You have spent a large sum of money on egg freezing, anticipating to undergo IVF (in vitro fertilisation) treatment in the future. However, due to changing life circumstances, you eventually find no need to utilise your frozen eggs.
For example, you might have conceived naturally after getting married. Alternatively, you might have remained single and had a change of heart in no longer wanting to have a child, because IVF treatment for single women is banned in Malaysia.
Indeed, a number of studies have shown that the overwhelming majority of women who freeze their eggs do not eventually utilise them. An Australian study published in 2021 estimated that at best, only one in five patients will eventually return to use their frozen eggs in IVF treatment.
Eventually, the time will come for you to decide on what to do with your unused frozen eggs, after concluding that you no longer need them in the future, and that it is not worthwhile continuing to pay such costly annual storage fees.
There are various options available, such as disposal, donation for research, or training of new laboratory staff, as well as donation for IVF treatment of infertile patients.
After having sacrificed so much of your hard-earned money, time, and effort in freezing your eggs, in addition to paying annual storage fees over several years; you would definitely feel heartbroken and a sense of wastefulness in simply discarding them, or donating 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 your frozen eggs. So why not donate to such patients in need, instead of wasting them?
Nevertheless, such a choice requires some serious soul-searching and hard thinking 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 who is genetically related to you and your family members may possibly be born.
Not all women who had frozen their eggs are eligible to donate. To date, Malaysian health care authorities have not specified any criteria for prospective donors of unused frozen eggs.
Instead, individual IVF clinics are free to set their own specific criteria for egg donors, which would thus vary from clinic to clinic. Generally, prospective egg donors must be quite young at the time she had frozen her eggs (preferably below 30 years of age), with her eggs being assessed to be of good quality before freezing.
Because the freezing (vitrification) process always cause some damage to the egg, however minimal, it is therefore highly essential for the eggs to be young and of good quality, so as to ensure a good survival rate after thawing, and to optimise chances of IVF success for the recipient patient.
Unlike in Singapore, patients considering to donate their unused frozen eggs in Malaysia are not required to receive professional counselling and advice from a certified fertility counsellor.
Hence, it is important to outline some of the key issues that a woman should consider before deciding whether or not to donate her unused frozen eggs to infertile patients.
Additional Hassles Of Infectious Disease Screening And Genetic Testing
Prospective egg donors must be screened to be free of infectious diseases such as HIV, syphilis, Hepatitis B, and Hepatitis C. Most likely, they would already have been screened once before the egg freezing process, but still have to undergo another extra round of screening at the time of donation.
Some IVF clinics may impose additional criteria such as genetic testing for some common hereditary diseases. Hence, the prospective donor must be willing to undergo the hassles of such additional infectious disease screening and genetic tests, at the time of her donation. The costs of such tests would likely be borne by the recipient patient.
Should The Prospective Donor Consult And Discuss With Her Husband And Other Family Members?
Absolutely yes. This is highly recommended, especially if the prospective donor is married and already have children.
Her husband should be the first person to be consulted, because of the possibility of accidental incest between the couple’s children and unknown offspring that will be born from the donation.
For older women near or past menopause, the unused frozen eggs would represent the last chance for the couple to have more children, so it is imperative that the husband must agree to his wife’s donation.
This is in accordance with the principle of mutual trust and joint decision-making in marriage. Ideally, the prospective donor should also consult her own children, especially if they are of school-going age and old enough to understand the implications of her donation.
The other stakeholders are the parents and in-laws of the prospective donor, whom should also preferably be consulted.
Chances Of Accidental And Unintended Incest
Although the possibility of accidental and unintended incest between unknown donor-conceived siblings exists, the risks are in fact quite low, given Malaysia’s relatively large population of 33 million, and the limited number of children that can be born from the donated frozen eggs, unlike the case of sperm donation.
Nevertheless, prospective donors must be aware that safeguards to prevent accidental incest in other countries are absent in Malaysia. In Singapore for example, there is a mandatory limit of three children born from each donor. In Britain, donor-conceived offspring are allowed to check from a centralised donor registry, whether they are genetically related to someone they intend to marry.
Additionally, egg donors and donor-conceived offspring are allowed access to non-identifying information on donor-conceived siblings, such as year of birth and sex.
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.
Egg donors must therefore be vigilant and warn their own natural children of the possibility of such genetic sexual attraction between themselves and unknown donor-conceived siblings.
Do Women Get Compensated For Donating Their Unused Frozen Eggs?
Unlike in Singapore, where payment for egg donation is banned by law, egg donors in Malaysia are allowed to receive substantial sums of money for their donation.
There is nothing to hinder recipient patients from compensating donors of unused frozen eggs, which may 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 such concerns do not apply to the donation of unused frozen eggs.
Because women donating their unused frozen eggs are rightfully being reimbursed highly expensive medical fees that they have already spent on egg freezing, ethical concerns with undue inducements and commercial egg trading do not apply here.
The Possibility That Your Unknown Genetic Child Might Contact You
Although the IVF clinic may have guaranteed that your donation of unused frozen eggs is anonymous, it is still possible that your unknown genetic offspring might unexpectedly contact you in the future.
There are news reports that donor anonymity has been rendered obsolete by the advent of cheap mail-order DNA testing kits and associated online ancestry and genealogy websites.
It is anticipated that universal DNA testing will become a health care norm in the near future, which will increase the likelihood of donor-conceived offspring inadvertently learning the truth of their conception via DNA matching with blood relatives on publicly accessible genomic databases.
Even if you had not placed your personal data on such databases, your family members or more distant relatives might have undergone DNA testing and have their personal information and family trees stored on such databases, which gives rise to the possibility that your unknown genetic child will eventually try to find you.
Hence, prospective egg donors must be aware of such risks, and be mentally and emotionally prepared for unexpected contact with their donor-conceived offspring, even though their donation was originally intended to be anonymous.
Possibility Of Future Regret If You Donated Your Frozen Eggs As A Childless Woman
Although you might have a sudden change of heart when it comes to having any children, regardless of whether you have gotten married after freezing your eggs, there is still the possibility of future regret if you have donated your unused frozen eggs as a childless woman.
As a woman gets older, there is no way to turn back the biological clock. Hence, once the frozen eggs have been donated, all chances of future motherhood with your own eggs will be lost forever.
Hence, 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 counselling should be provided to women considering donation, as required by most Western countries and Singapore.
Additionally, a lapse of at least one week between counselling and the signing of consent forms would be helpful in avoiding hasty decisions, and giving prospective egg donors enough time to think carefully about their choices.
After all, this is not just any ordinary 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 science at Peking University, China.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.