OBJECTIVE To examine compliance with ASRM's ethical guidelines regarding trait-based payment variation, presentation of risks and minimum recruitment age. DESIGN In June 2010, we systematically examined 207 websites, of which 102 were egg donor agency or IVF clinic websites that both recruited online and displayed compensation amounts. SETTING The Internet MAIN OUTCOME MEASURES Mention of increased payment for particular donor traits, recruitment age below 21, noting risks to donors. RESULTS Of the 102 sites, considerable numbers were non-compliant with ASRM's guidelines that prohibit varying compensation based on a donor's traits (34%), recommend an age of 21 or above (41%) and presentation of risks alongside compensation (56%). Trait-based payment variation was associated with being an agency rather than a clinic (p<.001), location in the West (p<.001), not being endorsed by ASRM or SART (p<.001), and referring to ASRM's guidelines about compensation (p<.001). Of sites mentioning traits, prior donation success was the most commonly paid for trait (64%). CONCLUSION Our data, the first to systematically analyze agency and clinic websites reveal that a large proportion do not follow ASRM's guidelines. These data have critical implications for policy, practice and research, suggesting needs for consideration of possible changes in guidelines, and/or improvements in compliance and monitoring by ASRM or others.

Oocyte donation has been used to treat human infertility for nearly 30 years, and remains particularly popular in helping women of advanced reproductive age, yet it also poses ethical concerns. Due to increasing demand and undersupply of available oocyte (or egg) donors, a niche business has developed in which “agencies” assist physician practices in advertising, recruiting, screening and even “matching” donors to recipients in need of such services. The advent of the Internet has increased the number and visibility of these services, creating a market in which programs bid for women perceived as having desired traits and superior pedigrees. A few questionable ethical aspects of these agencies have been examined by ourselves and others, including patterns of monetary compensation that directly conflict with the American Society for Reproductive Medicine's (ASRM) ethical guidelines, but many questions remain unexamined.For-profit agencies that recruit and often match egg donors with intended parents exist alongside licensed, professional fertility clinics that actually perform the medical procedures.