Angelica Cheng
Active Member

Key Issues To Consider Before Donating Your Unused Frozen Eggs — Dr Alexis Heng Boon Chin - CodeBlue
There are profound implications, because an unknown child who is genetically related to you may possibly be born.

Key Issues To Consider Before Donating Your Unused Frozen Eggs
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.