The Process of Egg Donor Recruitment is a Tricky Business

The Process of Egg Donor Recruitment

We all know it’s easier to hang a shingle on a door and open an egg donor agency than it is to secure a food handlers permit to sell food out of a street vendor food truck. We see all over the internet “Earn 5,000 plus expenses for the gift of life”  “Are you artistic, athletic, extremely bright?  Earn up to $9,000.00 by donating your eggs” We see advertisements recruiting egg donors of specific ethnicity, culture, religion, or other traits. While that in itself is perfectly acceptable what’s concerning that egg donation industry is the wild wild west and there’s no Sheriff in town – and honestly, sometimes we need a Sheriff.  But really who is that Sheriff going to be?  The Government?  The CDC?  The American Society of Reproductive Medicine (ASRM)?  The Society for Assisted Reproductive Technology? (SART)

Many propose that egg donation should become regulated to have better control on the process making it tougher for those who wish to open egg donation agencies and recruit egg donors.

But is that really the answer?

At present in the United States, there are no laws regulating egg donation.  There are guidelines established and set forth by The American Society of Reproductive Medicine (ASRM).  In 2007 ASRM implemented guidelines that addressed compensation regarding egg donation.  For instance ASRM stated that total payments to egg donors in excess of $5,000.00 require justification and sums above $10,000.00 are not appropriate.

Fertility and Sterility published on online study July 30th that stated that egg donors were often recruited unethically.  What does that mean exactly? “In the United States, it is common for egg donors to be recruited by clinics, often through advertising media, and offered a financial incentive for donating eggs to couples seeking fertility treatment” (Kenney & McGowan, 2008) The concern of course is that offering money to a “poor college student” would raise questions as to whether or not the recruitment process is ethical because the thought is that young college students might be desperate enough for money that they embark upon egg donation as a way to earn money without really thinking the process through rationally. Words like cohercion and exploitation have been bantered about in regards to compensation rates and egg donation.  For instance if an egg donor were offered $3500.00 to donate her eggs would she be more inclined to listen to the risks associated with egg donation then if she were to receive $15,000.00 to donate her eggs?  Would she be more inclined to sign on the dotted line and worry about possible side effects or ramifications down the road because she were soley motivated by money?

The focus of the Fertility and Sterility study was placed not only on agencies but clinic websites to aid them in recruiting potential egg donors to help infertile women have children through egg donation.  The study showed that in In June 2010, there were 207 websites that were systematically examined.  Out of those 207 websites 102 were egg donor agency or IVF clinic websites that both recruited online and displayed compensation amounts. The study went on to examine compliance with ethical guidelines of the American Society for Reproductive Medicine (ASRM) regarding trait based payment variation, presentation of risks, and minimum recruitment age.Out of those 102 sites, the study found that a considerable amount were noncompliant (about one-third) regarding ASRM’s guidelines that prohibit varying compensation based on a donors traits.  Furthermore 41% of those websites were not compliant regarding ASRM’s guidelines for egg donors being at minimum age of 21 or older to donate eggs, and even more troubling 56% of these websites were not compliant in regards to the presentation of risks alongside compensation.  And trait-based payment variations were associated with agencies rather than clinics – and that 64% of all websites mentioned traits, prior donation success was the most commonly paid for trait.

Is it necessarily a bad thing to compensate an egg donor who is of a specific ethnicity, or who is gifted musically, artistically, athletically, or intellectually? Or who has been a proven donor?  The researchers in this study say that paying donors for these kinds of traits doesn’t accurately represent what we know about genetics.  The researches admit that genetics does play a role in these traits; these traits are not linked to one gene.

Paying donors for traits such as physical or artistic ability does not accurately represent what we know about genetics, the researchers said. While genetics play a role in these traits, they are not linked to one gene, the researchers said.  It was also demonstrated that egg donor agencies were more likely than clinics to pay egg donors based on traits.

So basically what the researchers are saying is that you won’t necessarily have a smarter kid if the egg is from Harvard, nor will you have a more musically inclined kid if the egg is from Julliard, nor will you necessarily have a potential Olympic hopeful if the egg donor is an Olympic Athlete.

This then begs the question: Should we be compensating egg donors based on traits or should we be compensating egg donors all the same, straight across the board?

Another question: Is donating eggs for money really a bad thing? The majority of egg donors donate their eggs for money.  That’s really the bottom line.  Sure egg donors want to help an infertile family have a family, but really if you talk to most egg donors in the USA they will tell you that the extra money helps to pay off student loans, credit card bills, or even to help towards the down payment of a major purchase, car, house, or perhaps retirement. The researchers felt that paying women for prior successful donations was concerning because it creates an incentive for egg donors to donate repeatedly.

While Dr. Mark Sauer, a professor of obstetrics and gynecology at Columbia University Medical Center states there is no evidence that proven egg donor are better than women who are first time egg donors most recipient parents request to be matched with a proven egg donor.  It not only gives them great comfort knowing the egg donor selected produced a baby, but they also have the confidence that the egg donor has already been through this once, has demonstrated she has the ability to make the commitment to take medication correctly, attend medical appointments on time, follow the directions provided by the clinic during the egg donation cycle.

The researchers of this study showed that 56% of the websites didn’t disclose any sort of risk regarding egg donation.  There wasn’t any sort of literature that discussed infection, or ovarian hyperstimulation syndrome.  The study went on to show that 77% of these websites didn’t talk about emotional risks, psychological risks.  The study states that over 90% of the sites didn’t mention possible future risks to future fertility, and to fair we haven’t seen any negative long term effects of egg donors over the past 30 years; however as to date there haven’t been any long term studies following egg donors either.

We know that paying an egg donor and what egg donors are compensated has always been a hot topic and greatly debated for years.  However, if you look at other countries throughout the world we know that without compensation the supply for eggs dwindles and egg donor pools dry up and go away.

And this is just one of the many issues revolving around egg donation – it’s clearly complicated.

Does egg donation need to be regulated?  Are the current guidelines set forth by ASRM firm enough?  Is there a need to for stronger regulation?  Should intended parents and egg donors have the ability to negotiate what they think is fair regarding compensation, after all both parties are adults and at the end of the day this a business transaction.

More concerning would be things that the study didn’t cover:

Are recruiting methods for egg donors standardized across the board?  (Does each egg donor agency use a standardized form).

Are there standardized methods for genetic testing for potential egg donors?

What kind education do egg donor agencies and clinics provide potential egg donors regarding informed consent? Associated risks, etc?

What kind of record keeping standards do egg donor agencies follow?

What kinds of legal contracts are required for potential egg donors who work through clinics or egg donor agencies?

In regards to recruiting do egg donor agencies require all potential egg donors to have in person psychological screening and testing?

The field of egg donation is complicated with many layers. It’s treated differently than sperm donation and therefore the recruitment process is much different.  The most pressing question currently is – Does egg donation and its recruitment standards need to be regulated?  Or should the industry as a whole be self-regulating.  And is the  third party industry doing a good job presently self-regulating?

 
 

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