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Guidelines on Mental Illness and Egg Donation in the US
February 28, 2013
Fertility clinics in the United Kingdom routinely turn down egg donors with a history of bipolar disorder, according to a recent news investigation. Guidelines from the Human Embryology and Fertilization Authority in the UK state that prospective donors should not be accepted into the egg donor program if “they are known to have a particular gene, chromosome or mitochondrial abnormality that, if inherited by any child born as a result of the donation, may result in that child having or developing a serious physical or mental disability”. However, there is not currently a government ban on accepting eggs from women with the disorder and the guidelines are enforced on a clinic by clinic basis.
Fertility patients in the United States who are considering a donor egg in vitro fertilization (IVF) cycle might have similar concerns about the physical health and psychosocial history of their prospective donor.
Eric Flisser, M.D., a fertility doctor at Reproductive Medicine Associates of New York (RMA of New York) in Garden City, Long Island, says that egg donors in the US must meet the infectious disease requirements set forth by the Food and Drug Administration (FDA), American Society for Reproductive Medicine (ASRM), and Department of Health in the state in which the egg donation is taking place, but mental health guidelines are not set in stone. “Regarding psychiatric disease, ASRM does have a position that the donor should consult with a mental health professional to go over the psychological ramifications of being a donor. The point of that consultation is for the mental health professional to elicit a psychosocial history and to examine for significant psychiatric problems within the donor’s family,” Flisser states. ASRM recommends that the presence of significant psychopathology or history of heritable psychiatric disorders serve to exclude a woman from becoming an egg donor. While infectious disease exclusions are mandatory, mental health guidelines are recommendations not requirements.
According to ASRM guidelines on egg donation, prospective donors with a significant personal or family history of mental illness would meet exclusion criteria, but clinics are not required to exclude egg donors with mental illness. “We don’t know the gene that causes [mental illness] but we do know that diseases like Schizophrenia cluster within families,” states Flisser. If an egg donor screens positive for mental illness, it is responsibility of the fertility clinic to inform the recipient of the donor’s mental health diagnosis and allow the recipient to decide if they would like to proceed using the donor’s eggs.
In most cases, however, egg donation programs will not accept donor eggs into their inventory if they will have difficulty matching them to a recipient. A history of bipolar disorder or schizophrenia is no exception to this rule. Dr. Flisser assures fertility patients considering egg donation that due diligence has been done to protect the patient as much as possible in accordance with ASRM, FDA, and state guidelines.