Many agencies and clinics that use websites to recruit women to donate their eggs to those with fertility problems do not follow ethical guidelines, a new study says.
One-third of the websites examined in the study paid donors more for having presumably desirable traits, and more than half omitted the procedures' potential risks.
Among websites that mentioned specific donor traits, 64 percent said they paid more to women who had successfully donated eggs in the past, meaning the provided eggs resulted in a birth.
"Recipients often request to be matched to a 'proven' egg donor although there is no evidence that they are better gamete donors than women who have not previously donated or provided a success," said study researcher Dr. Mark Sauer, a professor of obstetrics and gynecology at Columbia University Medical Center.
The findings raise concerns over the possible exploitation of donors, and the risk that people will be devalued by paying them for a part of their body, rather than what is ethically allowed, which is to pay for their time and discomfort, the researchers said.
Paying women for prior successful donations is particularly concerning, the researchers said, because it creates an incentive for women to donate repeatedly. Some sites paid women an extra $500 for each previous successful donation. The American Society of Reproductive Medicine (ASRM) recommends women donate no more than six times in their lifetime.
The findings raise questions over how effective current guidelines (set by the ASRM) are at regulating the egg donation industry, and whether there is a need for stronger regulations, the researchers said.
Ethics of egg donation
The practice of paying egg donors, and how much to pay them, has been the subject of much debate, the researchers said. But without payment, the supply of eggs for infertility treatment may dwindle, and the rights of donors may be violated, the researchers said.
In the United States, there are no laws regulating egg donation, and guidelines for practice come from professional societies such as the ASRM. In 2007, the ASRM issued guidelines intended to address ethical concerns over egg donation, the researchers said. The guidelines suggest egg donors be paid no more than $10,000.
In the new study, Sauer and Robert Klitzman, of Columbia University Mailman School of Public Health in New York City, and colleagues analyzed information from 102 egg donor agency or clinic websites that recruited donors through the website and displayed a compensation amount.
They found that 34 percent of these websites mentioned paying donors more for certain traits, such as creative or athletic ability, physical appearance and performance on standardized tests.
Additionally, 56 percent of websites did not discuss short-term risks of egg donation, such as infection or ovarian hyperstimulation syndrome, a condition that can occur after taking fertility medications, and can lead to swollen ovaries and leaked fluid into the chest area.
The psychological or emotional risks of donation were not discussed on 77 percent of the sites, and 92 percent did not mention a possible risk to future fertility, through damage to the ovaries, the researchers said.
Forty-one percent accepted donors less than 21 years old — the minimum age for egg donation set by the ASRM.
Paying donors for traits such as physical or artistic ability does not accurately represent what we know about genetics, the researchers said. While genetics play a role in these traits, they are not linked to one gene, the researchers said.
Agencies were more likely than clinics to pay egg donors based on traits.
The researchers noted that studies have not looked at the long-term risks of egg donation, and it could be argued that a complete presentation of the procedure's risk would mention this lack of knowledge, the researchers say.
It's likely that women hear about the risks of egg donation when they visit the agency or clinic and consent to the procedure, but research suggests decisions involving risk are made based on first impressions, the researchers said.
The study was published online July 30 in the journal Fertility and Sterility.
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