The question of how much egg donors should be compensated is a tough and complicated question.
The NY Times has published two articles about egg donor compensation after a group of egg donors filed a lawsuit alleging they were undercompensated for their donations. The first piece is a reported article about the topic, and the second an op-ed piece.
Personally, I feel of multiple, conflicting minds on this. My first reaction is that egg donors aren't donors in this country and should be able to name their price. But my second thought is that of a clinical researcher. Some of the trials I run offer clinical compensation, and I am expressly forbidden by the Institutional Review Board from offering too much compensation, because that might coerce someone to enroll in a trial just for the financial benefit who wasn't truly comfortable. So from that vantage point, it seems there should be limits.
As a potential user of donor eggs, I was sent an egg donor profile from an agency yesterday and the donor is requesting $35,000 compensation. That's on top of the hefty fees for the agency and the clinic. Which is OMG yowza. She is smart and attractive and she's cycled before, but $35,000 - really? Mostly I've seen agency donors receiving compensation in the $5,000 to $10,000 range. Besides $35,000 being way more than we could ever afford, it seems ethically dicey to be priced beyond a certain amount (on the other hand, I was saddened that at least one woman in the NYT article was compensated only $2,000 for her cycle, which seems far too little). The articles also raise the question of how much the agencies and clinics profit off of these women, and that seems a fair question. It shouldn't be that the agency gets $20,000 and the donor only $5,000, when she is the one going through a somewhat invasive and emotionally wearing process.
I don't have the answers, but of course this lawsuit, and these articles come at an interesting time, since we are considering this route ourselves.
I was curious what others think about egg donation and compensation. Should there be limits? What is fair to all?
Mo
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The NY Times has published two articles about egg donor compensation after a group of egg donors filed a lawsuit alleging they were undercompensated for their donations. The first piece is a reported article about the topic, and the second an op-ed piece.
Personally, I feel of multiple, conflicting minds on this. My first reaction is that egg donors aren't donors in this country and should be able to name their price. But my second thought is that of a clinical researcher. Some of the trials I run offer clinical compensation, and I am expressly forbidden by the Institutional Review Board from offering too much compensation, because that might coerce someone to enroll in a trial just for the financial benefit who wasn't truly comfortable. So from that vantage point, it seems there should be limits.
As a potential user of donor eggs, I was sent an egg donor profile from an agency yesterday and the donor is requesting $35,000 compensation. That's on top of the hefty fees for the agency and the clinic. Which is OMG yowza. She is smart and attractive and she's cycled before, but $35,000 - really? Mostly I've seen agency donors receiving compensation in the $5,000 to $10,000 range. Besides $35,000 being way more than we could ever afford, it seems ethically dicey to be priced beyond a certain amount (on the other hand, I was saddened that at least one woman in the NYT article was compensated only $2,000 for her cycle, which seems far too little). The articles also raise the question of how much the agencies and clinics profit off of these women, and that seems a fair question. It shouldn't be that the agency gets $20,000 and the donor only $5,000, when she is the one going through a somewhat invasive and emotionally wearing process.
I don't have the answers, but of course this lawsuit, and these articles come at an interesting time, since we are considering this route ourselves.
I was curious what others think about egg donation and compensation. Should there be limits? What is fair to all?
Mo
Click here to subscribe
This is tough. My gut says there shouldn't be compensation - like there isn't with organ or blood donors (where I live). But the infertile in me says without compensation, fewer would do it and where would people who need donor eggs be then? I feel like around $5,000 is fair considering (where I live) surrogates are compensated $10,000 and they go through more than an egg donor would.
ReplyDeleteI find the idea of compensation to be unpalatable and just yuck. I would prefer laws such as those for organ donation--only those who truly want to altruistically donate would do so without trying to make a buck. But then likely less people would do it, so there's that. I am also troubled by the notion of a clinic taking in the dough, which you don't (I think) see with transplants. Could probably be solved if insurance routinely covered it but that's not going to happen anytime soon...
ReplyDeleteI should add that I've done 5 IVF cycles, so I'm kind of "eh" about the argument that women should be compensated for the "trauma" of shots etc. for me the trauma was the fear of never having a baby, not the procedures themselves. I'm sure blood marrow donations are much more painful and the recovery longer (I always went back to work the day after ER, no problem)...
ReplyDeleteHmmmm
ReplyDeleteYeah, the fee is most likely not all going to the donor, and like you stated, probably just a small fraction to the donor. However, I say let the market determine the price. I see no issue with harvesting eggs for the women's financial gain. But at the same time, I question the company and their tactics for recruiting the women. Who's to say that egg even came from that Harvard education woman? I see this whole issue as necessary as it is so very complex.
Having used DE myself, this issue is one I have considered. (BTW, I think $35,000 is a ridiculous amount to pay for a donor, FWIW.)
ReplyDeleteI guess I see the donor's situation as more akin to one of your clinical trial participates than to someone offering a commodity for sale. For one thing, I don't think it's strictly legal to "sell" eggs (though I don't know that for an absolute fact). My understanding has always been that the fee the donor receives is to compensate her for her time and effort in going through the process of producing the eggs vs. payment for the eggs themselves. Supporting this notion is the fact that the donors are generally paid the same amount regardless of how many eggs the cycle produces, or in fact, whether the cycle produces viable eggs at all. (Though it's likely a donor wouldn't be asked to donate again if she produced zero eggs in her first donation cycle.)
I think it's important that the compensation not be so high that it persuade donors to donate for the financial benefit when they aren't truly comfortable, and to be honest, when fees as high as $35K or $50K are being sought by an agency, I have to wonder how much of that fee is actually going to the donor vs. the agency.
I think it is the agency's whose fees should be capped. Realistically there is a finite number of people needing eggs - and this number will become smaller as more people freeze their own. There is a huge number of donors and more and more clinics are set up to freeze eggs with ever increasing success rates. I think donors should be able to charge what they want and the agencies should be limited for what they can charge for secretarial services. In this way market forces will bring more donors into the business and prices will come down.
ReplyDeleteHi, I think $35,000 is far too much. It would make me question their motive for donoring. I am not naive to think that money isn't a factor that motives a woman to donate, but I like to think that is not the only or major factor. Yes, as we know, IVF is a tough process and they should be compensated appropriately for their time and dedication/commitment and perhaps more if they have proven they will be fully compliant in the medical process. I feel the price should not be based on their physical attributes. We did a fresh with a donor, we paid her $5,000 (first cycle) and expenses. We did frozen donor egg cycle, I believe the clinic paid the donor $7,500 -$ 10,000 (eggs are split). A frozen DE at an experienced clinic has the same success rates as a fresh cycle, and most result in multiple high quality embryos. My children came from the frozen eggs, so I am bias, but the process was so much better than agencies, and living through the stress of the donor cycling. No matter what donor you choose, the child will be perfectly your child. If you have any questions about either type of DE cycle, I am happy to email me. Lynne
ReplyDeleteThis is an interesting issue. I used donor eggs through an agency. She received the entire fee ($5500 for a first time donor), and the agency got a separate $5000 fee (which in my view was highway robbery for the amount of work done). I think I'm OK with uncapped fees. After all, how many Harvard, model, and/or Rhodes Scholar types are there, really, who are interested in becoming egg donors? I think the price for *average* donors would probably stay about where it is now, or perhaps rise a bit if donors in the middle of the country really are being paid only 2 or 3K. The people who would really be hurt are Jewish, Asian and Black intended parents, because there are so few ethnic donors; if supply and demand does work in this market , their fees will surely go up.
ReplyDeleteI do think this is a short term issue. As someone already said, I think in a generation, egg freezing is going to become routine preventative care. I know I will encourage my daughter to do it. This could in turn create a secondary market of frozen eggs, marketed by mature women past child bearing age who can freely chose to donate their unused eggs without having to under go any additional medical procedures. I wonder what the price will be if the donor didn't initially undergo any pain and suffering on behalf of an Intended Parent?
you make a good point about this being a short-term issue. I hadn't thought about that. I've joked that I'll have Magpie's eggs frozen at age 16 so she'll never have to go through any of what I did (of course then she might need thousands of dollars of therapy to deal with the fact that her mom had her undergo an invasive reproductive procedure before the age of consent!)
DeleteMaybe all the cool kids will be doing it and she'll ask to get some frozen eggs for her 16th birthday! :)
DeleteQuestion, since your sister has proven her fertility, would you revisit using her eggs?
good question. I doubt it because she only has about 5 follicles, so wouldn't produce many eggs, and therefore would likely have to do numerous cycles. I guess I have "proven" fertility now too, but I completely wouldn't recommend anybody try to use me as a donor!
DeleteI hate seeing articles like this in the NYT, because the vast, vast, vast majority of the readers have zero idea what they are reading about, and then they form a negative opinion about donors and recipients... this goes for articles about general IF, issues surrounding adoption, surrogacy, donor embryos, etc. etc.
ReplyDeleteI wonder why it is so difficult for journalists to write facts without suggesting or stimulating so much drama?
anyway, I did not use donor eggs, so who am I to contribute here,
but,
we did use a surrogate, thru an agency, at CCRM,
as well as ultimately donating our embryos to another couple
(the ultimate irony is that I wound up being a sorta-egg donor, even though I was uber-IF).
the agency fees are high, but it is a free market economy and they can charge according to whatever expertise they offer. buyer beware. nothing you can do about that...
...and the same goes for clinics. everyone can have an opinion about clinic fees, but, let me tell you... WE got what we paid for. even if we never found "success" of a RLB at CCRM, we still got what we paid for. our local clinic was half the cost, but, we never would have gotten the results we did at their level of knowledge, lab, research, etc. they could not compare. I feel that CCRM, as a leading clinic that does research and has a top-level lab & embryologists is WORTH the sky-high fees they charge.
however... surrogates have a generally accepted range of fees- thankfully most surrogates have not decided as a group to form a monopoly and agree to double or triple rates... ultimately, they are setting their pay scale. there will always be IPs willing to pay for services, no matter how unbelievable the asking price. our first-time surrogate got $25k thru our agency. our agency got $25k of their own. clinic got 10k for FET & related services. lawyers got 15k (we paid for both). medical costs of pregnancy OOP. private insurance would have been another $25k minimum.
just laying out some facts.
there are surrogates getting $50k now... for first time, no C-section or any other added fees, "hidden" costs (maternity clothes, AFLAC, housekeeping, childcare, spousal wage reimbursement, etc etc etc etc). I think because at the moment, demand is much higher than the supply (sounds terrible... there are masses of IPs with big bucks, and relatively few women who can be surrogates).
at some point, the fee becomes questionable. because it gets so high, only the uber-rich can afford to have a child that way. I personally feel there needs to be a cap.
this "industry" needs self-regulation, and every time a fee goes up, it causes so much scrutiny upon those in need of this avenue for family building- looks more and more like you are "buying" a baby. the "ick" factor goes up accordingly.
so, when a surrogate is "proven" she can raise her fee a small percentage. after all, it is an asset, to show that you can handle the FET meds, the pregnancy, the screening, etc. I feel like all of that is fine, but there should be a nationwide set of fees. it would weed out those who have the wrong motives, as well as keep surrogacy accessible to those who need it who are not millionaires.
so, in regard to donor eggs, yes, I feel there needs to be compensation, but there also has to be a cap. these can take into account certain realities, such as a particular ethnicity or religion of the donor... high demand would have a higher fee, but a set percentage. there needs to be compensation because there are medical risks, and there has to be some acknowledgment and accountability involved for the health and well-being of the donor. personally, $5k - $10k seems reasonable for direct comp for donor, especially considering the variables involved. $35k? wtf... I just can't see that. maybe for an exact ethnicity blend match??
even though it sucks, it ALL has to be scrutinized though, because there will always be people who will prey on those in need.
keeping you in my thoughts...
thank you so much for your super thoughtful reply! really glad you were able to use a surrogate to add to your family (but sorry you had to endure what i'm guessing was a really difficult journey to get there). Mo
Deletemo,
ReplyDelete(me again...)
I think I have asked you before, but maybe you could just revisit with a quick answer to my nosey question... what are your thoughts on donor embryos, for you and will? we were ineligible to donate thru CCRM (too old at time of embryo creation), but they do have a program. just curious...
we're mulling it. donor eggs appeal because then Will and Magpie can share a genetic connection with the child. I worry that bringing in a donor embryo at this point might be a hardship on the donor embryo child that everyone else is related except for them. It seems "simpler" if all the kiddos were in the same genetic boat of not being related to us. It's a good question though. Thank you for asking. Will keep thinking on it!
DeleteI just have to add. We went through CCRM's donor embryo program, and on top of the FET fees, they added $5,000 donor embryo program fee to pay for what they say is the the donating couple's expenses - expenses that they would not itemize much to our disappointment. That sounded reasonable, I guess, until we found out that all recipient couples pay this extra $5,000 program fee whether the embryos out of the donation go to 1 couple or 6 couples. So, if there are, say, 6 recipients, they have collected $30,000 in program fees on top of the FET fees! The other disappointing detail was that they split donations among couples, meaning that if you are a successful recipient and hope to come back for a genetic sibling, it won't happen. Those remaining embryos were given to the next couple in line. Just a fyi.
DeleteI will forever love and thank ccrm, and like another poster said, their expertise was worth every penny. (I don't think you can equate medical expertise with donating eggs, do I remain mostly opposed to donor compensation.)
DeleteHowever, I am disappointed to read you wee charged 5k for embryo donor expenses. I was too old at the time of embryo creation yo qualify for their program (and for me, I could never do it) so I don't know what those expenses would be. Um, signing/notarizing docs? That's about it. Otherwise it seems embryo donors are getting compensated too. Yuck. Maybe it's viewed as a slice of the ccrm cost to get to the embryos, but still. Yuck. If someone was younger and qualified and somehow hit financial hard times, I would hope the prospect of 5K per donation wouldn't lure someone into donating when they otherwise weren't comfortable with it.
Intended parents in gestational carrier program go through similar testing as donor embryo couples. We did an expanded FDA mandated infectious disease panel, twice at 6 month intervals, that cost us about $3500-4000 out of pocket. If you have questions about what kind of testing goes on in the donor embryo program, please talk to a donor nurse. There is a lot of administrative work that goes along with third party reproduction, including donor embryos, that goes beyond just notarizing documents. The business office does not necessarily understand what tests must be done and when. This is not meant as a slight to anyone. A lot of women read this blog and I just don't want someone to be deterred from donor embryos.
DeleteI went to an Ivy League school, and every Sunday there were ads on the campus newspaper offering 15k - 20k for blonde, blue-eyed egg donors. Part of me finds this off-putting - being able to afford "designer babies" feels wrong. On the other hand, uncapped, solicited eggs means more eggs are available to the greater pool, which means more choice and more eggs for everyone. So, as gross as it feels, I think a free market approach is the right one.
ReplyDeleteI attended a fancy school where there was a very prominent ad in the student paper offering 6 figures for an egg donor of a certain ethnicity. Yea it might be ridiculous but let free market reign? I don't see the harm in it, yet.
ReplyDeleteIf you look at countries that forbid egg donors to compensate like the uk they have very long wait times for donors. However uk ladies scoot over to spain or the Czech Republic where donors can be paid and are more available. Some clinics have in house donors that are less expensive because you cut out the agency fee. They also generally have a flat rate they will pay their donors.
ReplyDeleteYou know, we keep flirting with egg donor here in the land of no answers, and I just bristle at the capitalist American system. I was reading somewhere in my exploration of the psych side of things that one of the issues DC ppl struggle with is the idea of payment. I also struggle with that part of it too even tho I am also a realist who understands that the financial incentive keeps the egg donor pool flush with options and cuts down on adoption-like waits. When we talk about the possible need for DE, we have always discussed doing it abroad where the compensation (and the process, as the girls there are more gently stimmed and not put at nearly as high a risk for OHSS as donors at, say, RBA where I have heard of them getting 40-55 eggs from one retrieval) necessitates that the donor be doing it at least in part from altruistic motives. That's a more comfortable story for me to tell. I honestly struggle enough with my resentment of egg donors (and 'fertiles' in general) so I wouldn't really want to add the genetic mother's unchecked greed at my personal expense to the story about, you know, the "gift" of a cell from a "nice lady" because, really, it makes both of those terms I put in quotations a bald-faced lie.
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ReplyDeleteWe used donor eggs for our #2 (similar reasoning to Mo for using donor eggs rather than embryos, as we have a mutually genetic child also), and this was an issue that we agonized over, both for reasons of our own finances and because I am a long-term worrier and had to feel comfortable with what we ultimately told the child. I also worried about how the donor would feel in 20 years. We ended up choosing to go overseas to a country that put a very low cap on donor compensation. We did give up some element of choice (since the donor pool was smaller), but we found a donor who was perfect for us. Having it not be a financial transaction (she did get some compensation, but since we have visited her home town, we know how much gas and time are worth, and it was at best a break-even proposition for her) means for us that first, she really thought about what she was doing, and went into it with the purpose of helping us, so I don't worry as much about how she will feel about it later, and second, our children will never feel like their donor sold them to us. They will know that her motives were not sullied by financial considerations. That was important to me. Of course now that it's over, I wish I could give her the world. We gave her a gift immediately after the donation, and plan to send another (via the agency) on the babies' birthday, but even that is strictly regulated by the agency, so we can't send anything too expensive. I am so grateful to her that words really cannot express it. Having said all of that, I don't feel comfortable promoting laws that would limit other people's decisions. I do think voluntary guidelines are acceptable, though. $35,000 for a "donation" is a lie. That's a sale. I am OK with that, but we should call it what it is, and the buyer and seller should both think very carefully about how they and their possible child will all feel about it later.
I haven't tried donating my eggs, but as far as I know, the egg donor compensation may vary with the country and it depends on the quality of donors because for those egg donors who have previously cycled or who have exceptional qualities may be paid for more compensation. The expenses like medical, travel and egg donor insurance are also included in egg donor expenses.
ReplyDeleteHave you thought about whether the donor is going to allow future contact with the child conceived through their donation? Sibling donor connections?
ReplyDeleteAustralia only allows altruistic donation, although you can donate anonymously through a clinic (not truly anonymous, just anon until age 18) and you are compensated for reasonable expenses (Less than $1000). Most people find their own donor, either family, friends or through online forums, but of course that doesn't work for everyone. I know some people go around the laws by paying for a holiday for the donating woman, but it's all done on the low down.
ReplyDeleteThe same goes for surrogacy here, only altruistic surrogacy (and even then not in every state).
I wouldn't say I am completely against a reasonable, regulated rate, but certainly not a free for all, where you are paying extra money for particular characteristics (intelligence, hair colour etc)
Hi Mo. Long time no see. Miss you my friend.
ReplyDeleteHey. I got one of all varieties. Would you ever want to call me, face to face, so to speak?
Let me assure you, as you know, the source of the child has Fuck All to do with how you can relate to them. Same goes for any family member.
I say it with a light heart, but let me assure you I was Dark and Miserable when I had to make the decision. Now? Cant really remember who is what or from where. Too busy trying to love them, keep them fed and clean.
Oh Roccie, thanks for your comment. Yes, it might be great to talk if/when we move forward in that direction. I love your comment. it is so reassuring, resonates with what i 99% of the way know to be true.
DeleteI'd like to pop in and comment as a previous egg donor and surrogate. If there is no compensation, I believe most would not venture into it. I myself was not compensated at high amounts listed here, but lower. I am an educated person who drove 2 hours to a clinic for many appointments, lost work time, wear & tear on my vehicle, the stress for my kids as I woke them far earlier on those days, and any other expense related to these family building endeavours, I never ever looked at it as a money making venture. Ever. I wanted to help create families, and share what I was blessed with, my fertility. One family I even billed my own insurance the drug costs and saved them over ten thousand dollars. I find it insulting that it be treated as a money making venture, by both IP's and possible surrogates/donors. I also find it insulting when I read IP's almost devaluing the very HUGE help being given to them, and crying foul over reasonable compensation. There should be a fine balance found with IP's, donors, Dr's, and ethicists. This balance would lead to clear guidelines, and across the board laws. I wish you well in your next step of family building <3
ReplyDeleteThe infertility business in the US is just that, a business, not a medical specialty. Medical tourism is the way to go. IVF with DE and DS for under 10K in The Czech Republic -- worked on the first try.
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