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  • Cited by 2
  • Print publication year: 2012
  • Online publication date: August 2012

9 - Balancing ethical criteria for the recruitment of gamete donors



Patients and clinics are constantly searching for donors. The increasing gap between supply and demand in most countries shows beyond doubt that the current systems are unable to attract a sufficient number of donors. The first suggestion for a solution is always the same: let’s pay. However, payment for body material is, at least in Europe, generally rejected on ethical grounds. Several alternative modes of compensation are currently applied. Still, the efforts made by clinics and/or governments to increase the donor pool are fairly limited. In order to curb commercialization, a number of countries do not allow clinics to take their own initiatives to attract donors. This entails that the task lies completely with the government. However, compared to the campaigns for blood and organs, governments show very little interest in organizing widespread awareness campaigns for gamete donation. Moreover, the rare campaigns that are set up are so little advertised that they might as well not be done. Only seldom are special organizations (such as the National Gamete Donation Trust in the UK) set up to alleviate the shortage of gamete donors. The most likely explanation for this reticence is that most governments and responsible institutions are not convinced of the moral status of the procedure and as a consequence do not want to associate themselves with this topic.

The practice of gamete donation is a complex system in which multiple ethical rules, legal restrictions and medical facts intermingle. Things are further complicated by the fact that there are many different types of donors. The different categories are based on dimensions with ethical, social and psychological consequences: gamete type (oocyte and sperm donors), anonymity (known, identifiable and anonymous donors) and remuneration (volunteer, commercial and patient donors) (Purewal and van den Akker, 2009). Given space restrictions, we will focus on the major findings and trends.

Ahuja, K. K.Simons, E. G. 2005 Egg-sharing: an evidence based solution to donor egg shortagesThe Obstetrician & Gynaecologist 7 112
Ahuja, K. KSimons, E. G.Mostyn, B. J.Bowen-Simpkins, P. 1998 An assessment of the motives and morals of egg-share donors: policy of “payments” to egg donors requires a fair reviewHuman Reproduction 13 2671
Almeling, R. 2007 Selling genes, selling gender: egg agencies, sperm banks, and the medical market in genetic materialAmerican Sociological Review 72 319
Anonymous, 2005
Baetens, P.Devroey, P.Camus, M.Van Steirteghem, A. 2000 Counselling couples and donors for oocyte donation: the decision to use either known or anonymous oocytesHuman Reproduction 15 476
Blyth, E. 2004 Patient experiences of an “egg sharing” programmeHuman Fertility 7 157
Blyth, E.Frith, L. 2008 The UK’s gamete donor “crisis” – a critical analysisCritical Social Policy 28 74
Blyth, E. 2009 Donor-conceived people’s access to genetic and biographical history: an analysis of provisions in different jurisdictions permitting disclosure of donor identityInternational Journal of Law, Policy and the Family 23 174
British Fertility Society Working Party on Sperm Donation Services in the UK 2008 Report and recommendationsHuman Fertility 11 147
Caulfield, T.Brownsword, R. 2006 Science and society: human dignity: a guide to policy making in the biotechnology era?Nature Reviews Genetics 7 72
Collier, R. 2010
Craft, I.Thornhill, A. 2005 Would “all-inclusive” compensation attract more gamete donors to balance their loss of anonymity?Reproductive Biomedicine Online 10 301
Daniels, K. 2007 Anonymity and openness and the recruitment of gamete donors. Part I: semen donorsHuman Fertility 10 151
Daniels, K.Feyles, V.Nisker, J.Perez-y-Perez, M. 2006 Sperm donation: implications of Canada’s Assisted Human Reproduction Act 2004 for recipients, donors, health professionals, and institutionsJournal of Obstetrics and Gynaecology Canada 28 608
Dickert, N.Grady, C. 1999 What’s the price of a research subject? Approaches to payment for research participationNew England Journal of Medicine 341 198
Ethics Committee of the American Society for Reproductive Medicine 2007 Financial compensation of oocyte donorsFertility and Sterility 88 305
EU Health and Consumer Protection, Directorate General 2006
Ferraretti, A-P.Pennings, G.Gianarolli, L.Magli, M. C. 2006 Semen donor recruitment in an oocyte donation programmeHuman Reproduction 21 2482
Guerin, J-F. 1998 Payments to gamete donors. The donation of gametes is possible without paying donors: experience of the French CECOS FederationHuman Reproduction 13 1129
Holland, S. 2001 Contested commodities at both ends of life: buying and selling gametes, embryos, and body tissuesKennedy Institute of Ethics Journal 11 263
Human Fertilisation and Embryology Authority 2005
Johnson, M. H. 1997 The culture of unpaid and voluntary egg donation should be strengthenedBritish Medical Journal 314 1401
Levine, A. 2010 Self-regulation, compensation, and the ethical recruitment of oocyte donorsHastings Center Report 40 25
Macklin, R. 1996 Cohen, C. B.New Ways of Making Babies: the Case of Egg DonationBloomingtonIndiana University Press
Nuffield Council on Bioethics 1995
Pacey, A. 2010 Sperm donor recruitment in the UKThe Obstetrician and Gynaecologist 12 43
Pennings, G. 1997 The “double track” policy for donor anonymityHuman Reproduction 12 2839
Pennings, G. 2005 Commentary on Craft and Thornhill: new ethical strategies to recruit gamete donorsReproductive Biomedicine Online 10 307
Pennings, G. 2005 Gamete donation in a system of need-adjusted reciprocityHuman Reproduction 20 2990
Pennings, G. 2007 Mirror gametes donationJournal of Psychosomatic Obstetrics & Gynecology 28 187
Pennings, G. 2010 The rough guide to insemination: cross-border travelling for donor semen due to different regulationsFacts, Views and Vision in Obstetrics and Gynaecology55
Pennings, G.Devroey, P. 2006 Subsidized in-vitro fertilization treatment and the effect on the number of egg sharersReproductive Biomedicine Online 13 8
Purewal, S.van den Akker, O. B. A. 2009 Systematic review of oocyte donation: investigating attitudes, motivations and experiencesHuman Reproduction Update 15 499
Rao, R. 2006 Coercion, commercialization, and commodification: the ethics of compensation for egg donors in stem cell researchBerkeley Technology Law Journal 21 1055
Rapport, F. 2003 Exploring the beliefs and experiences of potential egg share donorsJournal of Advanced Nursing 43 28
Schonfeld, T. 2003 Smart men, beautiful women: social values and gamete commodificationBulletin of Science, Technology and Society 23 168
Schover, L. R.Rothmann, S. A.Collins, R. L. 1992 The personality and motivation of semen donors : a comparison with oocyte donorsHuman Reproduction 7 575
Simmons, A. J. 1979 The principle of fair playPhilosophy and Public Affairs 8 307
Steinbock, B. 2004 Payment for egg donation and surrogacyMt Sinai Journal of Medicine 71 255
Thorn, P. 2007 Donor insemination: the needs of the childrenCreating Families Spring 8
Thum, M. Y.Gafar, A.Wren, M.Faris, R. 2003 Does egg-sharing compromise the chance of donors or recipients achieving a live birth?Human Reproduction 18 2363
Titmuss, R. 1970 The Gift Relationship: From Human Blood to Social PolicyNew YorkPantheon Press
Yee, S. 2009 “Gift without a price tag”: altruism in anonymous semen donationHuman Reproduction 24 3
European Parliament and Council