International Surrogacy

Search in blog

Shop By

  • Keyword
  • Release date
  • Tags

Search in blog mobile

Shop By

  • Keyword
  • Release date
  • Tags
Sunday, 25 July 2021 07:15

Mild Stimulation In Egg Donation Is Essential

There are two strong ethical reasons to avoid harm to egg donors: a duty to minimise harm and the proportionality rule. The general duty to minimise harm applies to all medical interventions but it is even more relevant for donors because they are submitting to the intervention for the benefit of others. Most forms of body material donation will carry with them some harm. This duty does not make that unacceptable but implies that harm is only acceptable when it is unavoidable, and this duty cannot be bypassed by asking the donor for consent. The informed consent form is not a safe conduct for high risks.

Whenever you mention ovarian hyperstimulation syndrome (OHSS) to a clinician, they will reply that it was indeed a serious problem in the past but that it is under control now. The current stimulation protocols bring the risk of OHSS down to zero. However, one wonders how the statistics can be explained as data from the European IVF-Monitoring Consortium show that severe OHSS has not disappeared. Moreover, the American Society for Reproductive Medicine recently calculated that the cumulative risk of a serious adverse event (including OHSS) after six donation cycles is between eight and 13 percent. All under control?

The constant emphasis on severe OHSS also diverts attention from the other complications and inconveniences, as if these are unimportant and negligible. However, mild and moderate OHSS may also affect the quality of life of the donor and bring additional burdens for her. According to the literature, these 'minor' physical side-effects are mentioned by approximately 30 percent of donors. These effects may result in extra visits to the clinic, absence from work, and being sick or in pain, all of which could last for days or weeks. All these consequences are largely avoidable. So why not prevent them?

The proportionality rule states that one should opt for the method of collection with the highest balance of benefits over burdens. An essential factor in calculating the benefit in egg donation is not the number of eggs per donation but the chance of obtaining a live birth per donation. The latter specification is important because the main reason for the high stimulation in egg donation (and IVF in general) is to obtain the highest number of mature eggs. The reasoning is simple: the higher the number of eggs, the higher the number of embryos and the higher the chance of pregnancy. The increased risk and the higher burden is the price donors pay for this high number. However, do we really need this number of eggs? We argue that the cost-benefit ratio of mild stimulation in egg donation is comparable to the ratio of conventional stimulation. When mild stimulation is used, fewer eggs will be collected but the live birth rates are equal to when high stimulation is used. If the benefits are comparable, mild stimulation must have a better balance because it results in much less harm and risk to the donor. The burden of proof is on those who apply high stimulation.

At the moment, it is highly unlikely that egg donors know that there is a risk-free alternative to the procedure that is proposed to them. To improve informed decision-making, the least a fertility clinic should do is tell them. Some people will probably reply that the donors should then be offered the choice. However, as mentioned at the start, that is not a justifiable approach. Being given the choice would certainly be an improvement to the present situation but the duty to minimise harm is not lifted by the donor's consent.

The general application of mild stimulation may have a huge impact on donor recruitment. At the moment, many possible candidate donors are deterred because they fear the high dosages of hormones and the unknown long-term effects. Moreover, first-time donors are much more likely to be willing to undergo more cycles than is the case at the moment. But most importantly, the egg donors would not be submitted to all the risks, harm and inconveniences that they presently report and would be respected for the good they do.

Just think about it in simple terms: when someone answers your call for help, would you knowingly do something to them that may harm them when you can get the help without the risk of harm? The answer should be no. The reason why high stimulation is still used appears to be profit. Thanks to vitrification, eggs collected after a stimulation cycle are frozen in batches of mostly six. These batches are then sold to recipients or other clinics for high prices. These prices are without any doubt a strong reason to continue the current practice. In fact, this may be an extra benefit of mild stimulation: it may put a brake on the increasing commercialisation of egg donation.

  • By Professor Guido Pennings
  • Professor of Ethics and Bioethics at Ghent University
  • Appeared in BioNews 1074
Read 200 times


We have been very satisfied, I have been comfortable at the clinic and with my doctor. I was heard. I could ask any questions. I like you have hu-mor, despite the circumstances. Great clinic. Your service has been very good. You have been a huge support and very spacious. You have been available 24 hours a day. You have the answer to all the questions we have been asked. You have accommodated our nervousness, you have rejoiced with us, you have been there throughout. I could not have wished ...
Read more
A and S
The communication with surrogate is easy and better than what we expected. The updates are provided as scheduled with occasional surprises
The support was great. It was easy on us that the coordination was done by the delivering dreams team while being completely transparent with us on the progress. The communication with the delivering dreams team was always fast, responsive, and easy.
E and K
Thank you kate. You have been great today and all the other days ❤ you are a great team. We are very satisfied and happy for your help.
We were confident before in our choice, but this experience has confirmed beyond any doubt that we choose the best agency.
I loved working with Susan and her team and highly recommend them to anyone considering her services. She's is great at every aspect of a process and knows how to handle delicate matters.
Diana Lyakhovetska
Susan truly understands the needs of parents using surrogacy, and offers comprehensive emotional support to parents as they experience the journey!
Christine Hughes Pontier
The team at Delivering Dreams is amazing! Their attention to detail and ability to put your mind at ease while growing your family is like none other. They handled everything for us, and I never once doubted they would help us accomplish our dreams.
Margaret Jones
I’ve known Susan for several years now, and I’ve always been impressed by her attention to her clients’ needs. I’ve known her to work ardently and diligently to solve whatever challenges, no matter how unique, that prevent her clients from completing their families. She is a problem-solver, and she earnestly believes in providing the best options and in making surrogacy opportunities realities: this is not merely a business for Susan. She will help customize the process for your needs and to ...
Read more
Mary Woods
Susan has a keen sense of business and goes to the max to solve her clients’ problems. She is super knowledgeable on business, laws and how things work in surrogacy in general, and specifically on Ukrainian surrogacy. She is an advocate for transparency in a market that’s often opaque and full of hidden risks. I really enjoyed working with Susan. She really pays attention to detail and was always looking out for my best interest above all. Highly recommend!
Laurie Tham
Delivering Dreams goes above and beyond what other surrogacy agencies offer. After speaking with Susan, I see how they anticipate every part of the process, down to details that I had never even considered. I didn’t know what I didn’t know! Surrogacy can be really complicated and confusing. What an amazing sense of relief to have a company so dedicated to managing the WHOLE process and taking away as much of the stress as possible.
Kate Varness
I have gotten to know Susan through a group where we are members. I have found her to be a genuine and caring person. Her consideration for others and love of her work with Ukrainian surrogates and parents-to-be are evident in all her decision making. She is passionate about being a force for the greater good and helping where she can. I have been amazed at the way she is able to smoothly navigate the complicated maze of requirements in the surrogacy process. I am happy to give her my highest...
Read more
Rose Anne Barbour Huck
Susan Kibler is kind.  She clearly loves those she works with and loves what she does.  Susan listens deeply and compassionately and can make you laugh all in the space of one conversation.  She is wonderful!  If you are feeling worried, she'll hear you.  If you have questions, she will find answers for you. If you need help, she does her very best to support you.  I feel so fortunate to have found her and imagine you will too.
Frances Russell
Susan has the ability to really connect on a personal level quickly.  I have found her easy to talk to and have been so grateful for her guidance.  She is one of those people who offers so much to her clients.  She sees the big picture and has a heart for the most intimate concerns.  She is highly skilled and able to manage what can certainly be challenging and uncomfortable experiences, making them feel easier.  She will take charge at the perfect times and guide you when you really need her...
Read more
Susan Seare
The international surrogacy world is complicated. Susan Kibler knows its ins-and-outs. She knows the people and outfits you can trust and the ones to avoid. She insists on the best for her clients and handles the details so they don't have to worry about them. If you want to take the international surrogacy journey, you can trust Delivering Dreams International Surrogacy Agency to guide you on that path.
Nancy Linnerooth
My friend and I had a positive experience working with Susan. Susan is always super responsive and caring. She is very professional, helpful and reliable. My friend has soo much troubles trying having a baby for many years. My friend and her husband were about to give up their dream of having a baby. Susan Kersch Kibler found the way to help. She has unlimited energy, attentive to detail and super efficient. Great to work with!
Polina Clend
Susan is passionate about helping people become families. She is a trustworthy confidant to have on your side.
Kristen Ancker
Our experience with Delivering Dreams has been overwhelmingly positive. The team seems to be genuinely dedicated to helping us to realize our dream of having a child. The constant communication leading up to the trip and the numerous touch points made us feel comforted in what has been a very challenging and uncomfortable situation. We always had streamlined communication through the group chat and was frequently checked on during our stay.

Under Ukrainian law, surrogacy is a legal affordable option for traditionally married couples to have children using their own embryos, or with either an egg or sperm donor. There must be a medical reason you can’t carry a child. You are also able to participate if you have had 4 unsuccessful IVF attempts.


Under Ukrainian law, surrogacy is a legal affordable option for traditionally married couples to have children using their own embryos, or with either an egg or sperm donor. There must be a medical reason you can’t carry a child. You are also able to participate if you have had 4 unsuccessful IVF attempts.