doação de óvulos no Brasil

Objective: The objective of this study was to assess the opinions of the Brazilian population about incentives for oocyte donation. Methods: A cross-sectional descriptive approach was used to consult the Brazilian public. The data collection involved the use of a structured questionnaire about legal and ethical issues surrounding oocyte donation. Individuals were randomly selected from the general population using different e-mail lists. Potential participants were contacted by e-mail and invited to participate in the study by completing an online web survey. Results: A total of 1,565 people completed the survey, including 1,284 women(82%) and 281 men(18%). Among the respondents, 1,309(83.6%) were university graduates, 1,033(66%) had a perconsidered themselves to be religious and 518 (33.1%) were health professionals. While many participants believed that women may donate their oocytes for altruistic reasons, the majority believed that a lack of oocyte donations is due to the prohibition of payments(64.3%) and that incentives would facilitate the decision to donate oocytes(84.7%). The majority of the participants(65.3%) agreed that a financial incentive(i.e., paying the donor) would be the most practical solution for increasing the number of oocyte donations. These results tended to be independent of gender, age, income, religion, education level and profession. Conclusion: While the Brazilian Federal Council of Medicine prohibits payments for oocyte donation, the majority of study participants had no objection to compensating oocyte donors. Moreover, most of the participants agreed that a financial incentive is the most practical solution to increasing the number of oocyte donations. keywords: Oocyte donation, Survey, IVF, Ethics, Public opinion. INTRODUCTION With the development of in vitro fertilization (IVF) techniques (Edwards et al., 1980), a wide range of new therapeutic possibilities have become available, including the use of donated oocytes. Oocyte donation (OD) is a treatment option for women with hypergonadotropic hypogonadism; women of advanced reproductive age; women with diminished ovarian reserves; women who are affected by, are carriers of or have 174 Original Article JBRA Assist. Reprod. | V. 17 | no3 | May-Jun / 2013 men with poor oocyte and/or embryo quality; or women who have had multiple previous failed attempts to conceive via assisted reproductive technologies donated oocytes (Lutjen et al., 1984), OD has become a common and routine procedure that gives satisfactory pregnancy and take-home baby rates (Murray & Golombok, 2000; Isikoglu et al., 2006; Pennings, 2007; Purewal & Akker, 2009; CDC, 2012; de Mouzon et al., 2012; ASRM, 2013; Zegers-Hochschild et al., 2012). Consequently, the global demand for oocytes has been increasing, and more couples are willing to use oocyte donation as a way to overcome infertility. relative to oocyte demand. The Brazilian Federal Council of Medicine (2011), which regulates medical practice in Brazil, has mandated commercial nature and that donors should not know the identity of the recipient (and vice versa). Similarly, the national Agency for Sanitary Vigilance (2011) has mandated that germ cell and tissue donations must be anonymous and that donors cannot be compensated. Thus, although oocyte donation involves unpleasant and intrusive procedures that are associated with some risks, the current policy in Brazil is to consider gamete donation as an anonymous/altruistic process only; offering payments and incentives to donors is forbidden. This decision may jeopardize the supply of oocyte donors. In fact, licensed clinics have encounthere are no data on the attitudes of the Brazilian people regarding oocyte donation. Considering that one of the first steps in the creation or modification of regulations is to determine the current perspectives of society, this study aimed to assess the opinion of the Brazilian population about incentives for oocyte donation. METhODS A cross-sectional descriptive approach was used to survey the Brazilian public between October and november 2012. Individuals were randomly selected from the general population using different e-mail lists. Potential participants were contacted by e-mail and invited to participate in the study by completing an online web survey. There were no restrictions on the population selection and no incentives for completing the survey. The data collection involved a structured questionnaire about the legal and ethical issues surrounding oocyte donation. The questionnaire was comprised of one part with nine questions that permitted only one choice (yes or no) for each response. An Internet-based system prevented double responses. The data are reported as percentages. The Chi-squared test was used when appropriate. The level of significance was set at P<0.05. RESULTS A total of 1,565 people completed the survey, including 1,284 women (82%, age: 37.5±8.2 years) and 281 men (18%, age: 44.1±12.4 years). Among the respondents, 1,309 (83.6%) were university graduates, 1,033 (66%) had a personal income of more or equal than $1,250.00 US dollars/month, 1,346 (86%) considered themselves to be religious and 518 (33.1%) were health professionals. The general characteristics of the participants are shown in Table 1. The general results showed that while many participants believed that women may donate their oocytes for altruistic reasons, the majority believed that a lack of oocyte donations is due to the prohibition of payments (64.3%) and that incentives would facilitate the decision to donate oocytes (84.7%). The majoriincentive (i.e., paying the donor) would be the most practical solution for increasing the number of oocyte donations. Table 2 summarizes these results. While there were slight group differences in the results, the responses among different subgroups of the population were relatively stable. The majority of the the most practical solution for increasing the number gender (Table 3), age (Table 4), income (Table 5), religion (Table 6), education level (Table 7) and whether the respondent was a health professional (Table 8). DISCUSSION In addition to a couple’s preferences, the decision about which technique to use in infertility treatment is primarily a medical matter. However, assisted reproduction procedures are regulated through legislation and/or ethical standards. These standards are often based on a society’s socio-cultural and religious structures as well as their ethical and moral values. Legislation often prohibits or imposes limitations on certain reproductive treatments without the necessary opinions and education of the society. These restrictions can lead to reproductive tourism, when couples travel to countries with flexible legislation seeking treatments they are unable to receive in their country of residence (Hughes & DeJean, 2010; Lunt & Carrera, 2010; Crozier & Martin, 2012; de Mouzon et al., 2012; Inhorn et al., 2012; Shalev Table 1. General characteristics of the study population.