o-199 cross-border reproductive care for egg-donation in dutch women

background: Commercial egg-donation is prohibited in the Netherlands. Women in need of this treatment find their path to countries with commercial egg-donation programmes. The extent of cross border reproductive care for egg-donation and opinions of Dutch gynaecologists on this subject have not been established. methods: An author-constructed questionnaire sent to all gynaecologists registered at the Dutch Society of Obstetrics and Gynaecology (NVOG). Questions assessed information about the gynaecologist, about his willingness to support patients who participate in a commercial egg-donation program, information about these programs and opinions about commercial egg-donation. The incidence of cross border reproductive care for commercial egg-donation between 2000-2008 was estimated. results: Of 94 out 101 Dutch fertility units at least one gynaecologist answered the questionnaire (response 93.1%). Gynaecologists in 47 hospitals supported patients who participated in commercial egg donation programmes in a foreign country. The same number provided no support for these patients. Compared to the interval 2000-2004 in the interval 2005-2008 requests for participation increased from 62 to 179( increase 288%). We also found a three fold increase of patients who actually went abroad to participate in a commercial egg donation program (45 versus 149, increase 331%) and a similar increase in care for pregnancies originating from commercial egg donation (32 versus 98, increase 306%). The large majority of patients took their own initiative to find an in stitution to help them with their aim to achieve a pregnancy. Information is provided by Freya a national platform for people with fertility problems (http://www.freya.nl/). Only in about 10% gynaecologists referred patients to an acquainted clinic abroad or recommended such a clinic. Most Dutch couples visit Spain (n = 109) for commercial-egg donation, followed by Belgium (n = 32), Eastern Europe (15) and the United State of America (11). Most women who travel abroad for a commercial egg donation program are 41 years or older. The age of the donor usually is below 35 years. The estimated price per treatment cycle lies between 3000 and 10.000 euro’s. Especially in the United States couples paid up till more than 30.000 euro’s per treatment. The large majority of acceptors has an age above 41 years. Only 30% of the Dutch gynaecologists is well informed about the age of the donors. They think that nearly all donors are aged 35 or lower. Donors usually undergo ovarian hyperstimulation and egg collection by follicle puncture to donate eggs for one acceptor (estimate 50%); in other clinics for commercial egg-donation the harvest from one donor is divided among two or more acceptors (estimate 30%). Furthermore, IVF patients may donate “surplus” eggs collected during an attempt to achieve a pregnancy (estimate 20%). To the judgement of 34% of the responding Dutch gynaecologists commercial egg-donation is not ethical, 56% of these responders is willing to provide support for those who seek help for commercial egg-donation aboard, 36% has the opinion that the Dutch government should allow commercial egg-donation with or without strict conditions conclusions: An increasing number of Dutch women get around the Dutch law and join cross-border commercial egg donation programmes. A small majority of Dutch gynaecologist mentions commercial egg donation sensible medical