More than 5 million children in Europe have been born as a result of assisted reproductive technologies, yet many European countries, including Norway, have regulations that restrict different aspects of these technologies. The result is that European women travel elsewhere to get services that are not currently available in their home countries. Now, the Norwegian Biotechnology Council is recommending that egg donation be made legal in Norway.
The council has proposed that egg donation be made legal by allowing women who need help to become pregnant to be egg donors.
But Arne Sunde, the Director of the Fertility Clinic at St. Olavs Hospital and a Professor of Medicine in NTNU's Department of Laboratory Medicine, Children's and Women's Health (LBK) believes that women being treated for infertility have enough to manage without the added stress of becoming egg donors.
Sperm and egg donation should be seen the same way
The majority of the Biotechnology Council members justify their position with the fact that many childless individuals want to see infertile women and men treated alike when it comes to donation access. Sperm donation has long been practiced in Norway, and now the Biotechnology Council is proposing to also allow egg donation. Helping women to have a long-awaited child is the primary argument of support for this change.
"It's great. I am for both egg donation and surrogacy in Norway," says Sunde, "but then comes the question of where to obtain the eggs. The Biotechnology Council is falling into the same trap as many countries have done when they start up egg donation programmes."
Hormone therapy makes for complex process
It is a relatively complex process to donate eggs. Women must undergo hormone therapy, and be anaesthetized when their eggs are removed.
Sunde says that it is easy to think that doctors should harvest eggs that are easily available, such as those from women who are undergoing fertility treatments and who have to go through this process anyway.
When Denmark started their egg donation programme, they began with the model now being proposed in Norway.
Childless women can't afford to give away their own eggs
According to Sunde, Danes abandoned this approach quickly. The reasons are twofold.
People who are childless are less fertile, and the eggs are generally of poorer quality. The second reason is that women who have trouble conceiving need their eggs themselves.
"Yet another reason is a dilemma that we know can arise: the donor doesn't become pregnant, but the recipient of the eggs does," says Sunde. "Since the Biotechnology Council is proposing open egg donation, that means that the child has the right to know who the donor is. So a donor who doesn't conceive risks having a child show up on her doorstep 25 years later. It's too much to ask of these women." He adds that doctors cannot predict which eggs are best.
Can reduce the donor's ability to conceive
Childless women need their own eggs, says NTNU Professor of Medicine Arne Sunde.
"When we take out ten eggs we don't know which of them will become children. The situation could arise that a woman gives away four out of ten eggs, and precisely those four eggs are the best. Then we've suddenly taken away the ability for the donor to become pregnant herself. We shouldn't put ourselves in that situation," says Sunde. He suggests a technical possibility where donated eggs are provisionally given away and frozen until the donor has had all the children she wants.
Sunde says, "If the donor hasn't conceived after five years, she can choose to use her eggs or give them away. This way you can establish a kind of egg bank. One disadvantage, however, is that this will result in a lot of eggs that are on hold and that can't be used for many years. Egg donation programmes require a lot of work and involve extensive bureaucracy. So although this possibility is technically feasible, it would require a lot of work and be impractical."
Should allow egg donation from healthy women
Sunde believes that the Biotechnology Council should allow egg donations from fertile volunteer donors, as is the practice is in many other European countries.
"This way we'll get good eggs that provide effective treatment, and childless women won't be subjected to the cross pressures of using their own eggs. There are actually women who want to donate eggs," says Sunde, who believes that part of the intent of allowing egg donation in Norway should be to ensure that children are able to find out who their egg donor is.
Going abroad to buy eggs
"For Norwegian couples to opt for egg donation in Norway, we have to take the leap and facilitate an egg donation programme that is as good as in other countries. Spain accounts for more than half of all egg donations in Europe. They do it professionally and safely. Many Norwegian couples also go to Finland, the Baltic countries and Sweden. Norwegian couples will continue to leave the country with the current proposal in Norway. And then the child is often unable to find out who their donor was," says Sunde.
He adds that doctors are responding with little enthusiasm to setting up an egg donation programme under the suggested conditions.
Sunde feels there is little point in setting up a system that won't work. "Those of us who work in this field know this. The Biotechnology Council should have looked more closely at how egg donation programmes work in other countries. Their proposal comes across as horse-trading, and it's a shame," he says.
A step in right direction
"I first voted to allow egg donations with healthy volunteer donors," says Bjørn Myskja, the Deputy Chairman of the Biotechnology Council and an NTNU Professor of Philosophy.
"The majority of the Council wasn't for it, and I think that the proposal to allow egg donations from women undergoing fertility treatments is better than banning donations altogether. Then we at least have the chance to try it out and build expertise," he says.
"The main objection to our proposal is that it won't come close to meeting the need," he adds, "but it will certainly be a step in the right direction. Then we can eventually expand the programme."
"I also don't think that we should be too overprotective of women being treated for infertility. There is reason to believe that many of them would be interested in donating eggs and helping others. We consulted a professional who believed that the proposal could be successfully implemented. But it's a pity if many professionals feel the same way Arne Sunde does," Myskja said.
Materials provided by The Norwegian University of Science and Technology (NTNU). Original written by Anne Sliper Midling. Note: Content may be edited for style and length.
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