Donation of Human Eggs for Research

Release of a Report by the BAC

1. The Bioethics Advisory Committee (BAC) announces the release of a report entitled “Donation of Human Eggs for Research”. This Report deals with issues related to the provision of human eggs for the purpose of research, especially research into embryonic stem cells, and is part of the BAC’s longer term intention to consolidate its views and recommendations in the area of human embryonic stem cell research.

2. The Report recommends that women donating eggs for research should be reimbursed for expenses incurred and compensated for loss of time and earnings as a result of the procedures required to obtain the eggs. The BAC reiterates the paramount importance of safeguarding the welfare of all research participants, which includes the non-commercialisation of eggs in order to avoid putting women at risk of exploitation. Should an egg donor suffer from any medical complication as a direct and proximate result of the donation, she should be provided with prompt and full medical care. Responsibility for this provision should rest with the researchers and their institutions.

3. In addition, the procurement or use of human eggs from any source by procedures not consistent with the recommendations in the Report should be prohibited. Recent developments in relation to compensation of egg donors in Europe and North America highlight international concerns over the potential trade of eggs across national boundaries and the exploitation of women.

4. The Report follows a public consultation conducted by the BAC from 7 November 2007 to 7 January 2008. To facilitate public deliberation and discussion, a consultation paper was sent to 94 research, governmental and healthcare institutions (including 21 fertility clinics), and professional and religious organisations for comment. In addition, members of the public were encouraged to share their views through various means including email, and an online discussion forum and e-consultation managed by REACH. A public talk on the subject was held on 22 November 2007.

5. Written responses from 23 organisations, institutions and individuals were received, and a total of 47 entries were received on the online discussion forum, as well as 10 responses through e-consultation. The 57 responses that were received through REACH were from at least 44 individuals. Views received can be summarised as follows:
   (a) Many respondents indicated that healthy women should be allowed to donate eggs for research because women should be able to decide on how their eggs are to be used so long as such decision is made voluntarily and on a fully informed basis;
   (b) Almost all respondents were opposed to commercialisation of eggs; and
   (c) The voluntary nature of the donation, the provision of proper and comprehensible information to donors, and the need to safeguard the privacy interest of donors were emphasised.

6. The Report states the need for fair treatment of women who donate their eggs solely for research. It emphasises the overriding concern that human eggs must not be treated as a saleable commodity, although reasonable payment appears to be justified so that a donor is not made worse off by her altruistic giving. It is necessary to consider how the provision of reasonable payment to donors could be distinguished from inducing women to provide eggs for monetary gain. This distinction should be socially acceptable and not exploitative or divisive.

7. Professor Lim Pin, Chairman of the BAC, says: “A guiding principle for the BAC is one of fairness, in that an altruistic donor should not be expected to suffer any financial loss from her donation, in the form of out-of-pocket expenses, loss of time and earnings, and cost of treatment for any medical complications that may arise. Reimbursement to ensure that she does not suffer financial loss from having contributed to the greater good of society is consistent with altruistic giving to research.”

8. In addition, the BAC continues to emphasise the importance of effective consent procedures, which entails avoiding conflicts of interest and ensuring that donors are aware of the risks in making a donation. Professor Lee Eng Hin, Chairman of the Human Embryo and Chimera Working Group, adds: “In view of the high level of dependence that a woman undergoing fertility treatment tends to feel towards her attending physician, she should not be approached by her physician concerning the possibility of donating eggs for research. In cases where a woman, on her own initiative, expresses her wish to donate eggs for research, consent should be taken by an independent third party.”

9. The BAC has considered international practices and guidelines on the donation of human eggs for research purposes, together with expert views on the subject. It has also carefully considered the feedback received from the public and the written responses from various organisations. It has reached the following conclusions, which form the basis of seven recommendations:
   (a) The general ethical principles of research involving human participants should apply to the procurement and use of human eggs for research;
   (b) It is ethically acceptable for fully informed and freely consenting healthy women, not undergoing any medical treatment, to donate eggs for research;
   (c) Women who are not undergoing fertility treatment and who donate eggs specifically for research should be compensated for loss of time and earnings as a result of the procedures required to obtain the eggs. In addition, they should receive reimbursement of expenses incurred, and should also receive prompt and full medical care if complications arise as a direct and proximate result of the procedures; and
   (d) Women donating surplus eggs from fertility treatment should not be compensated, as they do not incur additional loss of time and earnings to donate their eggs for research.

LIST OF RECOMMENDATIONS

Recommendation 1

The procurement and use of human eggs for research should be regulated.

Recommendation 2

Consent for the donation of human eggs for research should be obtained without any coercion or inducement. Potential donors must be provided with sufficient information in an understandable form, and given adequate time to make an informed decision.

Recommendation 3

Donors should be informed that they have the right to withdraw consent or vary the terms of consent any time before their eggs are actually used in research.

Recommendation 4

Consent for the donation of eggs for research from women undergoing fertility treatment should be taken independently of the treatment team. The donors should confirm in writing that they do not require these eggs for future reproductive use.

Recommendation 5

Women undergoing ovarian stimulation specifically for research should be provided with prompt and full medical care when complications occur as a direct and proximate result of the donation. Responsibility for this provision should rest with the researchers and their institutions.

Recommendation 6

Egg donors should be compensated only for loss of time and earnings as a result of the procedures required to obtain the eggs, and only if the eggs were obtained specifically for research purposes, and not as a result of clinical treatment. Such compensation should be in addition to any reimbursement of expenses incurred. The relevant regulatory authority should determine the appropriate amount of such compensation.

Recommendation 7 The procurement or use of human eggs from any source by procedures not consistent with the recommendations in this Report should be prohibited.

For media enquiries, please contact:

Ms Charmaine Chan
DID: (65) 6773 1726
charmaine@bioethics-singapore.gov.sg