Infertility is a problem in the United States. Couples struggling with infertility issues sometimes turn to egg donation as a solution. That can raise a question of how much an egg donor should receive for her egg contribution. The price issue has become the subject of a federal lawsuit filed in the Northern District of California, seeking a legal answer to the price question.
The price question arose because of price guidelines adopted by fertility clinics. The plaintiffs in the lawsuit, two women, argue that fertility clinics are engaged in price fixing in violation of federal antitrust laws. The plaintiffs claim that two industry trade organizations—the American Society for Reproductive Medicine and the Society for Assisted Reproductive Technology—have set prices below market rates. The price caps the clinics use are $10,000 per egg donation cycle, and the clinics say that caps are needed to prevent coercion and exploitation. In this report, Professor Rene Almeling, an expert in the egg donation business, discusses the issues involved.
Professor Almeling notes at the outset that there is very little regulation in the U.S. of fertility clinics. That includes doctors’ offices, where people go for infertility treatments, and egg agencies, sperm banks, and surrogacy programs. Most other developed countries have extensive regulations that govern the fertility industry.
Professor Almeling says that egg donations and sperm donations are similar in that donors are providing half the material needed to create an embryo. Egg donation is a bit different from sperm donation in that women are recruited to take medication daily for three weeks to help them produce multiple eggs. The eggs are then retrieved in outpatient surgery. For that egg donation, women are paid $5,000-$10,000.
As to sperm donation, donors are asked to come in weekly for a year, and each visit must be preceded by two days of sexual abstinence. After a man donates, if his sperm count is high enough for that sperm banks standards, he is paid for his donation. Sperm banks freeze the sperm and keep it for up to six months to assure freedom from AIDS. Women are paid in any event, and the eggs are not frozen.
There are differences in perception as well. Women who donate eggs are told that they are giving the gift of life. They are thanked and told how wonderful they are and what a difference they are making in the lives of those receiving their eggs. Sperm donors are treated much more like employees.
Professor Almeling said she found real differences between how men and women think of the children who are born from their donations. Sperm donors tend to think of children born of their sperm as their children. The see themselves as fathers who have children out in the world. Egg donors, however, tend not to think of themselves as mothers. Women were adamant that they were not mothers.
Women who are thinking of donating eggs need to be aware, says Prof. Almeling, that there is very little information about the long-range risks of these medications. The egg donation techniques have been around since the late 1970s, but there have been no studies of the long-term effects of these medications on women’s bodies. So women who donate are doing so without much useful information. Professor Almeling believes that is a problem for the industry.
As to the legal status of the case, the ethics of the suggested prices are an issue in the California case. However, the American Society for Reproductive Medicine (which suggested the price caps) has no enforcement authority. Professor Almeling found, in researching her book, that some women had been paid far in excess of the guidelines.
Rene Almeling is an Assistant Professor of Sociology at Yale University. Her research and teaching focuses on issues associated with gender and medicine. She is the author of the book "Sex Cells: The Medical Market for Eggs and Sperm," as well as a number of scholarly articles. The Legal Broadcast Network is a featured network of the Sequence Media Group.