Human Fertilisation and Embryology (HFE) Act 1990 (as amended)

• 12 (e)

  that no money or other benefit shall be given or received in respect of any supply of gametes, embryos or human admixed embryos unless authorised by Directions.

Directions

• • 0001 - Gametes and embryos

  …5. There is no restriction on the value of other benefits which may be given to the donor, but the only benefits which may be offered for this purpose are treatment services. These services should be provided to the donor in the course of the donation cycle unless there is a medical reason why they cannot be provided at that time….

Back to top

Selection of egg providers

• 12.1

  Where relevant, the possibility of donating gametes should be raised before a potential donor’s treatment cycle begins. Patients should not be put under pressure or unduly influenced to donate gametes or embryos.

• 12.2

  The centre should, as appropriate, treat egg providers involved in egg sharing arrangements in the same way as other potential gamete donors.

• 12.3

  The centre should ensure that:

  (a) care is taken when selecting egg providers in egg sharing arrangements

  (b) egg providers are fully assessed and medically suitable, and

  (c) the treatment offered is the most suitable for the egg provider and recipient(s).

Benefits

• 12.4

  If benefits in the form of treatment services are offered to an egg provider, they should be given in connection with the cycle in which eggs are supplied for a recipient’s treatment unless there is a clinical reason to defer those benefits. In the latter circumstances only, the egg provider may choose to donate all the eggs collected in the initial cycle and take advantage of the benefits in a subsequent cycle.

• 12.5

  Centres may offer benefits in kind (in line with those for egg sharing arrangements) if a man donates sperm.  The centre should, as appropriate, treat sperm providers donating for benefits in kind in the same way as other potential gamete donors.

Information

• 12.6

  The centre should provide women receiving eggs with the same information as other people seeking treatment with donated gametes. Also, before the egg sharing cycle begins, the centre should give the egg provider and the egg recipient the following written information setting out:

  (a) the criteria for selecting women providing and receiving eggs in egg sharing arrangements

  (b) how the centre proposes to distribute the eggs between the provider and the recipient(s)

  (c) the screening that a woman providing eggs in an egg sharing arrangement will undergo

  (d) the terms of the agreement to be made

  (e) the law relating to consent, in particular the rights of a woman providing eggs to vary or withdraw her consent and the implications of her doing so, and

  (f) available alternative treatment options.

Consent

• 12.7

  The person obtaining consent should ensure that an egg provider’s consent is recorded so that different conditions can be placed on:

  (a) the use of eggs and the use and storage of embryos created for the egg provider’s own treatment, and

  (b) the use of eggs and the use and storage of embryos created for the treatment of the recipient(s).

  These conditions should be able to be varied independently of each other.

• 12.8

  The person obtaining consent should tell the egg provider and recipient(s) that the egg provider may withdraw or vary her consent up to when an egg, or an embryo created using her eggs, is:

  (a) transferred to a woman

  (b) used in a research project (defined as being under the control of the researchers and being cultured for use in research)

  (c) used for training, or

  (d) allowed to perish.

  The possible consequences of this should:

  (a) be made clear to the egg provider and the recipient(s) before the egg sharing cycle begins, and

  (b) be set out in the written patient information included with the egg sharing arrangement. 

• 12.9

  The egg provider should be given enough time to consider the implications of donating, before her donation is used.

• 12.10

  If either the egg provider or the recipient in an egg sharing arrangement withdraws their consent after preparation has begun, the centre should bear any financial loss it sustains as a result.

Counselling

• 12.11

  The counselling of those intending to participate in an egg sharing arrangement should accord with the guidance from the British Infertility Counselling Association.

Confidentiality

• 12.12

  In addition to following standard procedures for protecting patient and donor confidentiality, the centre should ensure it keeps all notes, facilities and procedures for the egg provider separate from those for the recipient(s). Care should be taken to ensure that confidentiality is not compromised, for example, if the egg provider and recipient(s) are treated at the same centre at the same time.

Egg sharing agreements

• 12.13

  The centre should draw up separate agreements with the egg provider and with the egg recipient(s). These agreements should be consistent with each other. The centre should abide by the terms of egg sharing agreements it has made.

Agreement between a licensed centre and an egg provider

• 12.14

  When drawing up agreements between the centre and egg providers, centres should seek legal advice.

• 12.15

   The agreement between the centre and the egg provider should set out all the terms of the arrangement. It should identify clearly the egg provider and the centre, and be signed by both parties.

• 12.16

  The agreement should include a statement confirming:

  (a) that any patient who has consented to providing eggs for the treatment of others in licensed treatment under the HFE Act 1990 (as amended) will not be the legal parent of any resulting child/(ren)

  (b) what information will be available to the egg provider about the recipient and the outcome of her treatment, for example the number and sex of any resulting children, and

  (c) what information will be available to the egg recipient about the egg provider and the outcome of her treatment, for example the number and sex of any resulting children.

• 12.17

  The agreement should include a full description of what the treatment is expected to involve, including:

  (a) the number of treatment cycles covered by the agreement, and

  (b) the expected waiting time for treatment.

   

• 12.18

  The agreement should include a statement from the egg provider confirming that she has:

  (a) had an opportunity to talk with a member of staff qualified to explain the procedures involved in providing her eggs as part of an egg sharing arrangement

  (b) received verbal and written information about her treatment

  (c) received all the appropriate information listed in the relevant parts of this Code of Practice

  (d) been offered counselling about the implications of the treatment, and

  (e) been made aware of the screening that will be done before treatment begins.

• 12.19

  The agreement should include a statement confirming:

  (a) that the centre has obtained the patient’s consent to the treatment

  (b) that the centre has recorded appropriately the egg provider’s consent to the use of her eggs and the creation, use and storage of embryos from her eggs

  (c) that the agreement does not override the terms of paragraph 4A of Schedule 3 to the HFE Act 1990 (as amended). This states that the egg provider may withdraw or vary her consent about any embryo created using her egg at any time, until that embryo is:

  i) transferred to a woman

  ii) used in a research project

  iii) used in training, or

  iv) allowed to perish

  (d) the consequences of any variation or withdrawal of consent, and the liability of the parties involved to pay any resulting extra charges.

• 12.20

  The agreement should include a statement setting out:

  (a) what charges (if any) the egg provider is expected to pay to the treatment centre, and

  (b) if the egg provider’s treatment is provided at a discount, the circumstances under which she would be liable for the full cost of her treatment and the amount she would have to pay.

  NOTE: If too few eggs are collected for sharing, the woman should be given the option of using all the eggs for her own treatment, at the agreed discount.

• 12.21

  The agreement should include full details of the proposed arrangements for distributing the eggs between the provider and recipient(s), including:

  (a) the minimum number of eggs required for sharing

  (b) the number of recipients among whom eggs will be shared (this should be no more than two, excluding the egg provider), and

  (c) how these eggs will be distributed between the provider and recipient(s).

Agreement between a licensed centre and an egg recipient

• 12.22

  When drawing up agreements between the centre and egg recipients, centres should seek legal advice.

• 12.23

  The agreement between the centre and the egg recipient should set out all the terms of the arrangement. It should identify clearly the egg recipient and the centre, and be signed by both parties.

• 12.24

  The agreement should include a statement confirming:

  (a) that anyone who has consented to providing eggs for the treatment of others in licensed treatment under the HFE Act 1990 (as amended) will not be the legal parent of any resulting child/(ren)

  (b) the information that will be available to the egg provider about the recipient and the outcome of her treatment, for example the number and sex of any resulting children, and

  (c) the information that will be available to the egg recipient about the egg provider and the outcome of her treatment, for example the number and sex of any resulting children, and the information that will be available to any children of the egg recipient about the egg provider, including:

  i) information recorded on the HFEA Register that the children are entitled to receive, and

  ii) the circumstances under which they may receive such information.

• 12.25

  The agreement should set out what the treatment is expected to involve, including:

  (a) the number of treatment cycles

  (b) the expected waiting time for treatment, and

  (c) that a proportion of the eggs collected from the egg provider will be used for the provider’s own treatment.

• 12.26

  The agreement should include a statement from the recipient confirming that she has:

  (a) had an opportunity to discuss with an experienced member of the centre’s staff the procedures involved in receiving eggs as part of an egg sharing arrangement

  (b) received verbal and written information about her treatment

  (c) received all the appropriate information listed in the relevant parts of this Code of Practice (written information should be attached to the agreement)

  (d) been offered counselling about the implications of the treatment, and

  (e) been informed about the screening that the egg provider has undergone and the limitations of that screening in avoiding transmissible conditions.

• 12.27

  The agreement should include a statement confirming that the agreement does not override the terms of paragraph 4A of Schedule 3 to the HFE Act 1990 (as amended). This states that the egg provider may withdraw or vary her consent about any embryo created using her eggs at any time until that embryo is:

  (a) transferred to a woman

  (b) used in a research project

  (c) used in training, or

  (d) allowed to perish.

• 12.28

  The agreement should include a statement describing:

  (a) what charges the egg recipient is expected to pay to the centre, and

  (b) what treatment these charges will cover.

• 12.29

  The agreement should set out the proposed arrangements for distributing the eggs between the provider and recipient(s), including:

  (a) the minimum number of eggs required for sharing

  (b) the number of recipients among whom eggs will be shared (this should be no more than two, excluding the egg provider), and

  (c) how these eggs will be allocated between the provider and recipient(s).

Egg sharing for research

• 12.30

  As outlined in the previous sections, the centre should draw up agreements between the centre and the egg provider, and the centre and the egg recipient (in this case, the research group), including all relevant information.

• 12.31

  If eggs are being donated to research through an egg sharing agreement, the centre must ensure that the eggs are divided between the egg donor and the recipient (the research project) by someone not directly involved in the research project.

• 12.32

  If a centre offers egg sharing for treatment and research, equal benefits in kind should be available for both. This ensures that there is no advantage in donating to one recipient rather than the other.

Back to top

BICA Guidelines for Good Practice in Infertility Counselling (2008)

 

 

Back to top