Donor Egg IVF: The Moral, Legal and Ethical Considerations

My last post discussed the practical considerations of IVF using donor eggs. The moral, legal and ethical issues are just as pressing - if not more so. Here is a brief discussion of some of the relevant ones:

Age Considerations
How old is too old for egg donor IVF? When is a woman too old to be a mother? Does the fact that women, who already out live men, now attain an average life span of over 80 years of age entitle them to expand the limits of their reproductive performance? How does one rate the potential benefit of maturity, financial stability, all tempered by age have on child rearing against the influence of youth with it s clear physical and temporal advantages but which carries with it the ills of less stability maturity, wisdom, experience and perhaps long term commitment to family. Does the sharing of exposure to youthful physical endeavors with youthful parents outweigh the potential benefits of exposure to greater intellectual stimulation which is more likely to occur with more mature parents, albeit for a potentially shorter period of time? These are some of the questions that come up in considering the justification and merits associated with parenting at an older age.

The long-term quest for pregnancy is stressful at any age. After age 40 it takes on the added stress of the relentlessly ticking biological clock. Women between 40 and 43, who still have the ability to respond adequately to fertility drugs have the choice of attempting IVF with their own eggs or of using donor eggs. The choice of treatment is highly personal and should be considered in the light of the financial and emotional costs involved. As a woman’s age advances beyond 40 yrs and/or the closer she gets to menopause, the more likely it becomes that she would require multiple attempts at IVF to have even a reasonable chance of achieving a viable pregnancy with her own eggs. However, after the age of 43, the adverse effect of age on a woman’s egg quality so reduces the likelihood of successful IVF (with her own eggs) that egg donation represents the most rational choice.

Aspiring parents should be encouraged to carefully consider this reality. The couple must assess whether they can withstand the many possible disappointments on the road to child bearing. How important is it now that the child is genetically theirs? Is it more important to them at this point to achieve a pregnancy with donor eggs and get on with their lives? Potential parents have to answer these questions for themselves.

Legal Considerations
The “Uniform Parentage Act” which has been adopted by most states in the United States declares that the woman who gives birth to the child will be regarded as the rightful mother. Accordingly, there has to date not been any grounds for legal dispute when it comes to maternal custody of a child born through IVF with egg donation in the majority of states. In a few states such as Mississippi and Arizona, the law is less clear but nevertheless, has not been contested as yet.

Moral/Ethical Considerations
The moral-ethical and religious implications of egg donation are diverse and have a profound effect on cultural acceptance of this process. The widely held view that everyone is entitled to their own opinion and has the right to have such opinions respected, governs much of the attitude towards this process in the U.S. The extreme views on each end of the spectrum hold the gentle central swing of the pendulum in place. This attitude is a reflection of the general acceptance in the United States of diverse views and opinions and the willingness to allow free expression of such views and beliefs provided that they don’t infringe on the rights of others.

So where do we go from here? Can we, and should we, cryopreserve and store eggs or ovarian tissue from a young woman wishing to defer procreation until it becomes convenient? And if we do this, would it be acceptable to eventually have a woman give birth to her own sister or aunt? Should we store viable ovarian tissue through generations? Should egg donation become simply a future source of embryos generated for the purpose of providing stem cells, to be used in the treatment of disease states, or to “manufacture” fetuses as a source of spare body parts? If the answer to even some of these questions is “yes”…what about the checks and balances? Who will oversee and regulate the process and what form should such control take? Are we willing to engage this slippery slope, where the disregard for the dignity of the human embryo leads us to the point where the rights of a human being are more readily ignored?

Personally, I hope not.