Egg donation

from Wikipedia, the free encyclopedia

The egg donation , as allogeneic Eizelltransplantation referred to is one of the methods of reproductive medicine to fulfill the desire for children in case of unwanted childlessness . It is used when follicles in a woman's ovaries do not mature due to old age or as a result of illness . Egg donation is also carried out as part of surrogacy .

For egg donation, the ovaries of a donor are stimulated with medication to allow several egg cells to mature at the same time, which are then removed by puncture , usually under anesthesia . These egg cells are fertilized with sperm by in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) and transferred to the recipient ( embryo transfer ) or cryopreserved for a later transfer .

Egg donation is prohibited in Germany and Switzerland, and allowed in Austria since 2015.

Legal regulations

Egg donation is regulated differently in Europe . There are countries where it is banned, including Germany , Switzerland , Italy , Lithuania and Turkey . In most other European countries there are no legal regulations on this, in many cases it is tolerated. In the countries where egg donation is legally permitted and practiced (including France , United Kingdom , Spain , Netherlands , Belgium , Czech Republic , Slovakia , Poland , Ukraine , Austria ), it is largely subject to regulations that prevent exploitation to prevent the donor.

Germany

In Germany , all reproductive medicine procedures are regulated by the Embryo Protection Act (December 1990).

In § 1 paragraph 1 to 3 the following is stated:

(1) Anyone who is punished with a prison sentence of up to three years or a fine
  1. transfers a foreign unfertilized egg to a woman,
  2. undertakes to artificially fertilize an egg cell for any purpose other than to bring about a pregnancy of the woman from whom the egg cell originates,
...
 6. removes an embryo from a woman before it is implanted in the uterus, in order to transfer it to another woman or to use it for a purpose that does not serve its preservation, or
 7. undertakes to carry out artificial insemination or to transfer a human embryo to a woman who is willing to leave her child permanently after the birth to third parties (surrogate mother).
The egg recipient does not have to fear any criminal consequences
...
(3) Not to be punished
  1. in the cases of paragraph 1 nos. 1, 2 and 6, the woman from whom the egg cell or the embryo originates and the woman to whom the egg cell is transferred or the embryo is to be transferred.

It is also forbidden for gynecologists / reproductive centers in Germany to carry out preparatory measures for egg donation.

There are now lawyers who at least question the compatibility of the Embryo Protection Act with the Basic Law . Reproductive medicine, too, is striving to relax the legal possibilities. 

Due to the existing legal regulation in Germany, couples wishing to have children are forced to have the treatment carried out in another European country or in another country in the world; this phenomenon is also known as “fertilization tourism”. In the European countries bordering on Germany there are many reproductive medicine centers, some of which also work with German doctors or are given leading support.

The political party FDP is demanding that egg donation be approved in Germany. In the political party SPD there are parliamentarians such as Brigitte Zypries and Sonja Steffen who advocate approval of egg donation in Germany.

Austria

Austria has allowed egg donation since 2015, following a ruling by the Austrian Constitutional Court . Egg donation is also made possible for women couples who live in a community.

Decision of the European Court of Human Rights

The European Court of Human Rights first ruled in April 2010 that if a state allows artificial insemination , it should not prohibit egg donation. The court ruled that it was “unequal treatment that cannot be justified by objective and reasonable reasons” if couples in need of egg donation are excluded from artificial insemination. In November 2011 this decision was overturned by the Grand Chamber of the European Court of Human Rights. A ban does not conflict with the right to family planning.

frequency

After extrapolating figures from countries in which egg donation is permitted (USA, Great Britain etc.), it can be assumed that around 1000–3000 patients per year in Germany need egg donation for medical reasons In 2008 a total of 13,609 women were recipients of donated egg cells, in 2010 25,187 egg donation cycles were reported in Europe and in 2013 40,244 women in Europe were recipients of egg donation.

According to a study by ESHRE on “Cross Border Reproductive Care”, women in Europe go abroad for a total of around 24,000–30,000 treatment cycles for various reasons. From Germany, a demand for an estimated 2000 treatment cycles abroad is covered. The majority of women from Germany (80%) go abroad because the treatment methods in question are prohibited in Germany (such as egg donation). In particular, German women therefore go to the Czech Republic, Denmark and Spain. The success rates of pregnancy after egg donation are high. The birth rate (“baby take home rate”) is between 33% (UK) and 55% (USA) per embryo transfer.

Medical problems

After egg donation, pregnant women have an increased risk of developing a hypertensive pregnancy disorder , regardless of age, multiple births and the reproductive medicine method used . Pregnancies after an allogeneic egg transplant should therefore be closely monitored by doctors specializing in prenatal medicine. There is also an increased risk of bleeding in the first trimester of pregnancy .

See also

Individual evidence

  1. ↑ a b Egg donation must be allowed . In: taz , April 3, 2010
  2. ↑ The Burden of Late Motherhood . In: Süddeutsche Zeitung
  3. ↑ Debate about late motherhood broke out . In: Rheinische Post , December 4, 2007
  4. ↑ Artificial Insemination - Debate on the Frontiers of Science . In: Hamburger Abendblatt
  5. ↑ FDP for egg donation and non-commercial surrogacy . In: Ärzteblatt . 22nd September 2017
  6. ↑ Daniel Deckers: The calamities of the FDP . In: Frankfurter Allgemeine Zeitung . October 11, 2017
  7. ↑ Melanie Amann, Christiane Hoffmann, Caroline Katschak, Ann-Katrin Müller, Ralf Neukirch and Britta Stuff: Family for everyone . In: Der Spiegel . 32/2015 pp. 14-17
  8. ↑ Heike Haarhoff: Will egg donation be legalized soon? In: taz . November 25, 2013
  9. ↑ DiePresse.com: Artificial reproduction, medicine can help more
  10. ↑ Die Presse: ECHR: Egg donation is not a human right
  11. ^ The HFEA guide to infertility and directory of clinics . ( Memento of the original from November 20, 2008 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. In: HFEA  @1@ 2Template: Webachiv / IABot / www.hfea.gov.uk
  12. ↑ a b Fertility treatment in 2010 . In: HFEA 2012. (Last viewed: October 16, 2013).
  13. ↑ a b Assisted Reproductive Technology (ART). Report. Network success rate: 2010 national summary . In: CDC , 2012. (Last viewed: October 16, 2013).
  14. ↑ AP Ferraretti, V Goossens, J de Mouzon, et al .: Assisted reproductive technology in Europe, 2008: results generated from European registers by ESHRE . In: Human Reproduction 2012; 27: 2571-84. PMID 22786779 doi : 10.1093 / humrep / des255
  15. ↑ AP Ferraretti, M Kupka, J de Mouzon, et al. Assisted Reproductive Technology (ART) in Europe, 2010. Results generated from European registers by ESHRE. Preliminary results . ESHRE annual congress, 07. – 10.07.2013, London, UK PMID 25069504 doi : 10.1093 / humrep / deu175
  16. ↑ C. Calhaz-Jorge, C. De Geyter, MS Kupka, et.al .: Assisted reproductive technology in Europe, 2013: results generated from European registers by ESHRE . In: Human Reproduction 2016: 1-17 doi : 10.1093 / humrep / dex264
  17. ^ A b F Shenfield, J de Mouzon, G Pennings, et al .: Cross border reproductive care in six European countries . In: Human Reproduction 2010; 25: 1361-8. doi : 10.1093 / humrep / deq057
  18. ↑ Heribert Kentenich , Georg Griesinger: On the ban on egg donation in Germany: Medical, psychological, legal and ethical aspects . In: Journal of Reproductive Medicine and Endocrinology 10.5 (2013): 273-278.
  19. ^ Ulrich Pecks, Nicolai Maass, Joseph Neulen: Egg donation - a risk factor for hypertension in pregnancy: meta-analysis and case series. Dtsch Arztebl Int 108 (2011), 23-31, PMID 21285999 , doi : 10.3238 / arztebl.2011.0023
  20. ↑ PC Klatsky, SS Delaney, AB Caughey, ND Tran, GL Schattman, Z. Rosenwaks: The role of embryonic origin in preeclampsia: a comparison of autologous in vitro fertilization and ovum donor pregnancies. Obstet Gynecol. 116 (2010), 1387-92, PMID 21099607
  21. ↑ Myriam Baumgarten, Dominic Stoop, Patrick Haentjens, G. Verheyen, F. De Schrijver, Ingeborg Liebaers, Michel Camus, Mary-Louise Bonduelle, Paul Devroey: Oocyte donation is a risk factor for first trimester bleeding and pregnancy induced hypertension but without effect on the perinatal outcome. Hum Reprod 25 (Suppl. I) (2010), abstract online