any feedback on Egg Bank Asia?

[cantwait]

I’m looking at EBA but couldn’t find any reviews or feedback on it. Has anyone used their eggs what do you think about their egg quality and the success rate (in real life) I have friends used World Egg Bank, although she eventually conceived a boy after failing twice. I dont think their donor egg quality is very good, and heard their service isnt consistent. plus they are expensive and only offer 6 eggs.

Would really like to see what other think of Egg Bank Asia pls. TIA

 

[Angelica Cheng]

I’m looking at EBA but couldn’t find any reviews or feedback on it. Has anyone used their eggs what do you think about their egg quality and the success rate (in real life) I have friends used World Egg Bank, although she eventually conceived a boy after failing twice. I dont think their donor egg quality is very good, and heard their service isnt consistent. plus they are expensive and only offer 6 eggs.

Would really like to see what other think of Egg Bank Asia pls. TIA

I believe that new MOH regulations may have banned the import of frozen donor eggs into Singapore. Please refer to the new regulations:

https://www.moh.gov.sg/docs/librariesprovider5/licensing-terms-and-conditions/moh-cir-no-67_2021_1jun21_guidelines-on-the-import-and-export-of-embryos_and_annex-a_registry-version.pdf

Use of Donor Gametes or Embryos

Where donor gametes/embryos are used in any way, all the following additional declarations are required:

(i) The couple must provide a written declaration that they have paid no more than reasonable expenses for such use. As commercial trading of human gametes/embryos is prohibited in Singapore, the couple will be required to produce evidence (e.g. an itemised invoice) to support their declaration.

(ii) Written declaration by the overseas PGS lab and, where applicable, overseas AR clinic that the collection / retrieval of the gametes / embryos meet AR LTC 2020 paragraph 5.29.

(iii) Documentation that the donor was screened for the following transmissible diseases: (a) Hepatitis B; (b) Hepatitis C; (c) Syphilis; (d) Human Immunodeficiency Virus (HIV) (and whether a second test was repeated no earlier than 6 months from the time of donation); and, (e) Cytomegalovirus.

(iv) Documentation on whether the donor’s eggs have been used before, and if so, the number of live-births that the donor’s eggs have resulted in.

Notes:

1) Under the Human Cloning and Other Prohibited Practices Act (HCOPPA), only reasonable expenses may be provided for the supply of gametes and embryos. As per HCOPPA section 13, and MOH’s Licensing Terms and Conditions for Assisted Reproduction Services paragraph 5.31, “reasonable expenses” can include expenses relating to the preparation, preservation and quality control of the gametes/embryos.

2) In particular, if donor gamete / embryo is being used, please ensure that the following is observed: 5.29 AR Centres shall ensure that only: (a) oocytes donated by women between the ages of 21 and 35 at the point of oocyte removal;

 

[Angelica Cheng]

Advice and tips for Singaporean patients seeking egg donation in Malaysia - The New Savvy

With the increasing trend of late marriages and delayed motherhood in Singapore, coupled with the lifting of age limits in IVF treatment in Singapore since 2020, there is anticipated to be increasing demand for egg donation by older female IVF patients nearing or past menopause. Women with...

thenewsavvy.com

Advice and tips for Singaporean patients seeking egg donation in Malaysia

With the increasing trend of late marriages and delayed motherhood in Singapore, coupled with the lifting of age limits in IVF treatment since 2020, there is anticipated to be increasing demand for egg donation by older female IVF patients nearing or past menopause. Such women with diminished ovarian reserves often consider the egg donor option, after having failed IVF due to the reduced number and low quality of their retrieved eggs. In recently years, neighbouring Malaysia has emerged as a popular destination for Singaporean IVF patients seeking egg donation, due to close proximity and cost-competitive medical fees. Nevertheless, there are various pitfalls that patients have to navigate through, as highlighted by the Q & A below. Cumbersome travel and quarantine restrictions due to the COVID-19 pandemic are economically unsustainable in the long-term, and it is only a matter of time before borders reopen, and Singaporeans are once again free to travel to Malaysia for IVF treatment.

Is it difficult to find a local egg donor in Singapore?

Yes, because Singapore health regulations require egg donation to be altruistic, and payment can only be made to reimburse direct expenses such as traveling costs. The egg donation process is lengthy, tedious and painful, involving a few weeks of regular hormone injections, frequent blood tests and ultrasound scans, finally culminating in day surgery for egg retrieval. Additionally, there is also the hassle and inconvenience of commuting to and fro for numerous medical appointments. Understandably, without any financial incentives, very few local young women are willing to donate their eggs.

Why go for egg donation in Malaysia?

A large pool of egg donors of varying ethnicity and educational backgrounds are readily available in Malaysia because of generous financial inducements. Additionally, Malaysia has numerous IVF clinics and donor agencies that offer cost-competitive egg donation programs, which are much cheaper than other foreign countries such as USA, Australia and Taiwan. It is also much easier to source Asian egg donors in Malaysia, compared to Western countries such as USA and Australia. Moreover, Singaporean patients prefer to undergo IVF treatment at a destination close to home like Malaysia.

Are there any legal restrictions on egg donation in Malaysia?

Yes, only non-Muslim patients are allowed to receive egg donation. Shariah laws in Malaysia forbid Muslim patients from receiving egg or sperm donation.

What are the typical costs of egg donation in Malaysia (excluding medical fees)?

At the beginning of 2020, before the outbreak of the COVID-19 pandemic, egg donor agencies in Malaysia typically charge between 20k to 25K Malaysian ringgits, if you approach them directly. Egg donors are typically compensated between 5K to 8K Malaysian ringgits. Hence the gross profit margin of these agencies are typically between 12K to 20K Malaysian ringgits.

Which cities in Malaysia are good for egg donation?

Greater Kuala Lumpur and Penang. Most of the egg donor agencies are located here, and virtually all IVF clinics in Malaysia, even those from other cities and states, depend on these agencies to source egg donors for their patients.

What about egg donation in Johor that is much closer to Singapore?

Singaporean patients must beware that most egg donors in Johor come from out-of-town or out-of-state. As mentioned earlier, the overwhelming majority of egg donor agencies and agents in Malaysia are based in Kuala Lumpur and Penang, and IVF clinics in Johor rely on such agencies and agents to source egg donors for their patients. It is much more difficult to control and monitor the ovarian stimulation cycle of traveling egg donors from out-of-town or out-of-state, who reside far away from the IVF clinic. Such traveling egg donors may commute to the clinic for medical appointments, receive the hormone medications and then return to their hometowns where they are expected to self-inject for several days. Because supervision from the IVF clinic is not near at hand, the egg donor may not be bothered to strictly comply with such a painful and tedious routine of self-injections. If they are extra careless, the expensive hormone medications may not be kept properly refrigerated leading to spoilage and reduced potency. Without strict adherence to the injection protocol and proper refrigeration of hormone medications, the number and quality of eggs obtained from the donor will be severely compromised. Additionally, Singaporean patients must also take note that there are usually additional traveling and hotel costs associated with getting an out-of-town egg donor and her accompanying agency coordinator to travel to Johor.

Is it better to contact egg donor agencies directly, or get your selected IVF clinic to source egg donors from such agencies?

It is cheaper for you to contact egg donor agencies directly, and for them to arrange IVF treatment for you at their affiliated clinics, rather than getting an unaffliated IVF clinic to source egg donors for you from these agencies. Many egg donors agencies in Kuala Lumpur and Penang partner with their affiliated IVF clinic to offer special package deals that include egg donor costs plus medical fees. If you get an unaffiliated IVF clinic in Malaysia (particularly in Johor) to source egg donors for you, the clinic usually takes an extra cut of profit. For example, if the egg donor agency charges RM 25,000, the IVF clinic will charge you RM 30,0000, thereby taking a cut of RM 5,000 as additional profit.

Is embryo genetic testing necessary for egg donation?

Because it is unknown whether the egg donor is carrying any genetic defect, most Malaysian IVF clinics often recommend patients to do highly-expensive genetic testing of IVF embryos (PGS / PGT-A). This is completely unnecessary and a waste of money, if the egg donor is young and healthy, because chromosome abnormalities such as Down syndrome usually appear only in the eggs of older women. To evaluate whether the egg donor is carrying any unknown genetic defect, it is much cheaper to do genetic testing of the egg donor’s blood sample before starting IVF treatment. Moreover, you can also use NIPT (Non-Invasive Prenatal Testing) to screen for genetic defects in your unborn child after getting pregnant, which is also much cheaper than PGS (PGT-A). Although many fertility clinics claim that embryo genetic screening can improve the IVF success rates of older women, this usually refers to older women using their own eggs, which have a high incidence of chromosome abnormalities. PGS (PGT-A) will not improve the success rates of older women using a young egg donor. Patients must also beware of the risks of damaging the embryo during the ‘highly-delicate’ PGS (PGT-A) procedure, which involves extracting cells from the embryo after drilling a hole through the embryo shell (Zona pellucida).The smooth performance of this technique is often highly dependent on the skill and training of the laboratory staff (Embryologist). Even with high levels of training and accreditation, there is still a possibility of human error, particularly in a very busy laboratory that handles several such cases a day. Lastly, one must also beware that Malaysian IVF clinics often manipulate and play on the patient’s biased preference for either a boy or girl child, to persuade them to undertake embryo genetic testing for sex selection.

Should I choose fresh or frozen egg donation?

Some IVF clinics and egg donor agencies in Malaysia offer frozen egg donation as an alternative to fresh egg donation. The advantages of frozen versus fresh egg donation are greater convenience due to simpler logistics, as there is no need to coordinate and synchronize the treatment cycle of both donor and recipient; as well as lower costs due to negating the travel and hotel stay required for fresh egg donation. Another advantage is the greater certainty of the number and quality of frozen eggs available, which are unknown and non-guaranteed for fresh egg donation. Nevertheless, patients should use the same fertility clinic or IVF lab that recruited the egg donor and freeze her eggs. Avoid transferring frozen donor eggs from one medical facility to another. For best results, the thawing protocol must be matching and compatible with the freezing (vitrification) protocol, and only the same IVF lab that performs both the freezing and thawing processes, can ensure this. Patients should also beware that IVF success rates with frozen donor eggs are significantly lower than with fresh donor eggs.

What else should Singaporean patients be wary of when doing egg donation in Malaysia?

A critical piece of information that is often downplayed by Malaysian IVF clinics is the risk of accidental incest between half-siblings conceived by the same egg donor. Although such risks may be minimized in Singapore through safeguards that limit the number of children conceived per egg donor to three, it must be noted that there is no mandatory limit to the number of recipients that a single egg donor can donate to in Malaysia. Additionally, Singaporean patients should also be aware of the lack of appropriate counseling for egg donation in Malaysia. Rigorous counseling will ensure that both husband and wife are agreeable to egg donation, without any misgivings or emotional blackmail from either spouse, and without undue pressure from parents and in-laws. Additionally, they would also miss valuable advice on whether or not to tell their child the truth about his/her conception in the future.

 

[Angelica Cheng]

Singaporean patients undergoing egg donation should beware of Malaysian IVF clinics trying to hard-sell highly expensive embryo genetic testing (PGS / PGT-A) to them. Some of these hard-selling tactics include:

(i) Playing on their fears of unknown genetic defects being carried by the egg donor. Singaporean patient should note that there are much cheaper alternative methods of genetic screening such as testing of the egg donor's blood sample before starting IVF, or NIPT (Non-Invasive Prenatal Testing), which can be done after getting pregnant. A blood sample contains thousands of white blood cells, from which an abundant amount of DNA genetic material can be extracted. By contrast, only a few cells and tiny amount of DNA are extracted from the embryo during PGS (biopsy procedure). This makes it technically simpler and much cheaper to do genetic testing of the Egg Donor's blood sample, as compared to genetic screening of embryos with PGS / PGT-A.

(ii) Playing on their fears of Down syndrome. In reality, the chances of Down Syndrome with young donor eggs is extremely low. As seen in the attached tables and charts, the chances of Down Syndrome for a 20 year-old donor is 0.05% (1 in 2,000), while that for a 25 year-old donor is 0.083% (1 in 1,200). If patients are really worried about the possibility of Down syndrome, they can always do NIPT (Non-Invasive Prenatal Testing) after getting pregnant, which is very much cheaper than PGS (PGT-A).

(iii) Claiming that PGS (PGT-A) can improve the IVF success rates with donor eggs. This maybe true only for older women undergoing IVF with their own eggs, because of spontaneous genetic abnormalities that occur more frequently in the eggs of older women. Egg donors are typically very young, aged between 20 to 25 years of age, with very healthy eggs. Hence, PGS (PGT-A) will not further improve the already high IVF success rates of older women using donor eggs.

(iv) Playing on their biased preference for either a son or daughter. It is true that PGS (PGT-A) is the most effective method of sex-selection. But the question is whether it is moral and ethical for Malaysian IVF clinics to hard-sell such an expensive technique to Singaporean patients?

Controversial and unethical use of PGS / PGT-A for sex selection overseas by Singapore patients

Several years ago, the Straits Times reported on Singaporean couples traveling overseas for embryo sex selection by preimplantation genetic screening (PGS) via IVF treatment, due to the procedure being banned here. It was reported that most Singaporean Chinese couples doing PGS preferred a son...

singaporemotherhood.com

(v) Downplaying the risks of damaging the embryo during genetic testing with PGS (PGT-A). This is a highly delicate procedure that involves drilling a hole through the embryo shell (Zona Pellucidae), and extracting a few cells for genetic testing. No matter how well-trained is the lab staff (embryologist) doing the procedure, there is still a risk of human error. The more busy the IVF lab is, the greater the risk of human error, as lab staff are under pressure to complete procedures as fast as possible.

PGS Testing Risks

PGS testing (aka PGT-A) is not without risk. It's a common selection tool for choosing the best embryo to transfer during In Vitro Fertilization (IVF). Using a laser, a small biopsy of the embryo is taken and the DNA inside the sample is analyzed. Does this biopsy harm the embryo? Does PGS...

www.cnyfertility.com

Interesting videos which inform patients that PGS (Preimplantation Genetic Screening), also known as PGT-A (Preimplantation Genetic Testing - Aneuploidy) is absolutely unnecessary for egg donation cycles:

 

[cantwait]

Hello, May I ask for your opinion about the Singapore IVF clinics quality vs Malaysia IVF clinic quality? from service to success rate. Do you think Malaysia isnt as good? or about the same? thanks

Singaporean patients undergoing egg donation should beware of Malaysian IVF clinics trying to hard-sell highly expensive embryo genetic testing (PGS / PGT-A) to them. Some of these hard-selling tactics include:

(i) Playing on their fears of unknown genetic defects being carried by the egg donor. Singaporean patient should note that there are much cheaper alternative methods of genetic screening such as testing of the egg donor's blood sample before starting IVF, or NIPT (Non-Invasive Prenatal Testing), which can be done after getting pregnant. A blood sample contains thousands of white blood cells, from which an abundant amount of DNA genetic material can be extracted. By contrast, only a few cells and tiny amount of DNA are extracted from the embryo during PGS (biopsy procedure). This makes it technically simpler and much cheaper to do genetic testing of the Egg Donor's blood sample, as compared to genetic screening of embryos with PGS / PGT-A.

(ii) Playing on their fears of Down syndrome. In reality, the chances of Down Syndrome with young donor eggs is extremely low. As seen in the attached tables and charts, the chances of Down Syndrome for a 20 year-old donor is 0.05% (1 in 2,000), while that for a 25 year-old donor is 0.083% (1 in 1,200). If patients are really worried about the possibility of Down syndrome, they can always do NIPT (Non-Invasive Prenatal Testing) after getting pregnant, which is very much cheaper than PGS (PGT-A).

(iii) Claiming that PGS (PGT-A) can improve the IVF success rates with donor eggs. This maybe true only for older women undergoing IVF with their own eggs, because of spontaneous genetic abnormalities that occur more frequently in the eggs of older women. Egg donors are typically very young, aged between 20 to 25 years of age, with very healthy eggs. Hence, PGS (PGT-A) will not further improve the already high IVF success rates of older women using donor eggs.

(iv) Playing on their biased preference for either a son or daughter. It is true that PGS (PGT-A) is the most effective method of sex-selection. But the question is whether it is moral and ethical for Malaysian IVF clinics to hard-sell such an expensive technique to Singaporean patients?

Controversial and unethical use of PGS / PGT-A for sex selection overseas by Singapore patients

Several years ago, the Straits Times reported on Singaporean couples traveling overseas for embryo sex selection by preimplantation genetic screening (PGS) via IVF treatment, due to the procedure being banned here. It was reported that most Singaporean Chinese couples doing PGS preferred a son...

singaporemotherhood.com

(v) Downplaying the risks of damaging the embryo during genetic testing with PGS (PGT-A). This is a highly delicate procedure that involves drilling a hole through the embryo shell (Zona Pellucidae), and extracting a few cells for genetic testing. No matter how well-trained is the lab staff (embryologist) doing the procedure, there is still a risk of human error. The more busy the IVF lab is, the greater the risk of human error, as lab staff are under pressure to complete procedures as fast as possible.

PGS Testing Risks

PGS testing (aka PGT-A) is not without risk. It's a common selection tool for choosing the best embryo to transfer during In Vitro Fertilization (IVF). Using a laser, a small biopsy of the embryo is taken and the DNA inside the sample is analyzed. Does this biopsy harm the embryo? Does PGS...

www.cnyfertility.com

Interesting videos which inform patients that PGS (Preimplantation Genetic Screening), also known as PGT-A (Preimplantation Genetic Testing - Aneuploidy) is absolutely unnecessary for egg donation cycles:

 

[Angelica Cheng]

Hello, May I ask for your opinion about the Singapore IVF clinics quality vs Malaysia IVF clinic quality? from service to success rate. Do you think Malaysia isnt as good? or about the same? thanks

I believe that with respect to quality, the high-end IVF clinics in KL would be comparable to Singapore, such as Alpha IVF and KL Fertility Centre.

The problem is ethics and regulation, which is not as well-regulated in Singapore.

There is a lot of information that doctors try to hide from patients, as well as marketing gimmicks, especially regarding the three procedures of (I) PGS/PGT-A, (II) Egg Donation and (III) Egg Freezing.

 

[cantwait]

thanks thats very interesting. so in saying its less regulated in malaysia, would you think alpha singapore is better managed if you are going for DE? (sorry if its a beginner question). I have also heard TMC in malaysia to be good with good success rate but unable to verify. I understand theres no need to do PGS, however do you think the egg donation process itself is dodgy in malaysia (KL and other areas)? could you share more insights please? I wonder how well those girls look after themselves during donation. do they eat fast food or drink etc... Always a worry. thanks

I believe that with respect to quality, the high-end IVF clinics in KL would be comparable to Singapore, such as Alpha IVF and KL Fertility Centre.

The problem is ethics and regulation, which is not as well-regulated in Singapore.

There is a lot of information that doctors try to hide from patients, as well as marketing gimmicks, especially regarding the three procedures of (I) PGS/PGT-A, (II) Egg Donation and (III) Egg Freezing.

 

[Angelica Cheng]

thanks thats very interesting. so in saying its less regulated in malaysia, would you think alpha singapore is better managed if you are going for DE? (sorry if its a beginner question). I have also heard TMC in malaysia to be good with good success rate but unable to verify. I understand theres no need to do PGS, however do you think the egg donation process itself is dodgy in malaysia (KL and other areas)? could you share more insights please? I wonder how well those girls look after themselves during donation. do they eat fast food or drink etc... Always a worry. thanks

Have you read through this article:

Advice and tips for Singaporean patients seeking egg donation in Malaysia - The New Savvy

With the increasing trend of late marriages and delayed motherhood in Singapore, coupled with the lifting of age limits in IVF treatment in Singapore since 2020, there is anticipated to be increasing demand for egg donation by older female IVF patients nearing or past menopause. Women with...

thenewsavvy.com

It give some tips and advice for Singaporean patients seeking egg donors in Malaysia.

Beside wasteful genetic testing (PGS/PGT-A), there are other two points to beware:

(1) For IVF clinics that are not located in greater KL or Penang, most donors come from out-of-town or out-of-state. This is especially the case in Johor. It is much harder to monitor and control ovarian stimulation of egg donors (e.g. daily hormone injections, ultrasound scans), who need to travel long distances to and fro from the clinic.

(2) It is much cheaper for you to approach the egg donor agency directly and use their recommended affiliated clinic. If you approach the IVF clinic and ask them to source donors for you, they will take an extra cut of profit. For example, if the agency charges RM 20,000, they will charge you RM 25,000, and pocket the remainder as additional profit.

 

[cantwait]

Thank you. for now am looking at KL. Do you know any Egg donor agencies in KL or Penang? I could find anything when I researched them. I mean, maybe I should approach the clinics and ask which agency they use? or they wouldn’t reveal? I dont know how else to get the details of the agencies.

Have you read through this article:

Advice and tips for Singaporean patients seeking egg donation in Malaysia - The New Savvy

With the increasing trend of late marriages and delayed motherhood in Singapore, coupled with the lifting of age limits in IVF treatment in Singapore since 2020, there is anticipated to be increasing demand for egg donation by older female IVF patients nearing or past menopause. Women with...

thenewsavvy.com

It give some tips and advice for Singaporean patients seeking egg donors in Malaysia.

Beside wasteful genetic testing (PGS/PGT-A), there are other two points to beware:

(1) For IVF clinics that are not located in greater KL or Penang, most donors come from out-of-town or out-of-state. This is especially the case in Johor. It is much harder to monitor and control ovarian stimulation of egg donors (e.g. daily hormone injections, ultrasound scans), who need to travel long distances to and fro from the clinic.

(2) It is much cheaper for you to approach the egg donor agency directly and use their recommended affiliated clinic. If you approach the IVF clinic and ask them to source donors for you, they will take an extra cut of profit. For example, if the agency charges RM 20,000, they will charge you RM 25,000, and pocket the remainder as additional profit.

 

[Angelica Cheng]

Thank you. for now am looking at KL. Do you know any Egg donor agencies in KL or Penang? I could find anything when I researched them. I mean, maybe I should approach the clinics and ask which agency they use? or they wouldn’t reveal? I dont know how else to get the details of the agencies.

List of Egg Donor Agencies in Malaysia

Heart 2 ART
Website address:

Heart 2 ART - Assisted Reproduction Techniques. | Petaling Jaya

Heart 2 ART - Assisted Reproduction Techniques., Petaling Jaya, Malaysia. 17,226 likes · 5 were here. “Bringing Dreams to Life with Assisted Reproductive Technology” (A.R.T.)

www.facebook.com

heart 2 art

Affiliated IVF clinic: KL Fertility Centre

Egg Donors Asia
Website address:

https://eggdonorsasia.com/

Asian Egg Donor Agency for Intending Parents | Egg Bank Asia

Asian Egg Donor Bank providing high-quality services for intending parent including gender choice and IVF. Asian Egg Donation Agency to start you family.

www.eggbankasia.com

Asian Egg Donor Agency for Intending Parents | Egg Bank Asia

Asian Egg Donor Bank providing high-quality services for intending parent including gender choice and IVF. Asian Egg Donation Agency to start you family.

fertilitymy.com

Egg Donor Eggbank Asia

Egg Donor Eggbank Asia is on Facebook. Join Facebook to connect with Egg Donor Eggbank Asia and others you may know. Facebook gives people the power to share and makes the world more open and connected.

www.facebook.com

Affiliated IVF clinic: Island Fertility Centre

Egg donors and Surrogacy Malaysia
Website address:

Log in to Facebook

Log in to Facebook to start sharing and connecting with your friends, family and people you know.

www.facebook.com

Affiliated IVF clinic: Sunway Fertility Centre

Biosafe Egg Donor
Website address:

Bsafe EggDonor | Petaling Jaya

Bsafe EggDonor, Petaling Jaya, Malaysia. 129 likes. Welcome to the most amazing adventure of your life! By becoming an egg donor, you are helping cou

www.facebook.com

IVF Malaysia Consultancy 马来西亚试管婴儿咨询中心
Website address:

Log in to Facebook

Log in to Facebook to start sharing and connecting with your friends, family and people you know.

www.facebook.com

Zakuro Life

Egg Donor Preparation - Zakuro Life

Egg donation helps many women who are unsuccessful using their own eggs with IVF. Zakuro Life prepares donors for healthy, high quality and fertile eggs.

zakuro.life

Amanda Abigail
Website address:

Amanda Abigail

Amanda Abigail is on Facebook. Join Facebook to connect with Amanda Abigail and others you may know. Facebook gives people the power to share and makes the world more open and connected.

www.facebook.com

 

[Kelly Ng]

hello! I just saw this thread and wonder if there is any recommendation of doctor and agency for the egg donor program?

 

[Angelica Cheng]

hello! I just saw this thread and wonder if there is any recommendation of doctor and agency for the egg donor program?

Dear Kelly Ng,

Please see the following websites:

Egg Donation In Malaysia: Pitfalls That IVF Patients Should Avoid – Dr Alexis Heng Boon Chin - CodeBlue

Patients often have to navigate a complex web of marketing gimmicks, misleading information, and ethical pitfalls.

codeblue.galencentre.org

What are the available options and choices for women considering egg donation in Singapore?

Answer: In Singapore, it is mandated by law that egg donation should be altruistic (Human Cloning and Other Prohibited Practices Act, 2004). Egg donors are allowed to receive only minimal compensation for costs incurred such as traveling expenses. Here are 5 options for Singaporean IVF patients r...

www.quora.com

 

[Kelly Ng]

Dear Angelica,

Thank you for sharing the links. Wondering if theres anyone out who just did recently and won’t mind sharing her experience?

My hubby is a Malaysian but working in Singapore now. Our doctor here did advice us on getting egg donor. By flying the donor in and do the procedure. But we thought of goin back Msia as it will be more cost saving.

 

[Angelica Cheng]

Dear Angelica,

Thank you for sharing the links. Wondering if theres anyone out who just did recently and won’t mind sharing her experience?

My hubby is a Malaysian but working in Singapore now. Our doctor here did advice us on getting egg donor. By flying the donor in and do the procedure. But we thought of goin back Msia as it will be more cost saving.

Dear Kelly, talking about flying the egg donor in and out of Singapore, there was an interesting article a few years ago in Straits Times, on under-the-table payments to egg donors:

https://www.straitstimes.com/opinion/egg-donors-payment-ban-can-create-a-black-and-a-grey-market

Egg donors: Payment ban can create a black and a grey market

We are facing a brave new world with the advent of scientific breakthroughs such as the "three-parent" technique where a baby is born using DNA from three people. This is just one of many examples of new reproductive technologies to come, which will likely result in an insatiable demand for donated eggs. If not managed carefully, this can potentially lead to exploitation and abuse of both patients and donors.

Currently in Singapore, health regulations explicitly forbid women who donate their eggs from receiving payment for their contributions; and there has to be a completely altruistic transaction between the donor and recipient. However, the recipient patient is allowed to pay for the cost of reasonable expenses incurred during this process, such as travelling costs.

Such stringent regulations, together with the ban on social egg freezing (where women freeze their eggs when young and fertile, and keep them for future pregnancy) and the increasing trend of late marriages and motherhood, will boost the overwhelming demand for scarce donor eggs. Already, increasing numbers of local patients are seeking such fertility treatment abroad, as reported in The Straits Times a few years ago.

Banning payment of egg donors will not stop commodification, nor will it lead to a more ethically and morally acceptable situation. Instead, the combination of scarce supply, high demand by desperate patients, cash-strapped female university students, Internet technology and increasing globalisation and outsourcing of medical services, will inevitably fuel a black and a grey market for donor eggs.

This is best exemplified by the current situation in other jurisdictions that have banned commercial transaction of donated eggs. In China, for example, there have been tabloid reports of under-the-table payment for egg donation being made to vulnerable schoolgirls and university students by desperate patients, either through illegal brokers or via Internet websites. Reportedly, the amount of payment depended on the academic qualifications and physical beauty of the prospective egg donor.

Similarly in Australia, where most prospective egg donors connect to patients via the Internet, there have been stories of bidding wars in under-the-table payments to the most desirable egg donors. It was reported that one grateful couple "gifted" some dental work to their egg donor.

In Singapore, patients are usually required to seek and find their own egg donor, who may be a relative, close friend or even complete stranger. The pertinent question is whether under-the-table payment to egg donors can be prevented by the current system of donor screening and counselling put in place by the Ministry of Health. Could there also be other undue inducements, such as expensive dining and luxury hotel stay for donors sourced from abroad?

ETHICAL ISSUES

There are also ethical issues surrounding the lack of donor anonymity and its consequent psychological impact on both parents and children, if patients were requested to source their own egg donors.

Recently, numerous egg- donation agencies have sprung up in neighbouring countries which have offered their services in sourcing Asian egg donors for immigrant couples based in Western countries.

The usual practice is for a "coordinator" to accompany the egg donor while travelling abroad and "coach" her on passing rigorous psychological evaluation tests for egg donation. It is possible that some may target Singapore-based couples.

Hence, it would be very difficult for doctors and fertility counsellors in Singapore to discern whether prospective egg donors have been sourced through such foreign agencies and offered illegal under-the-table payments. After all, it is not the job of fertility clinics here to police such illicit activities. Perhaps, it may be in their own interest to turn a blind eye, even if they were secretly aware of such goings-on.

COLLUSION BETWEEN DOCS AND FOREIGN EGG DONOR AGENCIES

There is also a possibility of surreptitious collusion between local fertility clinics and foreign egg donation agencies. For example, doctors or nurses may drop a hint to their patients to seek such agencies, if they fail to solicit egg donation from their own relatives and friends.

Besides an outright black market in the form of illegal brokers and under-the-table payment to egg donors, a grey market may also emerge through ethically questionable practices by fertility clinics and doctors.

For example, in many jurisdictions that ban commercial transaction of donated eggs, there are seldom any laws that prevent local doctors from referring or recommending their patients to receive egg donation at foreign fertility clinics, in which they have a financial interest.

Furthermore, many of these jurisdictions also lack regulations that prevent locally registered fertility doctors from travelling abroad to perform procedures related to commercialised egg donation.

Another dubious practice is to encourage patients to freeze all their unfertilised eggs instead of embryos, on the pretext of preventing destruction of human life upon embryo disposal, as well as to avoid legal entanglements associated with divorce or separation. The excess unused frozen eggs can then be altruistically donated to other infertile couples.

It is often the case that patients who had successfully completed fertility treatment feel a deep sense of gratitude to their doctor. Hence, fertility doctors can easily manipulate the doctor-patient fiduciary relationship based on trust and goodwill, to cajole their former patients to altruistically donate their unused excess frozen eggs.

But in fact, because unfertilised eggs always survive the freezing process less well than embryos, the cumulative success rates for patients are diminished. These doctors may even earn additional medical fees from the egg-donation procedure, even though no commercial transaction of donated eggs has actually taken place between donor and recipient.

Because fertility doctors soliciting altruistic egg donation from their own patients usually control the distribution and allocation of the donated eggs to other patients, this can potentially lead to other abuses.

For example, premium medical fees can be charged to unsuspecting patients receiving egg donation, which could in fact mask the sale of the donated eggs. There is no longer a level playing field, because the patient's choice of fertility clinic would now be influenced by the availability of donated eggs rather than the doctor's skill and expertise.

Moreover, fertility doctors controlling distribution of scarce donor eggs may become the target of bribery. For example, desperate patients can offer to sign up for more expensive medical packages that include antenatal and postnatal care besides fertility treatment, in return for priority in receiving altruistically donated eggs.

Hence the Ministry of Health in Singapore should seriously reconsider a system of financial compensation of egg donors with appropriate checks and balances, similar to that implemented for kidney donors.

Rather than pretending that commodification of donated eggs cannot take place with an outright ban on payment to egg donors, it may perhaps be wiser and more prudent to permit and regulate it under a strictly controlled environment.