A significant number of US fertility clinics who recruit egg donors online are not adhering to the industry's own ethical guidelines, a new study says.
Their ethical failures include not warning women of the risks of the procedure and offering extra payment for traits like good looks.
Egg donation, like sperm donation is often criticized in itself for ‘commodifying’ the children that result and for deliberately breaking the link between children and their natural, biological parents.
The new study points out that women are recruited to donate eggs to fulfill a growing demand by couples seeking in-vitro fertilization (IVF), but a number of websites seeking to recruit them ignore standards set by the American Society for Reproductive Medicine (ASRM).
"I would argue that there needs to be more attention from ASRM about these agencies, because you don't want these women exploited," said Robert Klitzman, a professor of clinical psychiatry at Columbia University and lead author of the study that appeared in the journal Fertility & Sterility.
Opponents of egg donation say the procedure is inherently exploitative. The Centre for Bioethics and Culture (CBC), a US group which highlights the problems surrounding the fertility industry, say that the lack of proper research on the risks involved in egg donation makes obtaining informed consent from egg donors almost impossible.
They say that the list of known health dangers to women who provide their eggs was extensive includes Ovarian Hyperstimulation Syndrome, estrogen (linked to breast and uterine cancers, heart attack, stroke, and blood clots), and progesterone they are injected with; ovarian torsion; and kidney disease.
Ethical standards set forth by the ASRM specify that donors should be at least 21 years old, and those between ages 18 and 20 should receive a psychiatric evaluation first.
Also, women are supposed to be compensated for their time, rather than being paid for their eggs. Donor traits such as college grades or previous successful donations should not result in higher payment.
However, these recommendations are voluntary, and the guidelines carry no legal authority, though ASRM will sanction members who do not adhere to the guidelines. But that doesn't cover non-member organizations.
"Our ability to influence the behavior of non-members is pretty limited," said Sean Tipton, a spokesperson for ASRM.
To see how well recruiters follow the guidelines, Klitzman and his colleagues visited 102 websites recruiting egg donors. Some represented IVF clinics run by a physician, and others were agencies that connect women with clinics but don't actually provide any of the medical services.
Some 34 percent of the websites offered higher payment for certain traits, most commonly having previously donated successfully. Some also offered higher payments for educational achievement, athletic skills and good looks.
More than 40 percent of the sites also recruited women between the ages of 18 and 20.
About 26 percent of ASRM approved agencies or clinics paid more for certain traits, versus 63 percent of non-approved sites. Clinics, which have a physician on staff, were more likely to adhere to the recommendations than egg-donor agencies.
"There's no question that there are some agencies that don't seem particularly interested in what our guidelines are, and we don't know how to impact their behavior," said Tipton.
The study comes after a recent case in India, where it has emerged that a young girl who died in mysterious circumstances had been visiting a fertility clinic to donate eggs.
In a press release, the CBC said that the case highlighted the dangers posed by “invasive egg removal procedures, which masquerade under the lie of donation”.
The statement said: “These transactions are anything but 'donations' as young females -- nearly children themselves -- all over the world, desperately fall prey to offers of money like those made to Ms. Pandey.”
The CBC also pointed out that regulation, which has been called for by many in the Indian medical profession would do nothing “to protect young women who seek to 'donate' their eggs because they are in desperate need of money”.
“Regulated exploitation is still exploitation -- using young women as egg farms for affluent westerners wanting children,” the statement said.