Leveling the field for human egg donors
In the United States, there is a competitive market in human eggs provided for reproductive purposes. An “extraordinary” egg donor can earn as much as $50,000 when she offers her eggs to an infertile couple. In California, however, that same “extraordinary” individual would receive nothing, aside from payment for her direct expenses, if she provided those same eggs for research purposes. That could change soon.
A bill co-sponsored by four female Democratic legislators would allow women to sell their eggs for research, just as men can sell their sperm. But is the proposal, which has gone to the governor after passage in both the state Senate and the Assembly, a good idea?
Supporters of the bill say it is a matter of gender parity. Men can sell their sperm for whatever purposes they like, so why should women have limitations? The law as it currently stands, they argue, doesn’t keep women from selling their eggs; only from selling them for research purposes.
Some of those who oppose the measure are uncomfortable with the very idea that eggs are bought and sold as though they were just another product. In today’s market, Asian eggs often command higher prices than eggs from people of other ethnicities, and the eggs of a 5-foot-8 Stanford student with high SAT scores might sell for five times as much as those of a 5-foot-5 San Francisco State undergrad.
The bill’s defeat wouldn’t change any of that, but its opponents oppose expanding what they consider a distasteful marketplace.
The bill’s opponents also dispute the gender-parity issue. They note that retrieving eggs is a much more invasive and potentially harmful procedure than sperm retrieval. Providing eggs can be a several month process in which a woman takes powerful hormones to stimulate egg production, makes office visits to monitor her progress and then must undergo sedation so that the eggs can be retrieved.
The current ban on compensation is based on fears that women could be exploited. Women, especially poor women, might be inappropriately recruited — and feel economically coerced — into selling bodily products, without full knowledge of the potential medical and psychological risks of the procedure. Fertility clinic clients tend to be picky about egg donors; after all, they are choosing what they hope to be their children’s genetic forebears. Researchers just want eggs. Accordingly, they might be more likely than the clinics to want — and therefore attract — poorer, more financially desperate women.
The bill tries to address those concerns by providing for a rigorous research and compensation review process, but it still leaves open how recruitment for reproductive purposes and recruitment for research purposes would relate to each other. The legislation proposes rigorous oversight for research, though virtually none exists for fertility purposes. Still, the fertility industry could — and perhaps should — facilitate many of the donations, by contributing leftover eggs for research.
If Gov. Jerry Brown signs the bill expanding California’s egg market to research, the state should also create some kind of formalized coordination between the two types of donation, either through comprehensive oversight of all egg donations or through holding researchers responsible for a clinic’s egg procurement practices. Here are three things we think could help create a more responsible marketplace.
1) Better study and tracking of the health implications for donors. The hormones used have been associated with potentially severe reactions, and women undergoing egg retrieval risk infection and bleeding. There are currently no funds for research on the long-term effects, and little government oversight. California should require tracking and follow-up studies to assess the health risks of egg donation, regardless of the purpose for which the eggs are provided.
2) Researcher responsibility for ensuring that recruitment practices do not exploit women. Researchers should have a duty to oversee clinic recruitment practices and to report on their efforts.
3) Research protocol sensitivity to potential competition for a limited supply of donors. Researchers should prioritize efforts to acquire excess eggs rather than solicit new ones. Where recruitment of new donors is necessary, researchers should avoid practices that would limit the supply for reproductive purposes.
The integration of these forms of egg donation requires creating a level playing field between highly regulated research efforts and largely unregulated clinics. Better protection for women who provide eggs means ensuring informed consent and follow-up medical care, wherever the donation occurs.
Naomi Cahn is a professor at George Washington University Law School and the author of “Test Tube Families.” June Carbone is a professor at the University of Minnesota Law School and the coauthor, with Cahn, of “Red Families v. Blue Families.”
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