is in the news this week in a big way. Seems that you can't open a newspaper, (yes, some of us still read our news the old fashioned way!) or turn on the TV, or look on the internet without hearing about it. Add to that, the buzz on facebook within the professional and educational fertility
community and I feel surrounded by it.
Where to start. For one, there's the controversy about payment for egg donation. Or reimbursement if you like. What's enough? What is a person getting paid for? What's really the hot topic this week is the question of paying more for specific attributes. Like being blonde? I'd like to think that's a frivolous question, but my wanting to think that doesn't make it so. Check out this news reports and see for yourself.
What this and other stories have brought to light, again, is the non-regulation of egg donation fees. They list $10,000 as the "industry" standard. In fact, the industry standard is closer to $8,000. If you think I'm nitpicking, think about what $2,000 will buy. Then think about being a college student and what that would mean to them. This report talks about an agency charging $25,000 because of a prestigious college degree that the donor had earned. Anyway you look at it, that's a lot more to pay than $8,000. And to be very clear, we are paying it.
ASRM (American Society of Reproductive Medicine) offers guidelines, with no way of enforcing them. This is not to knock ASRM in any way. The guidelines in fact are adhered to by most reputable and responsible egg donor agencies. Which begs the question, how to find one? How to know who's reputable? How much does one pay and for what?
Stepping onto a very slippery slope here, when does it become simply selling? Or is just that, always, and the price doesn't really matter. Do the fees make sense given what women have to go through to donate eggs? Consider this, sperm is sold for about $100 and given the relative ease of donating sperm that makes sense. Donating eggs is much more intensive; involving medications, injections and surgical removal of the eggs. Vastly different than what a man has to go through to donate sperm. None of the above is without risks either; there can be significant abdominal pain, bloating, hot flashes and hyper stimulation.
State governments are involved, making decisions as different as sunrise and sunset. For example, quoting from a recent New York Times article:
Despite the growth of egg donation as a fertility treatment, it is largely the use of human ova to create embryos for stem cell research that has galvanized opposition among conservative and anti-abortion campaigners - leading to efforts to impose severe restrictions in some states.
Last fall, California adopted a law requiring egg donor advertisements to include specific warnings about health risks. The state already bans the sale of eggs for research purposes, in accordance with guidelines issued by the National Academy of Sciences.
In contrast, New York's Empire State Stem Cell Board decided last year that state research money could be used to pay women up to $10,000 for donating eggs.
Egg donation is a serious, complicated and expensive business. No question about that anymore. In the world of infertility, it may also be many women's only way to experience pregnancy and childbirth.
All this does for me is bring up more questions. Today's blog is more about questions than answers. Trying to understand the issues means asking the questions first. Are we getting what we are paying for? Are we paying for the "product" (the eggs) or the process that the donor is going through? Do we pay more for 10 eggs and less for 6 eggs, despite the process being the same for the donor? How much should we be paying? How do we ensure that we are with a reputable egg donation program? Where do we start wading through all these controversies to achieve creating the family we are longing for?
I'm going on facebook directly after posting this and asking people to weigh in. Luckily for me, many of my facebook friends are educators and professionals in the field of infertility. Maybe they will be kind enough to shed some light on this very complicated issue. Look for a follow up tomorrow on any words of wisdom that they share.