Speaking of Women's Rights...: Egg donation? More questions than answers.

Thursday, May 13, 2010

Egg donation? More questions than answers.

“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.”
This quote from a New York Times article on egg donation stopped me in my tracks for a couple of reasons. First, the very idea that my body might be considered a “prized source” gives me the heebie jeebies -- it's a pretty blatant statement of commodification and objectification.

Second: I’m just fascinated by the weird and complex world of compensated egg donation. I’m hoping to explore it more in a series of blog posts, but I want to start by summing up my initial reactions and posing a bunch of questions. I doubt I’ll find definitive answers to all of them, but I’ll try to dig in deeper.

Three (of the many) things that freak me out about egg donation

1. The thought of selecting donors based on traits that may or may not be genetic.

I understand that parents might want kids that look like them. Or, given some degree of choice in the matter, they might even want kids that are different from them in specific ways -- taller, blonder, straighter teeth. But does that really explain/justify seeking donors with particular SAT scores, or athletic abilities, or personality traits? I’m also curious about why certain traits seem important enough to potential parents that they would attempt to manipulate them.

An ad in a local free weekly paper reads:
Blue or Green Eyed Egg Donor Needed
Special donor needed for couple – begin at once. Seeking a healthy, college educated woman, 20-27. Best match would be 5’3” – 5’9”, slender/athletic build, blonde or brown hair. Extra great match to recipient: musical (voice/dance), athletic, adventurous, good sense of humor, empathetic. $5,000 compensation.
It’s as though the wannabe-parents are saying “Our dream child would have all of these traits, and science is too slow to figure out which ones of them are actually genetic – so we’ll assume ALL of them are, just to make sure we get the most perfect baby possible.” Even if a child can inherit empathy and a good sense of humor from her mother, what’s to stop a donor from claiming to have desirable traits that she really doesn’t have? Would the potential egg recipients demand proof? Is it OK for them to do that because they’re the ones holding the checkbook?

2. It’s risky and painful.

According the New York Times article, the donation process is like this:
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. […] 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.
This sounds like a big deal! Not easy. Not fun. I’m curious about how many people do this, and what motivates them. I’ve heard anecdotes about women who donate eggs to finance major expenses (travel, grad school), but I would bet there’s a lot more variety than that.

3. Regulating the whole business.

The New York Times article quotes a doctor who studied the phenomenon of women being offered large sums – up to $50K – for their eggs.
“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.”

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.
So a woman can be smart and independent enough to attend a “top university,” but when she considers becoming an egg donor there’s a danger she’ll become so dazzled by dollar signs that she cannot make a decision in her own best interest. According to Dr. Levine, some authority ought to dictate compensation, in order to protect women… from their own inability to make good decisions? This sounds problematic to me, not to mention paternalistic.

Of course, donating eggs is risky, and very, very complicated – and nasty negotiating tactics are reprehensible in this realm. I’m all for donors being empowered to choose wisely, and understand the risks they’re taking. I think some amount of regulation is appropriate, and necessary. But it’s hard to conceive of getting the details exactly right. How should women – and women’s right to control their own bodies - be protected when they're voluntarily donating eggs, and being compensated?

There is already a lot of knowledge and discussion about this out there on the internet. Good places to start: this article about egg donation in Canada, and Julie Shapiro’s blog. I’m just beginning to learn, and I hope to write more about this.

Please share your thoughts on egg donation in the comments! What do you think about compensation? Egg donors are often compensated, sometimes tens of thousands of dollars. How do you set a price for a human egg? What race and class dynamics do you think are at play? Who benefits? Who is being exploited?) What about kids born from pregnancies started with donated eggs – how do they feel about where they came from?

Photo credit: Carly & Art

16 comments:

  1. Thanks for the link to my blog. It's a fascinating topic. In a number of countries women cannot be compensated for providing eggs. It's perhaps not coincidence that many of those countries have a shortage of eggs. (In fact, many countries that do not provide compensation also have a shortage of sperm. But that's a whole different story.) The general guidelines in the US allow a woman to be compensated, but (at least in theory) she is not selling her eggs. She's being paid for the time and inconvenience. I wonder if this is a meaningful line to draw?

    ReplyDelete
  2. First, I would like to commend this blogger for referring to and looping Professor Julie Shapiro in to this important discussion about egg donation. I had the great pleasure of hearing Professor Shapiro speak on family formation issues faced by gay and lesbian prospective parents at a New England Fertility Society meeting a couple of years ago. Earlier this week, I posted Professor Shapiro's blog on donor compensation on my facebook page with a tickle to colleagues by sharing: "Note to Self: Read Professor Julie Shapiro's blog, everyday."

    (Note to Professor Shapiro: your assumptions regarding the need to synchronize the donor's cycle with the recipient's cycle, in fresh egg donation, is both accurate and, for the most part, standard practice at clinics offering egg donation services. As oocyte freezing becomes more reliable, I expect that we will see fewer fresh cycles and less of a need, therefore, to medically prep the recipient concurrently with her donor.)

    With respect to the first question posed regarding donor selection by traits, when first working in this field, after years of personal struggles with my own infertility, I was baffled by the pursuit of the “ideal donor”. I often became perplexed with prospective parents seemingly comfortable with (unnecessarily) elongating their infertility by searching for months and months (I had one client search for 4 years) for what they perceived to be the “perfect donor” (based on physicality, academic status and other attributes). Frankly, I sometimes still struggle with this. What I have learned, though, from my mental health colleagues, is that, particularly for women, it appears to be incredibly important to find a donor who “carries the thread of resemblance from the recipient mom’s parents, grandparents, siblings through to the next generation of her family.” I learned that in Eastern Medicine, this concept is spoken of as a “red thread” linking the donor conceived child to the extended family. I also now understand, again from my mental health colleagues, that successfully identifying a donor who presents with characteristics shared by the intended mom’s family (discussion about genetics aside) can make it easier for the donor conceived child…haven’t we all heard of the well-intentioned shopper on line at the market exclaim: “what a cute baby, she looks nothing like you!”.

    My suspicion, based on experience, is that more recipients are picky about donor characteristics for reasons of familial resemblance than the recipient (often portrayed in the media) who is offering big bucks for the thinnest, the most blonde, the most academically, athletically, artistically accomplished donor (although more than a few of those clients have walked through my office door…did I mention the recipient and his 4 year of donor search?).

    Regarding risks, I will suggest that in addition to medical risks, a donor may face legal and/or psychosocial/emotional risks. To my knowledge, though, most programs and agencies do want to only work with informed donor candidates. Most donor related websites address risks; there are on-line discussion boards, social-media pages, and professional organizations like the American Society of Reproductive Medicine and The New York State Department of Health who distribute objective material about the clinical process of egg donation. So many resources made available to the would-be donor that ignorance of the level of known risks, I would say, is likely rare. Ignorance of KNOWN risks, that is. And I do think it is fair to discuss exposure to risk relative to compensation.

    Lastly, with respect to regulation, I am one of those optimistic professionals in this field who thinks that we can and should self-regulate. I am encouraged by my colleagues who are interested in dialoguing about “best-practices” and do see a collective regard both for the recipient and the donor and for creating safe and appropriate practices as determined by medical professionals, attorneys and mental health providers.

    ReplyDelete
  3. Thank you Ms. Pogany for this very thoughtful and frank post about egg donation. It is a welcome change given the recent discussions in the media and blogosphere.

    I wanted to comment on Professor Shapiro's provocative question on whether there is any meaningfulness to the description of the compensation being paid to the egg donor. As Professor Shapiro correctly points out, egg donors are paid for assuming the risk of the procedure as well as the pain, suffering, inconvenience and other hardships that are necessarily involved in the process. The reason we make the distinction between a donor being paid for her eggs versus the pain and inconvenience, is that the egg donor will receive her full fee regardless of whether the doctor retrieves any eggs. So whether the doctor retrieves 0, 12 or 24 eggs, the payment is the same as long as she underwent the retrieval. If a donor was paid for each egg retrieved (or fertilized), then it would be a contract for the sale of an egg and likely illegal in every jurisdiction.

    ReplyDelete
  4. As to your first point...I think you are simply unaware of the emotions attached to giving up a genetic link to your child. (I'm not someone who has ever donated eggs or received donated eggs, FYI, but I read a lot of blogs of women who have) Once you've sacrificed your genetic link, do you then have to "settle" for what's available, or do you try to identify someone with as many of the positive traits that you think you have? It is a vast emotional minefield.

    I am unsure of the best way to address the compensation issue. I don't think it's any different than sperm donation, in the sense that compensation is appropriate. How much is appropriate? Well, considering the side effects of the medications and the potential hazards...significantly more compensation than that of sperm donors would be merited.

    ReplyDelete
  5. I'm in Afghanistan and women don't have any of the same rights as they do in the states. I worte a blog about the plight of women in this country titled "The other half" Here's a link to the article: http://www.ntm-a.com/blog/2-categoryblog-general/678-from-afghanistan-the-other-half-of-society

    ReplyDelete
  6. This comment has been removed by the author.

    ReplyDelete
  7. Thanks for the great comments everyone. And welcome to the Legal Voice blog! I’m looking forward to some very interesting discussions about this.

    @Amy and @areyoukiddingme – Thanks for pointing out a very important complicating factor in this whole conversation: people’s deep emotional investment in the process of having kids! The ‘red thread’ image is especially fitting.

    @jltusc – well-said about the regulation, transparency, and information as empowerment. I agree that regulations aren’t necessarily paternalistic by default – only those regulations that presume some inherent helplessness on the donor’s part. The more I learn, the more I think this might not currently be the case (at least not universally). But we’ll see!

    I appreciate the food for thought!

    ReplyDelete
  8. My first comment. Found your blog a couple of times inadvertently. Yours is one of those blogs I could start reading and not know when to stop.

    ReplyDelete
  9. Nice job, it’s a great post. The info is good to know!

    ReplyDelete
  10. This is my first time i visit here. I found so many entertaining stuff in your blog.

    ReplyDelete
  11. Egg donation is becoming an increasingly popular and sought after type of treatment for infertile people. It is an advanced type of third party reproductive treatment offering hope and solutions for people in despair.

    egg banks

    ReplyDelete
  12. Egg donation is significant for those who never conceive babies.. Thanks for sharing this great article with me..

    ReplyDelete
  13. Egg donation is extraordinary and life changing gift..It is last option for mum to fulfill their dream..Thanks

    ReplyDelete
  14. Greeting!
    Right Options Agency is dedicated to helping intended parents find the right NYC Egg Donor Agencies & Philadelphia. Let us guide you our egg donation process & services! It involves a number of steps, obviously involving people in the medical community, our organization and others, to ensure exact results with maximum chance of success and minimum risks to you.

    ReplyDelete
  15. As you have shared through this blog is correct. In any case, when there is no other choice about Chinese Egg Donors, Its better decision is the IVF method. What's more, it's might be helpful for the individuals who wish to raise family.

    ReplyDelete
  16. Naturally supports a woman's health needs by replenishing your body's "good" bacteria to help you feel and live comfortably while acting as a natural yeast infection treatment . great website to check out

    ReplyDelete