Financial compensation of oocyte donors: an Ethics Committee opinion
Ethics Committee of the American Society for Reproductive Medicine
Committee members:Judith Daar, Jean Benward, Lee Collins, Joseph Davis, Leslie Francis, Elena Gates, Elizabeth Ginsburg, Sigal Klipstein, Barbara Koenig, Andrew La Barbera, Laurence McCullough, Richard Reindollar, Mark Sauer, Rebecca Sokol, Sean Tipton, Lynn Westphal, …
“Financial compensation of women donating oocytes for infertility therapy or for research is justified on ethical grounds.”
Quoted verbatim from this paper.
Our editorial summary of this paper, not the article's abstract.
Abstract
Financial compensation of women donating oocytes for infertility therapy or for research is justified on ethical grounds and should acknowledge the time, inconvenience, and discomfort associated with screening, ovarian stimulation, and oocyte retrieval, and not vary according to the planned use of the oocytes, the number or quality of oocytes retrieved, the number or outcome of prior donation cycles, or the donor's ethnic or other personal characteristics. This document replaces the document of the same name, last published in 2007 (Fertil Steril 2007;88:305-9).
Judith Daar, Jean Benward, Lee Collins, Joseph Davis, Leslie Francis, Elena Gates, Elizabeth Ginsburg, Sigal Klipstein, Barbara Koenig, Andrew La Barbera, Laurence McCullough, Richard Reindollar, Mark Sauer, Rebecca Sokol, Sean Tipton, Lynn Westphal, 0000-0003-0284-2845
J Daar, J Benward, L Collins, Joe Davis, Joey Davis, J Davis, L Francis, E Gates, Liz Ginsburg, Beth Ginsburg, Betsy Ginsburg, E Ginsburg, S Klipstein, Barb Koenig, B Koenig, Andy Barbera, Drew Barbera, A Barbera, Larry McCullough, L McCullough, Rick Reindollar, Dick Reindollar, Rich Reindollar, R Reindollar, M Sauer, Becky Sokol, R Sokol, S Tipton, L Westphal
PMID 28340933 28340933 DOI 10.1016/j.fertnstert.2016.09.040 10.1016/j.fertnstert.2016.09.040 Ethics Committee of the American Society for Reproductive Medicine et al. 2016, Ethics Committee of the American Society for Reproductive Medicine 2016
Cite this article
Ethics Committee of the American Society for Reproductive Medicine (2016). Financial compensation of oocyte donors: an Ethics Committee opinion. Fertility and sterility. https://doi.org/10.1016/j.fertnstert.2016.09.040
Ethics Committee of the American Society for Reproductive Medicine. Financial compensation of oocyte donors: an Ethics Committee opinion. Fertility and sterility. 2016. doi:10.1016/j.fertnstert.2016.09.040
Ethics Committee of the American Society for Reproductive Medicine. "Financial compensation of oocyte donors: an Ethics Committee opinion." Fertility and sterility, 2016.
Ethics Committee of the American Society for Reproductive Medicine, 2021·Fertility and sterility
Financial compensation of women donating oocytes for reproductive or research purposes is justified on ethical grounds and should acknowledge the time, inconvenience, and discomfort associated with screening, ovarian stimulation, oocyte retrieval, and postretrieval recovery and not vary according to the planned use of the oocytes or the number or quality of oocytes retrieved. This document replaces the document of the same name published in 2016.
There is a growing threat to the practice of oocyte donation in the United States and all of us should take careful notice. This threat is posed by the escalating fees paid to young women for providing these services. I was shocked by the decision of St. Barnabas Medical Center in Livingston, New Jersey to double the compensation from the community standard of $2,500 to a startling $5,000 per cycle. These new fees were aggressively advertised throughout New Jersey and Manhattan in strategic periodicals, newspapers, and magazines. I was even more dismayed to see physicians and “ethicists” justifying the increase to the media (1) stating “there is nothing inherently wrong with bidding for human eggs.”
For years, I have advocated compensation to oocyte donors based upon time, effort, and risk of involvement. I have addressed this topic at speaking engagements and in position papers, typically defending the belief that physicians are capable of responsible restraint (2, 3). However, I have been increasingly concerned over the encroachment upon the traditional practice by both commercial enterprises and physician-led groups who have inflated the cost of donor compensation 500% in the past decade.
In most countries it is illegal to provide any compensation for oocyte donors. Many believe payment is inappropriate and many more agree that excessive compensation is ethically unacceptable, since it potentially exploits or even coerces young women to participate. Even if one considers the time spent traveling to the local office and waiting for an ultrasound exam to be “work,” donors now will be earning in excess of $300 per hour. I find it hard to believe that anyone thinks this “reasonable compensation” according to the recommendations of the Ethics Committee of the American Society for Reproductive Medicine (4).
If we are truly not guilty of “pimping for patients” (5) and if donors are not “selling eggs,” then we cannot justify another doubling of the compensation. I believe this is a flagrant violation of the Ethical Considerations of Assisted Reproductive Technologies issued in 1994 (4). What is most disappointing is that this violation comes from a highly respected group led by physicians held in esteem within our subspecialty, who stated in The New York Times “I’m not sure $5,000 is enough.” (1) I would ask them, “How much is enough?” Where does this stop and at what price to our patients and our profession? Inevitably, all of us will be forced to raise our compensation rates to meet this challenge. Most importantly, and most unfortunately, these expenses will have to be passed on directly to our patients, who are already spending considerable sums of money to seek this procedure.
I have always opposed government regulation and intervention, and I have often taken a public stand in defending our right to administer our own practices. However, for the first time in my career I am rethinking my position. If physicians are forced to drastically modify their practices to keep pace with commercial ventures or to compete with doctors whose modus operandi is “what the market will bear,” an approach to medicine so flagrantly greedy as to threaten the existence of the field, then I do believe it is time for regulation. These are truly sad events, and if we stand by and allow these changes to become standard operating procedure then we as professionals deserve the public criticism that will inevitably follow.
Ethics Committee of the American Society for Reproductive Medicine, 2016·Fertility and sterility
Financial "risk-sharing" fee structures in assisted reproduction programs charge patients a higher initial fee but provide reduced fees for subsequent cycles and often a partial or complete refund if treatment fails. This opinion of the ASRM Ethics Committee analyzes the ethical issues raised by these fee structures, including patient selection criteria, conflicts of interest, success rate transparency, and patient informed consent. This document replaces the document of the same name, last published in 2013 (Fertil Steril 2013;100:334-6).
Ethics Committee of the American Society for Reproductive Medicine, 2016·Fertility and sterility
Building families through the adoption of children has been supported by human society throughout history. The ethical appropriateness of patients donating embryos to other patients for family building, or for research, is well established and is affirmed by this Committee. The use of the term ''adoption'' for embryos is inaccurate and should be avoided. This document replaces the ASRM Ethics Committee statement by the same name, last published in 2013 (Fertil Steril 2013;99:1846-7).