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为考虑捐赠未使用的剩余冷冻卵子用于生育治疗的选择性卵子冷冻患者提供咨询。

Counseling Elective Egg Freezing Patients considering Donation of Unused Surplus Frozen Eggs for Fertility Treatment.

作者信息

Chin Alexis Heng Boon, Nguma Jean-Didier Bosenge, Nkurunziza Charles, Sun Ningyu, Tong Guoqing

机构信息

Singapore Fertility and IVF Consultancy Pvt Ltd., Singapore.

Department of Obstetrics and Gynecology, Kisangani University Hospital, Kisangani, Democratic Republic of the Congo.

出版信息

Asian Bioeth Rev. 2023 Nov 29;16(2):205-221. doi: 10.1007/s41649-023-00268-z. eCollection 2024 Apr.

Abstract

The majority of women who freeze their eggs for non-medical or social reasons, commonly referred to as elective egg freezing (EEF), do not eventually utilize their frozen eggs. This would result in an accumulated surplus of unused frozen eggs in fertility clinics worldwide, which represents a promising source of donation to infertile women undergoing IVF treatment. Rigorous and comprehensive counseling is needed, because the process of donating one's unused surplus frozen eggs involves complex decision-making. Prospective EEF donors can be broadly categorized into those who have achieved motherhood and those who remained childless and have given up on motherhood aspirations. A two-step systematic counseling protocol is proposed. Firstly, it is imperative to verify and ensure that these women do not want to conceive any children with their surplus frozen eggs before proceeding with further counseling and signing of consent forms. Secondly, various motivating and dissuading factors in the donation of unused surplus frozen eggs should then be comprehensively discussed with egg freezers to facilitate informed decision-making. Key motivating factors for donation include reciprocity in wanting to share the joys of motherhood among egg freezers who already have children, goodwill to help others in need, and avoiding the wastage of surplus frozen eggs after expending so much money, time, and effort. Key dissuading factors include fear of accidental incest between natural and unknown donor-conceived offspring, as well as apprehension of unexpected future contact with unknown donor-conceived offspring due to either donor anonymity being abolished in their jurisdiction or widespread consumer DNA testing.

摘要

大多数因非医学或社会原因冷冻卵子的女性,通常称为选择性卵子冷冻(EEF),最终并不会使用她们冷冻的卵子。这将导致全球生育诊所中积累大量未使用的冷冻卵子过剩,这是一个有前景的捐赠来源,可用于接受体外受精(IVF)治疗的不孕女性。需要进行严格而全面的咨询,因为捐赠自己未使用的过剩冷冻卵子的过程涉及复杂的决策。未来的EEF捐赠者大致可分为已实现母亲身份的人和仍未生育且已放弃生育愿望的人。本文提出了一个两步系统咨询方案。首先,在进行进一步咨询和签署同意书之前,必须核实并确保这些女性不想用她们过剩的冷冻卵子孕育任何孩子。其次,然后应与卵子冷冻者全面讨论捐赠未使用的过剩冷冻卵子的各种激励和劝阻因素,以促进明智的决策。捐赠的关键激励因素包括希望在已有孩子的卵子冷冻者中分享为人母的喜悦的互惠心理、帮助有需要的人的善意,以及避免在花费了大量金钱、时间和精力后浪费过剩的冷冻卵子。关键的劝阻因素包括担心自然受孕和未知捐赠者受孕的后代之间发生意外乱伦,以及由于其所在司法管辖区废除捐赠者匿名制或广泛的消费者DNA检测而担心未来与未知捐赠者受孕的后代意外接触。

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本文引用的文献

1
When elective egg freezers become egg donors: practical and ethical issues.
Reprod Biomed Online. 2023 Jul;47(1):151-156. doi: 10.1016/j.rbmo.2023.03.019. Epub 2023 Apr 2.
2
Elective egg freezers' disposition decisions: a qualitative study.
Fertil Steril. 2023 Jul;120(1):145-160. doi: 10.1016/j.fertnstert.2023.02.022. Epub 2023 Apr 7.
4
Singapore needs to update regulation of frozen egg donation after permitting social egg freezing.
J Assist Reprod Genet. 2022 Jul;39(7):1497-1500. doi: 10.1007/s10815-022-02526-9. Epub 2022 Jun 2.
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Disposition preferences in oocyte preservation patients.
J Assist Reprod Genet. 2022 Jul;39(7):1619-1624. doi: 10.1007/s10815-022-02518-9. Epub 2022 May 19.
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Hum Reprod Open. 2022 Feb 16;2022(1):hoac001. doi: 10.1093/hropen/hoac001. eCollection 2022.
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Women Electing Oocyte Cryopreservation: Characteristics, Information Sources, and Oocyte Disposition: A Systematic Review.
J Midwifery Womens Health. 2022 Mar;67(2):178-201. doi: 10.1111/jmwh.13332. Epub 2022 Feb 13.
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Underground Gamete Donation in Sunni Muslim Patients.
J Relig Health. 2022 Aug;61(4):2905-2926. doi: 10.1007/s10943-021-01440-1. Epub 2021 Oct 18.
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Disposition intentions of elective egg freezers toward their surplus frozen oocytes: a systematic review and meta-analysis.
Fertil Steril. 2021 Dec;116(6):1601-1619. doi: 10.1016/j.fertnstert.2021.07.1195. Epub 2021 Aug 25.
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