Re-imagining cross-border egg provision after Covid-19

by Dr Christina Weis

Barcelona, September 2017

A nurse in a Spanish fertility clinics suggests to a young female Russian tourist who inquires about donating her eggs to pay for her father’s medical bills to come back right away the following day to leave blood samples for the genetic testing, and if all was clear, to return within 6 weeks for another 3 week holiday to donate her eggs in return for 1000 €. (1)

 

Vienna, June 2019

An owner of a Russian gamete transportation agency exhibiting their services at ESHRE shares his new business idea in cross border gamete transport: rather than transporting eggs from Russia into the EU and struggling with restrictions and EU/non-EU law difference, he plans to recruit Russian egg providers in Russia, stimulate them in Russia, and send them – by bus or train – to an Estonian partner clinic for retrieval.

“They have to live in St Petersburg, or Moscow, for the stimulation process, and after the trigger we need to book [them] a ticket and they need to come to Estonia. Just for one day. (…) [[Because, if we send them to Estonia for the whole stimulation] it would be expensive, so oocytes would be too expensive to sell them, because we need to be at the market, with the market price.”  (2)

 

St Petersburg, January 2020

An embryologist in a Russian private fertility clinic reports of her growing number of Chinese fertility patients who seek Chinese, or ‘Asian’, eggs for their treatment in Russia. The People’s Republic of China prohibits the export of gametes, and ART treatment with donor eggs in China is highly restrictive. Chinese fertility patients are therefore hiring commercial agencies and courier services who recruit young women from Vietnam, Cambodia, the Philippines and Taiwan to cycle and provide their eggs in Russia, and leave immediately after retrieval.

“Luckily, we didn’t have any episodes [of OHSS or complications]. But, for real, we conduct the [cycles] sufficiently free of danger, (…) I would possibly keep them and watch over them, because there could be any complications, but they have short visas. So, with the visa, that’s what happens.”  (3)

 

April 2020

The novel corona virus Covid-19 has developed into a global pandemic and in the majority of countries, all fertility treatment has come to a standstill on the basis that it is a non-essential medical procedure.

ESHRE map

https://www.eshre.eu/Home/COVID19WG/Map (accessed 28/04/20)

While some clinics, for instance in the US, assure their clients and patients that treatment with donor gametes will continue, the HFEA in the UK extended the 10-year-egg freezing limit by two years.

Looking ahead, amidst the uncertainty of when will be ‘after’ Covid-19 and what will be after Covid-19, providers of reproductive services imagine two different scenarios. One being an increased demand in assisted reproductive services by the clients and patients whose ongoing treatment or imminent treatment has been put on hold, including an increased demand in donor gametes. The other being a decreased demand as clients and patients are suffering economically under the lockdown and may struggle to afford the treatment.

Either scenario – or any scenario following an ease of the lockdown and gradual return to the access of assisted reproductive services – will prompt us to reimagine gamete provision.

We know that there is no ‘back to normal’ and in light of the above examples which provide insights into the precariously balanced business models of un- or minimally regulated cross border reproductive travel involving providers and gametes, a ‘return to normal’ is not preferable. In other words, in many cases and many countries, ‘normal’ puts women’s lives and health at risk and this uncomfortable standstill prompts us to rethink the fertility chains of cross border gamete provision.

 

 

(1) Fieldnotes ‘ReproMigrants’ study, 2016-2017, UWE (Michal Nahman, PI and Christina Weis, RA)

(2), (3) Fieldnotes and interview recordings ‘Markets in Surrogacy’, 2019-ongoing (Christina Weis, DMU HLS FREC #3228)

Image: Taken by Christina Weis, St Petersburg, April 2015

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