Demand for human ova has been growing in recent years, fueled by infertility treatments and increased investment in stem cell research. Young women at top colleges and universities, long a prized source of eggs, are now being recruited not just through advertising in student newspapers but on Web sites like Facebook and Craigslist, even on highway billboards.
But a study in the most recent issue of The Hastings Center Report, a leading bioethics journal, found that the compensation being touted in ads aimed at young women often exceeded industry guidelines. The study is the latest development in a long-running debate over how much — or even whether — egg donors should be paid.
In the study, Dr. Aaron Levine, an assistant professor of public policy at the Georgia Institute of Technology, examined more than 100 egg donation ads from 63 college newspapers. He found that a quarter of them offered compensation exceeding the $10,000 maximum cited in voluntary guidelines issued by the American Society for Reproductive Medicine, a professional association.
The guidelines state that payments of $5,000 or more above and beyond medical and related expenses “require justification” and that payments above $10,000 “are not appropriate.” Ads in newspapers at Harvard, Princeton and Yale promised $35,000 for donors, Dr. Levine found, while an ad placed on behalf of an anonymous couple in The Brown Daily Herald offered $50,000 for “an extraordinary egg donor.”
“The concern is that some young women may choose to donate against their own best interests,” Dr. Levine said. “They’ll look at the money on offer and will overlook some of the risks.”
Uhhmmm, so the solution to the existences of downsides to egg donation is to pay the donors less? Isn't that exactly backwards?
This whole things sounds like when the NCAA periodically announces that its star basketball players should continue to play for them for free instead of playing for the NBA for millions. Of course the NCAA would say that. It's in their financial self-interest. And of course the medical-industrial complex would argue that young women should donate eggs for less than the medical-industrial complex would have to pay on the open market.
The study noted the possibility that the ads represented a “bait and switch” strategy, with large offers primarily designed to lure donors but with prices negotiated downward once they respond.
That was my reaction to the $50,000 ad at Brown about a decade ago -- somebody in the business was trying to get a lot of cheap publicity by theoretically offering a super high price for the "perfect" donor, but would tell most would-be donors that they only would get a lesser amount. It's a little sleazy, but not really a big deal.
In addition to limiting compensation, the society’s guidelines forbid paying additional fees to egg donors for specific traits. But the study found that every 100-point difference in a university’s average SAT scores was correlated with an increase of more than $2,000 in the fees advertised for potential egg donors in the campus newspaper.
Look, people who can't make babies the old-fashioned way therefore have to select somebody else's eggs or sperm. And that means they have to be practicing eugenicists. (The only alternative is to have somebody else select for you, such as in the bad old days when doctors asked medical students to do the honors on their assumption that M.D.s were the eugenic Master Race.) For example, when Jodie Foster decided she wanted babies but didn't want to have a man touch her, she had to choose somebody's DNA. Being Jodie Foster, Superwoman, she went, perhaps, a little over the top, looking for months before settling on a tall handsome scientist with a 160 IQ.
Our high culture has devoted so much effort to demonizing eugenics in recent decades that it allows self-interested operators to free ride. In a sensible culture, of course egg purchasers should pay more for eggs from donors with more desirable traits. That's how we get more donors with desirable traits to donate.
Fertility clinics, which maintain registries of potential egg donors, tended to observe the guidelines in their ads. Egg donation agencies or brokers, who act as middlemen by linking donors with prospective recipients, were far more likely to advertise the higher payments. Unlike egg donation agencies, fertility clinics are generally members of the Society for Assisted Reproductive Technology, which is affiliated with the A.S.R.M., and are therefore expected to abide by the guidelines.
Ruthie Rosenberg, who graduated from Brown last year, said the ads initially startled her but were so common that she became used to them.
“At first, it was totally shocking to me that people would target specifically what they were looking for, like religion, SAT score and hair color,” said Ms Rosenberg, 22. “But like anything else I was first exposed to at college, the shock wore off.”
Egg donation is restricted or banned in many industrialized countries. In the United States, by contrast, close to 10,000 children were born through the use of donor eggs in 2006, almost double the number in 2000, according to the Centers for Disease Control and Prevention. Critics say they fear that young women may not understand the potential physical and long-term psychological risks, including how they might feel years later about the experience.
The government should mandate "informed consent." But all this logically implies that donors should be paid more to compensate them for the risks, not less.
Sean Tipton, a spokesman for the reproductive medicine society, said that the group had little authority over egg brokers and that concerns expressed about donation smacked of sex discrimination. “It’s interesting to me that people get upset about egg donation in ways they don’t get upset about sperm donation,” he said. “You never hear discussions about, ‘Oh, the sperm donor is going to regret it some day that they have a child.’”
He should also pound the table about Women's Right to Choose.
A typical payment for sperm donation is under $100, and providing the sample is quick. The egg donation process, in contrast, takes weeks.
First, a series of hormone injections stimulate the ovaries to produce 10 or more ova in one cycle. Next, the eggs are extracted surgically, under local anesthesia. The fee received by the donor is for all the eggs produced in the cycle. Once the eggs are fertilized, one or more embryos are implanted in the infertile woman, while the rest are usually frozen for future use.
Donation can cause abdominal swelling, mood swings and hot flashes. The most significant risk is ovarian hyperstimulation syndrome, which can cause bloating, abdominal pain, and, rarely, blood clots, kidney failure, and other life-threatening ailments.
And therefore young women should risk all this for less money than they are getting now? Is that what bioethicists consider ethical?