Egg donation compensation: ethical and legal challenges

Abstract

Nearly 8,000 children were born in the US in 2011 as a result of assisted reproductive technology involving the use of donor oocytes. While this technology has been widely utilized, worldwide numbers are difficult to calculate. The ethics of the process and of payment provided to donors continue to be highly debated. This paper examines international debates about the legality and morality of the use of donor eggs to assist in family development and just recompense of donors. Aside from a nearly universal perspective that oocytes should not be purchased and sold as commodities, no consensus has been reached on appropriate recompense for egg donors. Major issues in this debate include the relative acceptability of monetary payment versus payment in the form of reduced fees for other reproductive services (often as a result of egg or sperm sharing) and the factors to be considered in determining the just compensation for the time, pain, discomfort, and potential physical risk egg donors face in this process. The effects of legal interventions imposed in various national contexts on the availability of this technology, the influence of egg cryopreservation, and the use of donated eggs for research rather than reproduction are discussed. The effects of US reliance on professional organizational guidelines to oversee donor compensation are addressed, including assessment of their effectiveness in preventing differential rewards for eggs of donors who share characteristics that are highly prized such as beauty, athleticism, and intellectual giftedness. Currently, there is little long-term monitoring of the physical and psychological aftereffects of oocyte donation. Lack of understanding of these effects makes determination of a just payment for egg donation challenging.

Assessing the use of assisted reproductive technology in the United States by non–United States residents

“…Many countries impose restrictions on oocyte donation, ranging from banning the practice altogether to limiting donor anonymity or compensation (20). These restrictions may reflect a variety of factors, including ongoing debates over the ethics of third-party reproduction (e.g., the potential for harm to children following anonymous oocyte donation, and whether compensation of oocyte donors inappropriately commodifies human genetic material or unduly influences potential oocyte donors) and may motivate non-U.S. resident patients to seek CBRC in the U.S. (20,(22)(23)(24)(25)(26).…”

Conflicts of Interest and Effective Oversight of Assisted Reproduction Using Donated Oocytes

“…Only 2.4% of donors who participated in their study reported donating more than 6 times. 86 Donating twice (42.1%) or once (31.6%) were also the most frequent numbers reported by the 19 donors interviewed by Almeling. 87 In addition to COI, COCs may play an important role during the monitoring stage.…”

Federalism and bioethics: Women's health and the regulation of oocyte donation

“…The same study finds that among the 80 donors interviewed, almost 20 percent donated solely because of financial need and approximately 60 percent of the sample identified remuneration as very significant in the decision to donate. 21 The vulnerability of potential donors relative to physicians and intended parents raises substantial concerns regarding the absence of strict oversight over the informed consent process, with some questioning the utility of this method altogether. 22 The medical and psychological risks present in oocyte donation, the potentially coercive payment offers, and the vulnerability of those most often targeted by intended parents and egg brokers illustrate the specific interests and needs of donors regarding their health and safety.…”