Egg donation in the UK, Belgium and Spain: an interdisciplinary study

用捐赠卵子进行体外受精最初是为了治疗患有卵巢功能衰竭或功能障碍的年轻女性。最近，使用捐赠卵子来治疗与年龄有关的不孕症的妇女的人数急剧增加，男同性恋夫妇为了生孩子而同时使用卵子捐赠者和代孕母亲的需求也在不断增长。冷冻和储存技术的发展促进了卵子捐赠治疗的增加，这意味着卵子现在可以独立于取卵的时间和地点使用。在欧洲，捐赠的卵子现在被用于超过25000个试管婴儿治疗周期，每年产生7000多名婴儿，但人们对提供卵子用于不孕症治疗的女性的动机、决策和经历知之甚少，尤其是在欧洲。越来越多地使用卵子捐赠治疗是激烈的政治和伦理辩论的主题，并为实践专业人员和政策制定者提出了许多困境。虽然根据欧盟立法，在欧洲正式禁止出售人类卵子（允许对卵子提供者进行“合理补偿”），但各国对相关法规的解释存在相当大的差异，导致在实践中存在重大差异。英国、比利时和西班牙代表了不孕不育领域技术发展前沿的三个国家，但它们在如何实施和管理卵子捐赠方面发展了不同的做法。本研究的总体目的是探索英国、比利时和西班牙卵子捐赠的社会、政治、经济和道德配置。我们的研究问题是：卵子捐赠行为如何受到国家经济、政治、文化和道德背景的影响？新的生殖主体性是如何作为（性别化的）社会技术过程（如卵子捐赠）的结果而出现的？在不孕症治疗的背景下，卵子提供者如何理解和构建卵子捐赠？他们的道德推理如何受到新自由主义、生物经济背景的影响？在全球生殖市场中，专业理性和商业编排的作用是什么？如何通过对比不同的政策和实践背景来促进卵子捐赠的改进？该研究在很大程度上是定性的，并使用多种数据收集方法，分为五个阶段，以实现其目标。第一阶段是背景设定阶段，包括：审查少量现有研究；详细分析了捐赠的相关政策法规；并与欧洲和国家层面的主要利益相关者进行了12次访谈。第二阶段将包括对捐助者招募和营销活动的分析，以探索捐赠是如何代表的，并深入了解招募实践。第三阶段包括对提供卵子的75名妇女（每个国家25名）的详细访谈，以及对参与捐赠的45名专业人员（每个国家15名）的访谈。它将探索提供卵子的女性的经历、动机和道德决策，并为英国、比利时和西班牙的捐赠实践、政治和经济组织提供证据。第四阶段的目标是综合前几个阶段的研究结果，在与主要利益相关者合作举办的两个研讨会上进行讨论，旨在帮助我们从研究中提出建议。第五阶段将包括项目会议的结束和进一步的传播。利益攸关方将通过一个特别召集的咨询小组全程参与。除了发展有关人体组织供应和商业化的理论外，研究结果将直接用于英国和欧洲的政策和实践。因此，受益者包括政策制定者、不孕症临床医生、卵子提供者和相关的倡导组织。

IVF with donor eggs was first intended for use with younger women suffering from ovarian failure or dysfunction. More recently there has been a sharp increase in use of donor eggs for women with age-related infertility, and a growing demand among gay male couples who combine the use of an egg donor and a surrogate in order to have a child. The increase in egg donation treatment has been enhanced by developments in freezing and storage techniques, meaning eggs can now be used independently of the time and place of their retrieval. Donated eggs are now used in over 25,000 IVF treatment cycles in Europe, creating over 7000 babies per year, yet little is known about the motivations, decision-making and experiences of women who provide their eggs for use in infertility treatment, particularly in the European context. The growing use of egg donation treatment is the subject of fierce political and ethical debate and presents a number of dilemmas for practice professionals and policy makers. While the selling of human eggs in Europe is formally prohibited according to EU legislation ('reasonable compensation' for egg providers is permitted), there is considerable variation in the interpretation of relevant regulations between countries, resulting in significant differences in practice. The UK, Belgium and Spain represent three countries at the cutting edge of technological developments in the infertility field but which have developed differing practices relating to how egg donation is practiced and governed. The overall aim of this study is to explore the social, political, economic and moral configuration of egg donation in the UK, Belgium and Spain. Our research questions are: How are egg donation practices shaped by national economic, political, cultural and moral contexts? How do new reproductive subjectivities emerge as a result of (gendered) socio-technical processes such as egg donation? How do egg providers understand and frame egg donation in the context of infertility treatment and how is their moral reasoning shaped by a neo-liberal, bio-economic context? What is the role of professional rationalities and commercial choreographies in a global reproductive marketplace? How can a comparison of contrasting policy and practice contexts facilitate improvements in egg donation? The study is largely qualitative and uses multiple methods of data collection, organised across five phases, to achieve its objectives. Phase one is a context-setting phase which will involve: reviewing the small number of existing studies; a detailed analysis of relevant policies and regulations about donation; and 12 interviews with key European and country-level stakeholders. Phase two will involve analysis of donor recruitment and marketing campaigns to explore how donation is represented and to gain insight into recruitment practices. Phase three comprises detailed interviews with 75 women who have provided their eggs (25 in each country) as well as 45 interviews with professionals involved in donation (15 in each country). It will explore the experiences, motivations and ethical decision-making of women who provide their eggs as well as generating evidence about the practical, political and economic organisation of donation in the UK, Belgium and Spain. The objective of Phase four is to synthesise the findings from the previous phases for discussion at two workshops held in collaboration with key stakeholders and designed to help us develop recommendations from the study. Phase five will include an end of project conference and further dissemination. Stakeholders will be engaged throughout, via a specially convened advisory group. As well as developing theories about the provision and commercialization of human tissue, the findings will be used to directly inform policy and practice in the UK and Europe. Beneficiaries therefore include policy makers, infertility clinicians, egg providers and related advocacy organisations.