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16 March 2023

How much should we pay women for their eggs?

We have a choice: act as though women’s bodies are for sale, or under-compensate women who put their bodies on their line.

By Ellen Pasternack

Over pizza a few months ago, an old friend told me that he was expecting not just one baby but up to forty of them. He had signed up to be a sperm donor.

Not many people know that there is a shortage of sperm donors in the UK (perhaps surprisingly, given that sperm are extremely abundant). Being a family-oriented man from a large brood of siblings, when my friend learned of this shortage he thought, well, wouldn’t that be a nice way to help somebody? As I listened, and read the rather touching optional letter he had written for his future offspring to read, I found myself agreeing. Really, wouldn’t this be a nice way to help somebody? Should I look into donating eggs?

In theory, I am sold. It would mean a lot to me to know there was a child or children somewhere out there that I had helped to create, without needing to be in a position to have a baby myself. On a medical level though, it’s less attractive. For a man, being a sperm donor means going into an uninspiring room and doing the deed into a sterile cup. For a woman, it’s less easy. First you will have a two-week course of daily self-administered injections, to suppress your normal hormonal cycle and then stimulate your ovaries to produce lots of mature eggs at once, rather than the usual one per month. “Gruelling” is the word commonly used to describe this regime when women undergo it as part of IVF.

When this is done, the eggs still have to be “retrieved” from inside you. You will be sedated before a long, hollow needle is passed through the wall of your vagina and into each ovary in turn to suck up the glut of eggs you’ve been stimulated to produce. Clinic websites generally talk only about “discomfort” during and after retrieval procedures, but all else being equal this is something I’d rather not have to find out for myself.

[See also: Baby Tech preys on parents’ guilt]

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That’s if everything goes to plan, which of course cannot be guaranteed. Ovarian hyperstimulation syndrome is a fairly common reaction to the injected hormone regimen; if you’re very unlucky, it can lead to blood clots, acute kidney failure and even death. There are also anecdotal reports of women who believe egg donation caused them to become infertile, possibly by exacerbating previously minor and undiagnosed cases of endometriosis (one writer said that aged 24 she was deemed a “perfect donor”; three years later she “had to come to terms with the fact that while my egg donations had produced two children, I would never be pregnant myself”).

In America, female college students can make thousands of dollars if they agree to take on these risks. In the UK, it’s illegal to pay egg donors, though they can receive up to £750 “compensation” each time they go through the process (similarly, sperm donors cannot be paid but can be compensated £35 per donation). This is the same whether you donate via the NHS or any number of private clinics where very large sums of money change hands.

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While £750 is not to be sniffed at, it wouldn’t cover even one month’s rent for a single person in a house-share in most parts of London; I think many would agree that it isn’t a sum commensurate with what is asked of egg donors. Therefore, efforts to recruit donors have to rely on appeals to women’s altruism. At London Egg Bank, I am invited to “be amazing – apply to donate” and told that “egg donation is a kind and generous act”. The listed benefits of egg donation include, as well as the £750 compensation, “breaking down taboos” and “the reward of a job well done”.

A look at the side of their website filled with information for their intended customers puts this into perspective. An IVF package using donor eggs from two women costs £20,000. A pre-treatment consultation with a fertility specialist will set you back £250. It seems unlikely that anyone involved in this profit-making enterprise is doing it out of the goodness of their hearts, or for “the reward of a job well done”.

[See also: Don’t invite us to bring our babies to work, give us proper maternity leave]

I am also reminded here of the fact that, reportedly, Kim Kardashian owns a handbag (made from the skin of a specially bred albino crocodile, no less) worth several times more than what she paid to a surrogate who gave birth to one of her children. Whatever you think of surrogacy, if you are seeking to exchange money for a baby, it’s surely appropriate to ensure those who sacrifice to create your child are, within reason, compensated as generously as you can afford.

In this case it isn’t the fault of clinics or intended parents that egg donors aren’t better compensated: the £750 cap is set by law. I can see where the regulation is coming from, because allowing money in exchange for body parts opens the door to all sorts of ethical complications. But the halfway house we seem to have settled on all-but guarantees that the kind and giving nature of some young women is treated as a resource to be mined.

The proportion of UK births using donor eggs, sperm or embryos has more than doubled since 2006. We can only expect this trend to continue as technology becomes more sophisticated, and the number of older parents and parents in same-sex couples increases. We are going to have to confront the ethics of these issues; what we have currently is an inconsistent botch job. You can’t have it both ways: either it isn’t about money, we should all be motivated by altruism, and only minimal sums to cover expenses should change hands; or people pay tens of thousands of pounds to profit-making clinics for donor-assisted fertility. Why should the woman risking her body be the only one not allowed a slice of the pie?

[See also: Babies can happen to nice girls, too]

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