The phrase “third-party reproduction” refers to the use of eggs, sperm or embryos that have been donated by a third person (donor) or surrogacy (gestational carrier) where another woman provides her uterus so that a woman can have a child. However, the third party’s involvement is limited to the reproductive process and does not extend into the raising of the child.
Third party reproduction has made open a candid discussion of sperm, oocyte and embryo donation as a common practice. This breakthrough has given way to the donation of human oocytes and embryos as a routine similar to other donations such as blood and major organ donations.
- Sperm donation
It is the donation by a man, the ‘sperm donor’, of his sperm, to impregnate a woman who is not his sexual partner. Sperm is always donated through a sperm bank or clinic, which are subject to varying state regulations, including restrictions on donor anonymity and number of offspring. Use of sperm donated by a relative or a known friend or either the wife or the husband is not permitted by law.
INDICATIONS
- Heterosexual couples suffering from male infertility(low sperm count /motility, absent sperms)
- Lesbian couples/Single women.
- Egg donation
It is the process by which a woman provides one or several eggs (ova, oocytes) for purposes of assisted reproduction or biomedical research. For assisted reproduction purposes, egg donation involves the process of in vitro fertilization(IVF) as the eggs are fertilized in the laboratory.
Indication
- Congenital absence of egg/Turner’s Syndrome
- Acquired reduced egg quantity / quality
- Oophorectomy/Premature menopause
- Chemotherapy/ Radiation therapy
- Diseases of X-Sex linkage
- Repetitive fertilization or pregnancy failure/Ovaries inaccessible for egg retrieval
Donors include the following types:
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- Donors unrelated to the recipients who do it for altruistic or monetary reasons. They are often anonymous donors typically recruited by egg donor agencies or, sometimes, IVF programs.
- Designated donors, e.g. a friend or relative brought by the patients to serve as a donor specifically to help them.
- Patients taking part in shared oocyte programme. Women who go through in vitro fertilization may be willing to donate unused eggs to such a program, where the egg recipients together help paying the cost of the In Vitro Fertilization (IVF) procedure.
3.Surrogacy
A surrogacy arrangement or surrogacy agreement is the carrying of a pregnancy for intended parents.
Gestational surrogacy: The pregnancy results from the transfer of an embryoin the surrogate, created by in vitro fertilization (IVF) where an egg is removed from the intended mother or an anonymous donor and fertilized with the sperm of the intended father or anonymous donor. The child is thereby genetically related to the woman who donated the egg and the intended father or sperm donor, but not the surrogate.
Traditional surrogacy: The surrogate is impregnated naturally or artificially, but the resulting child is genetically related to the surrogate. The child is thereby genetically related to both the surrogate mother, who provides the egg, and the intended father or anonymous donor. This is legally not permitted in India.
A relative, a known person, as well a person unknown to the couple may act as a surrogate mother for the couple.
Indications
1.Normally functioning ovaries but who lacks a uterus.
2.Women with congenital absence of the uterus (müllerian agenesis)
3.Prior hysterectomy( benign or malignant conditions)
4.Congenital müllerian anomalies such as a T-shaped or hypoplastic uterus
5.History of infertility or repetitive pregnancy loss
- Untreatable intrauterine scar tissue.
7.Medical contraindication to pregnancy
Monetary compensation may or may not be involved in these arrangements. If the surrogate receives compensation, the arrangement is considered commercial surrogacy; otherwise, it is referred to as altruistic.
Ethical Issues
Third-party reproduction is a complex process requiring consideration of social, ethical, and legal issues.When a child is conceived this way, parents must decide whether to tell their child or keep this information private. Many countries have laws that allow children to know who their gamete donor is. This may be a difficult choice to make ,but,it is ultimately a parent’s choice.
This article has been written by Dr. M. Gouri Devi Medical Director Ridge IVF Fertility Group
