Why Egg Donors Should Be Compensated

Back in college, the popular way to make beer money was to sell your plasma. It was so popular that the student handbook listed the plasma center along with a few local dry cleaner recommendations and coupons to a sandwich shop. I'm not sure what the going rate was back in 1992, but a quick search online yielded that the going rate for plasma is about $70/week (two donations a week at $35 each).

What made me think of this today? Because I read an argument against compensating egg donors stating that no other donated body part or product receives financial compensation. And that's just not true, there's plasma. In fact, it is legal in America to be financially compensated for cells, though you cannot be compensated for organs.

FoxNews reported back in November that plasma donations were up as first time donors stepped up to earn gas and grocery money by selling their blood product, which brings us to Salon's article this week on Broadsheet discussing the increase in egg donors and the ethics of paid donations. Quoting a recent Boston Herald article and the constant discussions around the Internet on this topic from the Wall Street Journal to the Washington Post, the post begins: "In these stark economic times, what's a gal to do when the creditors have the phone ringing off the hook or when her boss shovels her onto the fast-growing pile of the nation's unemployed? For an increasing number of women, it means considering selling their eggs for anywhere from $5,000 to $10,000."

Donations are, by their very definition, gifts without compensation. I fully agree with anyone who argues that donors who receive compensation are not donors by definition; though I also argue that donor is an antiquated word that no longer holds meaning in our society. Political donors give money with gain both tangible and intangible in mind from access to positions within an administration to simply having your desired party in place when policy is being decided. Philanthropic donors gets a building named after them after they cough up a ten million dollar check. It's not that there aren't people out there doing something for nothing, but most people want recognition of their gift, if not financial compensation.

If it helps, we can rename egg donors "egg suppliers" instead.

Tracy Clark-Flory did a fantastic job on the Salon piece pointing out that donors who are solely financially-driven usually do not make it through the rigorous screening process required of all potential donors (though returns with an alarmist final thought on financial desperation). Those who donate solely to make money with no regard to the enormity of the task on hand--emotionally or physically (for themselves, their recipient, and any children born of their gametes)--are generally left disappointed with a rejection slip. Over 90% of wannabe donors do not make it to that first lupron needle.

But what about the yuckiness of feeling like life is being bought or sold? Frankly, there is plenty of yuckiness in the world that we'll need to discuss in addition to this topic such as the fact that our medical system is a for-profit system, benefiting off the health woes of society. That our pharmaceutical companies do not make drugs out of the goodness of their hearts, but to turn a profit. Our medical system in and off itself is not noble. It's goal is not to keep society well, but to keep society well while turning a profit.

Every child has a price tag regardless of how that child comes into your family. It may be as low as a handful of co-payments or it may stretch into the tens of thousands depending on how much assistance you needed with family building. But in all circumstances, what you are paying for is a service, not a child, and those who state otherwise to make their argument do so to be inflammatory and insulting.

But what about the fear that women are being exploited? I think it demeans the intelligence of women and our ability to make choices. If I need money, there are a multitude of ways I can make money beyond going through rigorous testing, daily injections, and painful surgical procedures (aaah, who am I kidding? No one would pay for my eggs). It is certainly not a quick buck. If a woman chooses to be an egg donor, she is doing so because something within the process speaks to her whether its because she wants to help or know her gametes have entered greater society or sees it as a win-win situation.

I believe in compensating donors perhaps because I see egg donors in the same way I see doctors--someone who is being compensated for their job in helping another person. There are definite health risks to the job and if we're going to pay certain health professionals accordingly due to the health risks inherent to the field, I believe we should pay egg donors for the hazards they endure. Think of it similar to a soldier's hazard pay that is part of their overall salary, with egg donors simply receiving the hazard pay portion for their limited role in the process.

Without compensation, I don't believe people will behave altruistically and donate without being specifically asked. Those who have a match--a sister or cousin or friend--have a leg up on those who do not have a donor. Fertility is a time-sensitive situation and those wishing to treat it should have the means to treat it. I am constantly bothered by the comments that always come in response to articles concerning infertility that yawn on about how there are too many kids in the world and how parenthood is not a right. And it's not, but where do we draw the line as a society between what is important, necessary, and what is not? I think we'd all agree that having future generations is a necessity and therefore, it's not our job to decide who and who does not get to populate this future generation but whether we want it to exist at all. Deciding worthiness is never a healthy exercise.

Organ donation as well as the bone marrow registry and blood banks suffer greatly from the lack of financial compensation and I think with the exception of an altruistic few, these programs only exist as well as they do because people are willing to donate when they believe a life is at stake. It may be driven by fear of their own loss or a sense of guilt knowing that they had the ability to save someone. But I don't believe that we donate with the same heart when we believe only happiness is at stake. And it's true--infertility is not life threatening in the most basic sense of the word. It is life-style threatening and there is emotional well-being at stake, but mental health is never as valued as physical health in our society until we are affected ourselves.

My only quibble with the article is when Clark-Flory points out that "there has been scant study of the long-term health effects of egg donation" and this is true in terms of egg donation, but the long-term health effects would be similar to someone undergoing an IVF cycle and those risks have been well-studied. They have been the subject of books such as Beth Kohl's Embryo Culture and the information is passed from doctor to patient during the mandatory IVF consultation most clinics require. Are there risks--of course--and not just the initial risks of OHSS. There are risks far down the line when you override a body's cycle and introduce hormones at a high level. But women take it every day and the first IVF babies are currently having pregnancies of their own.

As clinics state, the increase in donors is not just financial in nature. People are better informed, more knowledgeable about infertility and the technology that exists. Instead of debating whether or not there should be payment, time may be better spent discussing a price cap for compensation and having reputable agencies adhere to financial guidelines. And whether we should be compensating anyone who has a job that should be done altruistically so that we can sidestep any yuckiness.

Nipping it in the bud since it always shows up in the comment section: adoption is not a cure for infertility. It is a wonderful system that needs to be considered in and of itself and not as an answer to premature ovarian failure.

Others debating egg donation as well as the ban on organ donation:

Dr. Amy Tuteur asks, "Can selling cells be ethically justified within a system that bans selling of organs? Without financial compensation, the supply of donor sperm will drop precipitously, and the supply of donor eggs will likely disappear altogether. Yet that is hardly as disastrous an outcome and the thousands of deaths resulting from a ban on selling organs."

Surrogacy 101 brings up an MSNBC article on the same topic stating, "perhaps there is more interest in becoming an egg donor now because it is in the media every day (it seems) and although they (potential donors) might think it's easy money I doubt that the pool is much larger due to all of the 'unqualified' applicants."

Fertility File runs through a plethora of arguments for and against compensation. He states in conclusion: "Because there are good arguments in favor of and against the restriction of paying donors, I don’t agree with the government’s black-and-white policy of just saying NO to every case. There needs to be some flexibility with reasonable checks and balances against abuse. A blanket ban is not the best for everyone involved."

Melissa is the author of the infertility and pregnancy loss blog, Stirrup Queens and Sperm Palace Jesters. She keeps a categorized blogroll of over 1600 infertility blogs and writes the daily Lost and Found and Connections Abound, a news source for the infertility blogosphere. Her infertility book, Navigating the Land of If, is forthcoming from Seal Press in Spring 2009. She is the keeper of the IComLeavWe (International Comment Leaving Week) list which is currently open for February.