Don de gamètes et accueil d’embryons

Donation of gametes, be they oocytes or spermatozoa, or embryos, represents three palliative methods for the management of a couple’s infertility. They are combined with medically assisted procreation techniques. Once their indications have been confirmed, practicing these interventions has been legalized by the French Bioethics Law of 29 July 1994. The fundamental general principles are: donation is voluntary, non-remunerated, anonymous and confidential; these programs are conducted within mandated organizations and under the responsibility of practitioners authorized to collect and handle the gametes provided as a donation or by the biologist who is responsible for frozen embryos. In terms of management, the analysis of indications, compilation of legal documents, serological testing of donor and recipient couples, pairing of donor and recipient, and data collection are essential in the functioning of the system. The federation of French Centers for the Study and Conservation of Sperm (CECOS) reported a pregnancy rate of 10-15 % per cycle obtained by intracervical insemination with donated sperm, with better success rates being achieved after intrauterine or in vitro fertilization. The French Group for the Study of Oocyte Donation (GEDO) published clinical pregnancy annual rates ranging from 17 to 22 %, after transfer of frozen-thawed embryos derived from donated oocytes. Transferring “fresh” embryos is now authorized by the French decree of 24 June 2004 and should improve these results. The rare studies on the follow-up of gamete donation indicate good outcomes in terms of child development and family relationships. The more recent technique of embryo donation is currently implemented in some authorized centers; the evaluation of their results necessitates some more years of observation.