Use of fetal oocytes in assisted reproduction.

Some researchers have suggested that fetuses eventually might be used as a source for oocytes in oocyte donation programs (1, 2). One variant is to remove oocytes from the ovaries of aborted fetuses, mature them in vitro, and use them as donor oocytes for couples who need eggs as part of their IVF effort. A second variant is to remove ovaries from aborted fetuses and transplant them in women who lack ovarian function so the transplanted tissue eventually will contribute to the wom-an's normal reproductive cycle. Although at present the use of fetal oocytes for conception is hypothetical and speculative, its endorsement by some researchers and its critique by government-sponsored commissions make timely a discussion of its ethical dimensions (3, 4, 5). The argument for using fetal oocytes, if this use were feasible, is first to help meet demand for oocyte donation and second to avoid risks and complications for adult donors. Oocytes presently are obtained from women who donate extra oocytes from their own IVF attempts ; patients who agree to donate incidental to hysterectomy or other abdominal surgery; and friends, relatives, or women unknown to the recipient who donate oocytes following hormonal hyperstimulation and oocyte retrieval. Many clinicians maintain these methods have not been sufficient to meet demand; moreover, each has limitations. For example, hormonally stimulating anonymous donors presents physical risks, is potentially exploit-ative, and adds to the costs of assisted reproduction. Maturing oocytes in vitro from fetal ovaries could create an abundant source of oocytes and it could reduce the costs of oocyte donation. Although fetal oocyte use would help meet a need in oocyte donation, its prospect raises a number of sensitive ethical concerns. First, fe-tal oocyte use would pose practical problems in gaining informed consent from donors and recipients. The donor, a woman who has just terminated her pregnancy, is placed in the position of deciding to continue her and her part-ner's genetic line through the potential birth of grandchildren at the same time she elects not to continue this line through the birth of a child. This complicated request would be especially problematic if made immediately following an abortion, when the woman may feel emotionally vulnerable. Therefore, presenting the option before abortion might lead to a more considered and informed choice. As in consent for research on aborted fetuses, the woman's decision to terminate her pregnancy needs to be made before her consent to …