Consultation on the Use of Frozen Eggs in Fertility Treatment: Discussion Document (2008)
The Nathaniel Centre welcomes the opportunity to comment on the use of frozen human eggs in fertility treatment.
A Catholic approach to the transmission of human life is characterised by two key beliefs: the dignity of the human person and, flowing from that, a belief that the context in which humans are conceived, and the means that are used, reflect this dignity. The conjugal act is seen as the only means that is wholly consistent with the dignity of the human child. The use of technology in human reproduction is assessed as upholding the dignity of the human person to the extent that it assists the conjugal act but does not replace it. Children must always be conceived in a way which shows that they are respected and recognised as equal in personal dignity to those who give life. This rules out all actions which in any way instrumentalise or treat the child as an object, whether intentionally or otherwise.
One of the implications of this is the need we have, emotionally, psychologically and spiritually to experience ourselves from our very origins as contingent beings; beings who came about in a fortuitous way conceived for no other reason than love, beings conceived in a way that is free from the manipulation of other persons. Technological interventions that allow parents to exercise ever greater control and dominance over the sorts of children that are born can put this very human quality of our existence at risk. A selfless love calls for parents to accept children as gifts without introducing a conditional element into their acceptance into a family.
The freezing of human embryos is always to be regarded as an affront to their innate dignity in so far as it suspends, and puts at risk, the inviolable right to life that is theirs simply by virtue of the fact that they are fully human. While not condoning IVF, we recognise that the technology which allows eggs to be frozen and stored might, in the foreseeable future, mean that there are fewer embryos that are stored in this way and also, ultimately, discarded.
A Catholic approach to marriage and procreation precludes the donation of gametes from a third party outside of the marriage relationship. The mutual and exclusive self-giving of the spouses that characterises the permanent and loving commitment at the heart of marriage calls forth a reciprocal respect that means couples recognise the right to become parents only through each other.
Given these risks and benefits, what is your opinion on ACART's proposed advice to the Minister of Health? Please give reasons for your views.
(See chapter 3 for a discussion of risks and benefits, and chapter 6 for the proposed advice.)
Any assessment of risks to the health and well-being of children must first take into account the physical risks associated with the use of a particular intervention. While it is stated that "the risks to a resulting child associated with the use of frozen eggs are no greater than the risks associated with the use of frozen embryos or [IVF] generally" (p. vi) we also note that there have only been a relatively low number of children born from frozen eggs and that "it is still a relatively new technique" (p. 13). Therefore, while the available evidence may point to its safety (p. 13), it has to be accepted that because there is "a lack of data on outcomes for children born from eggs that have previously been frozen" (p. 8), this technology remains largely experimental.
In other words, given the overall depth of the data available, it seems that at best ACART's view on the acceptability of the risks can only be provisional. On that basis it seems somewhat premature to be declaring this an established procedure.
It is our considered view, therefore, that at this time the use of eggs that have been frozen should reflect the way that we approach the use of other novel or innovative clinical practices; it needs to occur against a background of the sort of ethical and medical oversight that is provided by a specialist Health Research Ethics Committee. In the event that the relevant committee in question may not have the necessary expertise amongst its current members, there should be provision for its makeup to be complemented by persons with the appropriate scientific and medical background.
What is your view on the information that ACART suggests should be collected to monitor the use of frozen eggs in fertility treatment?
(See chapter 3)
In line with what we have said above, we agree that there needs to be ongoing and extensive collection of data so as to better assess the outcomes, and especially the risks, associated with the use of eggs that have previously been frozen. It is beyond the scope of our expertise to comment more specifically on either the nature or the manner of collection of this information.
Has ACART identified all the ethical issues relevant to the use of frozen eggs in fertility treatment? Do any of these issues affect ACART's proposed advice that the use of frozen eggs should be allowed in fertility treatment? If so, how?
(See chapter 5 for a discussion of the ethical issues, and chapter 6 for the proposed advice.)
The posthumous use of frozen eggs raises similar ethical issues to the posthumous use of frozen sperm. We regard the use of assisted human reproductive technologies in such circumstances as inconsistent with the dignity of the child because it intentionally deprives them of a relationship with a mother and a father for reasons that ultimately amount to the satisfaction of adult needs.
As noted above, a Catholic approach to marriage, emphasising as it does the connection between the conjugal act and the transmission of human life, rules out for moral reasons the reception of gametes from a third party.
While not condoning IVF, we can see that the use of egg freezing might lead to fewer embryos being stored. We are not opposed to it on the basis that it will limit the harm that is associated with the storage and subsequent discarding of human embryos that is a characteristic of IVF infertility programmes.
At the same time we remain particularly concerned that this technology might lead to a significant increase in women postponing pregnancy for "social reasons". We note that ACART considers the freezing of eggs as "at best a backstop measure for those who are at risk of losing their fertility altogether, and that it would be unwise for women to rely on egg freezing for social reasons" (p. 12). On the basis of a Catholic approach to the transmission of human life (briefly outlined above) we agree with this assessment for reasons that include, but go beyond, the obvious clinical contraindications of egg freezing.
Should the use of frozen eggs in fertility treatment become an established procedure? If not, why, and how should the use of frozen eggs be regulated?
We do not believe that the use of frozen eggs should become an established procedure at this particular point in time because we regard the use of this technology as still largely experimental. (See our answer given in Question 1 above.) For reasons related to a Catholic understanding of the transmission of life we also believe that this procedure should be limited to those requiring it for "medical" reasons as opposed to "social" reasons.
Should the use of frozen eggs in fertility treatment be limited to the individuals the eggs came from, or should frozen eggs be able to be donated to others for use in fertility treatment?
While out of step with a Catholic understanding of marriage, we recognise that current procedures allow for couples to receive gametes donated by third parties. Our reasons for arguing that the use of frozen eggs should be limited to the individuals they come from are the same reasons we use to argue against the donation of any gametes by a third party; the mutual and exclusive self-giving of the spouses that characterises the permanent and loving commitment at the heart of marriage calls forth a reciprocal respect that means couples recognise the right to become parents only through each other.
Should frozen eggs be able to be donated for research purposes?
We uphold the principle enshrined in New Zealand legislation and culture, that transactions involving body tissue not be commercialised. On that basis we see no reason to oppose the donation of eggs for ethical research projects.
As we have stated on other occasions, research using gametes should be regulated through the development of guidelines and then allowed to proceed on a case-by-case basis having undergone appropriate ethical scrutiny and having received appropriate ethical approval. We would expect that such research would be governed by the same or very similar ethical provisions as applies to research on other types of human tissue.
We remain concerned about the very real potential for the exploitation of women that would result from an increased demand for human eggs for purposes unrelated to fertility treatment. Because the donation of frozen eggs presumably means that such eggs are no longer required for fertility reasons, this practice could, in theory, lessen the need to procure eggs in other ways.
We oppose all research using frozen eggs to create a human embryo.
We are also opposed to all research involving the fusion of human gametes with gametes of other species so as to create human-animal hybrid embryos.