Authority wants answered.
a: Should ways be sought of increasing the supply of eggs for use in research and infertility treatment? If so, what ways?
b: Should ovarian tissue from live donors be used in research?
c: Should eggs or ovarian tissue from cadavers be used in research?
d: Should eggs or ovarian tissue from foetuses be used?
e: Should ovarian tissue from live donors be used in treatment?
f: Should eggs or ovarian tissue from cadavers be used in treatment?
g: Should eggs or ovarian tissue from foetuses be used in treatment?
h: If you think eggs or ovarian tissue from any of these sources should be allowed to be used in treatment or research, whose consent should be required? When should it be given and in what form? Should there be any difference in the consents required for eggs or tissue used for research and eggs or tissue used for treatment?
THE CENTRAL issue in a new report on donated ovarian tissue revolves around the controversial possibility of using the eggs of aborted foetuses to help infertile women become pregnant.
The consultative document published yesterday by the Human Fertilisation and Embryology Authority (HFEA) also sets out the problems and benefits of the future use of eggs or ovaries taken from living women or from cadavers.
It is set against the background of a shortage of eggs for fertility treatment, which means that women who are unable to produce their own eggs may wait three or four years for a donation.
At the same time scientific advances mean that using foetal tissue could be technically possible in two or three years' time.
Explaining the key moral and scientific issues, the report says: 'A potential difficulty might be thought to be that a generation of human development would be skipped if foetal ovarian tissue were used in infertility treatment.'
It goes on: 'In the case of children born from cadavaric or foetal ovarian tissue, the particular implications of finding out that their genetic mother had died before they were conceived, or was an aborted foetus, are unknown.'
While the authority's report is careful to be impartial and the document is a factual one, members of the HFEA have decided to take a lead in one aspect, which is the complex problem of obtaining the consent of a donor.
The report states that its view - 'at this stage' - is that consent of a donor should always be obtained.
Obviously a foetus cannot give consent but there are further complications and at present egg and sperm donation requires that 'informed consent' is given by the donor. But, under abortion laws, a father's consent is not required for a woman to proceed to terminate a pregnancy. When a person dies, next-of-kin are asked for permission before organs are taken, even if the deceased carried a donor card.
The report says: 'This potential safeguard of a donor's interests could itself lead to questions being raised as to next-of-kin's motives. For example, a donor's parents might consent in the hope that, although they have lost a daughter, they might gain access to a genetic grandchild.'
The authority has taken on board public anxieties and the report says: 'The HFEA is aware that while the public is generally willing to accept organ donation, and the use of foetal tissue for therapeutic purposes generally, it may feel an instinctive repugnance to the use of ovarian tissue from these sources.
'The public may still be alarmed that the frontiers of medical science are being pushed forward too far and too fast.'
At a press conference yesterday to launch the document, the authority's chairman, Professor Sir Colin Campbell, said he believed that people may find that their initial response changes as they learn more about the issues involved.
The 10-page document has been written for the layman and the authority is inviting the widest possible public response by 1 June. To help people respond it lists the questions that it is seeking answers to (see panel).
It sets out its own legal powers as the body that controls and licenses fertility clinics, semen and embryo storage and fertility treatment research. It explains how existing controls operate, what the scientific issues are and lists social and moral questions and consent difficulties.
Donated Ovarian Tissue in Embryo Research & Assisted Conception; public consultation document; Human Fertilisation & Embryology Authority, Paxton House, 30 Artillery Lane, London E1 7LS.
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