The use of donor eggs for infertility treatment has soared in the United States, mostly among women older than 40 whose eggs are no longer viable for in vitro fertilization and among gay men wishing to have a child. But the ethics of how to compensate egg donors -- who are often college-age women -- have been a long-standing issue in the field of reproductive medicine. Donating one's eggs is not without some physical and psychological risk. Some ethicists have questioned whether young women are coerced into donation by the lure of big money.
A study published in the new issue of the Hastings Center Report suggests this issue is far from resolved and that voluntary guidelines set by the American Society for Reproductive Medicine are sometimes ignored. Researcher Aaron D. Levine evaluated 105 advertisements from 63 different student newspapers (that's where ads for egg donors are usually placed). About half the ads met the ASRM guidelines of compensating egg donors $5,000 or less -- the amount considered fair for the donor and yet not high enough to be exploitative or to commodify human eggs.
Another 27% provided compensation between $5,000 and $10,000, which is also within ASRM guidelines, although the guidelines call for justifying an amount that exceeds $5,000. Finally, 23% offered compensation exceeding $10,000, which violates guidelines. Levine found that the ads in violation of ethics rules were placed by donor agencies, rather than infertility clinics or individuals, and usually appeared in the papers of prestigious universities, such as Harvard and Brown. Some of these ads request applicants with specific attributes, such as a particular ethnicity, high SAT scores or brown hair.
Given that almost one-quarter of the ads studied are in violation, Levine suggests voluntary guidelines used for egg donor solicitation in this country don't work. Violating these ethical guidelines, Levine writes, "has few serious consequences."
In an editorial accompany the study, however, an ASRM member says the system works well. John A. Robertson, a law professor at the University of Texas who chaired the ASRM ethics committee, says that the amount of compensation is arbitrary; no one really knows what is appropriate compensation. Moreover, he says, there is little the reproductive medicine profession can do about this issue. Trying to enforce the ethical guidelines might force behind-the-scenes deals, he notes. Finally, of the ads that request specific donor characteristics, he writes, "We allow individuals to choose their mates and sperm donors on the basis of such characteristics. Why not choose egg donors similarly?"
One point overlooked in the debate is the soaring cost of higher education. College women comprise the largest market for donor eggs, and students struggling to pay college bills may be more tempted than ever to part with their genetic material. I can imagine some women, down the road, may regret that exchange.
-- Shari Roan
Photo: Human eggs in a laboratory dish. Credit: Rick Meyer / Los Angeles Times