egg donation and the economy

I have been fielding inquiries from reporters recently about the whether the current economic downturn is driving women to be egg donors. Although it makes sensationalistic news copy and sounds plausible, there is no way to draw any convincing conclusions from the actual statistics. According to the CDC, the most reliable source for assisted reproductive technology statistics in the US, the number of fresh donor egg cycles has been steadily increasing every year, irrespective of the state of the economy. [In 2005, the latest year for which complete statistics were posted, there were nearly 10,000 fresh (as opposed to frozen) donor egg cycles in the US.]

But what about the economy’s influence on the recipient’s side? An IVF cycle using donor eggs can cost up to $30,000 (this factors in medical costs, plus donor compensation and agency fees). If the economy is so bad, wouldn’t people have less money to spend on these costly procedures, thus decreasing the demand for donors? The prevailing assumption is that fertility patients are so desperate that they would go to any expense to undergo treatment, despite their incomes or chances of success. We’ll have to wait and see if the numbers continue to increase in 2006, 2007, and 2008 before we begin to draw any conclusions. It is true that those taking advantage of the assisted reproductive technologies are generally wealthier than the general population, since it is prohibitively expensive for most people (and insurance does not cover it in most states). And the possibility of a larger and better quality donor pool, motivated by the need for extra income, may keep the number of donor cycles from slipping steeply.

Of all the pieces I have seen and read on this, Dr. Sanjay Gupta’s video clip was the most sound and reasonable (part of the CNN article Dim economy drives women to donate eggs for profit).  I agree that marketing, outreach, and egg donor education has help boost the number of donors in our pool more than any other factor. True, once they hear about it, compensation is the primary incentive for potential donors, in good or bad economic times.  However, the unfortunate impression that impoverished women are driven to sell their body parts for money is way off base, and indicates a complete misunderstanding of the realities of egg donation.

Here are some facts about egg donors and egg donor compensation that most people don’t know:

  • The ethical limit for compensation is $10,000, according to guidelines submitted by the ASRM (the American Society for Reproductive Medicine) in 2000 and again in 2007. Any legitimate clinic or agency abides by ASRM guidelines.
  • Donors are compensated for their time and effort, not for their eggs. The compensation remains the same no matter how many eggs are retrieved.
  • As Dr. Gupta points out, the vast majority of women ages 21-30 are ineligible. Donors must be in excellent health, non-smoking, and fit. They must be free of infectious and genetic diseases (some women are not even aware they are carriers for some diseases such as cystic fibrosis or Fragile X). They go through a whole battery of psychological and medical tests, plus a course of injections for about 8-12 days, and only get paid when it’s all over. It’s hardly a way to make a quick buck.

But here is what most outside the fertility industry don’t know: each donor is chosen specifically by a recipient, who is typically an upper middle class highly educated Caucasian or Asian-American, looking for the same. (Matches for other ethnic groups are made, of course, but with less frequency.) Recipients often demand high academic achievement and test scores, great physical attractiveness, athletic, musical, and/or artistic ability, and other highly desirable traits.

I get many applications from women who are fit, healthy, and fertile. They would likely pass their medical screenings, but for most of them, it would not be easy to find recipients for their eggs. Because of the nature of the demand, the reality is that most egg donors are educated, middle class women looking to supplement their incomes, not poor fertile women exploited by rich, infertile ones.

The best sources for statistics and information are the Web sites for the American Society for Reproductive Medicine (ASRM.org), the Society for Assisted Reproductive Technology (SART.org), and the Center for Disease Control (CDC.org).

Click here for more specific information on egg donation.