Alana Cattapan

Social egg freezing: risk, benefits and other considerations

In late 2012, the American Society for Reproductive Medicine (ASRM) and the Society for Assisted Reproductive Technology (SART) announced that they would no longer consider oocyte cryopreservation (i.e., egg freezing) to be experimental. In their joint practice guideline, published in early 2013,[1

Good eggs? Evaluating consent forms for egg donation

Beyond gaps in the provision of information, the informed consent process for egg donation is complicated by conflicts of interest, payment and a lack of longitudinal data about physiological and psychological risks. Recent scholarship has suggested that egg donation programmes could improve the informed consent process by revising consent documents. At a minimum, these documents should include information about eight key criteria: the nature and objectives of treatment; the benefits, risks and inconveniences of egg donation; the privacy of donors and their anonymity (where applicable); disclosure that participation is voluntary (withdrawal); the availability of counselling; financial considerations; the possibility of an unsuccessful cycle and potential uses of the eggs retrieved. This study evaluates the incorporation of these minimum criteria in consent forms for egg donation, obtained through requests to Canadian fertility clinics. Even when clinics were considered to have met criteria simply by mentioning them, among the eight consent forms assessed, none met the minimum standards. Only half of clinics addressed privacy/anonymity concerns, financial issues and the possibility of a future cycle. Improving the quality of consent documentation to meet the minimum standards established by this study may not be an onerous task. For some, this will include re-evaluating how they include one or two elements of disclosure, and for others, this will require a substantial overhaul. Using the criteria provided by this study as the minimum standard for consent could ensure that donors have the basic information they need to make informed decisions.

Frozen in perpetuity: ‘abandoned embryos’ in Canada

The matter of ‘abandoned embryos’ arises when surplus IVF embryos are frozen and stored for later use. If the fertility clinic or storage facility in question does not have clear direction about what to do with these embryos, and/or payment for storage ceases, and/or the embryo providers cannot be reached, the embryos raise an ethical and practical challenge. On the one hand, there is a commitment to respect the autonomy of embryo providers to determine what should happen to their frozen embryos. On the other hand, there are weighty reasons why fertility clinics and storage facilities do not want responsibility, potentially in perpetuity, for other people’s frozen embryos. This article examines the matter of ‘abandoned embryos’ – the emergence of the term, its use in policy and law, and its implications in the Canadian case. We demonstrate that despite an intricate legislative framework, there are important gaps that leave fertility clinics and storage facilities in the tenuous position of discarding ‘abandoned embryos’ without clear authorization, or storing them indefinitely. We argue that clarity in consent procedures coupled with flexible time limits on embryo storage provide an approach that can best serve the interests of all involved.

Of research and reproduction: defining embryo ‘Research’ in Canada

This article traces how embryo research has been theorized in Canada from the late 1980s to the current day. We find that research on human embryos has gradually come to be viewed in dichotomous terms, with scientific research pulled apart from experimentation to improve assisted reproduction procedures within fertility clinics. This distinction has been made manifest most clearly in the federal government’s 2007 consent regulations. The distinction between ‘improvement of assisted reproduction procedures’ and ‘research’ is problematic on two accounts. First, interviews reveal that many Canadian IVF patients do not distinguish between the improvement of assisted reproduction and broader conceptions of ‘research’. This suggests that patients may be consenting to participate in embryo experimentation even where they do not understand its purposes. Second, the dichotomy may allow researchers and clinicians to evade research protocols that might otherwise apply in Canadian law. This could permit fertility clinics to conduct what might in other contexts fall under the category of ‘research’ without prescribed oversight, and may even enable clinicians and researchers to engage in practices that policymakers deliberately sought to proscribe. We call for a re-evaluation of the legal distinctions on embryo experimentation built into Canadian law, and indeed built into broader discussions of embryo research.

Everything and nothing: regulating embryo research in Canada

This article examines how medical and scientific professionals experience and engage with the governance of embryo research in Canada. Drawing on the history of embryo regulation in Canada and the findings of a survey conducted with lab directors in Canadian fertility clinics, we identify a disjuncture between the rules established by legislation, regulations, and research ethics guidelines and the real-life experiences of professionals in the field. This disjuncture, we argue, is the result of both the absence of implementation mechanisms that would give substance to the governing framework, as well as an inability on the part of medical and scientific professionals to engage in robust self-regulation. Overall, we demonstrate that in an ethically charged and highly technical area of policy-making like embryonic research, clarity about the roles and responsibilities of government and professionals in policy-making and implementation is critical to effective governance.

Precarious labour: on egg donation as work

Abstract This article examines the relationship between social reproduction and reproductive technologies in Canada to interrogate the value in reconceiving egg donation as a form of labour, rather than as a matter of health. It argues that understanding egg donation as labour both highlights the potential for egg donors to be autonomous, agentic subjects within exploitative circumstances, and offers new possibilities for the governance of what has been, to date, a failed policy field.