Zum Verbot der Eizellspende in Deutschland: Medizinische, psychologische, juristische und ethische Aspekte

According to the German embryo protection act, oocyte donation is forbidden by penal law in Germany. Approximately 3-4% of all women before age 40 fail to achieve pregnancy via their own gametes, despite otherwise favorable psychological and medical circumstances. It is estimated that as a result several thousand German women travel abroad to receive donated oocytes. Typical reasons for oocyte reception are genetic predispositions (e.g. Turner Syndrome), women without ovaries (either by genetic predisposition or after bilateral ovarectomy), women with premature ovarian failure (about 1% of all women under 40 years of age) and women with depleted ovarian reserve. The success rates after oocyte donation are comparatively high. The delivery rates per attempt lie between 30 und 50%. Severe hyperstimulation syndromes after ovarian stimulation of the donor must be avoided. The complication rates for oocyte donors are relatively low. The new treatment option of oocyte vitrification allows temporally splitting oocyte donation from oocyte reception by cryo-storage of unfertilized gametes. The so-called egg sharing model and the altruistic donation model are both practiced, but the concept of sharing surplus oocytes from an infertility treatment cycle has several disadvantages (e.g. the recipient may receive oocytes of "second choice"). Investigations into the psychological well-being of the children as well as the parent-child-relationship after oocyte donation show no major differences as compared to children born after conventional, non-donor conception. From a medical, psychological and ethical point of view the treatment risks of the oocyte donors deserve particular attention. Exclusively financially motivated oocyte donation has to be considered a serious issue in that context. Accordingly, meeting the demands for appropriate information, education and counseling of the donors are paramount. Women, who undergo oocyte donation abroad, should be informed that in some countries (e.g. Spain) anonymous oocyte donation is still practiced (implying that the genetic origin of the child can later not be determined). In contrast, in Germany according to the current guidelines sperm donation is only performed if all parties involved agree that the genetic background can be revealed to the child later on. In line with the position of several legal scholars in Germany, there is an overall tendency to scrutinize the ban of oocyte donation in Germany. Arguments in favor of allowing oocyte donation relate to issues of personal freedom, the right to create a family and the autonomy of recipient and oocyte donor. For several reasons and since several years a revision of the German embryo protection act is called for. In the process of such revision, the option of oocyte donation should be taken into account.