As we can foresee ,in the future we would be having registered ART egg banks functioning independently as per the ethical clauses applicable to the society and dictated by law. Only denuded, metaphase 2 oocytes would be frozen/vitrified, banked and latter distributed to ART clinics. ICSI is mandatory for frozen thaw oocyte cycles. In case fresh oocyte donation cycles are carried out, the maturity of the oocyte may be checked by the morphological scoring of the OCC but I still feel that due to limited number of oocytes available to the clinics ICSI should be performed.
Since the IVM is more of a research issue presently and wont be clinically applicable to or setups before next 10 years ,GV and M1 oocytes are to be rightfully discarded.
In Canada, laws and policies consistently reject the commodification of human organs and tissues, and Canadian practice is consistent with international standards in this regard. Until the Assisted Human Reproduction (AHR) Act of 2004, gamete donation in Canada was an exception: Canadians could pay and be paid open market rates for gametes (sperm and egg) for use in in vitro fertilization (IVF). As sections of the AHR Act forbidding payment for gametes (Section 6) and permitting only reimbursement of receipted expenses (Section 12) gradually came into effect in 2005, Canada did away with this anomaly. Medical practice and legal prohibitions in assisted human reproduction are now consistent with other areas of medicine where tissues and organs are taken from one person to benefit others: Altruistic donation, rather than selling and buying, will be the norm. The prohibition of payments for gametes introduced with the AHR Act places medical donation for IVF on a par with all other organ and tissue donation for a wide range of medical conditions. Because of the previous anomaly, however, the change has interrupted expectations: Patients who were able to pay to secure egg donations prior to 2004 are no longer able to do so, and the supply of donor sperm also is expected to fall dramatically over a period of time. As per ICMR guidelines chapter – V, sourcing, storage, handling and record keeping for gametes, embryos and surrogates, Para 26, subpara (6) An ART bank may advertise for gamete donors and surrogates, who may be compensated financially by the bank. This is an ideal recommendation and I feel that the gamete donation should be permitted but monitored by legal bodies. This will ensure regular availability of gametes for the needy and bring end to unscrupulous practices bringing smile in life of large number of patients.