You have spent a large sum of money on egg freezing, anticipating undergoing IVF (in vitro fertilization) treatment in the future. However, due to changing life circumstances, she ultimately finds no need to use her frozen eggs.
For example, you may have conceived naturally after getting married. Alternatively, you may have remained single and changed your mind by not wanting to have a child anymore, because IVF treatment for single women is prohibited in Malaysia.
In fact, several studies have shown that the vast majority of women who freeze their eggs ultimately do not use them. An Australian study published in 2021 estimated that, at best, only one in five patients will eventually use their frozen eggs again in IVF treatment.
Eventually, the time will come for you to decide what to do with your unused frozen eggs, after concluding that you will no longer need them in the future, and that it is not worth continuing to pay such expensive annual storage fees.
Various options are available, such as disposal, donation for research or training of new laboratory staff, as well as donation for IVF treatment of infertile patients.
Having sacrificed much of her hard-earned money, time, and effort in freezing her eggs, in addition to paying annual storage fees for several years; he would definitely feel heartbroken and a sense of waste by simply discarding them, or donating them for research and/or training of new lab staff.
Your doctor will likely try to persuade you that there are many infertile IVF patients who need their eggs frozen. So why not donate to those patients in need, instead of wasting them?
However, such a choice requires serious soul-searching and deep thought on your part; because this is not just a good deed to help another woman conceive a child.
There are profound psychological, social, and ethical implications, because an unknown child may be born who is genetically related to you and your family members.
Not all women who have frozen their eggs are eligible to donate. To date, the Malaysian health authorities have not specified any criteria for potential donors of unused frozen eggs.
Instead, individual IVF clinics are free to set their own specific criteria for egg donors, which would vary from clinic to clinic. In general, potential egg donors should be fairly young at the time their eggs are frozen (preferably under 30), and their eggs have been assessed to be of good quality before freezing.
Because the freezing process (vitrification) always causes some damage to the egg, however minimal, it is very essential that the eggs are young and of good quality, to ensure a good survival rate after thawing and to optimize the chances of hatching. IVF success rate for the recipient patient.
Unlike in Singapore, patients considering donating their unused frozen eggs in Malaysia are not required to seek professional advice from a certified fertility counselor.
Therefore, it is important to summarize some of the key issues a woman should consider before deciding whether or not to donate her unused frozen eggs to infertile patients.
Additional Infectious Disease Screening and Genetic Testing Issues
Potential egg donors must be screened for infectious diseases such as HIV, syphilis, hepatitis B, and hepatitis C. Most likely, they have already been screened once before the egg freezing process, but still need to undergo another additional round of screening at the time of donation.
Some IVF clinics may impose additional criteria, such as genetic testing for some common inherited diseases. Therefore, the prospective donor must be willing to undergo the inconvenience of such additional genetic testing and infectious disease screening at the time of their donation. The costs of such tests would likely be borne by the receiving patient.
Should the potential donor consult and discuss with her husband and other family members?
Absolutely. This is highly recommended, especially if the potential donor is married and already has children.
Her husband should be the first person to be consulted, due to the possibility of accidental incest between the couple’s children and the unknown offspring that will be born from the donation.
For older women near or past menopause, unused frozen eggs would represent the last chance for the couple to have more children, so it is imperative that the husband agrees to his wife’s donation.
This is in accordance with the principle of mutual trust and joint decision-making in marriage. Ideally, the potential donor should also consult her own children, especially if they are of school age and old enough to understand the implications of her donation.
The other interested parties are the parents and in-laws of the potential donor, who should preferably also be consulted.
Possibilities of accidental and involuntary incest
Although there is the possibility of accidental and unintentional incest between unknown donor-conceived siblings, the risks are quite low, given Malaysia’s relatively large population of 33 million and the limited number of children that can be born from frozen donated eggs, unlike of the case of sperm donation.
However, potential donors should be aware that there are no guarantees in Malaysia to prevent accidental incest in other countries. In Singapore, for example, there is a mandatory limit of three children born to each donor. In Britain, donor-conceived children can check with a centralized donor registry to see if they are genetically related to someone they intend to marry.
In addition, egg donors and donor-conceived children can access non-identifying information about donor-conceived siblings, such as year of birth and gender.
Then there is also the widely reported phenomenon of ‘genetic sexual attraction’, which is sexual attraction between close relatives who first met as adults, for example siblings who were separated at birth and adopted by different families.
Therefore, egg donors should be vigilant and warn their own natural offspring of the possibility of such genetic sexual attraction between themselves and unknown donor-conceived siblings.
Are women compensated for donating their unused frozen eggs?
Unlike in Singapore, where payment for egg donation is prohibited by law, egg donors in Malaysia can receive substantial sums of money for their donation.
There is nothing to prevent recipient patients from compensating donors for unused frozen eggs, which can be coordinated and facilitated by the IVF clinic itself.
Although payment for egg donation has received much criticism, due to various ethical and moral issues, most of these concerns do not apply to unused frozen egg donation.
Because women who donate their unused frozen eggs are legitimately reimbursed for the high medical costs they have already spent on egg freezing, ethical concerns with undue incentives and the commercial egg trade do not apply here.
The possibility that your unknown genetic child may contact you
Although the IVF clinic may have guaranteed that your unused frozen egg donation is anonymous, it is still possible that your unknown genetic offspring may contact you unexpectedly in the future.
There are news reports that donor anonymity has become obsolete due to the advent of cheap mail-order DNA test kits and associated online genealogy and ancestry websites.
Universal DNA testing is anticipated to become a standard of care in the near future, increasing the likelihood that donor-conceived children will inadvertently learn the truth of their conception through DNA matching with blood relatives in public access genomic databases.
Even if you had not placed your personal data in such databases, your family members or more distant relatives may have undergone DNA testing and have your personal information and family trees stored in such databases, resulting in the possibility that your unknown genetic child will eventually try to find you.
Therefore, prospective egg donors must be aware of such risks and be mentally and emotionally prepared for unexpected contact with donor-conceived offspring, even though the donation was originally intended to be anonymous.
Potential for future regret if you donated your frozen eggs as a childless woman
Although you may have a sudden change of heart when it comes to having children, regardless of whether you got married after freezing your eggs, there is still a chance of regret in the future if you donated your unused frozen eggs as a childless woman. .
As a woman ages, there is no way to turn back the biological clock. Therefore, once the frozen eggs are donated, all chances of future motherhood with your own eggs will be lost forever.
Therefore, it is strongly recommended that you have at least one child of your own before deciding to donate your unused frozen eggs to another woman.
In conclusion, women should think carefully about these various issues before deciding to donate their unused frozen eggs to help another woman conceive a child.
Perhaps professional counseling should be given to women considering donation, as required by most Western countries and Singapore.
Also, a gap of at least a week between counseling and signing consent forms would be helpful to avoid hasty decisions and give potential egg donors enough time to think carefully about their options.
After all, this is not just any good deed, but an extraordinary act of kindness, a wonderful and miraculous gift of love and life that could result in a “bundle of joy” for a childless couple.
Dr. Alexis Heng Boon Chin, originally from Singapore, is an Associate Professor of Biomedical Sciences at Peking University, China.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of any Blue code.