Mitochondrial Donation and Egg Donor Consent in Australia

Abstract

Background: Legislation to permit mitochondrial donation (MD) in Australia was introduced into Federal Parliament in early 2021, and the techniques may be legalized and made available soon. MD enables women affected by disease-causing mutations in their mitochondrial DNA to have a genetically related child who is unlikely to inherit these mutations. MD relies on the donation of oocytes. Australia’s oocyte donation system does not meet current demand for oocytes and MD would add to this. Consequently, the implementation of MD would raise critical questions about the system of procuring donors and using their oocytes. The proposed model for implementing MD in Australia does not address these issues. We address two key inter-related concerns – oocyte availability and donor consent – in how best to meet current and future demand for donor oocytes. Aim: To consider ethical, social, and regulatory issues arising from the proposed implementation of MD in Australia, particularly oocyte availability and donor consent issues. Method: We discuss the current system of oocyte donation in Australia and consider likely impacts of MD on this. We review alternative systems that have been proposed to enhance the availability of oocytes, focusing on ethical aspects of these with reference to specific features of the Australian context, donor consent, and MD. Results: MD will increase demand for oocytes if introduced in Australia. Alternative procurement systems to address the shortage of oocytes may be required. Refining the system of consent used for oocyte donation may be an important feature of increasing oocyte availability for MD. Conclusion: As Australia presses ahead with the potential implementation of MD, consideration should be given as to whether the current system for oocyte donation is adequate. We conclude that it is necessary to consider alternative systems for enhancing oocyte availability in Australia, which, in some circumstances, may include changing consent procedures.