Egg Donation and Surrogacy

The Washington Times has run an article, “Our bodies, our sales: No windfalls in plasma, egg donations” stating that while egg donation and surrogacy may provide financial payoffs, the criteria and long-term implications should be taken into consideration.  Kathy Benardo, director of the NAFG egg donor program, is quoted throughout this article on the economy’s impact on egg donation:

“I can get up to 100 applications a week.  Some don’t follow through when they see the screening they have to go through. Some are out of our age range [of 21 to 29 years old]. I even once got an application from a man. We also have a body-mass index qualification and an educational level qualification.”

Click here to read the article.

(Article in New Scientist: “Cheap IVF offers hope to childless millions”)

Despite the public perception that Africa is overpopulated, the majority of infertile couples reside in Third World countries, especially in Africa. The causes of infertility in Africa are much different from those in Europe and the US. In my experience, Western couples seek IVF and egg donation because of premature ovarian failure, polycystic ovarian syndrome, reproductive organs damaged by cancer, or unexplained infertility, either primary or secondary. In Africa, it is caused mainly by epidemic, untreated sexually transmitted disease and infection. Furthermore, there are horrific conditions unimaginable in the West, such as early teenage intercourse and pregnancy that leads to vaginal fistula or other complications, infections from genital mutilation, and the severe social ostracism associated with these genital diseases and infertility.

So low-cost ART (assisted reproductive technology) in Africa is controversial, since it treats a symptom, rather than a cause. But efforts to find low cost methods of treatment have created some ingenious, low-tech methods. One is the INVOcell, a capsule that uses the intended mother as an embryo incubator, rather than a costly mechanical incubator that requires electricity. The most typical treatments are less invasive (such as IUIs) that avoid costly IVF, although the success rates are lower than those in developed countries.

There are programs that raise money for equipment and training for these clinics: see the site for the Low Cost IVF Foundation.

I have yet to read any reference to egg donation or surrogacy (traditional or gestational) in regard to Africa yet; it is probably too costly and controversial.

New York State’s 11-year, $600 million stem cell research initiative was approved as part of last year’s state budget; now labs can pay women to donate their eggs for research.  We are not sure yet what portion of the budget will fund the study of human oocytes (eggs), how the oocyte donors will be recruited, and how much the donors will be paid (although compensation will be within limits set by the American Society for Reproductive Medicine (ASRM).

The full text of the resolution and public statement can be found on the NYSTEM website, “ESSCB Statement on the Compensation of Oocyte Donors” (New York State Stem Cell Science).

We will continue to post on this issue as we learn more.

Tonight, Cindy Hsu of CBS New York contributed yet another story about the growing popularity of egg donation, featuring Northeast Assisted Fertility Group’s egg donor program.

“If you’re motivated you can do a wonderful thing and help somebody and help yourself at the same time, but do not think that this is a way to walk into $10,000 and pick up your check,” said Northeast Assisted Fertility’s Sanford Bernardo.

“In fact, the payment is not for your eggs. You’re not selling eggs. It’s for the time and suffering involved.”

Click here to see the video.

This time it’s in the Boston Herald. Sanford Benardo is quoted:

“Benardo said the egg donation and surrogacy agency has seen applications from potential egg donors double — the [egg donation] agency pays female donors a flat rate of $10,000 after a woman’s eggs are retrieved.”

The article acknowledges that making money through egg donation is not quick and easy. Furthermore, the depressed economy is diminishing the demand for egg donors, making it even harder.

CNN video: “Egg Donors on the Rise” – click the “Play” button below to watch:

The CNN segment on egg donation (“Egg Donors on the Rise”) was pretty fair, but it left some large components out of the story:

• The Doctors.
  • The reporter did not speak to any fertility doctors who perform these medical procedures to get their opinion on the alleged surge in egg donation. This may be because doctors are probably not seeing any actual increase. As we’ve said many times on this blog, any woman can apply to be an egg donor, but the majority will never actually donate because they are not qualified, or cannot find an egg donor recipient to be matched with. Fertility treatments are expensive, and the economy may affect patients’ ability to pay for them just as much as it motivates women to donate.
  • Doctors could also speak to the efficacy of egg donation (about 50% of embryos transfers result in a live birth), as well as the risks, which I believe were overstated in the piece. The chance of hyperstimulation is about 1%, and since it is always treated, it is not severe.
• The Donor Egg Recipients.
  • Infertility is why egg donation exists in the first place. Maybe it would have been hard to find a family willing to admit on national TV that they used an egg donor, but they could have acknowledged the disease of infertility (I was able to, briefly). It affects millions of people.

I was also surprised to see Debora Spar (an economist who is now president of Barnard College) express such a negative view of compensated egg donation. It seems at odds with the attitudes expressed in her book, The Baby Business, which describes the need for political debate and regulation. She is extremely knowledgeable, but her five-second sound bite left a bad taste in my mouth. Fertility treatments are indeed highly regulated by the FDA and professional organizations (the ASRM, for example), yet analogies to the “wild west” persist.

Nothing in the story was new, but the background of the bad economy makes the headline “Women Sell Their Eggs for Money!” all the more sensational. Commercial egg donation has been around for at least fifteen years. If it weren’t for the compensation, it would be difficult to get donor eggs for infertile couples. So egg donors are paid, according to ASRM regulations. In the United States, it’s legal and safe. As usual, most journalism is not particularly interested in the reality of egg donation and surrogacy, which is indeed fascinating but too complicated for a three-minute story.

I would recommend Liza Mundy’s Everything Conceivable (Knopf, 2007) for a multifaceted, intelligent, and compassionate journalistic treatment of the subject.  (See also Randi Kaye’s “Eggonomics” entry on the CNN site.)

Date: Monday, December 10

Time: 10:00 PM

<Click to watch the CNN video, “Egg Donors on the Rise”>

Tune to CNN for Anderson Cooper’s coverage of egg donation, which features Northeast Assisted Fertility Group:

TONIGHT: Dough for eggs!  Tough times can mean ‘eggceptional’ measures. See why women are lining up in clinics across the nation to donate their eggs! You won’t believe the going rate.  Go to CNN.com to read the rest.

Click here to watch the Anderson Cooper 360 webcast, or tune into the studio webcam.  CNN is also welcoming bloggers (or anyone interested in egg donation) to join the Anderson Cooper Live Blog to discuss the segment in real time.

NAFG’s position remains steadfast: we believe that infertility is a disease, for which egg donation is an effective treatment. NAFG egg donors are paid only for their time and effort, and not for the outcome of the egg retrieval.  Our recipients, in turn, get the opportunity to have a child. As long as egg donor compensation is not coercive, we believe that all parties will benefit — with minimal medical or financial risk.

Northeast Assisted Fertility Group to be Featured on CNN’s “Anderson Cooper 360” Next Week – Story on Egg Donation

<Click to watch the CNN video, “Egg Donors on the Rise”>

Now CNN has picked up on the “surge” in egg donation and they invited Sanford and me to participate in the story. They were especially interested in speaking with an egg donor who was motivated by the current economic downturn. A few of our fabulous donors agreed to participate in the story; they chose one who was sufficiently motivated by money.

Randi Kaye and her team came to our office today and were very professional. Ms. Kaye asked me questions about the relationship between the economy and the number of egg donation applicants we receive, and I agreed that there was an increase. She did veer into sensationalism on occasion:

“Just HOW desperate are these donors?”

“How do you respond to people who say this is baby selling?”

“How do you respond to the term ‘debt donors’?”

[Desperation is not a desirable quality in an egg donor. The American Society for Reproductive Medicine endorses compensation for egg donation as ethical (I handed them the ASRM position paper) and no one claims egg donation is baby selling. I never heard the term “debt donor.” My response to that one was “Huh?”: I trust they will edited that one out, and “debt donor” doesn’t catch on.]

In each case, I attempted to get back on track to the real story: infertility is a disease, and egg donation is a very effective treatment. Egg donors are paid for their time and effort, and recipients get the chance to have a baby. If the egg donor compensation is not coercive, then all parties benefit with little medical or financial risk.

They plan to air the story next week; I‘ll post the date as soon as it’s confirmed.

Amy Benfer’s piece in Salon yesterday questioned the editorial logic behind the Times publication of Kuczynski’s article, but concluded that it was at least honest in choosing not to mitigate the writer’s vanity, selfishness, and sense of entitlement. She had a slightly more generous attitude toward Kuczynski than many of her readers, as well as Thomas Frank, who wrote in today’s Wall Street Journal (!) that Kuczynski’s surrogacy is the ultimate act of capitalist exploitation, proving the end of our love affair with the rich. As if these were bad things. (And his opinion is surrounded by articles about a $500 billion stimulus package, a car industry bailout, and ads for luxury watches, jewelry, and diamonds.) Really, Tom, you give Kuczynski too much credit.