Here’s the shocker: people are willing to pay more for highly desirable egg donors! This is hardly news, although it is reported as such.

These outrageous offers get publicity, but they are far from the mainstream, and in fact, probably bogus. For many recipients, compensation within the ethical limits can be a hardship.

Any SART and ASRM registered clinic pledges to abide by the guidelines of these organizations. If a clinic works with an agency donor, the clinic should make sure that the agency complies with these guidelines as well. Some clinics require a letter from us testifying to our compliance. Plenty of agencies are members of SART, even though the article implies otherwise.

Here is one response to the Hastings Center Report that studied advertisements for egg donors.

People with access to expensive IVF treatments tend to be more educated, and are typically looking for donors similar to them. The SAT is the handiest objective barometer of intellectual abilities, so scores can be an important search criterion for some prospective parents.

However,  there is no concrete evidence that egg donors with high SAT scores produce smarter children. Furthermore, there is no evidence that egg donors with high SAT scores have better cycles (resulting in live births) than women with average scores.

Offering more than the ASRM-established limit of $10,000 is not only unethical but a waste of money. As IVF patients come to realize the hard way, paying more does not always mean getting more. These outrageous offers can only provoke unwanted government regulation. They are bad for individual patients as well as for the industry as a whole, and should be discouraged by all ASRM members (doctors, lawyers, agencies).

The situation in Canada demonstrates how a lack of clear regulations for egg donation has a ripple effect of deviance from standard protocols in other parts of the process. The egg donation arrangement where a young woman was coerced to donate for an unofficial compensation even after having a failed cycle which produced no viable embryos and caused her painful hyperstimulation, was handled badly at every step, starting with egg donor/recipient relations to the medical procedure. What doctor would agree to cycle an egg donor after her last retrieval was so poor?

Doctors in the US scrupulously pore over egg donors’ records, and if there are any concerns she would not be allowed to donate again. Perhaps it is the ready availability of so many good candidates in the US that allows American doctors to be so picky. Doctors also have their own success rates at stake, which they need to maintain to attract patients.

The egg donation business in the US shows how a sensibly regulated free market works to the advantage of all, especially compared with Canada’s grey market or the UK, where they are so skittish that compensated donation is completely banned.

“This is an industry that is not regulated at all. What you can’t get on Google is whether an agency is going to push you toward using an egg donor so that clinic can boost its stats.”

The misconception that the fertility industry is unregulated is so persistent, even so-called experts perpetuate it (out of ignorance and laziness). Fertility medicine is highly regulated by the FDA, and there are some firm ground rules set by the ASRM as well.*

On the second part of her statement: I do not know why an agency would have any interest in increasing a clinic’s statistics; I guess if the agency were affiliated with the clinic, this statement may make some kind of sense. But statistics are highly accessible to anyone, and you don’t need to hire a consultant for $125 an hour. I encourage all our clients to go to SART, click on For Patients, the Find a Clinic: plug in your zip code for a clinic near you or click on a state for all its registered clinics. There you can find the clinic’s CDC-reported statistics for the past few years, where they separate their cycles by donor and non-donor, and in the cases of non-donor, ages of their patients. If your clinic’s statistics seem less favorable than some others, discuss them with your doctor. Some fertility clinics take on more difficult cases, and this skews the results somewhat.

Fertility is stressful and painful; it can cause marital conflicts, financial distress, and a host of other problems.  There are a number of psychologists who specialize in this field. We recommend them to our clients when the counseling offered by the IVF clinic is not enough. But paying yet another party (in addition to the clinic, psychologist, insurer, agency, lawyer, donor, etc.) seems just too much for most people.

* For more information on fertility regulation, see David Adamson, “Regulation of Assisted Reproductive Technologies in the United States,: 39 Family Law Quarterly 722 (2005), as well as the ASRM Web site.

The Michigan and Indiana cases discussed did not follow the proper legal or medical protocols at all; in fact, the egregiousness is stunning. These surrogacy cases should have never happened in the first place. Michigan is one of the few states hostile to surrogacy and we, or any legitimate agency, would never allow a surrogacy to take place there. All the clinics we work with have very strict protocols in place for medical and psychological screening; the single man from New Jersey would have never even made it into our program (as we are careful about the intended parents we work with), let alone pass the psychological screening that would take place at the clinic.

The article mentions that the American College of Obstectricians and Gynecologists recommends that “surrogacies be handled by nonprofit agencies,” but I am unaware of any such agencies with the legal experience to handle such complicated arrangements.

The field of surrogacy (and assisted reproduction in general) is not as unregulated as commonly perceived.  In fact, there is case law and/or statutes in a number of US states, where surrogacy can be practiced legally and safely (see our article, “Assisted Reproductive Technology: Egg Donation and Surrogacy in Law and Practice,” in the Bloomberg Corporate Law Journal, for more specific information).  The source for laws or precedent governing any arrangement is the state where the baby will be born, since that is the state that issues the birth certificate and where parental rights are extinguished and established. So there should be prior procedures to at least draw from in the carrier’s home state; if any contractual performance (or birth) is to take place in other states, the laws in those states should be examined carefully as well.

It is true that issues of custody are clearer when both intended parents contribute genetic material. When fifty or one hundred per cent donor material is used, it is especially important for the intended parents to be screened by clinical professionals.

We believe that by expanding our pool of egg donors, gestational carriers, and clients, it will be even easier for donors, recipients, gestational carriers and intended parents to take advantage of our services.  Press releases are linked below:

• Washington, DC
• Atlanta
• Miami
• Dallas

“Our new locations will offer the opportunity for our egg donors, gestational carriers, and intended parents to work locally, or take advantage of our recruitment efforts in other cities across the country. This makes NAFG unique among surrogacy and egg donation programs.”  – Sanford Benardo, Founder and President, Northeast Assisted Fertility Group

Unless these quotations are wrong (and they may indeed be, if Barnard’s student journalism is as poorly researched as this panel discussion), these Barnard gals don’t really understand egg donation.

According to the panel’s organizer, who is apparently a student in her junior year: “Donors typically receive anywhere from $4,000 to $25,000 per egg.” This shows complete ignorance of the process, in which eggs are retrieved in numbers ranging from 5 to 20 or more at a time (no doctor would retrieve just one egg!). The donor gets paid per retrieval, not per egg. Her compensation does not depend on the number of eggs retrieved, but is a fixed amount agreed upon before the donation process starts. The compensation limit is $10,000 per retrieval, but these panel participants quote higher compensation fees throughout to make egg donation seem exploitive.

They also mention that egg donor advertisements do not include the risks. This is generally true, but although anyone can apply, only a small percentage of applicants actually go through with it (most do not qualify). Women who do donate are given extensive information about the risks. Most women who donate choose to do it again, and find it a very positive experience.

The panel discussion did not include any actual egg donors or anyone who conceived a child through egg donation: perhaps their participation would have injected some reality.

“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.

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.

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.