We know for sure that the number of donors has significantly declined since the law was adopted. In Quebec, the supply of sperm banks has barely changed since the law was adopted, there is no shortage but because AHR is subject to a growing number of requests, clinics sometimes have to “import” the precious seed from Ontario.
The situation is even more worrying with egg donation because it is impossible to “stock up” on eggs since they are harder to store, unlike the male gametes. The situation is more problematic in Quebec than anywhere else because a new technique of ultra-fast freezing (vitrification) has been used for over two years in other provinces but not in Quebec, says Dr Jacques Kadoch. “Until then, before the advent of this technology, we could only use fresh eggs”, he says.
Lack of eggs: the consequences
No egg banks, rare voluntary donors surrounding women who want eggs and even less altruistic donors. Result: more and more women from Quebec are going to the United States or to Mexico to seek the egg that will be fertilized by their man. This is what we could call reproductive tourism and, according to Dr Kadoch, it is on the rise.
The word shortage is not part of the vocabulary in the fertility clinics of these countries because the banks are well supplied by paid donors.
“We see more and more requests from women in Quebec who go buy eggs there or stay in Quebec and buy them in a catalogue. Eggs are sent vitrified, they are thawed here and we proceed to the fertilization with the partner’s sperm”, says the gynaecologist.
The problem is that the Quebec government refunds the expenses of couples who buy sperm outside the country but those who buy eggs outside of the country do not receive the same treatment, why? “Only because the technology of vitrification did not exist when the law passed (on Assisted Human Reproduction)”, says Dr Kadoch.
All these women who cannot spend thousands of dollars to buy eggs overseas will surely denounce this double standard eventually. And if they ask for reimbursement, the government is heading towards a financial catastrophe, says the specialist.
The solution: pay the donors?
Yes, says Dr Kadoch without hesitation. He cites Spain where the government sets the amount given to the donors.
If our government decided to do the same, it would reduce the amount of women who go outside of the country to buy eggs and possibly ask to be reimbursed eventually.
Furthermore, “when paying the donors, we have a better control over the donations and, therefore, on inbreeding problems related to multiple donations…”
Paid donations: the opposition
The opinion of Dr Kadoch is far from unanimous. Many people are against paid donation and ague that it would be an ethical breech.
Abby Lippman, teacher at the Department of Epidemiology, Biostatistics, and Occupational Health at McGill University and member of the board at the Federation for Planned Parenthood of Quebec (FQPN) thinks that the reproductive human material should not be bartered and commercialised because some poor women could see an opportunity to earn substantial amounts of money.
Her opinion is widely shared but, according to Dr Kadoch, “we should have think tanks on this subject regrouping experts from various fields…”
The “black market” in Quebec
Even if we cannot size its importance, we know that there is an illegal business of eggs donation in Quebec. “Professional donors” even place ads and are handsomely paid for their eggs, says Dr Kadoch.
The remuneration of donors would not eradicate this type of business but the gynaecologist thinks that it would refrain its propagation.
We should also keep a registry of women who donate repeatedly because they are more at risk of developing ovarian cancer.
According to Abby Lippman, a registry of children born from assisted human reproduction should also exist to be able to monitor their health. It could also be useful to avoid the possible consequences of meeting with their half-brothers and half-sisters.
She goes further and affirms that we should also start thinking about the increase in infertility and, incidentally, the increasing use of assisted reproduction. What causes this decrease of fertility?
But that’s another matter…
