Las bioeconomías de la provisión de óvulos en Estados Unidos y en España: una comparación de los mercados médicos y las implicaciones en la atención a las donantes

Los sistemas reguladores que controlan la reproducción con la participación de terceros determinan el modo en que las personas que donan materiales y trabajo reproductivos –óvulos, esperma y servicios de gestación subrogada– son escogidas y compensadas. Estados Unidos y España tienen regulaciones muy diferentes en lo que concierne a la reproducción con terceros, pero ambos son líderes mundiales en la prestación de tratamientos de fertilidad con donantes de óvulos. En este trabajo, analizamos el modo en que dos diferencias fundamentales entre estos sistemas –cómo son escogidas y cómo son compensadas las donantes– influyen en el mercado más amplio de los óvulos humanos, así como las implicaciones que esto tiene para las mujeres proveedoras. Apoyándonos en entrevistas y en el trabajo de campo realizado en Estados Unidos y en España, este artículo compara cómo la donación de óvulos compensada opera en un sistema público/privado regulado (España) frente al modo en que lo hace en un sistema médico no regulado de libre mercado (Estados Unidos). Exploramos cómo las diferentes bioeconomías reproductivas influyen en la mayor biodisponibilidad de unas mujeres sobre otras en el mercado de los óvulos humanos. Finalmente, hipotetizamos que los avances en las tecnologías de crioconservación de óvulos –y, por ende, el incremento del almacenamiento de óvulos en bancos– puede fomentar una cultura del consumo de los cuidados de la fertilidad en ambos países

Egg donor self-reports of ovarian hyperstimulation syndrome: severity by trigger type, oocytes retrieved, and prior history.

PurposeTo evaluate self-reported survey data provided by US oocyte donors on their experiences with ovarian hyperstimulation syndrome and possible correlations between OHSS severity and number of oocytes retrieved, trigger type, and prior OHSS history.MethodsAn 85-question retrospective survey was administered online. Survey questions included demographic information, reasons for donating, immediate per-cycle experiences and outcomes, perceptions of informed consent, and perceived impact of donation on long-term health. Quantitative Data for this study was collected between February 2019 and September 2020 via QualtricsXM (January 2019), an online survey platform. Follow-up interviews were also conducted. Participants were recruited via fertility clinics, egg donation agencies, and online forum. The research was approved by the University of California, San Francisco Institutional Review Board (#14-14765).ResultsOf 420 initiated US oocyte donor online surveys, 289 (68%) respondents provided detailed information on per cycle experiences with ovarian hyperstimulation syndrome, number of oocytes retrieved, and trigger type over a total of 801 cycles. On cycles where donors reported receiving GnRH agonist triggers (n = 337), they reported milder OHSS compared to cycles with hCG or dual triggers. Among donors undergoing multiple retrieval cycles, the severity of OHSS in second cycles was strongly associated with OHSS severity in first cycles.ConclusionSelf-reported OHSS in oocyte donors is lower in GnRH antagonist stimulation protocols combined with GnRHa trigger and in cycles where donors reported fewer than 30 oocytes retrieved. Donors who reported severe OHSS on a prior cycle were significantly more likely to experience severe OHSS on a subsequent cycle

Eggonomics: Vitrification and bioeconomies of egg donation in the United States and Spain

© 2023 The Authors. Medical Anthropology Quarterly published by Wiley Periodicals LLC on behalf of American Anthropological Association. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.Regulations governing assisted reproduction control the degree to which gamete donation is legal and how people providing genetic material are selected and compensated. The United States and Spain are both global leaders in fertility treatment with donor oocytes. Yet both countries take different approaches to how egg donation is regulated. The US model reveals a hierarchically organized form of gendered eugenics. In Spain, the eugenic aspects of donor selection are more subtle. Drawing upon fieldwork in the United States and Spain, this article examines (1) how compensated egg donation operates under two regulatory settings, (2) the implications for egg donors as providers of bioproducts, and (3) how advances in oocyte vitrification enhances the commodity quality of human eggs. By comparing these two reproductive bioeconomies we gain insight into how different cultural, medical, and ethical frameworks intersect with egg donor embodied experiences.National Science Foundation, Grant/AwardNumber: 1828783Peer reviewe