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Assisted Reproduction

About That Uproar Over Egg Donor Compensation

One of my favorite bloggers, Pam Madsen, provides a compelling retort to the brouhaha sparked by recent news accounts of egg donors receiving “excessive” compensation:

Nobody in the fertility field likes to draw too much attention to egg donor compensation – and the issues that surrounds it. It is bad for business – and it could be bad for couples that need donor eggs to build their families. Over my many years of working as a fertility advocate – egg donor compensation has always been a hot button issue. Everyone likes the idea that women who donate their eggs do it completely out of the goodness of their heart…because they are motivated and drawn to helping infertile women have a child. And, many of them may feel really good about that part of the equation. But the hard facts are – in countries where there is no egg donor compensation there are few egg donors. Egg donor compensation is crucial for keeping egg donation alive.

Egg donation also remains a way for young women with few financial resources to raise between $8,000 and $10,000 in a relatively short period of time. Some egg donors do this over and over again – traveling from one center to another with no one tracking their donation history. And there have always been rumors of some young women being paid much higher numbers to correspond with their SAT scores, good looks, and where they are enrolled in college. Doesn’t sound pretty – does it? Well, sometimes it’s not.

A recent article from CNN reports on the recent rise of potential egg donors across the country.

The women profiled in the story are quite clear – they need the money to make ends meet. Now – not just anyone can be an egg donor. Egg donors have to go through a rigorous physical and psychological screening process – but how do we feel about women being so highly motivated by compensation? Does it matter? Should anyone care that the numbers of egg donors have risen with a falling economy? Do we need even more safety checks in the system to make sure that these women truly understand that while they are fixing short term economic problems in their lives – that they are making life time decisions about giving up their genetic material. Desperate people do desperate things – and do we want desperate egg donors who are lured in by big compensation dollars?

Today more than ever – all of us in the “baby making business” have to be more vigilant than ever in managing the lines between fair compensation and enticement. Because as we all know – the compensation will be spent – and the decisions that these women are making now more than ever out of financial stress – are decisions that they will have to live with for a life time.


4 comments for “About That Uproar Over Egg Donor Compensation”

  • Thanks for posting, Andy and thanks for writing on such an important topic, Pam. To clarify, according to ASRM Guidelines and consistent with the practices at so many donor egg programs, donors are compensated between $5,000 (where ASRM sets the standard for “appropriate” compensation) and $10,000. Recently we polled the donors registered with Prospective Families (donors set their own compensation at my agency)and were pleased to learn that 70% of the approximately 130 donors registered with our agency are asking comps below $7500.00 (no donor who cycles through PF is comped more than $10.000.00). Also, there seems to be some connection to regional practices around donor comps, as well. Many in-house donor programs in New York City set a flat-comp for all donors at $8,000.00. An in-house program in the south, run by a colleague, comps all their donors at $3500.00.

    As I consistently say to clients, colleagues and the media, yes, the extreme compensations are out there (no one denies the findings by Mr. Levine as published by the Hasting Center about the $30,000 Ivy League donors) but there are good clinical practices who pay close attention to donor compensation, clinics where adherence to the ASRM guidelines is the threshold for whether or not a donor candidate will even get through the front door.

    This issue of commodification of certain donor characteristics (intellect or rather where she is currently matriculating, physicality, talents e.g.) is a matter about which, I suspect, debate and discussion will continue for as long as we have egg donors, but, today’s Fertility Advocate blog addresses a more fundamental issue, whether compensation should be offered, at all.

    Those of us who are genuinely in this business because we feel a tremendous sense of empathy for those who cannot conceive, have to look at this issue realistically. We know from the U.K. and other countries wherein donor compensation is illegal that there is a tremendous void of donor candidates…apparently, altruism is not enough of a motivator to donate. We know that some level of monetary compensation is necessary and we know (we trust) that there are enough safe-guards in place to “screen-out” the donor only interested in the check at the end of the cycle.

    Today’s blog also mentions concern that donors (and we all do have to acknowledge that these are very young women) may have a short-term perspective when deciding to donate, that they may be responding to an immediate financial need without regard for the long term ramifications of donating, particularly donating multiple times. At Prospective Families, we want every donor to think about the fact that, given the success rates of egg donations, given that a cycle is, statistically, likely to result in a pregnancy (and if there are high-grade frozen embryos, there is a chance that a next sibling can result from just that one fresh-donation) and given that many of these young women have yet to have their own children…we have an equation likely to yield many genetic half-sibs.

    So, your call to action, as always, Pam, is spot-on. Collaborative reproduction is a beautiful (and to a great degree) altruistic partnership that allows for much yearned for babies to be born. I am sitting in my office, looking at my wall of baby photos and thank-you notes from clients, I am thinking about the follow-up e-mails donors who have worked with my staff send, post-cycle, I know we are all doing good work. And for those of us who are “vigilant…in managing the lines between fair compensation and enticement”, my hope is that donors, recipient parents and referring physicians will see clear to agencies committed to best practices, we are out there!

  • Hi Andrew — I also want to add to Pam’s amazing blog post which I loved.

    In regards to It is what it is.

    As you know I am a mother via egg donation and I had no qualms whatsoever compensating my egg donor. The fact of the matter, I wanted to become a mother, I had tried for 16 years, my eggs were shot, I’d had 9 losses, she had healthy eggs. I needed them. She had a student loan she needed help with. We compensated her, we didn’t feel guilty, or bad. We stayed within ASRM guidelines. End of story.

    In regards to intended parents who are looking for egg donors who are intelligent, talented, artistic, athletic, or what have you? I say so what. It’s their choice, they are giving up their genetics and so why should that be a bad thing?

    I refuse to feel guilty because I selected a really tall egg donor (because I am so damn short), who was pretty, had curly hair ( I have straight hair and I hate it) and who has amazing blue eyes, and I thought was really funny. There’s nothing wrong with selecting those characteristics whether they be physical or emotional that resonate and connect with you.

    The sticky wicket in all of this or the real “egg donation dilemma” isn’t that we compensate our egg donors. It’s how much. And I truly think it’s because “needles and lots of drugs are involved.” I know that sounds elementary, and truly simple but it’s true. If all our egg donors had to do was have an amazing orgasm and ejaculate eggs we wouldn’t be having this conversation. We’d be treating it like we do sperm donation. And frankly we don’t pay much attention to that.

    This is a complicated issue and this is where the sticky wickett comes into play. How much is too much? Where do we draw the line. We have people on one side of the arugment who say “Free Market, don’t tell me how much I can or can’t spend when I am doing business with another adult.” and then the other side of the argument is “When we compensate egg donors over 10k we are exploiting them. They stop paying attention to the seriousness of the procedure and focus on the dollar amount”

    Am I in support compensating egg donors over 10k? No. And here’s why. I think it’s already the wild wild west in regards to agencies, policies, guidelines, and compensation regarding egg donation. Anyone can hang a sign outside their business and refer to themselves as an agency. I also have some really specific opinions in regards to who should be owning and operating egg donation agencies as who shouldn’t (but that’s a conversation for another time.)

    If everyone created their business module and their practice like Amy Demma for instance, or Theresa Erickson then there would be no issues. But the problem is they don’t. And there are agencies out there that do exploit their egg donors and treat them as a commodity which frankly turns my stomach.

    So now we get down to the nitty gritty and heart of the matter. It’s about the ethical treatment of our egg donors. Our egg donors are patients first and our egg donors second. Without them we wouldn’t have our children. Oh I know, I know, I hear all the time, “Without the intended mother you wouldn’t have your child” but really, it has to start somewhere, and it begins with her egg. With that being said, we as intended parents need to treat her with reverence I think. The least of which is respect and concern for her well being.

    This means that we need to select our egg donor agencies with care only working with egg donation agencies that care about their egg donors and put their health first. That means working with agencies who abide by and uphold ASRM’s compensation guidelines. That means working with clinics that abide by the 6 cycle rule with ASRM. ( I honestly don’t know of too many clinics who don’t follow that guideline).

    I am concerned that if we don’t mind our p’s and q’s and abide by the guidelines set forth that are incredibly reasonable, and we don’t regulate “ourselves” the government is going to step in and do it for us. And if egg donation is regulated and compensated becomes illegal our donor pool is going to dry up. We will then be faced with the same issues the UK is faced with. They come here for treatment as well as Spain and the Czech Republic.

    The bottom line for me — I want the government to stay out of my uterus and not control my family building options. I think the only way we can do that is to continue to self regulate, and I mean really self regulate and not pretend to do so.

    Thanks for letting me rant.

    • Thank you for the rant, Marna! I could not have said it any better.

      It is so difficult today in this industry because it has become the wild west and those agencies that do adhere to ASRM guidelines are at a competitive disadvantage. Unfortunately, self-regulation only goes so far and while I do not want any government intrusion, I am not so sanguine about our industry being able to reign in those that defy the standards and protocols the majority of us adhere to.

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