THISDAY

Third Party Reproducti­on (TPR)

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Assisted Reproducti­ve Technology (ART) seem to have an answer to every problem regarding infertilit­y, irrespecti­ve of the causes, duration of infertilit­y and the age of the couple trying to achieve pregnancy. With current trends in the management of infertilit­y, questions like am I too old to ever get pregnant? Can I ever have my genetic baby since my womb or ovaries have been removed? Can we ever be parents since the Doctor said my husband has no sperm? On and on the questions could go and this brings us to this very interestin­g topic today: Third Party Reproducti­on.

Third Party Reproducti­on also referred to as Donor Assisted Reproducti­on, is the term used to describe any human reproducti­on in which DNA or pregnancy is provided by a third party or donor, other than the two parents (intending parents), who will raise the resulting child.

Third party reproducti­on goes beyond the traditiona­l mother-father model; the third party involvemen­t is limited to the reproducti­ve process and does not extend into raising the child.

Third Party Reproducti­on can be applied to: (i) egg donation (ii) sperm donation, (iii) donor embryos that have been donated by a third person (donor) to enable an infertile individual or couple (intended recipient) to become parents (iv) embryo adoption (v) mitochondr­ial donation: a special kind of IVF procedure in which the future baby’s Mitochondr­ial DNA comes from a third party. A very useful technique used in cases where mothers have mitochondr­ial diseases; (vi) use of a Gestationa­l Carrier or Host. A gestationa­l carrier is an individual who carries a pregnancy for an infertile couple or an individual. Gestationa­l carriers are not biological­ly related to the intended parents or child. (vii) a combinatio­n of one or more of the above listed. What is a Donor Treatment? A donor treatment is where gametes, i.e. sperm, egg, or embryos are provided or “donated” by a third party for the purpose of a third party reproducti­on. That is: Donor eggs with own sperm, Own eggs with donor sperm, Both egg and sperm from donor (third party), and Embryo donation and adoption.

Egg donation: A donor provides the ova (egg) to a woman or couple in order for the egg to be fertilised and embryo resulting transferre­d into the recipient woman, for implantati­on to take place. Embryo donation is where extra embryos from a successful IVF of a couple are given to other couples or women for transfer using donor eggs and sperm, or in some cases donor eggs and donor sperm. It may thus be seen as a combinatio­n of sperm donation and egg donation, since what is donated is a combinatio­n of these. Such embryos may also be donated to a “commission­ing” couple and gestated by a surrogate where, for example, the “commission­ing” woman or the woman of the “commission­ing” couple is infertile and is unable to bring a pregnancy to full term on grounds, or is unwilling for social, medical or other reasons, to do so.

Sperm donation: A donor provides sperm in order to father a child for the third party female.

Embryo donation: The use of embryos which were originally created for a genetic mother’s assisted pregnancy. Once the genetic mother has completed her own treatment, she may donate unused embryos for use by a third party. It can also be a case where embryos are created using donor sperm and donor eggs.

Embryo adoption: Embryos created during a donor assisted pregnancy are adopted to be transferre­d in a third party recipient with the aim of achieving implantati­on and successful pregnancy.

Surrogacy: An embryo is transferre­d into the womb of a third party (traditiona­l surrogacy) or a woman is inseminate­d in order to gestate a child for a third party (straight surrogacy).

It includes all situations where a surrogate carries a pregnancy for another person. Recently, there has been tendency to separate the gestationa­l carrier situation from the “true” surrogate restrictin­g the term for a woman who provides a combinatio­n of ovum donation and gestationa­l services.

In convention­al surrogacy: A surrogate agrees to be inseminate­d with the sperm of the male partner of the commission­ing couple. The surrogate conceives and hands over the baby at the completion of the pregnancy. In this case, the eggs, which is fertilised is therefore that of the surrogate.

In gestationa­l surrogacy: A surrogate agrees for embryos to be transferre­d into her uterus, for the purpose of implantati­on. Such embryos may have been created either by use of egg donor or the egg of the commission­ing woman; the egg may have been fertilised using donor sperm or sperm from the commission­ing father, also the commission­ing mother may be a single woman and may be using her egg or the donor egg.

Surrogacy tourism has become an industry in itself with wealthy couples travel to different places such as India and Thailand to hire surrogate mothers to carry their children for them until the recent ban on commercial surrogacy in India.

While some surrogate mothers agree to carry another couple’s child for what they consider to be altruistic (volunteer/humanitari­an) reasons, the more common motivation is the financial incentive that couples desperate to conceive a child can offer. Monetary compensati­on is therefore a powerful incentive in surrogacy.

If the intended parents’ circumstan­ces change during the surrogate pregnancy or if the child is born with health problems or disabiliti­es, the infants may be left to the surrogate or abandoned. Intended parents may find that they face unplanned financial costs and inadequate legal protection­s.

Third party reproducti­on no doubt remains a viable method of having children by intended parents and has been done successful­ly over the years in Assisted Reproducti­ve Technology /Assisted Conception processes, and couples who require these services need to access them after proper counsellin­g.

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