Qualified women have been selling their eggs on the open fertility market for many years. There are some who would call this a form of reproductive prostitution but egg donation is quite common: The going rate nationally is between $5,000 and $8,000 per cycle, more for attractive, educated women.
Getting paid for donating eggs for stem cell research, however, has never been kosher. Until now.
Going against the bioethical grain, the Empire State Stem Cell board - which will award $50 million a year for stem cell research in New York - agreed in June that there is no real difference between a woman donating oocytes (eggs) to a fertility clinic that hopes to make a baby than there would be to donating eggs to a lab researching stem cells. In other words, to help meet an ever increasing demand for eggs, it's ok now to get paid for giving them up for somatic cell nuclear transfer research (a.k.a. cloning).
Said the board, "The risks associated with donating oocytes to stem cell research are no greater than those associated with reproductive donations. Moreover, donating oocytes to stem cell research arguably confers a greater benefit to society than does oocyte donation for private reproductive use."
Said David Hohn of the Roswell Park Cancer Institute in Buffalo, "We were unable to come up with an ethical reason for why we should pay for reproductive donations, but not for research."
The New York policy jumps ahead of the
National Academies' guidelines, which strongly discourage any form of payment for non-reproductive egg donation. New York has also gone beyond California's guidelines on paying for eggs: The
California Institute for Regenerative Medicine's rules limit payment to egg donors to just "expenses." No one has decided just what constitutes expenses, so you can bet there is some flexibility there.
New York's policy is in line with the guidelines developed by the
American Society for Reproductive Medicine: $5,000 is about right, no one should get more than $10,000 for egg donation. Pretty good compared to say, sperm donation at about $100 a pop.
Before anyone starts to think that's easy money, consider what an egg donor must endure. Hormone manipulation (one injection per day for 10 days of Follicle Stimulating Hormones) may include side effects such as headaches, mood swings, bloating, nausea and bloating as the ovaries to swell and produce many eggs. PMS cubed, that's how one woman described it. Permanent damage to the ovaries is a risk, albeit small (one or two percent). Extracting the eggs requires twilight sedation (outpatient) by way of IV. Using a vaginal ultrasound probe, a small needle is guided through the vaginal wall to the ovaries in order to vacuum out the mature eggs.
I don't have a problem with women making deals for their eggs; the notion of comodification of body parts doesn't concern me (OK, I do not want to see kidneys or other organs listed on Craigslist). I see the ethical issues this way: Donors don’t get paid for their eggs, per se; they should be compensated for the arduous process of egg retrieval. Because of the time involved, plus discomfort and risk, it would be wrong not to pay women.
What must accompany the new New York policy is a wide-open informed consent process. Women have to know what they're in for, and unfortunately, the human egg industry is largely unregulated and full of brokers and third party outfits that may not feel bound by medical ethics to assure full consent.
If the market for research oocytes remains robust, there will be advertisements that may entice economically vulnerable women to go for the money, without fully discussing risks. Let's make sure all women have all the facts.
New York's health department produced a
guidebook on egg donation. It lays out the facts, and cautions against aggressive brokers who line up eggs but who don't do medicine.
See also the
National Academies report, mentioned above.
Mad
