Page last updated at 17:50 GMT, Wednesday, 9 December 2009

Is it right to pay women for their eggs?

By Clare Murphy
Health reporter, BBC News

Embryos being placed on a CryoLeaf
The maximum any donor can receive in expenses is currently 250

The fertility watchdog is to look at offering more generous compensation to egg and sperm donors as a means of tackling the severe shortage of supplies for those desperate for a baby.

But some are uneasy about the prospect of handing over significant amounts of cash for spare human parts, warning it may be a step too far towards the commodification of the body.

A group of feminists who dub themselves No2eggsploitation has written to the Human Fertilisation and Embryology Authority registering their concerns, arguing that money could well induce poor, vulnerable women to undertake "significant health risks" involved in donation.

Our main concern is that this will induce women who are in financial need to take significant risks with their health - it is not acceptable to create a situation in which poorer women are disproportionately induced to take such risks

But this is really where the problem lies - and why some people feel so strongly donors should receive more in the way of compensation. Unlike the relatively straightforward process of donating sperm, offering eggs is a much more arduous process that is not risk free.

A female donor must effectively undergo a cycle of IVF herself, involving daily injections to stimulate her ovaries into releasing eggs which are then harvested under anaesthetic.

Just the same

The principle health risk is that she develops ovarian hyperstimulation syndrome, which can in the most extreme cases be fatal.

We are rescuing eggs which would otherwise have gone to waste
Tony Rutherford
British Fertility Society

This appears to be rare, although No2eggsploitation's letter argues that the HFEA has no way of monitoring the risk. More generally it is invasive and time-consuming, yet at present she can only claim the same as a man who offers a specimen of his sperm - a maximum of just £250 in expenses for their troubles.

It is a derisory payment, according to Laura Witjens of the National Gamete Donation Trust, which leaves many donors out of pocket and pointedly fails to draw any distinction between the sperm and the egg donor.

Compensation payments
Upper and lower age limits for donors
10-family limit for sperm donors
Egg and sperm donations within family
Donors only wanting to give to certain patient groups

The chair of the HFEA, Professor Lisa Jardine, said over the summer the situation did indeed need to be reviewed if more women were going to come forward and help tackle the chronic shortage of eggs in this country. There has also been a decline in the number of sperm donors, which some blame on the removal of anonymity for those who donate.

It is this lack of gametes - as sperm and eggs are collectively known - which is thought to have driven the rise in "fertility tourism" from Britain - often to countries where generous compensation payments are indeed made to those who give.

And it is clearly effective: Spain for instance, where relatively high payments are made that remain in keeping with EU legislation on the subject, has no such drought.

Along with upper and lower age limits for donors as well as sperm donations between family members, the HFEA is now set for a major review of the rules regarding compensation for donation.

But is it right?

Donna Dickenson, emeritus professor of medical ethics and humanities at the University of London, argues passionately against such payment - which effectively, she says, creates a market in body parts.

What we also need to guard against is pushing up the price of treatment so that many couples would be completely left out
Laura Witjens
National Gamete Donation Trust

"Of course we should trust women as autonomous individuals, but we don't let people take up dangerous jobs and say - oh, well that was your choice. We have extensive health and safety legislation to protect them and egg sale should be no different.

"I have immense sympathy for the women who want these eggs because they desperately want a baby, but we have to think about the wellbeing of the women who are donating, and why they are doing so."

She also questions the ethical distinction that has been drawn between receiving cash for your eggs and putting your kidney up for sale. While sperm may indeed renew itself, a baby girl is born with all the follicles - which eventually yield eggs - that she will possess during her lifetime.

Dr Tony Rutherford, the head of the British Fertility Society, believes however there is a "very, very big difference".

"We really have to be clear about this. Unlike kidneys, eggs have a finite lifespan. Once they have formed after 10-15 days they would just die. We are rescuing eggs which would otherwise have gone to waste.

"Nevertheless any plans to introduce higher compensation need to be very carefully considered and monitored. The women themselves would need to be carefully selected and this certainly isn't something we would want to see people making a career out of, doing over and over again.

"A figure in the region of £1,000 to £1,500 would seem a reasonable one."

Sharing the eggs

Indeed all those who fly the flag for the infertile say this is not something which should be entered into without serious consideration - and there is a sense that the UK should not go down the same path as the US, where eggs exchange hands for many thousands of dollars and there are cases of serial donors.

"We need to set a price which respects the contribution, but is not a way to make a living," says Laura Witjens of the NGDT.

"And what we also need to guard against is pushing up the price of treatment so that many couples would be completely left out."

In fact both those opposed and in favour of an increased compensation note that in some respects the principle of gametes for gain is already established.

For those having problems conceiving but who may not be able to afford IVF, "egg sharing" programmes offer them the option of donating their eggs to other infertile couples in exchange for discounted or even free treatment for themselves.

As IVF prices continue to rise, this is a form of compensation that can be worth thousands of pounds.

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