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新加坡在允许社会冻卵后,需要更新对冷冻卵子捐赠的监管规定。

Singapore needs to update regulation of frozen egg donation after permitting social egg freezing.

机构信息

School of Medical & Life Sciences, Sunway University, 46150, Subang Jaya, Selangor Darul Ehsan, Malaysia.

出版信息

J Assist Reprod Genet. 2022 Jul;39(7):1497-1500. doi: 10.1007/s10815-022-02526-9. Epub 2022 Jun 2.

Abstract

With social egg freezing being permitted in Singapore, there is expected to be an accumulated surplus of unused frozen eggs (vitrified oocytes) available for donation in coming years. A comprehensive update of current healthcare regulations pertaining to frozen egg donation is needed to resolve various pertinent ethical issues. In particular, the issue of egg donor anonymity should be addressed, together with the lack of sharing of medical and family information about the donor to prospective recipient patients and donor-conceived offspring. Rigorous and comprehensive genetic testing of prospective egg donors must be mandated to protect the welfare of recipient patients. Older women above 35 years of age should be required to have at least one child, before being allowed to donate their unused frozen eggs, to prevent any future regret and psychological problems of remaining childless, while being unsure of whether they have an unknown genetic offspring out there. New regulations drafted to address these ethical issues must also prevent potential conflicts of interests. For example, fertility doctors soliciting and encouraging former patients to donate their unused frozen eggs face an obvious conflict of interest, because additional medical fees will be earned by performing the egg donation procedure on other patients. A centralized donor registry should be established by the Singapore government to oversee the distribution and allocation of donated unused frozen eggs to infertile IVF patients. Such a registry could also facilitate sharing of vital health information about the donor to recipient patients and donor-conceived offspring.

摘要

随着新加坡允许进行社会层面的冻卵,预计未来几年将有大量未使用的冷冻卵子(玻璃化卵子)可供捐赠。为了解决各种相关的伦理问题,需要对现行的冷冻卵子捐赠相关的医疗保健法规进行全面更新。特别是,应该解决卵子捐赠者匿名的问题,以及缺乏向潜在的受卵患者和由捐赠卵子受孕的后代分享有关捐赠者的医疗和家庭信息的问题。必须对潜在的卵子捐赠者进行严格和全面的基因检测,以保护受卵患者的福利。年龄在 35 岁以上的高龄女性,在被允许捐赠其未使用的冷冻卵子之前,应该至少生育一个孩子,以防止因未来无法生育而感到遗憾和出现心理问题,同时也不确定是否有未知的遗传后代。为了解决这些伦理问题而起草的新法规也必须防止潜在的利益冲突。例如,寻求并鼓励前患者捐赠其未使用的冷冻卵子的生育医生,就面临着明显的利益冲突,因为对其他患者进行捐卵手术会带来额外的医疗费用。新加坡政府应建立一个集中的捐赠者登记处,以监督捐赠的未使用的冷冻卵子在不孕不育的 IVF 患者中的分配和使用。该登记处还可以促进向受卵患者和由捐赠卵子受孕的后代分享有关捐赠者的重要健康信息。

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本文引用的文献

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Guidance regarding gamete and embryo donation.配子和胚胎捐赠指导。
Fertil Steril. 2021 Jun;115(6):1395-1410. doi: 10.1016/j.fertnstert.2021.01.045. Epub 2021 Apr 8.
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Is Payment for Egg Donation an Undue Inducement?卵子捐赠报酬是否属于不当诱因?
New Bioeth. 2018 Nov;24(3):240-248. doi: 10.1080/20502877.2018.1521497. Epub 2018 Sep 19.

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