Thursday, April 16, 2009

Egg Donors

Ms. Spock somewhat recently posted about egg donors and questions about safety and compensation. I realized when I posted my comments I had the contents of a post myself.

It might make more sense to read Ms. Spock's post first, but most of it can stand on it's own (there were a few modifications from the original comment):

Oh my gosh! I am so late to the party and this is a subject near and dear to my heart.

1) We really don't know the long term risks of fertility treatments either to the woman (either donating or for her own eggs) or for the children produced from IVF and IVF with ICSI. I applaud more studies (especially long term prospective studies) in this area.

2) Registry? I think that is one way of studying the risks. I also think women should be limited to donating 6 times (I think my clinic follows ASRM guidelines for 4 times although a quick internet search could not verify that was the current ASRM guideline) for their own good. This might be a way to track that. Furthermore, I would like it if all adult donor children had the right to contact their genetic contributer.

3) We currently pay for eggs. We call it donation but at several thousand dollars it really is payment. I wonder if this amount will go down when (if?) freezing eggs becomes a more viable option. Then someone could shop for donor eggs like donor sperm and she wouldn't need to be "Ms Right Now". I also think that women might have a harder time separating themselves from their genetic component and this might also be driving up the cost compared to DS because it may lead to fewer donors.*

Another thing that really chaps my hide is that women are encouraged to give their donor a gift. A couple acquaintances in Seattle were encouraged to give rather expensive gifts - around $100, I think. I mean you are already PAYING them a huge amount and now we pretend that it was all done out of the goodness of their hearts? Please. IMHO a nice card saying that you appreciate it would be the best solution.

Personally, I am very glad that I was able to avoid that whole thing by finding a known donor. Sure, I was willing to pay her because I wanted a kid and it was worth it to me. The funny thing is, both my donor and my second choice (who I picked because I liked her not because of her 'fees') refused to be paid because they were doing it out of the kindness of their hearts. We gave our donor a gift of about $1000. Hey, it was great to spoil her - she was willing to do so much for us.

Now, some compensation is important. Donors miss work, they are uncomfortable, they risk short term and long term side effects. They should at least be compensated for any income they lose in the process and any costs (transportation, etc.) that they incur. Here I would like to add that medical "guinea pigs" for medical drug / treatment trials (ones who do not benefit from the treatment - ie are healthy) often get paid only a few hundred dollars.

Finally, I think that we may be missing some potential donors by pushing the financial piece. My second choice donor - when I encouraged her to donate through the clinic said, "I wouldn't feel comfortable doing that because I don't want to get paid."

On a bit of a tangent: One study on blood donation found that donations went DOWN after people were compensated with movie tickets. Yes, they were less likely to do it unless they felt they were being completely altruistic.

Think of how we view blood donors vs plasma donors.

And here is where I wave my white flag of defeat: If it takes spending thousands of dollars to get women to donate - if it really can't be done any other way - then, by all means, pay them.
*For further reading in regards to the differences between how we treat sperm donors vs egg donors, see this dissertation. The author concludes that it is a difference in how society views and treats men and women, in terms of their genetic contibution, and not relative supply and demand nor time involved that effects compensation.


battynurse said...

Great post. Some great things to think about too. I have to admit though that I don't really see the cost of donated eggs going down much since it's a lot harder to get the eggs from women than sperm from men. Also there are so many that do it for the money to pay for school or whatever.

Anonymous said...

Our little gift to our donor was closer to $500.

Hi everyone! o/


Lorraine said...

I think there is so much mystery surrounding egg donation. Some well-placed PR would do a lot towards making it less of a foreign concept.

Egg donation doesn't have the resume-polishing effect of a teach america stint, but it would be easier for more women to manage an egg retrieval than two years in an inner city school. Maybe the altruistic need an agency of their own to donate through - or if the spin was better, it wouldn't have the plasma-donor taint to it.

Anonymous said...

We gave our donor a small gift. But I would be offended if someone asked me to give her a gift. It was a gift from my heart. Why would I need to be asked.

singletracey said...

Interesting. Like you, I believe that donors deserve some compensation. I was lucky, (and am still lucky) that my sister did it free (I think the only thing I bought her was an extra birthday present and a pizza). Anyway, I do think the comp is what drives most donors....just my opinion.

Kami said...

Battynurse - I agree that it is harder for women at least in terms of physical discomfort, but in my neck in the woods, women get paid 80 times more per donation. Put another way, a man would have to donate 80 times to make the same amount . . . that would be once a week for a year and a half. And if he wants to have sex . . . well, he may have to skip that week. If he tries to do both and his sample isn't up to par, he doesn't get paid.

DH - Ok, let's say $750 then. :)

Lorraine - I have wondered the same thing. Is it possible to impress on a 20 something what a great gift it would be? My second choice was a 20 something and she had an aunt dealing with IF so she understood.

Skrambled - I think they ask because getting a gift is part of that clinic's retention process. A gift because you are moved to . . . a different agenda.

Singletracy - I think you are right and still wonder if different advertising and PR might motivate others. Of course, when the subject comes up with a 20 something, I always mention the comp. Maybe I am part of the problem.

Mumof 2 said...

Hi, everyone, I'm new to this! I've thought about donating eggs over the last couple of years. Last week I found out that a friend of mine, T, isn't likely to be able to concieve her own child. They cancelled her first IVF 6 days in and her next 2 failed, the last they were only able to harvest 2 eggs, which were useless. She's 29 and starting early menopause. A mutual friend came to me and asked if I would help. I'm 34, my children are 13 & 15. I've raised them on my own since I was 3 months pregnant with my second. I fell pregnant young and easily. I always have felt guilty? I think that is the word, that I did when so many women try and try and can't. I had always hoped to have more children with a partner. My partner has 3 children of his own, and had a vasectomy after his 3rd, he definitely does not want anymore. I found that really difficult and I struggled for a while with it. But I really thought about it and I really honestly believe that I couldn't start again anyway. Do I leave a man I care about in the hope of finding a man that wants to have children with me just for the sake of me having children with a father and for my children to have the more siblings?? How long would that take? My kids would probably be in their 20's!!
So, I'm looking very seriously into the donation process. I tell my children?? Neither T or I want people to know that her child won't be from her egg. I see this as a gift to her (by the way, here in Australia, its illegal to do it for monetary gain).
I don't know how other donors feel, whether they see this child as their own, a half-sibling to their children, because I don't. T will be carying this child, giving birth and so on. Do other donors tell their own parents?
I'm looking forward to starting this process, seeing the doctors and counsellors to have some questions answered!

Kami said...

Hi Mumof2. Thanks for commenting. I applaud you for thinking about being an egg donor for your friends. You didn't exactly ask . . .but here are my thoughts.

I think it is important to be open about the egg donation to the children who are the product of this conception. Although there isn't a lot of research in egg (or sperm) donation children, the research is clear in terms of adoption that open is better. The problem is that children need to be told before age 4 to never remember being told, but at age 4 they are unlikely to keep it a secret from everyone else

I don't know what to suggest in terms of telling your parents or your children. I know my donor's parents know, but she isn't close to them so I can't say that it has had much of an impact on her. I think she has been open about the process to her children, but they are too young to understand what that means.

I guess, if it were me, I would error on being more open then less just because secretes can make something that is ok appear less than ok.

Good luck to you and your friend in navigating this journey. Please feel free to email me if you would like. I would also love to hear how it turns out.

MrsSpock said...

I can't believe I'm just now reading this...I do like the analogy about blood donors vs plasma donors. An apt one, I think.

I myself would consider being an egg donor, but I don't think anyone would want mine. As Gregory Peck said in "Arsenic and Old Lace", insanity runs in the family.

B said...

interesting ideas.

In Oz it is against the law to pay for anything to do with human bits. Organs, blood, and donor sperm or eggs or embryos or surrogacy. It is genuinely a donation.

This can make it difficult for women to find others who are willing to donate. Or, it is often a close friend or family member (which may or may not present different complications). Some women advertise in parenting magazines and strangers respond. Most clinics will not accept a woman who has not already finished family building for herself.

I don't know what the difference here is in terms of rates of donor eggs, embryos and surrogacy.

Sara said...

Dear all,

As a "20-something" donor and cousin of a woman who has gone through IVF several times with unsuccessful results, I find this post and many of the comments offensive.

I did not donate to my cousin; she was her own donor. However, I would in a second if she ever asked me, and I would expect compensation.

I did not expect a gift from my recipient couple, although I had heard stories that other girls had received very expensive gifts. Before I was even aware of this gift, I had already composed and sent a "thank-you" card to my couple for choosing me for this experience. I don't know how much this gift cost but it was not necessary to me. I learned more about why I didn't have children, the nature of my current relationship, and what was possible for my future. I also learned how lucky I am to be able to help in this way.

Since my donation, my partner and I have decided we want to marry and have children, and that we want to donate again. With the money I received, I was not able to put a dent in my grad school debt, but I was able to pay off other debts and get a head-start on saving for our future together. We do not need the money now, but I would do it again in an instant to help a couple in need. Now that I know how lucky I am (and after the care we took to make sure I and my body were healthy during the donation process), I now understand how devastating it would be not to be able to conceive on my own.

My couple is on my mind all the time, from the first time I learned they were pregnant to the day I cried when I learned they had lost the pregnancy. I pray for them every week in church that they will conceive in the future using the embryos that were frozen after the retrieval. My friends and family also receive updates when I get them and we all pray for **** and *****.

My cousin is also on my mind as she struggles to conceive. I am lucky and have a job that is salaried. I do not need to take time off a minimum-wage job to attend doctor's appointments and semi-invasive surgical procedures. But as my cousin would tell you, this process is as exhausting for the donor as it is for the recipient - as she is both for herself.

I am still struggling with hormone imbalances post-retrieval and my couple has lost one pregnancy. If they ever asked me again to donate, I would do it in a second - not to make money, but because I made a commitment to them to help them start a family.

Kami said...

Thank you Sara for these views. I have a post up today that I would love to hear your thoughts.

I'm sorry, although I understand, that you found some comments and the post offensive.

My biggest issue is clear in your comment - you call yourself a donor yet you expect to be compensated. When people are compensated for their time/energy/body they are being paid and are not donating.

I don't have an issue with paying people to give someone their eggs, but then it should be egg selling and not egg donation.

If someone wants to donate their eggs, then we should reimburse them for time lost, travel expenses, etc. Then a gift, in my opinion, would be warranted.

I love that you pray for your recipient couple. I think most donors, especially the ones who will donate again, do it out of kindness as well.

Again, thank you for your comments.

Anonymous said...

I would LOVE to actually donate my eggs to a family struggling with infertility. I have two children and am not interested in having more, but every birth control option that my husband and I have tried failed. I am 33 and it seems people are not interested in a donor passed 30. No one looks passed the age to see my great health, excellent fertility results, etc. It's a shame, I wish I could help (at no cost).