Ethical implications and controversy of egg donation

  1.  AngelicaQWERTY

    Hello! I’m concerned because I want to be an egg donor but some people told me it is not as ethical as it seems. For example, religious views around the world vary regarding this issue and I understand that some of them see it as an unfair or not appropriate way of conceiving a baby. I can understand that today’s society has evolved a lot, so these kind of issues are not of general interest anymore, but we are forgetting what nature has given to us “thanks” to these kind of techniques. The worst of it is that money issues are involved, both for the donor and the recipient: while recipients have to pay large amounts of fast money, donors receive huge payments. I think this is becoming crazy and want to know what are the ethics of the egg donation process nowadays, because if it is another type of “service”, then I don’t want to donate my eggs. Thanks!

    P. S. I say this without any intention of offending anyone.

    December 5, 2015 at 9:25 am
    #7930 Reply
  2. Sandra F. Sandra F.
    inviTRA's Moderator

    Dear AngelicaQWERTY,

    This is, as you’ve mentioned in the title of this topic, a controversial issue and can be seen from several points of view. It should be clear that it involves various persons: assisted reproduction specialists, egg donors, donor egg recipients, medical ethicists, fertility clinics, egg donor agencies, and health insurers. Conflicts of interests between these groups may arise when analyzing the ethics of egg donation. However, medical ethics have been defined in 4 basic principles, i.e. justice, autonomy, beneficence, and non-maleficence.

    As for autonomy, it is related to que quality of consent involved in the egg donation process and the economic compensation donors get for their participation. Some experts agree that high financial incentives translate into higher pressure or even coercion. This, as in many situations in life, prevents us from making informed, clear decisions, because the money may become the motivation for the “volunteer”.

    This issue is of particular interest within the US (see Egg donation in the USA), where egg donors receive large amounts of money, and that’s why the payment has become a taxable income (see Taxes on egg donation: should payment be taxable income?). Studies have shown that women who donate their eggs for financial reasons develop more emotional harm from the procedure at the end, which makes them more likely to regret their decision if compared to women with altruistic purposes.

    Justice has also become a controversial principle because some experts agree that fertility treatments in general are subject to distributive justice, which translates into an inequitable distribution. This is, again, related to financial issues: women and couples who can afford higher payments for agency fees, compensation and even advertising usually get treatment faster than those with less purchasing power.

    Injustice is also related to infertility specialists, who are committed to provide adequate treatment for their patients. This means they will do whatever they can to ensure that a successful pregnancy occurs. If there aren’t enough egg donors available for each infertile woman, then infertility specialists are unable to provide optimal fertility options for their patients, so they are forced to resort to egg donor recruitment. Thus, they have to face a conflict of interests, because they have to encourage egg donation and, at the same time, care for the health of prospective donors, who wouldn’t get involved in egg donation if egg donation put their health at risk.

    Finally, regarding beneficence and non-maleficence, a conflict of interests also arises in this sense, because egg donation is supposed to improve the health of an infertile person and prevent harm, but what about donors? In this vein, they undergo a surgical procedure (i.e. follicular puncture) without expecting any clinical benefit. Thus, experts must think twice when choosing a young woman to be an egg donor, placing her at risk for harm, for the benefit of an infertile person.

    This is a brief summary of the ethical issues involved in egg donation, but of course there is a lot to be discussed and this issue can be seen from several points of view. Be it as it may, the American Society for Reproductive Medicine (ASRM) acknowledges there is a need for further study, especially in relation to stimulation of ovarian function medications, which entail various risks for the donor.

    Hope this helps

    December 17, 2015 at 12:58 pm
    #7931 Reply
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