Letur H
Centre de fertilité, institut mutualiste Montsouris, 42, boulevard Jourdan, 75014 Paris, France.
J Gynecol Obstet Biol Reprod (Paris). 2007 Dec;36(8):727-37. doi: 10.1016/j.jgyn.2007.06.012. Epub 2007 Sep 11.
This review aims to evaluate, in France, oocyte donation, an assisted reproductive technique (ART), for which 25 years of experience have shown its efficacy for the palliative treatment of infertility caused by ovarian exocrine failure. Its indications have since been expanded to cover certain genetic diseases and document failures of other ART attempts. Oocyte donation is performed within the framework of French legislation - bioethics laws 94-653 and 94-654 of 29 July 1994, and the revised bioethics law 2004-800 of 6 August 2004. Its main fundamental principles are: voluntary, free, anonymous donation, for which regulated confidentiality is assured and now - judicial decree 2004-606 of 24 June 2004 - and the synchronization of donor-recipient cycles with fresh embryo transfer in accordance with established safety procedures. According to the 2004 results of the French Group for the Study of Oocyte Donation (GEDO) for French centers actively involved in ART, the chance of pregnancy was increased to 43.4% for synchronized cycles with fresh embryo transfers versus 18.7% for deferred cycles with frozen-thawed embryos (P<0.01). In addition, follow-up studies reported the excellent family relationships and physical and psychological development of these children. The major difficulties encountered in the daily practice of oocyte donation concern the recruitment and management of donors, but also, and above all, the lack of optimal means to exercise this medical specialty, due to the lack of recognition of the organizational duties incurred, which are the cornerstone of the character-specific functioning of this type of ART. In comparison, we foresee that the discrepancies of this ART practice in Europe, with it differential facets, will lead to medical nomadism for those couples financially able to do so, when national conditions of access fail because of prohibitions but also as a consequence of insufficient means to perform the inherent tasks. Today, it seems essential to provide information on the particularity and practice of oocyte donation required for the comprehension of its obligations for the different players with the aim of obtaining the means necessary for the perpetuation of its practice.
本综述旨在评估法国的卵母细胞捐赠这一辅助生殖技术（ART）。25年的经验已证明其在卵巢外分泌功能衰竭所致不孕症的姑息治疗方面的有效性。此后，其适应症已扩大到涵盖某些遗传性疾病以及记录其他辅助生殖技术尝试的失败情况。卵母细胞捐赠是在法国立法框架内进行的——1994年7月29日的生物伦理法第94 - 653号和第94 - 654号，以及2004年8月6日修订的生物伦理法第2004 - 800号。其主要基本原则是：自愿、免费、匿名捐赠，对此确保有规范的保密措施，现在——2004年6月24日的司法令第2004 - 606号——以及供体 - 受体周期与新鲜胚胎移植同步，并遵循既定的安全程序。根据法国卵母细胞捐赠研究小组（GEDO）2004年针对积极参与辅助生殖技术的法国中心的研究结果，对于新鲜胚胎移植的同步周期，妊娠几率提高到了43.4%，而对于冻融胚胎的延期周期，妊娠几率为18.7%（P<0.01）。此外，随访研究报告了这些孩子良好的家庭关系以及身体和心理发育情况。卵母细胞捐赠日常实践中遇到的主要困难涉及供体的招募和管理，但更重要的是，由于缺乏对所承担组织职责的认可，而这些职责是这类辅助生殖技术特定功能的基石，所以缺乏开展这一医学专业的最佳手段。相比之下，我们预计欧洲这种辅助生殖技术实践的差异，及其不同方面，将导致那些有经济能力的夫妇出现医疗游牧现象，当由于禁令以及执行固有任务手段不足导致各国的准入条件不允许时。如今，似乎有必要提供关于卵母细胞捐赠的特殊性和实践的信息，以便不同参与者理解其义务，从而获得使其持续开展所需的手段。
