Compliance with donor age recommendations in oocyte donor recruitment advertisements in the USA

Abstract

IVF using donated oocytes offers benefits to many infertile patients, yet the technique also raises a number of ethical concerns, including worries about potential physical and psychological risks to oocyte donors. In the USA, oversight of oocyte donation consists of a combination of federal and state regulations and self-regulatory guidelines promulgated by the American Society for Reproductive Medicine. This study assesses compliance with one of these self-regulatory guidelines - specifically, ASRM's preferred minimum age for donors of 21. To assess compliance, 539 oocyte donor recruitment advertisements from two recruitment channels (Craigslist and college newspapers) were collected and evaluated. Of these, 61% in the Craigslist dataset and 43% in the college newspaper dataset listed minimum ages between 18 and 20, which is inconsistent with ASRM's preferred minimum age recommendation of 21. Advertisements placed by oocyte donor recruitment agencies were more likely than advertisements placed by clinics to specify minimum ages between 18 and 20. These results indicate that ASRM should evaluate and consider revising its donor age guidelines. IVF using donated human eggs can help many patients who have difficulty having children. However, the technique also raises ethical concerns, including concerns about potential physical and psychological harms to egg donors. In the USA, oversight of egg donation relies on a combination of federal and state regulation and professional self-regulation. Governmental regulations address only limited aspects of egg donation, such as the potential spread of infectious diseases and the reporting of success rates, leaving voluntary guidelines developed by an association of medical professionals to address most issues, including ethical concerns raised by the practice. One of these voluntary guidelines recommends that egg donors should be at least 21 years of age. In this article, we analysed 539 egg donor recruitment advertisements published on Craigslist and in college newspapers to see whether fertility clinics and egg donor recruitment agencies follow this recommendation. We found that 61% of advertisements in the Craigslist dataset and 43% of advertisements in the college newspaper dataset listed minimum ages between 18 and 20 and, thus, did not follow the recommendation that egg donors be at least 21 years of age. Advertisements placed by egg donor recruitment agencies were more likely than advertisements placed by fertility clinics to list minimum ages between 18 and 20. These results indicate that the American Society for Reproductive Medicine should evaluate and consider revising its donor age guidelines.

Alignment between expectations and experiences of egg donors: what does it mean to be informed?

“…The findings presented in this paper highlight the presentation of potential risks as a gap in the informed consent procedures for compensated and uncompensated egg donors. This concurs with existing literature that addresses the challenges of providing fully informed consent ( Alberta et al, 2013 , Alberta et al, 2014 ; ASRM, 2004 ; Gezinski et al, 2016 ; Kenney and McGowan, 2010 ), as well as ways to improve consent by utilizing multi-media platforms ( Madeira et al, 2018 ). Theories of informed consent for medical practice emphasize two conditions for the validity of patient autonomy: understanding and voluntariness ( Faden and Beauchamp, 1986 ; Skillern et al, 2013 ; Valapour et al, 2011 ).…”

Risk Disclosure and the Recruitment of Oocyte Donors: Are Advertisers Telling the Full Story?

“…Their self-regulatory force extends to ASRM members; IVF clinics that are members of the Society for Assisted Reproductive Technology (SART), which is an organization of ART professionals affiliated with ASRM; and to oocyte donor agencies that register with SART, signing an agreement to abide by ASRM guidelines. 35 Several studies have examined compliance with various ASRM guidelines, 36 and two studies have evaluated risk disclosure on clinic and donor agency websites. 37 However, to our knowledge, no studies to date have examined compliance with the ASRM guidelines regarding risk disclosure in recruitment advertisements.…”

A survey on public opinion regarding financial incentives for oocyte donation in Brazil

“…Oocyte donation involves unpleasant and invasive procedures that are associated with certain risks and thus require a substantial commitment on the part of the donor. These risks include complications with the drugs that are used to induce ovulation, complications with follicular aspiration and ovarian hyperstimulation syndrome; potencial negative impact on future fertility and psychological damage (Bodri et al, 2008;Kramer et al, 2009;Bukulmez et al, 2010;Aragona et al, 2011;Stoop et al, 2012;Weinerman & Grifo, 2012;Alberta et al, 2013;Siristatidis et al, 2013). While OD is not prohibited in Brazil, the practice usually involves a long wait for the oocytes, which often exceeds one year.…”