Tuesday, June 16, 2009

Why the difference?

Continuing the conversation about egg donors (started awhile back) and, specifically, why we treat and compensate egg donors so much differently than sperm donors.

Consider the following differences:
  • Men are paid (in my town anyway) $50.00 a shot (no pun intended) compared to women who are paid $4000.
  • Men don't get paid if their sample is unusable. Women do.
  • Men would need to donate every 4-5 days for a year to make as much as a woman and that is assuming his samples are always good. Want to have sex? He'd better time it just right or there goes his $50.00
  • Yes, a woman goes through considerably more pain, but she is also done in less than 2 weeks (not including the prep time, but men have some prep time too)
  • Female donors are required to see a counselor before donating to make sure they have really thought things through. Males are not.
  • A recipient is required to get counseling before proceeding with using donor eggs, but not before using donor sperm.
  • According to this dissertation, women are expected to be more altruistic than men in their motivation
  • Recipients of eggs, but not sperm, are encouraged (or flat out told) to give the donor a gift on top of that donor's fees.
  • It was my donor's personal experience that people did not approve of her donating her eggs and compared it to giving away her children. I don't have similar knowledge about men, but one of Brad's acquaintances donated sperm and Brad thought he was doing it because he thought his genes would better the species.
I have some thoughts on why we treat sperm donors and egg donors so differently, but I would love to hear your thoughts. Why the difference? Do you think it is fair? Is it really market driven or is there something else going on? Any other thoughts? For those of you in the market for both sperm and egg donors, what has been your experience?


battynurse said...

So is it slightly tacky to point out the difference of a guy could potentially (probably?) enjoy his donation process but it's highly unlikely a woman would enjoy that many needles.
No, I don't tend to think it's fair when I slow myself down and think about it. But part of it could be related to the whole idea that guys can and do walk away from a child that is biologically theirs without looking back at times. I think men are not viewed to be as attached to their offspring as women are even if it's not true. I don't think I'm voicing that right but society (at least US society) tends to see men as not being as involved as women. I think it's changing but slowly. Just my thoughts.

Anonymous said...

This may not be the deepest comment you will get, but I would cum for $50. I would not do what I did for IVF for $4000. The only reason I did it and will do it again is for a baby. Worth way more than a couple of grand.

Maybe because I'm OOP $4000 seems like small change for what we're asking them to do.

Caro said...

It used to be that only men were paid in the UK, now neither is.

Sky said...

Honey, I was going to give you my 2 cents on this and then, right in your closing paragraph you said it. Yes, I believe it's completely driven by market conditions. I don't know any woman who will endure 2 months of bullshit:

-constant blood tests
-transvaginal ultrasounds
-self-injected stimulation drugs
-"twilight" anesthesia
-physical discomfort
-massive hormone side effects
-and the icing on the cake: risk of hyperstimulation and in rare cases death

all that for $50. No way! And if they were willing, clinics would be all too happy to encourage it (think of all of the potential DE recipients they lose because of exorbitant cost).

The inconvenience to men is negligible and the risk is zero.

From an emotional standpoint, I'm going to say something that's sure to piss off a lot of people but PC isn't my thing. Men simply don't have the same biological imperative women do regarding offspring. And that's probably because in their genetic code is the whole propagation of species directive vs. women who are programmed to nurture (or risk species' end). Women grow and carry their children - men have a much more detached role.

All that to say, I think the compensation variance makes sense (and, frankly, I wouldn't have donated my eggs for anything under 10M - not that anyone would be stupid enough to pay that kind of coin for my genes - but just making a point).

Kami said...

Battynurse and Sky - PC or not, I think that is the biggest reason women are paid more. I think we believe (and I think it is biologically driven) that women have a stronger tie to their genetic connection and we pay them more to entice them to give and give again.

I also think that there is a connection between women (even anonymous) helping women get pregnant that is not present with DS. Not to mention time and space. The woman donor being at the same clinic near the same time where that sperm is at least 3 months old and maybe from across the country. It just makes it seem less from a person and more from a store.

I think the reason we pay for DS and DE - as opposed to an actual donation - is because the demand is so high. People who donate a kidney (often to a stranger) do not get any compensation even though their risks are far higher.

As a society we shy away from people selling body parts, yet I think that is what this is. We just pretend otherwise.

I think the counseling makes sense because of that stronger bond we perceive the woman has with her genetic tie and because it is very costly if she bails half way through.

The amount of trouble / risk is definitely higher for a woman and I think that is worth more. I just find it hard to see it as being worth that much more.

Bottom line is that my discomfort comes from acting like it is a gift / purely altruistic, but then paying them as if it is a business transaction.

I guess in this case it is both and that's just the way we (as a society) have found to be ok with it.

FWIW, I would have gladly paid our donor the going rate of $4,000. Would we still be friends or would it feel more like a business arrangement? I don't know.

I am also glad we have that option in this country because I think it is clear that compensation motivates people to donate their gametes.

Sky said...

Oh, please don't let anyone tell you it's altruistic - that's just horse crap.

Do some egg donor's also feel good about helping out a fellow woman, yes, I'm sure they do. But the monetary incentive being paramount is evidenced by the fact that in countries where egg donor compensation is illegal, there is an insurmountable waiting list for donors.

I equate this notion to people who insist they're not just working for the money. I say, Of course you are. If you won the 320M lottery tomorrow, would you quit? No one says they'll stay so far. I get it that they also like their jobs and that's great - but don't BS me, the real motivator is the money.

Kami said...

Sky - Exactly! So why do we insist on calling it "donation" and not "egg selling" or "egg buying"? Does it matter the words we use?

And the fact is, it bugs me that I need to buy someone's eggs. I would rather have them donated. But why? Is there a gut feeling that we shouldn't buy/sell body parts/cells that is beyond logic?

Sky said...

Kami, yes, we should call it "buying" but we live in a world rampant with hypocrisy and if you don't play the game, you become the "difficult" outcast.

It makes everyone FEEL better if we call it a "donation" and everyone knows full well there is no "donating" involved. It's the game "civilized" societies play in order to get what they WANT while still pretending to uphold moral integrity.

Geohde said...

I've always assumed it was simple economics that drove it- if it's harder to get women to donate eggs, the demand will be higher for a scarcer resource and consequently the unit price will be more. Also there is MUCH less 'sample' to work with each time and it requires medications (injected) and a minor surgery. One male effort can potentially father many more babies than a female one and doesn't require surgery or medication.


Lisa said...

What an interesting topic! On the pro side, one can make the point about it being market-driven (as egg donation becomes more "popular", stands to reason the price should come down, but, probably won't). But, on the con side, clearly, to me, at least, as women we are "expected" to have more of a bond with our genetic material.

You've definitely got me thinking tonight and I hope you won't mind if I pick up on this topic and explore it myself.

Lisa DG said...

My two cents- this may be another example of the differences between men and women.

I agree that the process is more complicated and risky for DE- I mean an ejaculation does not have the potential to lead to ovarian hyperstimulation and loss of fertility- DE does have that potential risk (even though it is small). Plus- pumping your body with injections and the anesthesa pose risks in and of themselves.

But back to the mars versus venus theory. The process may be more emotionally complicated for women. Yes- they are merely contributing genetic material, but women may be more bonded or attached to that material. Men seem to look at the process as a smiple "deposit" whereas women look at it as the potential to give life to the world. Women seem to have more ability to think things over obsessively and to feel regret or second guess themselves. Now- before everyone gets enraged at my June Cleaver attitude, think about other ways men and women ARE different. There are too many to name here but you must admit that this is true.

Men will jack off for $50, and women simply will not. There's no shortage of sperm to buy. Demand for eggs are now far higher than the number available. In some countries who do not compensate for egg donation, there can be extremely long wait times.

In summary, I think it comes down to demand, the complication and potential risks of the process, and the emotional baggage women have around most things and especially something like this. Do I think that men should have pre-donation counseling? Yes. I think that part should be the same. In fact, the compensation should be higher too. But- if they are willing to do it for $50, why in the world should we give them more.

Some men out there would probably even pay $50 to go in a room, be handed a cup and told to do their business- where everyone knows what they are doing in that room. But that's just another way men are different than women.

Sara said...

I don't think that the system is unfair to men at all. Our biology is different, whether we like it or not. Sperm are easy to access and abundantly available. Eggs are not. Those are the breaks. This is a place where the notion of equal rights really doesn't apply.

I think that in each case, the payment is approximately proportionate to the inconvenience/risk/discomfort. I agree that it's not like organ donation, because there is no financial compensation to offset the discomfort and substantial risk of organ donation, but then again, most people probably place a higher value on organ donation than gamete donation. As you pointed out, your donor was criticized for donating her eggs. Is anyone ever criticized for saving a life? I think the non-monetary social value (i.e., the emotional and social reward) of organ donation is much higher.

I also think that society places a different set of pressures on men and women, as several people have pointed out, and that this occurs regardless of the feelings of the individuals involved. If I wanted to donate eggs or become a surrogate, my husband would balk unless there was money involved, even though I would definitely do it for free (if my eggs were worth donating, or if a friend or family member needed a surrogate), knowing what I now know about infertility. So, the payment wouldn't be to convince ME to do it, but rather to make it acceptable to my family. Unlike with sperm donors, the family of the egg donor pays a price too (time away, cranky mom/wife, risk of injury or death, etc.) So, it is easier to justify making one's family pay that price if they are getting something in return.

I do realize, though, that most egg donors in the US are broke college students, so the family argument may not be relevant for them.

Regardless, I'm fine with it. Call it donation or buying and selling, either way, I think it's a good thing if done with respect for everyone involved.

Kami said...

All good points.

Sara - My donor talked about impact to her family because of mood swings. It is a bigger, if short term, commitment.

Interestingly, the dissertation noted above found a greater supply of women. I don't understand how that can be the case, however.

Lavender Luz said...

I don't have an answer, but your bullet points and the ensuing discussion is fascinating. Truly.

niobe said...

Fascinating discussion.

Interestingly, in the surrogacy world, because of the economy, these days I've noticed that there seem to more more surrogates looking for intended parents and fewer parents with the financial resources to compensate a surrogate.

Since we're considering back-to-back surrogacies, we just didn't have the $30-$40K base fee that some experienced surrogates request. (note: that doesn't include screening costs, legal costs, travel costs, IVF costs, etc.) While I think those fees are completely reasonable, given what a surrogate has to go through, it just wasn't financially possible for us to work with a surrogate who was seeking compensation at the high end of the scale.

battynurse said...

This is all very interesting. And you're right. It is a lot more like egg buying. To me that also feels stickier in telling your child someday that well I bought the egg that became you. Even though that will likely be the case if there is a child someday. And no I don't have a problem with the egg donor route but yes it doesn't truly feel like it's a donation in most cases.

Leslee said...

I have no personal experience with DE, but I do with Known DS and wanted to mention that we and our donor had to go to counseling before we were allowed to do dIUIs to make sure we all understood the consequences (both positive and negative). And, while we didn't have to pay our donor, we did get him some extra nice Christmas presents! ;)

I would imagine that if a woman producing eggs was as simple as a man producing sperm, egg donors would be paid $50 as well.

Anonymous said...

Great discussion - but I doubt the cost of the donor is going to come up with my (hopefully) future child. Actually that thought had never occured to me, but now I wonder, kids always want to know!

In some ways, I am happy that we bought our eggs. It makes me feel like they are really "mine". I know if someone gave them to me they would still be mine, but there would (I think) be another little piece the donor could claim. By paying, they "donor" sort of writes off the "donation". Can I somehow write the $4K off on my taxes since it is for a donation?!

This FET cycle I have pretty much forgotten there is a donor involved! I know at some point the genetic stuff will come up, but my involvement is the same for this cycle as someone using their own eggs. Strange that I feel so detached from the whole process! Great discussion.

katedaphne said...

Hi Kami. Sorry I am late to the party here, but I do have one thought re: calling it donation vs. buying eggs.

While I would donate eggs for free to a close fmaily member or friend (on another planet where I didn't have crap eggs, I mean), I would not go through the pain, difficulty and trouble for a stranger without compensation. That said, even being compensated I would still consider myself to be donating the eggs.

*I would be taking the money for the TROUBLE, not for the product.*

That is, you can have the eggs for free, but you can't have the time, stress, dildocam shots, etc. I'll need a little money for those.

Kami said...

MMM - That is a great way to look at it . . .you bought them, their yours. BTW, I believe you can write off the $4,000.

Katedaphne - Also an interesting way to look at it. In that scenario, would you need more compensation for pain, inconvenience, etc. if you were a proven donor or had a certain degree?

katedaphne said...

Kami, no I think a flat fee would be fine, and I'd probably want it around $4000-$5000. Paying more for certain degrees or characteristics gets a little close to eugenics for my personal taste.

For a proven donor, that's a little squishier. You might say, the trouble is the same, so no. But then, you could say, you are offering a gift of more value, so yes. I dunno, I'd lean against it. But I sure see why an intended family would want to pay more for a proven donor!! It is a lot of money to pay for such an unknown...

This is one reason I am against much regulation in this area -- different people, both the patients and the donors, have different comfort levels. I don't know that we ALL have to agree, as long as the two parties involved agree.