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05 December 2003

Dear __________

Compensated Egg Donation (Egg Giving)

As you may recall I wrote to you in July of this year [CH(03)05] in relation to egg giving arrangements. In this letter I stated that the Authority had never authorised or approved of egg giving and that we would be reviewing this practice over the next few months and would issue guidance to clinics by the end of 2003.

Egg giving is an arrangement whereby a person seeking IVF treatment agrees at the outset to go through one cycle of treatment in which all the eggs collected are donated to one or more other women, followed by a further IVF cycle for their own treatment at reduced cost.

This review has now been completed and was discussed by the full Authority at its meeting in November. The opinions of the professional bodies (RCOG, BFS, RCN Fertility Nurses Group and BICA) were taken into consideration as was practice in the rest of Europe.  All the professional bodies consulted regarded egg giving as an unsuitable practice. The Authority also noted that a survey of practices in other European countries found no evidence of egg giving being undertaken.

The Authority was concerned that egg giving arrangements expose women unnecessarily to two treatment cycles with all the inherent medical risks.  Of particular concern to the HFEA was the extra risk of ovarian hyperstimulation syndrome (OHSS).  Although the risk to IVF patients of suffering OHSS is low, about 1%, those taking part in egg giving programmes run this risk twice. The Authority was not convinced that egg giving offers any significant advantage to the egg provider that would justify these additional risks, especially as the egg provider would have no chance of pregnancy in her first cycle of treatment.

Some women, and their partners, find in vitro fertilisation treatment physically and psychologically demanding. If a couple, taking part in an egg giving arrangement find the experience of the first cycle stressful, they may be unable to contemplate further treatment. This would put the couple in the unacceptable predicament of either undergoing an additional cycle of infertility treatment with all the attendant risks or abandoning their primary goal of achieving a live birth.

In the light of these concerns the Authority expects that a clinic should not make an arrangement with a woman seeking in vitro fertilisation treatment whereby the woman agrees, prior to the commencement of her own treatment, to go through one cycle in which all of her eggs are donated to another woman or women.

This guidance may be taken into account by a Licence Committee in determining whether a clinic is carrying out suitable practices.

Clinics that offer egg sharing are reminded that, in operating such schemes, they must comply with the requirements of the HF&E Act 1990 and the Code of Practice. In particular, centres must ensure that suitable practices are used and that the interests of the egg provider are protected at all times. As I mentioned in my previous letter we will be undertaking a wider review of all gamete donation practices, including egg sharing, during 2004.

If you have any queries regarding this letter you can contact Dr Chris O'Toole by telephone on 0207 539 3324 or via e-mail at chris.otoole@hfea.gov.uk.  

Yours sincerely

Suzi Leather
Chair

Page last updated: 14 April 2009

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