Page URL: https://www.progress.org.uk/ncobbodies6

This policy document is part of a response submitted by the Progress Educational Trust (PET) to the Nuffield Council on Bioethics' Consultation on Human Bodies in Medicine and Research.


Are there any additional purposes for which human bodily material may be provided that raise ethical concerns for the person providing the material?

Autologous donation (self-directed donation) is a trend that is especially prevalent in the USA. For example, increasing numbers of people are freezing gametes (sperm and eggs) for their own future use long before they actually consider parenthood. Autologous donation also occurs in relation to other types of human bodily material, such as umbilical cord blood.

The benefit from autologous donation accrues (at first glance) only to the donor. There is consequently a tension between autologous donation and some of the concepts, such as altruism, reciprocity and solidarity, commonly used to promote donation to others (see Richard Titmuss' 1970 book The Gift Relationship: From Human Blood to Social Policy). However, it does not automatically follow from this that autologous donation is undesirable or unethical. Autologous donation is entirely compatible with notions of autonomy (including reproductive autonomy), and it may have the wider benefit of reducing demand for donated human bodily material.

A recent study from the Leeds Centre for Reproductive Medicine, reported at the European Society for Human Reproduction and Embryology's annual conference in June 2010, indicated that a large number of female students would freeze their eggs. The researchers surveyed 98 medical students and 97 students of education and sports studies. The average age of the groups was 21. They gave the students general information about the procedure of egg freezing and the costs involved (£3000 per attempt), and then asked if the students would consider having such a procedure. 80% of the medical students hypothetically said yes, compared to 50% of the education and sports studies group. The students said they would undergo egg freezing to allow time to build a career or relationship, or to become financially stable.

This points to the interesting fact that autologous gamete donation is not only being used not only in the face of foreseeable fertility problems, but also as a 'just in case' precautionary measure. This is part of a broader interest in the idea of 'future-proofing' one's fertility, against both pathological infertility and the natural decline in fertility that occurs over the course of one's life.

While there is nothing intrinsically wrong with the ambition of future-proofing one's fertility, there is a risk that current techniques for so doing become subject to unrealistic expectations. There is no guarantee, with current biomedicine, that preserved gametes or embryos can be used to ensure a future pregnancy. So anyone who defers parenthood, in the expectation that preserved gametes or embryos can be used to insure against future infertility, risks profound disappointment if every future attempt at fertility treatment is unsuccessful.

Current UK law has interesting consequences for autologous donation. Storage of gametes for 'social' (non-medical) reasons is limited to 10 years, and where fertility problems are foreseeable, this may be extended to 55 years. This is an entirely arbitrary time limit in both instances, and the rationale behind distinguishing between social and medical storage is far from evident. We have no ethical objection to indefinite storage, and we concede the need for some sort of limit only for practical reasons, because the logistics of indefinite gamete storage would be difficult if the practice became routine. We would prefer the time limit for social gamete storage to be extended to the time limit for medical gamete storage.