CConsidering how long the cost of living has been a crisis, it’s taken a while for it to affect the price of a coveted commodity: home-produced human eggs. After being fixed at £750 for 13 years, the compensation cap for women who donate their eggs is finally going up, in England, Northern Ireland and Wales, to £986.
Not that this amount should be seen as a payment, compensation or tip. The BBC reported on the increase and was at pains to remind women that financial compensation is an incentive to be nice, nothing more: “Egg donors warned not to do it for £986 cash prize“.
Perhaps that’s why the Human Fertilisation and Embryology Authority (HFEA) didn’t round the figure up to £990: the four-pound price might have attracted a more calculating woman, who might wonder why the full compensation for this gruelling but unnecessary service wouldn’t be enough to afford a decent iPhone, just before her laboriously cultivated eggs are harvested under anaesthetic.
The revised but relatively modest amount serves as a test of women’s altruism, and their collective altruism as a guarantor of the purity of the fertility industry. While more prudish countries have banned egg donation, as with commercial surrogacy, and others, such as the US, have encouraged a fertility-free market, the UK has compromised: if young women can be persuaded to provide eggs or carry fetuses for less or no cost, the whole industry is absolved of its commodification. No women were forced, out of financial need, into the reproductive market. On the other hand, it could be argued, they were not paid properly either.
For the benefit of a commercial clinic that could advertise IVF (from an “altruistic egg donor”) for at least £12,000, a British donor, for her £986 compensation, submits to the screening and invasive procedures that could earn an American student $10,000. While admittedly more generous than Scotland’s recently advertised offering of, in principle, state approval for women who “give the joy of creating a family”. In the UK, egg donors (though we must not forget the achievements of sperm donors) seem to be the only ones in this thriving sector who are expected never to sully the miracle of IVF with an itemised bill.
Much credit for this system must go to the HFEA, whose purchase friendly website (which describes egg donation as an “astonishingly selfless act”) Potential donors would never guess that the long-term health risks are still considered, by a significant number of academics, to be under-researched. Nor that, for many familiar with the screening, testing, daily injections, scans, bloating and discomfort of ovarian stimulation and egg collection, this is not something they would want to ask a young woman – perhaps as young as 18 – to do for unknown beneficiaries.
Similarly, the positive stories about egg donation from the BBC and the Scottish Parliament are not matched by stories from women who reported being hospitalised, traumatised or regretting donating human tissue.
In a discussion about the increased compensation on Mumsnet last week, an egg donor who was “very ill due to excessive bleeding” wrote: “It is definitely not something I would do again and I would never have done it in the first place if I hadn’t been asked to by someone incredibly important to me.”
strict ovarian hyperstimulation syndrome (OHSS) is a rare but not unknown side effect; about a third of women experience it, according to the HFEA, mild OHSS“which can normally be effectively treated at home with pain relief”. A statement that would be more reassuring if clinicians were not in the habit, as is increasingly apparent, of trivializing women’s pain.
The grief that arises when a woman who has donated eggs is later unable to become pregnant may be even more difficult to manage, but it is not included on the HFEA website.
To compound these unknowns, British egg donors must agree that any resulting children (from up to 10 families) will be allowed to seek contact when they turn 18. While the HFEA is right in light of all this to call egg donation an astonishingly selfless act, it should perhaps ask itself why a thriving industry worth over £470 million should be formally dependent, no less than some strict religious enterprise, on boundless female selflessness and self-mortification. Around one in six IVF procedures now use donor gametes.
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If it is unfair to wonder whether there is a man who would so painfully dedicate his body to the reproductive interests of a stranger, it is hard to think of another part of the British economy that is so critically dependent on women being nice. Or, given current expectations, even nicer than usual.
The analogy with freely donated blood and organs, while usefully underscoring the generosity of egg donors, is inaccurate: the lives of the egg recipients are not at risk; donor eggs are produced to order; egg donors are invited to accept risks that commercial recruiters can profit from. “Donating,” one leading clinic tells interested women, is “the most priceless gift you can give”. For parents, the pack of eight fresh eggs costs £13,245.
Even if women are actively paid to provide eggs, the lack of long-term research has raised doubts about the possibility of informed consentOf course, in an industry where impoverished women are tasked with carrying, giving birth, and quickly giving up babies created at the behest of the most pampered parents on the planet, you would expect a certain level of indifference toward the companies that are, in short, labeled egg production facilities.
But research suggests that not only are some women encouraged by their egg providers to ignore potential long-term complications, there is also minimal interest in the industry to identify what those complications are, if any. It is rare for people to turn to the British Hen Welfare Trust but in its charitable concern for the interests of egg producers it could certainly relieve the HFEA.