Donor conception, surrogacy and social infertility frameworks

A 34-year-old woman with Turner syndrome sits in your fertility clinic with her partner. She will never conceive with her own oocytes, and you can offer her a family through donor oocyte. Across the corridor, a gay couple asks whether they can have a child through surrogacy here in Australia. A third patient, a single teacher, wants donor sperm and has never tried to conceive. The technique is the easy part of these consultations — the counselling, the consent, the law and the welfare of the child are where the Fellowship marks live. This topic is that consultation.^[1][20]

Overview and definition

Third-party reproduction is any treatment in which a person outside the intending parent or parents contributes gametes, embryos or gestation. The four pathways you must hold in your head are donor sperm, donor oocyte, embryo donation and surrogacy.^[1][6]

Two ideas anchor the whole topic. First, the ASRM has retired the old words "known" and "anonymous" in favour of directed (identified) and nonidentified donors — say the modern terms and you signal current practice. Second, gestational surrogacy (the carrier is not the genetic mother) has displaced traditional surrogacy (the carrier's own oocyte is used) in regulated ART, because it separates the genetic, gestational and intending-parent roles and avoids the custody disputes that dog traditional arrangements.^[6][9]

"Social infertility" is the umbrella term for people without a medical bar to conception who still need a third party to build a family — single women, same-sex couples, and people without a partner. The clinical pathway is usually identical to medical infertility; what differs is the access criteria, the counselling and the legal-parentage mechanics.^[20]

References21ShowHide

1. [1]Practice Committee of the American Society for Reproductive Medicine and the Practice Committee for the Society for Assisted Reproductive Technology Guidance regarding gamete and embryo donation Fertil Steril, 2021.PMID 33838871
2. [2]Ethics Committee of the American Society for Reproductive Medicine Informing offspring of their conception by gamete or embryo donation: an Ethics Committee opinion Fertil Steril, 2018.PMID 29605404
3. [3]Ethics Committee of the American Society for Reproductive Medicine Financial compensation of oocyte donors: an Ethics Committee opinion Fertil Steril, 2016.PMID 28340933
4. [4]Practice Committee of the American Society for Reproductive Medicine and Practice Committee of the Society for Assisted Reproductive Technology Repetitive oocyte donation: a committee opinion Fertil Steril, 2020.PMID 32482251
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