Infertility and Assisted Reproduction
Egg Donation for IVF and Stem Cell Research: Time to Weigh the Risks to Women’s Health
Permitting Payment for Women Providing Eggs for Research
Statement by Our Bodies Ourselves / June 2013
In 2009, New York became the first state to permit payments to women who provide eggs for research. Other states are now considering similar policies.
There are a number of problems with this practice:
- Supporters of allowing payment for human eggs contend that the practice promotes “equity for women” as “research subjects.” This language is misleading. Research subjects are recruited to study the effects of a drug or procedure. In this case the eggs are the research subjects, not the women. The short-term and long-term effects of the egg-harvesting drugs and procedures on healthy young women are not being studied, collected, reported, or followed. Women who provide eggs for research are thus not research subjects, but the suppliers of raw materials, and the impact on their health is not being systematically assessed.
- Advocates of commercial egg donation argue that it creates “equity for women,” so that those who provide eggs for research would get compensated at the same rate as women who provide eggs for reproductive purposes. Equity, however, is a misapplied principle in this case given that many young women providing eggs for reproductive purposes have experienced serious complications and infertility due to their “work” as egg providers. Rather, what drives support for commercial egg donation is increasing the numbers of eggs available to researchers, yet the only ethical approach in furthering this goal is to collect adequate safety data before expanding the market for eggs into the research arena. Particularly at risk are low-income women more likely to risk their health to produce muchneeded income to pay for tuition or basic living expenses.
- Supporters assert that research is suffering due to “lack of needed tissues” and that research using women’s eggs will ultimately help women with cancer and help improve infertility treatment. However, there is substantial evidence to suggest that the drugs and procedures used for egg harvesting and retrieval actually increase infertility in previously young, healthy women. Passing infertility problems from one group of women to another, or subjecting a healthy group of women to substantial risks so that other women may at some point benefit from improved treatments, will not serve the aims of medical research or bolster public support.1
- Egg harvesting uses powerful drugs (including some unapproved by the FDA for these purposes) to both suppress and hyper-stimulate a woman’s endocrine system to produce large numbers of mature eggs. The most well documented side-effect of egg harvesting is ovarian hyper-stimulation syndrome, which can cause organ damage, ovarian rupture, and in rare instances death.
- Proponents contend that current laws deny a woman’s “fundamental ability to make informed decisions.” Quite the contrary, without sufficient information or studies on both the short-term and long-term health risks to women providing eggs, including studies of the hormones routinely used, it is not possible for women to make an “informed decision.” Better safety data are essential.
- Proponents also contend that existing laws and regulations are adequate to protect women from being unfairly exploited or enticed by compensation. Yet they offer no evidence or analysis to back this assertion. Moreover, some stem cell scientists continue to express reservations about paying women for eggs to be used in research.
- The American Society of Reproductive Medicine (ASRM), some of whose members stand to profit directly from commercialized egg donation, supports payment for eggs for research. The ASRM also successfully lobbied earlier to weaken the California law requiring warnings on adds offering women money for their eggs and are on record (in New York state, for example) opposing the establishment of mandatory registries that would document the true
extent of serious injury associated with egg harvesting.2
- Those concerned about equity, informed consent, and the progress of medical research would do better to put their efforts into policies that would promote the collection of long-term safety data, make consent truly informed, and ensure that the health and needs of young women entering these arrangements are protected.
1. In California, AB 926 (which passed the CA Senate in July 2013) would allow compensation to women providing eggs for research. The state of California acknowledged the danger to women’s health in paying for eggs for research by passing SB 1260 in 2006 (this legislation prohibited such payments beyond compensation for direct expenses). AB 926 would repeal SB 1260 and also be at odds with a similar prohibition in Proposition 71, which established California’s stem cell research program.
2. There is one independent, national voluntary registry for all participants in ART procedures based at the Dartmouth-Hitchcock Medical Center in Hanover, NH, but the majority of fertility centers do not display the placard that would inform their clients and patients of its existence. (See www.ifrr-registry.org)
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