Fertility preservation provision in the NHS in Scotland: guidance
Scottish Government and NHS Scotland fertility preservation guidance provides recommendations and guidance for clinicians on which patient groups should be considered for fertility preservation treatment and individual eligibility criteria.
Annex E
Gamete storage for use by third party reproduction
Some patients undergoing gamete storage may subsequently require third party reproduction (donation and surrogacy). For this, they are considered to be gamete donors, requiring additional screening tests, as specified in the current HFEA Code of Practice and they will be required to complete a questionnaire regarding risk of genetic disease and recent travel.
The need for surrogacy will often be unclear at the time of gamete storage. Options would therefore be to (i) treat all as potential donors, (ii) treat selected individuals as potential donors, or (iii) treat none as potential donors and undertake additional screening at the time of use.
Considerations include:
- unnecessary investigations at storage, with cost and inconvenience considerations
- infection tests changing between storage and use: these tests therefore need to be undertaken at storage with repeat at three to six months as per current regulations
- tests that will not change are CF, karyotype, blood group: these could therefore be undertaken at time of use
- donor questionnaire: important for identification of recent travel/behavioural/infection risk
We suggest that all individuals undergoing gamete storage are assessed as to the potential need for third party reproduction, recognising that the individual’s situation in the years to come is difficult to predict. This applies equally to those storing sperm and eggs, and it is important to recognise that this possibility should be discussed (and recorded) with all patients proceeding to fertility preservation procedures. If there is considered to be a possibility of needing third party reproduction, the following approach should be taken:
- infection-related tests should be done at the time of gamete storage, with medical/behavioural/social questionnaire and repeat testing at three months in compliance with HFEA Code of Practice, if using NAT testing or repeat testing at six months if using serology testing only
- karyotype, blood group and CF screening should be done at time of gamete use, not at the time of gamete storage
- genetic questionnaire: to be completed at the time of gamete use
Contact
Email: anthea.taylor@gov.scot