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

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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.