May 12, 2010

Should Some Egg Donors Be Paid More?

A study published in a recent issue of a leading bioethics journal found that compensation being offered for young women to sell their eggs to infertility treatment clinics often exceeds industry guidelines, fueling the debate over how much - or even whether - egg donors should be paid.

The demand for human ova has been growing in recent years, as infertility treatments and increased investment in stem cell research grows. Many young women at top colleges and universities, a prized source of eggs, used to be recruited mainly through newspaper ads. But more recently, popular websites such as Facebook and Craigslist are enticing young women to sell their eggs for top dollar.

In the study, Dr. Aaron Levine, an assistant professor at the Georgia Institute of Technology, examined more than 100 egg donation ads from 63 college newspapers. He found that 25 percent of them offered more than the $10,000 maximum compensation - voluntary guideline - as cited by the American Society for Reproductive Medicine.

The guidelines state that payments of $5,000 or more above and beyond the medical and related expenses "require justification" and that payments above $10,000 "are not appropriate."

Levine found that newspaper ads at Harvard, Princeton and Yale promised $35,000 for donors. One ad placed on behalf of an anonymous couple in The Brown Daily Herald offered $50,000 for "an extraordinary donor."

The troubling concern is that some "young women may choose to donate against their own best interests," said Levine. "They'll look at the money on offer and will overlook some of the risks."

The study suggested that many ads represent a "bait and switch" strategy, with large offers designed to lure donors in, but then negotiate prices downward once they respond.

While the society limits compensation, it also forbids additional payments be made to egg donors based on specific traits. But the study found that for every 100-point increase in a university's average SAT scores, the price offered goes up $2,000 or more to qualifying egg donors.

Fertility clinics, most of which are members of the Society for Assisted Reproductive Technology, tend to stick to the guidelines in their ads. It's the egg donation agencies or brokers - who act as middlemen for the clinics - who were far more likely to advertise higher payments.

The Society for Assisted Reproductive Technology is affiliated with the American Society for Reproductive Medicine, and is therefore expected to abide by the guidelines.

Egg donation is banned in many industrialized nations. In the United States, however, close to 10,000 children were born through the use of donor eggs in 2006, almost twice as many as in 2000, according to the Centers for Disease Control and Prevention.

Many critics express fear that young women may not understand the potential physical and psychological risks, warning how it may affect them years later.

"It's interesting to me that people get upset about egg donation in ways they don't get upset about sperm donation," Sean Tipton, a spokesman for the reproductive medicine society, told the Wall Street Journal. "You never hear discussions about, "ËœOh, the sperm donor is going to regret it someday that they have a child.'"

A typical payment for sperm donation is under $100, and providing the sample is quick. The egg donation process, in contrast, takes weeks.

The process starts with a series of hormone injections that stimulate the ovaries to produce 10 or more ova in one cycle. The eggs are then extracted surgically using local anesthesia. The fee the donor receives is for all the eggs produced in one cycle. The unused eggs are frozen for future use by the clinic.

Potential risks include abdominal swelling, mood swings and hot flashes. The biggest risk is ovarian hyper-stimulation syndrome, which can cause bloating, abdominal pain, and, possibly - although rarely -, blood clots, kidney failure, and other life-threatening conditions.

Last fall, California passed a law requiring egg donor agencies to include specific warnings about health risks in their ads.

Besides egg donation for fertility, opposition from many conservatives and anti-abortion campaigners on the use of human ova for stem cell research has led efforts to impose restrictions and regulations of both procedures in many states.

Wendie Wilson, owner of Gifted Journeys, an egg donation agency in Los Angeles, told the Wall Street Journal that she opposes regulations of the procedure, saying that payments above $10,000 were rare and generally reserved for women who had previously donated and whose eggs resulted in pregnancy.

Supporters of egg donation are concerned that government officials may soon clamp down on the practice, as other countries have done.


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