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Commentary In recent years, clinical assisted reproduction techniques (ART) are increasingly being practiced worldwide, which in turn has led to an accumulated surplus of cryopreserved embryos within fertility clinics [1,2]. Nevertheless, in those countries where the commercialization of embryo donation is banned – and former ART patients are expected to donate their cryopreserved supernumerary embryos altruistically to infertile couples – the resultant effect is often severe shortages and long waiting lists for prospective recipients [3]. Couples who have attained success in clinical assisted reproduction are usually reluctant to donate their cryopreserved supernumerary embryos to other couples [4]. This is because frozen embryos are psychologically conceptualized by former patients as biologic tissue, living entities, 'virtual' children having interests that must be considered and protected, siblings of their living children, genetic or psychological 'insurance policies', and symbolic reminders of their past infertility [5]. Under such circumstances, whereby legally donated embryos are in such short supply and high demand, medical professionals and health institutions can easily exploit the situation for profiteering in medical fees, particularly if they possess exclusive rights of distribution of the donated embryos to prospective recipients.

Can the difference in medical fees for self and donor freeze-thaw embryo transfer cycle, be in fact a cover-up for the sale of donated human embryos?