My friend and preeminent legal scholar, Susan Crockin, outlines the important factors to be considered regarding egg donation after Facebook and Apple offer elective egg freezing for an employee benefit.
Dramatic improvements in egg freezing and thawing techniques have made its elective use a “hot topic.” Apple and Facebook’s decision to offer elective egg freezing as an employee benefit is the latest and most public example of what some have only half jokingly dubbed the new graduation wallet. In reality, elective egg freezing for young women without fertility issues is a benefit with many unintended consequences. As with much medical progress, history teaches us you can’t put the genie back in the bottle: before we jump too far into this newest disruptive technology, it is imperative to enact safeguards that promote its fair and desired application.
Apple and Facebook may have the best of intentions, but no woman should undergo a medical procedure without thorough, informed discussion with an objective medical professional.
What does that mean in practice? First, stimulating women’s ovaries and retrieving eggs is a two-week medical process that is not without medical risk. Offering or promoting it to women who may never need it should be done cautiously. Employers may have the best of intentions, but no woman should undergo a medical procedure without thorough, informed consent obtained through discussion with a genuinely objective medical professional.
Second, there are other costs, including annual storage fees.
Third, ultimately disposition decisions need to be made for the vast majority of eggs that will likely never be needed. For most of these young women, having babies the old-fashioned way will still work better, be easier, less expensive and more fun.
Fourth, these smart, young, fertile workers share a lot of characteristics with ideal egg donors. Ultimately, these unneeded eggs may end up “on the market.” And if you don’t work for Apple or Facebook, want to preserve your fertility and need to find a way to pay for it, you might be offered an egg-sharing option. All of this may be tempting for women, employers and doctors alike, but it raises serious ethical, informed consent and conflict of interest issues.
Moreover, there are fundamental fairness issues here. Should we endorse coverage of this technology as a lifestyle choice when most of those who actually need this technology to have a family – cancer patients facing chemotherapy, carriers of crippling genetic disorders who want to avoid passing them on to their children and same-sex couples – still pay out of pocket? None of them should be overlooked in any benefits plan or campaign to encourage or cover family building.
If we had stopped medical progress in 1978, Louise Brown, or the 5 million I.V.F. babies that have come after her, would never have been born. Egg freezing is yet another significant medical advance. For some women it will be the right answer; for others it will be unnecessarily risky business. But, like all medical breakthroughs, full and informed consent, coupled with comprehensive, fair policies that make similar benefits available to those who need it to build their families now, will make this welcome, rather than questionable, medical progress.