Ahuja K K, Mostyn B J, Simons E G
Cromwell IVF and Fertility Centre, Cromwell Hospital, London, UK.
Hum Reprod. 1997 Dec;12(12):2845-52. doi: 10.1093/humrep/12.12.2845.
The question of payment to egg donors has recently focused the attention of both the Human Fertilisation and Embryology Authority (HFEA) and licensed clinics. An acute shortage of egg donors and the rising costs of assisted conception treatment are matters of grave concern to many patients. To understand the emotional and social effects of egg sharing and egg donation, we conducted a survey of attitudes in a group of women who had some knowledge or experience of egg donation. A total of 750 questionnaires were sent out of which 217 were returned within the specified time limit. From these, 107 respondents had experience of egg donation and 110 had made enquiries about donation. The data from these questionnaires were collated and tabulated by the National Opinion Polls (NOP) Research Group. An analysis of the data produced the following key findings: (i) donating or sharing eggs is a social issue, 94% discuss it with partners/family/friends; (ii) altruistic motives are not the prerogative of non-patient volunteers-egg share donors felt that helping the childless was as important as having a chance of in-vitro fertilization (IVF) for themselves; (iii) the treatment procedure causes the most anxiety for egg donors. The recipients were most concerned about delays, donor characteristics and how the eggs were allocated; (iv) most respondents (65%) with prior experience of egg sharing would do it again - 63% of egg share donors, 72% of egg share recipients; (v) cash rewards to egg donors and outright advertising for donors were rejected by 64 and 62% of the sample respectively; and (vi) counselling was highly valued and there were no instances of 'shattered lives' after treatment. The findings do not support the recently announced intentions of the HFEA to disallow payment to gamete donors on the grounds of devalued consent. There is no precedent in modern medicine for egg sharing. The patients surveyed drew a clear distinction between egg sharing and financial rewards. As long as egg donation is not covered by the National Health Service, it is fairer to offer egg sharing than to refuse treatment to those unable to pay.
向卵子捐赠者支付报酬的问题最近引起了人类受精与胚胎学管理局(HFEA)以及持牌诊所的关注。卵子捐赠者的严重短缺以及辅助受孕治疗成本的不断上升,是许多患者极为关切的问题。为了解卵子共享和卵子捐赠的情感及社会影响,我们对一群有卵子捐赠相关知识或经历的女性的态度进行了调查。总共发放了750份问卷,其中217份在规定时间内被收回。在这些问卷中,107名受访者有卵子捐赠经历,110名曾咨询过捐赠事宜。这些问卷的数据由全国民意调查(NOP)研究小组进行了整理和制表。对数据的分析得出了以下主要发现:(i)捐赠或共享卵子是一个社会问题,94%的人会与伴侣/家人/朋友讨论此事;(ii)利他动机并非非患者志愿者的特权——卵子共享捐赠者认为帮助无子女者与自己获得体外受精(IVF)机会同样重要;(iii)治疗过程给卵子捐赠者带来的焦虑最大。接受者最担心的是延误、捐赠者特征以及卵子的分配方式;(iv)大多数有卵子共享既往经历的受访者(65%)会再次这样做——63%的卵子共享捐赠者、72%的卵子共享接受者;(v)分别有64%和62%的样本拒绝向卵子捐赠者提供现金奖励以及直接为捐赠者做广告;(vi)咨询服务受到高度重视,治疗后没有出现“生活破碎”的情况。这些发现并不支持HFEA最近宣布的以降低同意的价值为由禁止向配子捐赠者支付报酬的意图。卵子共享在现代医学中没有先例。接受调查的患者明确区分了卵子共享和经济奖励。只要国家医疗服务体系不涵盖卵子捐赠,提供卵子共享比拒绝为无力支付费用的人提供治疗更为公平。