerned. Some people believe that the interests of children to be born should be taken into account, although there is extensive debates over how this should be done.

15. Assisted Conception

All books in this flagship series contain carefully selected substantial extracts from key cases, legislation, and academic debate, providing students with a stand-alone resource. This chapter discusses the regulation of assisted conception. It first examines the regulation of assisted conception in the UK, which involves a detailed look at the legislation: the Human Fertilisation and Embryology Act 1990, and the work of the Human Fertilisation and Embryology Authority (HFEA). The chapter analyses: the licensing procedures through which clinics are inspected and authorized to perform certain procedures; access to treatment; consent to the use of gametes (sperm and eggs); gamete donation; rules governing the parentage of children; and preimplantation genetic diagnosis (PGD). It also considers mitochondrial transfer and genome editing.