Egg donation for stem cell research: ideas of surplus and deficit in Australian IVF patients’ and reproductive donors’ accounts

Abstract

We report on a study undertaken with an Australian in vitro fertilisation (IVF) clinic to understand IVF patients' and reproductive donors' perceptions of oocyte (egg) donation for stem cell research. Such perspectives are particularly valuable because IVF patients form a major recruitment group for oocyte donation for research, and because patients and donors have direct experience of the medical procedures involved. Similar studies of oocyte donation have been carried out elsewhere in the world, but to date very little social science research has been published that reports on donation for research, as distinct from donation for reproduction. Our respondents expressed a distinct unwillingness to donate viable oocytes for stem cell research. In our analysis we consider a number of factors that explain this unwillingness. These include the labour of oocyte production, the inscrutability of oocytes (the lack of a test to identify degrees of fertility) and the extent to which the oocytes' fertility sets the parameters for all downstream reproductive possibilities. We draw on the science studies literature on affordances to make sense of the social intractability of oocytes, and compare them with the respondents' much greater willingness to donate frozen embryos for human embryonic stem cells research.

Juggling on a rollercoaster? Gains, loss and uncertainties in IVF patients' accounts of volunteering for a U.K. ‘egg sharing for research’ scheme

“…IVF is a rollercoaster, with sudden emotional, financial, physical highs and lows; the NESR then involves trying to juggle a wide range of other uncertainties of possible gains and losses while on that rollercoaster. It has been argued that IVF patients should not be confronted by these quandaries ‘at a time of particular vulnerability’ (Waldby & Carroll, 2012:525). That view would derive some support from the literature questioning the acquisition for research of fresh embryos from IVF patients (Ehrich, Williams, & Farsides, 2010; Haimes & Taylor, 2011; Scott et al., 2012), even if one acknowledges the crucial, contextualised, differences between eggs and embryos.…”

“…Since fresh eggs (in contrast to failed-to-fertilise eggs) ‘are always potentially useful to patients’ (Roberts & Throsby, 2008:160; Waldby & Carroll, 2012) and since patients regard producing sufficient eggs as an early successful step in IVF (Haimes & Taylor, 2009), it is unsurprising that, for most interviewees, contemplating losing 50% of those eggs was a significant consideration. Most interviewees (including all seven who went on to provide eggs) reported having produced ‘lots’ of eggs in previous cycles, ranging from 17 to 46:

‘ … it's not something that somebody who wasn't producing a lot … could really think about, because it's halving their chances’ (M02:469–510).

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“…Numerous debates have arisen over the social and ethical challenges involved in acquiring eggs for research (Haimes, Taylor, & Turkmendag, 2012; Waldby & Carroll, 2012), highlighted by the ‘Hwang scandal’ which revealed falsified results and the likely abuse of women persuaded to provide eggs (Baylis, 2009). One contentious issue is whether women should be given any financial, or other, return, either for the eggs, or for undergoing the possible risks of ovarian stimulation and egg collection (Egli et al., 2011).…”

Enculturating Cells: The Anthropology, Substance, and Science of Stem Cells

“…In some global contexts such as India the assured embryonic surplus eclipses the provenance of the human embryonic form as embryos are traded in "exchange for free IVF cycles" or seen as a "sacrifice for the greater good" (Bharadwaj 2009b, p. 253;2010b, p. 114). In other national contexts, such as Australia, the embryonic supply is disrupted on account of unwillingness to donate oocytes for stem cell research (Waldby & Carroll 2011). Additionally and frequently, women's bodies are co-opted as sites of "regenerative labor" in the bioeconomy of stem cells (Waldby & Cooper 2010, p. 3;Waldby 2011).…”

Rendered invisible? The absent presence of egg providers in U.K. debates on the acceptability of research and therapy for mitochondrial disease

“…This description is clearly a simplification; each element could be described in much greater detail to indicate the breadth and depth of this role (Baylis 2013 ; Waldby and Carroll 2012 ). Not only does the egg provider change her daily routines and give up time and money, she also draws upon the personal, familial, community and employment networks, within which she is embedded, to make her role as an egg provider possible, not least in organising or changing possible child care and or work arrangements.…”