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Creating and selling embryos for “donation”: ethical challenges

Published:October 31, 2014DOI:https://doi.org/10.1016/j.ajog.2014.10.1094
      The commercial creation and sale of embryos has begun, which poses a series of ethical questions that have received little scholarly attention. Some of the concerns that arise are similar to those posed by the sale of gametes, while other issues differ markedly. Questions emerge, first, regarding the rights of the unborn children and their ability to know their biological parents. Companies that create human embryos de novo may wish to keep gamete providers anonymous. Many of these offspring thus will never learn that their parents are not their biologic parents. Yet, such disclosures, regarding not only one but both of these biologic parents, may be important for these individuals; and a lack of this knowledge may impede their physical and psychological health. Second, questions surface regarding the fees that providers should charge for embryos and whether these amounts should vary based on the traits of 1 or both of the gamete donors. Some prospective parents may seek specific traits in a baby (eg, height or eye/hair coloring), which prompts the creation of embryos from 2 gamete donors who possess these characteristics. Third, ownership of embryos created without an advanced directive by patients poses dilemmas (eg, disposition of any remaining embryos). Fourth, guidelines do not yet exist to limit the number of embryos sold from each pair of gamete donors. Hence, unbeknownst to each other, full siblings could potentially meet, get married, and procreate. This discussion has several critical implications for future practice and professional education and policy. Patients with diseases associated with genetic tests may well ask obstetricians, gynecologists, and other physicians about these techniques and practices. Clinicians can refer such patients to assisted reproductive technology specialists; however, familiarity with the basic aspects of the issues and complexities involved could aid these providers and their patients Several of these issues can be addressed relatively easily through guidelines from professional associations (eg, limiting the number of embryos sold from each pair of gamete donors). Because creation and sales of embryos will likely spread, consideration of appropriate responses is critical to establish standards of care to help the future offspring, and ensure ongoing public trust.

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      References

      1. Zarembo A. An ethics debate over embryos on the cheap. The Los Angeles Times November 19, 2012. Available at: http://articles.latimes.com/2012/nov/19/local/la-me embryo-20121120. Accessed Aug. 14, 2014.

        • Van Hoof W.
        • Pennings G.
        Cross-border reproductive care around the world: recent controversies.
        in: Botterill D. Pennings G. Mainil T. Medical tourism and transnational health care. Palgrave Macmillan, Hampshire, UK2013
        • Cohen I.G.
        • Adashi E.Y.
        Made-to-order embryos for sale: a brave new world?.
        N Engl J Med. 2013; 368: 2517-2519
      2. The World Health Organization. WHO guiding principles on human cell, tissue and organ transplantation. endorsed by the sixty-third World Health Assembly in May 2010, in Resolution WHA63.22. Available at: http://www.who.int/transplantation/en/. Accessed Sept. 12, 2014.

        • Mahlstedt P.P.
        • LaBounty K.
        • Kennedy W.T.
        The views of adult offspring of sperm donation: essential feedback for the development of ethical guidelines within the practice of assisted reproductive technology in the United States.
        Fertil Steril. 2010; 93: 2236-2246
        • Wydra M.
        • O’Brien K.M.
        • Merson E.S.
        In their own words: adopted persons experiences of adoption disclosure and discussion in their families.
        J Fam Soc Work. 2012; 15: 62-77
        • Brodzinsky D.M.
        Children’s understanding of adoption: developmental and clinical implications.
        Prof Psychol Res Pr. 2011; 42: 200-207
        • Levine A.D.
        Self-regulation, compensation, and the ethical recruitment of oocyte donors.
        Hastings Cent Rep. 2010; 40: 25-36
        • Keehn J.
        • Holwell E.
        • Abdul-Karim R.
        • et al.
        Recruiting egg donors online: an analysis of in vitro fertilization clinic and agency websites’ adherence to American Society for Reproductive Medicine guidelines.
        Fertil Steril. 2012; 98: 995-1000