Double embryo donation

1. Good day to everyone!
I am glad to have this opportunity to be in front of you and, given the very short time I have
at my disposal, I will cut to the chase and present the information. For the beginning, I start
by telling you that I will make an overview of the double gamete and embryo donation'
situation within 23 European countries, and then offer you details on the legal status in two
of these countries, namely Romania and France, and in the end of my presentation, I will
make several observations, based on the discussions held by me with 24 persons from
Romania and France, which had undergone double gamete and embryo donation
procedures.
I. With the support of my Fertility Europe colleagues I succeeded in creating a general
overview on the access to double gamete and embryo donation in 23 European countries.
I do not have the necessary time to emphasize strongly the data of these two info
graphics, but I kindly request you to look generally at them. By evaluating the data, we
note that in 13 countries of the above-mentioned 23's, both double gamete donation and
embryo donation are authorized. These procedures are not authorized in 3 countries
(Norway, Sweden and Malta), being clearly forbidden by law. In France, Germany and
Croatia, embryo donation is authorized but it is forbidden to use a donated spermatozoon
and a donated egg to create an embryo; quite the opposite, in Island, the double gamete
donation is allowed but the embryo donation is forbidden. In Turkey and Romania none of
these procedures are not legally regulated. There are various characteristics of some of
the countries included in this particular overview - for instance, in some of the countries
only the procedures with known donor are authorized, and in other countries the
procedures are legally regulated but, due to lack of donors, patients choose to go to clinics
from abroad etc.
II. After this general overview at European level, I invite you to pursue more in details the
situation within Romania and France; I selected these two countries because I hold the
citizenship of both of them and, due to the fact that I live and I am an active member of
association, I could easily find persons (doctors and patients) available to help me
understand better the phenomenon of conceiving by double gamete and embryo donation.
The situation between those two countries is very different, the only common ground of
France and Romania being the fact that people need to get cross-border fertility care.
A) It is clearly forbidden by law in France to conceive an embryo by a donated egg and a
donated spermatozoon, and thus I will detail some significant features from embryo
donation; this procedure is regulated by the French Bioethics Law of 1994, but the
decision of coming into force was signed only in 2000. More precisely, the first child born in
France, pursuant to a procedure of embryo donation, was Clara, born in 2004.
In France, there are three main legal principles to be followed for embryo donation:
− volunteering: in order to donate embryos, the two partners (even if those two are
separated) have to sign a written consent; in case if one of the partners dies, the
law allows to donate embryos only with the consent of the living partner;
− free of charge: the embryo donation is not subject of any type of financial
compensation;
− anonymity: the donating couple will not be able ever to know the identity of the
receiving couple, or the other way around. The child born pursuant to an embryo
donation procedure cannot know the identity of the donating couple.
As regards the anonymity, the French law stipulates that (article L2141-6 of Public Health
Code), in case if there is a health need of the child conceived by embryo donation, only a

2. doctor is allowed to have access to the medical file of the donating couple. This medical
data is kept for a minimum period of 40 years.
In France, the couples suffering from double infertility or holding the risk to pass a genetic
disease are allowed to go to embryo donation. The couple that wishes to undergo an
embryo donation procedure has to submit a request to a Court, but the couple doesn't
need to have the assistance of a lawyer for this legal procedure. Theoretically, the judge
can ask for a social investigation to take place to assess the family receiving the embryo.
Costs. If the woman is under 43, the legal age stipulated by French laws for IVF
reimbursement, all medical expenses related to the embryo donation procedure are
covered by social security.
Success Rate. The most recent statistics on embryo adoption which I found on the site of
Biomedicine Agency in France are from 2009, and indicate a success rate of 25% per
embryo transfer.
Currently, the number of couples in France willing of undergoing embryo donation is
notably higher to the number of donating couples, and this situation generates significant
times of waiting.
B) Opposite to France, Romania is one of the European country which doesn't have an
ART law. As of 2004 to nowadays, there were 6 attempts to pass a law in the assisted
reproduction's field, but without any concrete result. At the moment, there has been a draft
law debated as of 2013, at the Romanian Parliament, but the approval process has been
coming to a halt.
Although there is no specially dedicated ART law, there are some legal regulations
stipulated in the General Law of Health in Romania and in legal acts concerning human
cells and tissues. Thus, as regards gamete donation, the donation of eggs is performed
from a known donor, based on an authenticated act by a notary public; the donor and the
receiving party go in front of the public notary to sign an "authenticated written document",
after the donation had been approved by the approval commission of the living donor.
Nowadays, none of the ART clinics in Romania have sperm banks, for this type of
procedure the genetic material is imported mainly from Denmark. But, I point out that
neither double donation of gamete nor embryo donation are regulated in Romania. Based
on the discussions had with several doctors in Romania, the conclusion emerged is that in
Romania there is a legislative void, and these procedures cannot be performed in the
Romanian clinics. At least one of the ART centers of Bucharest addressed in the past,
based on the request of the patients, the National Agency of Transplant to request
instructions for potential embryo donation procedures, but this authority hasn't ever come
with an answer. Therefore, the couples in need of double gamete or embryo donation are
guided by Romanian doctors to look for solutions outside of the Romanian borders.
III. In order to conduct the research for this presentation I asked for testimonials from
couples in France and Romania. Subsequently, I communicated by emails, instant
messages or by phone with 24 women: 16 women from Romania, and 8 from France. The
sample is not sociologically representative and I didn't do a scientific research, but I grant
myself to show you some of the conclusions obtained following the discussions, which I
found very interesting, without being, I repeat, representative from a statistics point of view.
Therefore, from 24 subjects with whom I communicated, 21 are women in a stable couple

3. with the father of the child, and 3 of them are single mothers. It was only the women who
gave the testimonials, even though I invited each time both partners. Their children are
between 2 months and 6 years old.
As of these 24 women / couples, 15 had conceived following a procedure of donated
gametes, and 9 of them had undertaken an embryo adoption.
14 of these women managed to obtain a pregnancy and get birth to a child after the first
attempt, 9 of them after the second attemppt, and one of the women succeeded in the
third attempt.
As regards the reason why they went to double gamete or embryo donation:
− 13 of the couples suffered from severe infertility in the case of both partners
(confirmed by previous attempts with their own gametes, without any result),
− 3 of the subjects were women with an egg reserve which was severely diminished,
and without having a stable partner (two of them had in the past undertaken
chemotherapy),
− for other 3 couples there were confirmed genetic issues, which led to the medical
recommendation to go for this type of procedure,
− in 5 cases, just one of the partners (more precisely, the woman) was suffering from
a certified severe infertility, namely very poor egg reserve. In this category, the
reason why the couple chose to undergo embryo adoption was the financial reason
in the case of 4 (the cost being of about EUR 1,700 for the transfer of two donated
embryos and the need of staying for 1-2 days in the country where the clinic was
located, in exchange of about EUR 5,000 for the egg donation procedure and a
one-week or more stay in the country where the clinic is located); all these four
couples who indicated the financial factor as main reason for taking the decision
and go for embryo adoption instead of IVF with egg donation are from Romania.
One of these couples indicated that the main reason of choosing embryo adoption
and not egg donation, although the man was theoretically fertile, the results of his
sperm test showing normospermia, was the couple's mandatory feeling to be on
equal level, from a genetic point of view, as regards the child.
As regards the location of fertility centres where the procedures took places, in 23 of
those 24 cases was about cross-border fertility care. Therefore, 6 of 8 subjects from
France did double gametes donation procedure in Spain, and 3 of 16 couples from
Romania did double gametes donation procedure in Greece, and the other 13 chose
clinics located in the Czech Republic. Two of the France-based couples opted for embryo
adoption, one couple from Spain (time of waiting: 3 months), and the other couple from
France (time of waiting: two years and four months).
In conclusion, I will not summarize the information already presented to you above.
Instead, I will show you a chart with the answers offered by the couples whom I'd talked to
in order to elaborate this presentation. When I asked them to tick, in a written anonymous
questionnaire, the answer to the question: "At this moment in time, in your daily life, the
fact that you do not have any genetic connection to your child is: 1) not important at all, 2)
more or less important, 3) important, 4) very important”, all 24 interviewed mothers opted
to tick the option no. 1: a "not important at all” fact.
Thank you for your attention!