Egg donation compensation: ethical and legal challenges

Nearly 8,000 children were born in the US in 2011 as a result of assisted reproductive technology involving the use of donor oocytes. While this technology has been widely utilized, worldwide numbers are difficult to calculate. The ethics of the process and of payment provided to donors continue to be highly debated. This paper examines international debates about the legality and morality of the use of donor eggs to assist in family development and just recompense of donors. Aside from a nearly universal perspective that oocytes should not be purchased and sold as commodities, no consensus has been reached on appropriate recompense for egg donors. Major issues in this debate include the relative acceptability of monetary payment versus payment in the form of reduced fees for other reproductive services (often as a result of egg or sperm sharing) and the factors to be considered in determining the just compensation for the time, pain, discomfort, and potential physical risk egg donors face in this process. The effects of legal interventions imposed in various national contexts on the availability of this technology, the influence of egg cryopreservation, and the use of donated eggs for research rather than reproduction are discussed. The effects of US reliance on professional organizational guidelines to oversee donor compensation are addressed, including assessment of their effectiveness in preventing differential rewards for eggs of donors who share characteristics that are highly prized such as beauty, athleticism, and intellectual giftedness. Currently, there is little long-term monitoring of the physical and psychological aftereffects of oocyte donation. Lack of understanding of these effects makes determination of a just payment for egg donation challenging. Keywords: compensation, ethics, law, assisted reproductive technology, recompense