Report on Ideal Reproductive Treatment Using Donor Sperms, Eggs and Embryos

Report on Ideal Reproductive Treatment Using Donor Sperms, Eggs and Embryos

December 28, 2000

Special Committee on Medical Technology for Reproductive Treatment
Assessment Subcommittee for Advanced Medical Care of the Health Science Council

IБ@Introduction

1. Background on the deliberations of this committee

БЫ The first baby born as a result of in-vitro fertilization in Japan was reported in 1983, and a baby was born as a result of micro fertilization for the first time in 1992.Б@As reproductive treatment technology advances, those who are unable to conceive due to infertility (in this report, infertility refer to the condition in which a man and a woman of reproductive age who want to have a child are unable to conceive and require medical treatment to improve their chances of conception), are given greater chances to have children.Б@Thus, an increasing number of people are receiving reproductive treatment in Japan.

БЫ A 'Survey on Public Awareness of Medical Technology for Reproduction' was conducted by the study group on awareness of medical technology for reproduction by doctors and the general public (a special research involving Grant-in-Aid for Scientific Research, Ministry of Health, Labor and Welfare) (chief researcher: Takumi Yanaihara, professor at Showa University; researcher in charge: Zentaro Yamagata, associate professor at Yamanashi Medical School) in February 1999. From the study, it was estimated that 284,800 people are receiving treatment for infertility (use of ovulation inducers:165,500; artificial insemination:35,500; in-vitro fertilization 17,700; micro fertilization:14,500 and other forms of treatment:51,600).

БЫ The Japan Society of Obstetrics and Gynecology established a registration and reporting system for the clinical application of IVF(in-vitro fertilization) and ET(embryo transplantation), GIFT (gamete intra-fallopian tube transfer), ZIFT (zygote intra-fallopian tube transfer), in March 1986 and publishes the results and analysis of reported casesБ@each year.Б@According to the report in fiscal 1999, 11,119 babies were born as a result of these treatments in 1998, and a total of 47,591 such babies have been born since 1989.

БЫ While reproductive treatment is becoming common in this country, the following problems have arisen in recent years:

In Japan, where there is no law regulating reproductive treatment, artificial insemination and in-vitro fertilization using the sperms and eggs of a married couple have been performed only in limited cases and in accordance with the voluntary rules established by doctors, mainly by The Japan Society of Obstetrics and Gynecology.Б@However, in June 1998, a member of The Japan Society of Obstetrics and Gynecology announced that he had performed in-vitro fertilization using donor sperms and eggs in contravention of the rules of the society.Б@As shown in this case, some members have begun to violate the rules of the Japan Association of Obstetricians and Gynecologists, which have functioned as self-imposed regulations to date.
In December 1998, Osaka District Court pronounced judgment in favor of a man who denied the legitimacy of a baby born to his wife as a result of AID (artificial insemination by donor) performed without his consent.Б@Thus, the issue of the welfare of children born as a result of reproductive treatment using donor sperms has come to the fore.
In some cases, commercial deals such as the sale of sperms or surrogate conception are being conducted.

БЫ The present situation surrounding reproductive treatment in Japan is that, while medical technology for reproduction is advancing rapidly and reproductive treatment is widely performed, we do not have any effective system to regulate and guarantee the appropriate implementation of such treatment.Б@As a result, various problems have not been properly dealt with.

БЫ Under these circumstances, the establishment of regulation and systems that ensure reproductive treatment is carried out appropriately are urgently needed. It is important to determine whether each case of reproductive treatment should be permitted and how they should be regulated, what legal framework is needed to secure the legal status of the children born as a result of such treatment and what kind of organization should be established for the administration of reproductive treatment.Б@To this end, it is necessary to reach a consensus with the general public.

БЫ When discussing the nature of reproductive treatment, it is necessary to seek the opinions of specialists from a variety of fields including medicine, ethics, jurisprudence, etc. since this issue involves ethical, legal and other problems.

2. Deliberations of this special committee

БЫ Based on the current situation described above, a Special Committee on Medical Technology for Reproduction (hereinafter referred to as "this special committee") comprises of specialists in medicine, nursing science, bioethics and jurisprudence, and was established on October 21, 2000 under the Medical Assessment Subcommittee for Advanced Medical Care of the Health Science Council, to discuss this issue comprehensively from the different viewpoints of the individual specialists.

БЫ In the light of the fact that this issue has the potential to exert a major impact on the lives of many people, we need to garner the opinions of the general public.Б@This special committee held 5 hearings to solicit the opinions of patients and those who are well-informed in the fields of religion, law and medicine.Б@Based on these opinions and the result of the "Survey on Public Awareness of Medical Technology for Reproduction" conducted from February to March 1999, the issue was discussed carefully.

БЫ In addition, in order to understand the situation of reproductive treatment in other countries, we put questions to experts from Britain, Germany and other European nationsБ@Б@ in March 1999, and exchanged opinions with HFEA, the organization in charge of authorization and information management concerning reproductive treatment in Britain, in September 2000.

БЫ Reproductive treatment is classified into two categories: that using the sperms, eggs and embryos of a married couple and that using donated sperms, eggs and embryos.Б@Each is performed using various technologies such as artificial insemination, in-vitro fertilization, embryo transplantation, surrogate conception and so on.Б@This special committee focused on reproductive treatment using donor sperms, eggs and embryos such as AID, in-vitro fertilization using donor sperms, in-vitro fertilization using donor eggs, transplantation of donor embryos and surrogate conception (surrogate mother, host mother): These are the areas which problems involving the establishment of parental links and donations made for commercial gain may arise performs because in these cases, the sperms, eggs or embryos of a third person are used, or a third person other than the wife of the patient couple bears the child.Б@A system ensuring the appropriate implementation of such treatment, in particular, needs to be established in the form of regulation.

БЫ This special committee has set 29 times during the last 2 years and 2 months, including meetings to discuss the subject of multifetal pregnancy reduction.Б@Starting from June 2000, we examined and discussed the "Proposal on Reproductive Treatment Using Sperms, Eggs and Embryos Donated by a Third Person" prepared by the working group organized by 5 members after four sessions of deliberation.Б@The members were Michiko Ishii, Naotake Kato, Eiji Maruyama, Takumi Yanaihara, and Yasunori Yoshimura.Б@Based on these discussions, we started to delibere the draft report of this special committee prepared by the secretariat in October 2000.

БЫ After careful deliberations over a long period of time, this special committee has summarized its views on reproductive treatment using donor sperms, eggs and embryos.Б@We present the summary together with the attached "Multifetal Pregnancy Reduction", a summary of the issues discussed by this special committee prior to the discussion of the main subject.

Return To Top

Index / Next