12. Egg sharing arrangements

Version 2.0

Refer to principles 2, 5, 6, 10 and 12

Regulatory principles that apply to licensed centres

  • 2.

    have proper respect for the privacy, confidentiality, dignity, comfort and well being of patients and donors;

  • 5.

    provide prospective and current patients and donors with sufficient, accessible and up-to-date information in order to allow them to make informed decisions;

  • 6.

    ensure that patients and donors have provided all relevant consents, before any licensed activity is undertaken;

  • 10.

    maintain proper and accurate records and information about all licensed activities;

  • 12.

    ensure that all licensed research that they undertake meets proper ethical standards, and is only undertaken where there is both a clear scientific justification and no viable alternative to the use of embryos;

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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

  • Gamete donors may receive licensed services, such as treatment, storage, or access to licensed services, in return for supplying gametes for donation. Egg donors who receive a benefit should be provided with that benefit in the course of the donation cycle unless there is a medical reason why they cannot be.

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Selection of egg and sperm providers

  • 12.1
    Where relevant, the possibility of donating gametes should be raised before a potential donor’s treatment begins. Patients should not be put under pressure or unduly influenced to donate gametes or embryos.
  • 12.2
    The centre should, as appropriate, treat gamete providers receiving benefits in kind in the same way as other potential gamete donors.
  • 12.3

    The centre should ensure that:

    (a) care is taken when selecting egg and sperm providers donating for benefits in kind

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

    (c) the benefit offered is the most suitable for the egg or sperm provider and recipient(s) (where relevant).

Benefits

  • 12.4
    Centres may offer benefits in kind, in the form of reduced-price or free licensed services (for example, fertility treatment or storage) or quicker access to those services, in return for providing eggs or sperm for the treatment of others.
  • 12.5
    If benefits in the form of licensed 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 receive the benefits in a subsequent cycle.

Information

  • 12.6

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

    (a) the criteria for selecting people providing and receiving gametes in exchange for benefits in kind

    (b) how the centre proposes to distribute the gametes between the provider and the recipient(s) (where relevant)

    (c) the screening that the gamete provider in a benefit in kind arrangement will undergo

    (d) the terms of the agreement to be made

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

    (f) available alternative treatment options.

Consent

  • 12.7

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

    (a) the use or storage of the gametes, and the use and storage of embryos created for the gamete provider’s own treatment, and

    (b) the use of eggs or sperm, 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 gamete provider and recipient(s) that the gamete provider may withdraw or vary their consent up to when the gametes or embryo(s) are:

    (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 gamete provider and the recipient(s) before the treatment begins, and

    (b) be set out in the written patient information included with the benefits in kind agreement. 

  • 12.9
    The gamete provider should be given enough time to consider the implications of donating, before the donation is used.
  • 12.10
    If either the gamete provider or the recipient in a benefits in kind arrangement withdraws their consent to treatment after preparation has begun, the centre should bear any financial loss it sustains as a result.

Counselling

12AInterpretation of mandatory requirements

The centre must offer anyone intending to participate in a benefits in kind arrangement the opportunity for counselling.

  • 12.11
    The counselling of those intending to participate in a benefits in kind 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 gamete provider separate from those for the recipient(s) (where relevant). Care should be taken to ensure that confidentiality is not compromised, for example, if the gamete provider and recipient(s) are treated at the same centre at the same time.

Benefits in kind agreements

  • 12.13
    The centre should draw up separate agreements with the gamete provider and with recipient(s). These agreements should be consistent with each other. The centre should abide by the terms of benefits in kind agreements it has made.

Agreement between a licensed centre and a gamete provider

  • 12.14
    When drawing up agreements between the centre and gamete providers, centres should seek legal advice.
  • 12.15
     The agreement between the centre and the gamete provider should set out all the terms of the arrangement. It should identify clearly the gamete 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 or sperm 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 gamete 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 recipient about the gamete provider and the outcome of the treatment, for example the number and sex of any resulting children.

  • 12.17

    The agreement should include a full description of what the benefits in kind are expected to involve, including:

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

    (b) the expected waiting time for treatment.

  • 12.18

    The agreement should include a statement from the egg or sperm provider confirming that they have:

    (a) had an opportunity to talk with a member of staff qualified to explain the procedures involved in providing gametes as part of a benefits in kind arrangement

    (b) received verbal and written information about the 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 gamete provider’s consent to the use of their gametes and to the creation, use and storage of embryos from the gametes

    (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 gamete provider may withdraw or vary their consent about any embryo created using their gametes 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 gamete provider is expected to pay to the treatment centre, and

    (b) if the gamete provider’s treatment or storage of their gametes is provided at a discount, the circumstances under which they would be liable for the full cost of this treatment or storage, and the amount they would have to pay.

    NOTE: If too few eggs are collected for use in a benefits in kind agreement, the woman should be given the option of using or storing 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 or sperm between the provider and recipient(s), including:

    (a) the minimum number of eggs required for a benefits in kind arrangement

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

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

Agreement between a licensed centre and a recipient

  • 12.22
    When drawing up agreements between the centre and recipient, centres should seek legal advice.
  • 12.23
    The agreement between the centre and the recipient should set out all the terms of the arrangement. It should identify clearly the 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 or sperm 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 or sperm 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 recipient about the egg or sperm provider and the outcome of the treatment, for example the number and sex of any resulting children, and the information that will be available to any children of the recipient about the egg or sperm 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 or sperm as part of a benefits in kind 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 or sperm 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 or sperm provider may withdraw or vary their consent about any embryo created using their eggs or sperm 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 the benefits in kind arrangement

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

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

Benefits in kind for research

  • 12.30
    As outlined in the previous sections, the centre should draw up agreements between the centre and the gamete provider, and the centre and the recipient (in this case, the research group), including all relevant information.
  • 12.31
    If gametes are being donated to research through a benefits in kind agreement, the centre must ensure that the eggs are divided between the donor and the recipient (the research project) by someone not directly involved in the research project.
  • 12.32
    If a centre offers benefits in kind in exchange for donating gametes both to other patients and to research, equal benefits in kind should be available. This ensures there is no advantage in donating to one recipient rather than the other.

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Other legislation, professional guidelines and information

Code of Practice edition: 8