Why Women Seek Donated Eggs

The inability to conceive is deeply painful for most infertile women. One woman told the Liverpool Daily Echo that she was devastated by the news that she had gone though early menopause. “I just cried and cried when I realised it meant I would not ever be able to conceive naturally,” she said. “We have thought about adoption, but I feel it is my right as a woman to have my own baby and to experience being pregnant.” Though the pain at being told you will never reproduce is extreme, it is doubtful that anyone has the right to have her own baby. People may have the right to reproductive freedom. If the state, for instance, intervened by preventing certain people from reproducing, those people’s rights would be violated. But a natural inability to conceive is not a similar violation of one’s rights. Even so, many women feel that they are being denied a good that is rightfully theirs—motherhood—and will pursue it at all costs. If a woman’s infertility issues are related to ovulation, donor eggs may resolve her infertility. This creates a powerful pull toward seeking donated eggs. The Western Mail quotes one woman as saying, “At the moment there is a feeling of incompleteness, that our lives are not fulfilled. [Finding an egg donor] would make us really happy and bring absolute joy to us.” Her husband added: “It would be fantastic to have a child – it would make my life complete. I would have someone to share my passions in life, in sport and in culture, with, my language and my lifestyle.” Phrases such as bring absolute joy to us and make my life complete betray a bit of an imbalance. Children cannot supply absolute joy or completeness in life, and to place this expectation on one’s offspring is to burden them with a weighty load.

Those seeking egg donation ought to determine whether their expectations are unreasonable, and whether the costs (emotional, medical, monetary, social, etc.) are worth the risks involved. They also ought to ask why they consider egg donation a better option than adoption. Often, people downplay adoption because they want “their own” children. But egg donation denies parents a child who is genetically theirs anyway. The reason it is chosen over adoption might be the greater proximity to having “one’s own” children, including the process of bearing and birthing the child and the potential for a genetic link to the father. My point here is not that all people who seek egg donation are driven by a wild and irrational pursuit of children at all costs, but that those who are considering egg donation ought to examine their motives before proceeding.

Why Women Donate Eggs

Two main motivations exist for women who donate: altruism and money. Some women donate specifically to an infertile relative. Others donate to help pay for college or to get out of debt. Few women claim finances as their primary motivation. Donor women are portrayed in the media as altruistic, as wanting to help others start families. No doubt this picture is often accurate. But a comparison between egg donation rates in the Unites States, where financial compensation is not regulated, and the United Kingdom, where it is capped at the equivalent of $400 USD, is revealing.

An article in the Bristol Evening Post quotes Pip Morris, manager of donor recruitment at the National Gamete Donation Trust, as saying: “There is a shortage of donors throughout the UK and it is basically because people are not aware that they can help others.” His explanation does not quite hold, though. The article, written November of 2008 refers to campaigns “launched in London, Birmingham, Liverpool and Manchester to encourage more women between the ages of 18 and 35 to sign up to be egg donors,” but donors have not come forward in sufficient numbers to meet the demand. Women in the UK typically wait years for a donor.

An August 2009 article in the Times Online (London) shows a debate over proper donor compensation. The side that argues for increased compensation (moving from $400 to $1100) says: “We have never had enough egg donors in the UK. The kind of woman who donates her eggs is usually someone with a social conscience who has witnessed a family member experience the heartache of childlessness.” And that’s where the problem lies. Not enough women are sufficiently motivated by altruism. Dr. Tony Calland, Chairman of the British Medical Association ethics committee, says: “We remain steadfastly against any payment for gametes. […] We feel that paying donors might encourage some people, who would not otherwise, to put themselves at risk of medical intervention.” However, here in the United States beginning egg donors are compensated $5000 on average, which is 12.5 times the amount deemed suitable in the UK. Lack of regulation on compensation means American clinics can offer amounts as high as they have to in order to attract donors. And if compensation is too high it is hard to see this practice as egg donation instead of egg selling. Furthermore, if compensation is a motivation, and clinics benefit financially from drawing in more donors because that means they can serve more clients, then the potential for abuse begins to escalate.

Today on campuses across the nation, student newspapers advertise top dollar to healthy, intelligent, beautiful, young women who are willing to donate their eggs. Those who donate will graduate with far less college debt. Because of these women’s donations, couples across the globe who have struggled with infertility will be able to conceive children. Is it possible that such a process could be anything but positive? In this paper I will examine the ethical implications of egg donation. I will spend time examining egg donation’s role in the potential exploitation and endangerment of women, the commodification of children, and a series of social and familial issues.

INTRODUCTORY DEFINITIONS

Before moving too far, it would be helpful to define a few terms. A gamete is a cell that has the potential to form a new organism when joined with another gamete. In humans these cells are eggs and sperm. Female gametes, sometimes called ova (singular is ovum), are called oocytes (singular is oocyte) before they mature. I will use the term eggs to refer to female gametes in general and will use the more specific terms when necessary.

The topic of the paper is egg donation, which is used in certain forms of Assisted Reproductive Technology (ART). ARTs treat infertility, generally by artificial means such as introducing a third party and/or manipulating gametes in a laboratory. In vitro fertilization (IVF) is the ART treatment that makes use of most donor eggs.

Egg donation refers to the process whereby a woman agrees to undergo fertility treatments that cause several of her eggs to mature, has those eggs surgically harvested, and allows them to be used in the IVF cycle of another woman, often one who is unable to produce eggs of her own in sufficient quantity or of viable quality.

INFERTILITY & EGG DONATION IN THE UNITED STATES

U.S. Infertility Rates

Data compiled by the CDC from the 2002 National Survey of Family Growth demonstrates that infertility affects a large number of women. According to this survey, around 7.3 million women between the ages of 15 and 44 (11.8% of all American women in that age range) have an impaired ability to have children, and 2.1 million married women (7.4%) between those same ages are technically infertile (meaning they tried to get pregnant for at least 12 consecutive months and did not succeed).

The Data on the Use of ART, IVF, and Egg Donations

Of these 7.3 million American women, 184,000 (0.3%) pursued ART. Of those who used ART, most pursued IVF treatments. An industry analysis done in August of 2009 says, “ART now produces more than 50,000 babies per year in the U.S. via 142,000 IVF procedures (nearly tripled since 1999), and demand is growing from the ranks of 7+ million infertile women.” Though the causes behind infertility are legion, the American Society for Reproductive Medicine (ASRM) says that a quarter of all infertile women have problems with ovulation, which would lead many of them to need donated eggs in order to reproduce. ASRM further reports, “donor eggs are used in nearly 10% of all ART cycles in the United States” As for the number of children born from donated eggs, the Boston Globe reports that in 2005, “the most recent year federal statistics are available, about 6,500 women successfully delivered babies with egg donors, an 88 percent increase from five years earlier” Now that we have the numbers for why eggs are needed for ARTs, we will look briefly at why women choose donor eggs and then will turn to the specifics of the egg donation process itself, which will surface a few ethical issues and begin the ethical deliberation on our topic.

This post is here so people can leave comments, questions, etc. about what I have put up.

Blessings,
James

Then I learned that all moral judgments are “value judgments,” that all value judgments are subjective, and that none can be proved either right or wrong. I even read somewhere that the Chief Justice of the United States had written that the American Constitution expressed nothing more than collective value judgments. Believe it or not, I figured it out for myself – what apparently the chief justice couldn’t figure out for himself – that if the rationality of one value judgment was zero, multiplying it by millions would not make it one whit more rational. Nor is there any “reason” to obey the law for anyone, like myself, who has the boldness and daring – the strength of character – to throw off shackles….I discovered that to become truly free, truly unfettered, I had to become truly uninhibited. And I quickly discovered that the greatest obstacle to my freedom, the greatest block and limitation to it, consists in the insupportable “value judgment” that I was bound to respect the rights of others. I asked myself, who were these “others”? Other human beings, with human rights? Why is it more wrong to kill a human animal than any other animal, a pig, or a sheep, or a steer? Is your life more to you that a hog’s life to a hog? Why should I be willing to sacrifice my pleasure more for the one than for the other? Surely, you would not, in this age of scientific enlightenment, declare that God or nature has marked some pleasures as “moral” or “good” and others as “immoral” or “bad”? In any case, let me assure you, my dear young lady, that there is absolutely no comparison between the pleasure I might take in eating ham, and the pleasure I anticipate in raping and murdering you. That is the honest conclusion to which my education has led me – after the most conscientious examination of my spontaneous and uninhibited self.

Terrifying. This is the teaching under which our students sit today.