Egg Donation

Now if the supermarket shelves are anything to go by, Easter is just around the corner. But  a recent article I read in the Daily Mail talked about far more important egg that people are giving away, rather than the chocolate variety.

I am talking about women who donate their eggs in the UK. These volunteers are not paid for their time (other than expenses and loss of earnings up to £250), and they cannot remain anonymous, but they still really want to help.

 

The thing is, we always hear stories in the media of celebrities having babies in later life – Marcia Cross of Desperate Housewives had twins at 44 – so we sometimes forget that as women get older in life, it does become more difficult to conceive.  

 

Egg supplies dwindle dramatically after 35 (for more information on your fertility age, see our sister blog here). By 40, the chance of getting pregnant in any given month is just 5% compared to 20% at age 30. Dr Kamal Ajuha, MD of Britain’s largest fertility clinic, the London Women’s Clinic, said that after the age of 42, fertility treatment is highly unlikely to work with a women’s own eggs.

 

So it is for this reason that many couples need to seek egg donation. But it is here where the problems start. Firstly, egg donation is very expensive, and secondly there is a dire lack of egg donors in the UK. This is largely because in 2005, the Human Fertilisation and Embryology Authority ruled that egg and sperm donors could no longer remain anonymous. From this date, donations plummeted, now clinics have waiting lists for donor eggs of up to 3 years. There are fewer than 500 registered egg donors in the UK – which is nothing when you consider 1 in 6 couples will seek medical advice on infertility, and 25% of these will go on to have treatment. 1200 couples are thought to be waiting for egg donation.

 

So what does this mean for treatment abroad? Well basically huge numbers of couples from the UK are now travelling to countries including Spain, Ukraine, South Africa and India, where egg donors are still anonymous. In these countries, donors are also paid generously compared with the UK. This is definitely something to consider if you are trying for a family, for more information on fertility treatment abroad, look at these blogs.

Fertility Tourism in Spain

Have you travelled abroad for fertility treatment? We would like to know...

Found an interesting story in the Independent the other day about  a couple who conceived using donated eggs and sperm in Spain, which I thought I would share with you.

Nicola and Nigel Dawson are the proud parents of twin daughters, Mia and Hannah, now one year old. The twins were both conceived with the eggs and sperm of strangers – donors whose identity they will never know, since the treatment took place in Spain, where donor anonymity is preserved.

 How did it all happen? Well, the Dawsons, who didn’t qualify for free treatment within their Primary Care Trust, embarked on their first cycle of IVF in October 2004. Three failed IVF cycles and £15,000 later, they discovered that Nicola may be experiencing an early menopause, and was unlikely to conceive at all.  The choice the Dawsons faced was either adoption or conception using donor eggs. They decided on donor eggs but the problem was availability as the UK currently suffers from an exceptional shortage of donors, so the Dawsons decided to investigate treatment abroad.

The Dawsons were told they would have to wait 18 months to 2 years for treatment in the UK, but when they looked for treatment abroad, the waiting period was only 4-6 weeks. What’s more, the clinics offered success rate of 60%, 20% higher than had been quoted in the UK.  Faced with the statistics, Nicola and Nigel decided to travel to Barcelona, joining the growing numbers of Britons heading abroad for fertility treatment. The most popular destinations are Spain and the Czech Republic, where eggs are plentiful and donors can preserve their anonymity. What is more in the UK donors’ expenses are capped at £250, while in Spain women egg donors can claim up to €900

During the process, Nicola and Nigel were advised to use donor sperm, as well as donor eggs. The Dawsons have chosen not to hide the fact that they aren’t their daughters’ biological parents, and have started telling the girls already.  However, the girls still look similar to Nicola and Nigel, as staff at the clinic worked hard to ensure a similar genetic donor match, which they found just 5 weeks after the Dawson’s initially approached the clinic. After their treatment, the rest of their care, from the scans to the birth, was received in the UK.

The Dawsons would rather their children knew the identity of the biological parents for health history reasons, but there is little doubt that the laws ensuring anonymity positively impact on the availability of donors. When the UK Government lifted anonymity for egg and sperm donors in 2005, the effect was a catastrophic decline in donor numbers. Now anyone born by donated sperm, eggs or embryos can obtain identifying information about the donor when they reach the age of 18. Between 2004 and 2006, the number of treatment cycles using donated eggs fell 25%, while the numbers using donated sperm fell by 30%. There are currently only around 800 registered egg donors in the UK and the number of sperm donors is around 300. As a result, demand far outstrips supply and UK patients face hefty waiting lists and relatively low success rates.

 The UK’s biggest infertility support group, the Infertility Network, are working towards public debate on donorship in the UK. But until this education process is addressed, fertility tourism to the continent looks likely to rise. I think that with such a big decision, there needs to be as much information as possible for people considering treatment, whether in the UK or abroad.

Fertility Tourism – “each year 20-25,000 women from Britain are travelling abroad to access treatment which is unavailable to them at home”

There has been a lot of quite heated discussion about the fertility tourism industry lately, so much so that I thought we needed another blog. The last fertility blog was about IVF and this one is all about surrogacy. It is based on a news article that appeared on Bio News.org and IVF.net about British couples travelling abroad for commercial surrogate arrangements.

Views are very mixed on this. Professor Naomi Pfeffer, an expert in the ethics and regulation of controversial developments in medicine, said at the ‘Motherhood in the 21st Century’ conference at UCL that couples travelling abroad for commercial surrogacy are engaging in a form of exploitation. In the UK, women who act as surrogates for infertile couples are allowed to receive up to £10,000 in expenses, but any further payment is illegal. This has contributed to an acute shortage of surrogates and means many couples travel abroad to countries like India where commercially-arranged surrogacy is permitted. Professor Pfeffer warned that more vulnerable members of society could feel pressured to be surrogates in order to repay debts or buy food.

Lord Robert Winston, Professor of Fertility Studies at Imperial College, agrees that paying for commercial surrogacy was ‘a form of exploitation,’ while Professor Sammy Lee, an IVF expert who teaches medical ethics and embryology at UCL, said that the acute shortage of egg and sperm donors in the UK would quickly lead to more couples going abroad.

However, responses to Professor Pfeffer’s comments have varied hugely. Dr Malpani, a doctor from an infertility clinic in Bombay disagrees strongly with this view in his blog.

He describes a typical surrogate’s story:  “She is poor; lives in a slum; has two children; and a husband who works, but cannot make ends meet. She can continue eking out a life of quiet desperation, and because she is not educated, can never exit this hellish life. One way out of this trap is to earn some money by being a surrogate. Not only does this earn her family some money which may allow her to get a better education for her children, it also ensures her some rest and pampering during her pregnancy.”

Dr Malpani does agree that some clinics can exploit these women, who are often very poorly educated, but he calls for regulations and guidelines to protect the surrogates. He says “to claim that it’s the infertile women who are exploiting the surrogates is very unfair”. He continues that it’s in the infertile couple’s best interests that the surrogate be well-nourished and well-cared for during her pregnancy, to ensure their baby gets the best prenatal care. Similarly, the following blog views surrogacy in India as the fastest-evolving form of assisted reproduction and as a benefit to the Indian economy.

So, travelling abroad for surrogacy is obviously a big issue for all concerned, but it is not going away - A study, presented at the European Society for Human Reproduction and Embryology (ESHRE)’s annual conference, indicated that each year 20,000-25,000 women from Britain are travelling abroad to access treatment which is unavailable to them at home. We would love to hear your thoughts on this very emotive issue – who do you agree with?

Fertility Tourism – "each year 20-25,000 women from Britain are travelling abroad to access treatment which is unavailable to them at home"

There has been a lot of quite heated discussion about the fertility tourism industry lately, so much so that I thought we needed another blog. The last fertility blog was about IVF and this one is all about surrogacy. It is based on a news article that appeared on Bio News.org and IVF.net about British couples travelling abroad for commercial surrogate arrangements.

Views are very mixed on this. Professor Naomi Pfeffer, an expert in the ethics and regulation of controversial developments in medicine, said at the ‘Motherhood in the 21st Century’ conference at UCL that couples travelling abroad for commercial surrogacy are engaging in a form of exploitation. In the UK, women who act as surrogates for infertile couples are allowed to receive up to £10,000 in expenses, but any further payment is illegal. This has contributed to an acute shortage of surrogates and means many couples travel abroad to countries like India where commercially-arranged surrogacy is permitted. Professor Pfeffer warned that more vulnerable members of society could feel pressured to be surrogates in order to repay debts or buy food.

Lord Robert Winston, Professor of Fertility Studies at Imperial College, agrees that paying for commercial surrogacy was ‘a form of exploitation,’ while Professor Sammy Lee, an IVF expert who teaches medical ethics and embryology at UCL, said that the acute shortage of egg and sperm donors in the UK would quickly lead to more couples going abroad.

However, responses to Professor Pfeffer’s comments have varied hugely. Dr Malpani, a doctor from an infertility clinic in Bombay disagrees strongly with this view in his blog.

He describes a typical surrogate’s story:  “She is poor; lives in a slum; has two children; and a husband who works, but cannot make ends meet. She can continue eking out a life of quiet desperation, and because she is not educated, can never exit this hellish life. One way out of this trap is to earn some money by being a surrogate. Not only does this earn her family some money which may allow her to get a better education for her children, it also ensures her some rest and pampering during her pregnancy.”

Dr Malpani does agree that some clinics can exploit these women, who are often very poorly educated, but he calls for regulations and guidelines to protect the surrogates. He says “to claim that it’s the infertile women who are exploiting the surrogates is very unfair”. He continues that it’s in the infertile couple’s best interests that the surrogate be well-nourished and well-cared for during her pregnancy, to ensure their baby gets the best prenatal care. Similarly, the following blog views surrogacy in India as the fastest-evolving form of assisted reproduction and as a benefit to the Indian economy.

So, travelling abroad for surrogacy is obviously a big issue for all concerned, but it is not going away - A study, presented at the European Society for Human Reproduction and Embryology (ESHRE)’s annual conference, indicated that each year 20,000-25,000 women from Britain are travelling abroad to access treatment which is unavailable to them at home. We would love to hear your thoughts on this very emotive issue – who do you agree with?

Born in the USA

"I discovered that a number of British couples visit the Big Apple for different reasons"

When I think of a trip to New York I think of going on a shopping spree, or checking out the Statue of Liberty, but in a recent news article,  I discovered that a number of British couples visit the Big Apple for different reasons – it might be their last chance to have a child, through IVF treatment.

What is more, IVF treatment in the US provides an added dimension because couples are allowed to pick the sex of their child — a process that is banned in the United Kingdom, except when it is used to screen for genetic diseases. American medical centres report interest from British patients who find out about their “family balancing” IVF services through online advertisements. At one New York clinic, half of the embryos at present undergoing tests belong to British parents.

The Genetics and IVF Institute in Virginia was one of the first medical centres in America to offer family balancing. Between 10 and 15 per cent of the 400 pre-implantation diagnosis cycles that it oversees each year come from abroad.  And this medical tourism doesn’t come cheap – the bill for procedures, travel and hotels can add up to £20,000.

On our side of the pond, the Human Fertilisation and Embryology Authority  remain more cautious about sex selection in IVF. “In the US there is no official regulator to monitor clinics and no legal obligation to offer the counselling that is an important part of treatment,” a spokesman said.

So, there is clearly a lot to think about before undergoing IVF treatment abroad, and a lot more than I have covered in this short blog. After all, booking a normal holiday can be a pretty stressful experience, let alone with life altering decisions about a new baby, and the huge expense involved in both the travel and the treatment. But here are some useful sites that might provide more information on, for example, the laws on IVF for different countries, the counselling policies etc, the specialist travel insurance required:  the International Medical Treatment Association; Treatment Abroad.com; http://www.yoursurgeryabroad.com/infertility-treatments and www.bionews.com.