The Transnational Fertility Market

According to the BBC, there is a growing trend among Western Europe’s well-to-do to travel to Romania for egg donations. Wait-lists for egg donations in the UK may be as long as seven years, while they are readily available in the Romanian market.
In Bucharest, women earn up to £150 for donating their eggs. Due to Romania’s relatively low standard of living, earning more than a month’s wages for egg donation may seem like a steal. However, given the extensive medical procedures involved in the donation, including hormone treatments and surgical egg retrieval, the profit isn’t as great as it may seem.
This is an issue that I have a hard time wrapping my head around. I believe in giving women agency to make decisions about their body. And I think that women should have the ability to use their bodies for financial gain or to help others. *BUT* given the realities of international political economies, I feel uncomfortable in advocating for the right of affluent Western women to travel abroad and consume the eggs of women in lesser developed countries.
Dr. Stephen Wilkinson, a medical ethics specialist, notes that: “[Egg donation] is such a difficult area of ethics. One the one hand, people are benefiting from the money. But on the other, we do have this residual concern about exploitation and about inducing women to do something that’s not in their best interests.” Ummm yeah. Not to mention the underlying issues of xenophobia and racism.
It’s no coincidence that women in Romania earn £150 for a donation, while women in the UK earn upwards of £1000 and women in the US receive around $8000.
Also, interesting to note is that in both the UK and the US women are paid for their “time and effort” in the egg donation process–not for the eggs themselves. The idea behind this policy is that payment should not be the primary motivation in donation. BUT considering that women in their twenties are the target suppliers of eggs, this ethical consideration seems out of touch with the realities of the market. Thoughts?
Check out Becoming an Egg Donor for more info.

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12 Comments

  1. Jessica
    Posted December 28, 2004 at 12:18 pm | Permalink

    I’m so glad that Lauryn wrote about this, because I’ve had such mixed feelings about it. I actually considered egg donation for a while, but after learning about some of the health risks decided against it.
    What was so tempting was the amount of money I could get in such a short time. While Lauryn is right to point out that US women can get $8,000 for egg donation, that’s just the price if you go through a public program. You make a TON more if you go through private lawyers, etc. (just google egg donation and you’ll see what I mean).
    You can apply to be an “extraordinary donor” and pretty much name your price. An extraordinary donor is basically someone who has high SAT scores, a graduate degree, etc. or someone who is insanely phyically fit or “beautiful.” After seeing how creepy the whole thing was I couldn’t even think about doing it.

  2. Posted December 28, 2004 at 12:29 pm | Permalink

    There’s still class issues involved with egg donation in America, though they’re not as agregious as what’s going on in Romania. The only place I’ve ever seen ads for egg donation was in our college newspapers. Many, if not most, college women are broke and always looking for extra money, at least that’s how it was at my university here in the South. I doubt there are many women with good-paying jobs or good sources of money coming in (parents, husbands, etc.) who donate their eggs– who on earth would want to unless you’re in desperate need of money? It sounds incredibly painful, invasive and scary. It’s not like jacking off into a Dixie cup like men do for sperm donation.

  3. Katha Pollitt
    Posted December 28, 2004 at 12:35 pm | Permalink

    If you believe young women should have the ‘agency” to do whatever they want with their bodies, does that extend to selling their kidneys or other body parts, which is now illegal? Society has thousands of laws that regulate/ban things people might like to do with their bodies– ride a motorcycle without a helmet , for example — because of public policy considerations. Egg “donation” is not risk-free– I think society has a right to say it is too dangerous and is essentially exploitative, whatever the fee and however much young women might like to make the money. In principle, I don’t think giving infertile women the experience of pregnancy should override health considerations.
    However, once you subject egg donation to the market, as you seem to think is okay, it stands to reason people will go global to undercut the price, with eggs as with everything else. You might not like it aesthetically — but the principle is the same, no? We don’t buy american in this country, we choose cheaper goods made in third world countries where workers are paid much less. If egg donation is just another business, and women have ‘agency’ to engage in it, then these romanian women are just taking advantage of globalization, and globalization is taking advantage of them.
    I think the concept of agency is overrated, frankly.

  4. lauryn
    Posted December 28, 2004 at 11:22 pm | Permalink

    Hmmmm…well, my thoughts on the body politic are entirely convoluted. For example, I believe that women (and men) should be able to use their bodies to engage in sex for money. Lots of people (particularly legislators) argue that street-based sex work is generally exploitative, and feel that society should prohibit individuals from engaging in this activity. While I don’t support the legalization of sex work, I believe that sex work should be decriminalized because it seems too paternalistic to tell sex workers that society supports their going to jail for providing a service that might exploit them. (I know this isn’t a perfect analogy, just a different way to think about the body politic). Now where this intersects with egg donation I’m not sure…
    I’m *definitely* not an advocate for the market approach…I just don’t believe there is a way around it.
    And while I agree that agency *is* often overrated, I still feel like it’s an important concept to consider. In the US, egg donation requires informed consent of the donor. If the egg donor still feel compelled to donate their eggs and assume the risk, then I feel like they have [some] agency in the decision making process. *BUT* I definitely agree that public policy can trump individual agency. Perhaps eggs donation should be treated like organ donations, where individuals are allowed to give an organ, but not receive payment. I’m not sure.
    But, given the number of ladies I know considering the process, I feel like it’s an issue ripe for feminist critique. Anyone know of any feminist theory on the issue?

  5. Posted December 29, 2004 at 12:54 am | Permalink

    I agree that [e]gg “donation” is not risk-free (can’t compare with sperm donation bec. of the ovarian stimulation and the retrieval, a surgical procedure). However, you should know that, as sx procedures go, this is minor surgery. [This is the best depiction I could find. The probe with the needle is in the vagina (the pink area).]
    I’m not familiar with the Ro situation, but my take on this is: women, even Ro women, in consultation with their MD, are quite capable of making informed medical decisions. Jessica provides a great example of this: she considered it, researched it, and decided that the health risks outweighed the [financial] benefits. Why assume other financially needy [Ro] women are not capable of doing the exact same thing? Moreover, why assume “society”, or “the government” has more interest in/better knowledge of a particular woman’s health, than the woman herself?

  6. Posted December 29, 2004 at 12:57 am | Permalink
  7. NYMOM
    Posted December 29, 2004 at 11:29 am | Permalink

    Maybe it’s like kidney and other organ donations in the third world…We now know that many women from poor families are forced into donating their organs for money…Perhaps we are seeing the same thing with these egg donations…
    I think it’s just better to keep these things within Western Society where both the buyer and seller are protected by the same laws…

  8. Liberal AND Proud
    Posted December 29, 2004 at 12:41 pm | Permalink

    I understand your discomfort with the idea of affluent women purchasing the eggs of women in “under developed” countries.
    But unfortunately, if your going to use the argument of “women in control of their own bodies” to argue in favor of choice, well you have to accept the tenet that choice involves using their bodies for commerce. You need look no further than the stripper article at the top of this page.
    The issue of health concerns also is risen in the pro-choice argument.
    This is all about “moral apprehension or discomfort” isn’t it? And that is the same argument that conservatives use against abortion.
    I’m not saying that I am for or against the idea of women selling their eggs. I’m a Catholic so you can discern for yourself which side MY morality falls on.
    What I am for is women’s, NO the right of ALL of us…to CHOOSE.

  9. Katha Pollitt
    Posted December 30, 2004 at 10:43 pm | Permalink

    I don’t know if this is still an active thread, but I’d like to query that notion that society should just let women (or men) make their choices about health and medical issues. No one likes to think that they may not have enough info to make an informed choice, it’s like saying people are stupid or infantile,but realistically, most people don’t know a lot about medical science–what the risks are, what the benefits are. That is why we want the FDA to test drugs, instead of just putting everything on the market and letting individual consumers do their own research. The people you think can evaluate whether egg donation is worth the pain and hormones and unknown future effects are the people who go on fad diets, have past-life regression therapy, tell breast cancer patients they got sick because of negative thoughts etc. (I don’t mean people on this list, of course! i am thinking of people in general .) I don’t see a lot of evidence that Americans, on the whole, make such great health choices. think of all those women having breast implants, setting themselves up for a lifetime of replacements. Is that their choice? Or are there things they don’t know or don’t want to know? People can be very short-sighted.
    Do we know that women considering egg donation have all the facts, and all the possibilities that may crop up down the road? This is totally unnecessary surgery — it doesn’t benefit them at all, except financially. And it’s not like they are saving a life, as when donating a kidney (about which the rules are very strict).
    I don’t see an analogy to abortion here. Abortion is one of the safest operations — much safer than childbirth, which is the alternative. We would not want women to have abortions with methods that are dangerous, would we? That’s what I fear about egg donation. Under the rubric of “agency” important public health and public policy issues get lost.

  10. Liberal AND Proud
    Posted December 31, 2004 at 3:26 pm | Permalink

    I didn’t mean to imply that choice SHOULD be made without some level of research, education, etc.
    Of course it should. But that is true of any medical procedure, abortion included.
    The difference is that egg donation is literally…to the nth degree…a voluntary procedure. However, unlike abortion, which is decided based on medical and moral grounds (and yes…it IS used as “reverse” birth control at times…that IS the great undiscussed issue), egg donation as we are discussing is being used for “commercial/economic” reasons.
    The issue isn’t that people shouldn’t be “allowed” to do it because they do not have enuf access to information, or because it’s dangerous (people make bad decisions every day) the issue is it inherently “wrong”.
    Which I think brings us back to the whole moral discussion. Which brings us back to choice, and whether or not people have the RIGHT to choose.

  11. Posted February 2, 2005 at 6:42 pm | Permalink

    There is a good discussion in favor of allowing women to become egg donors at http://chezmiscarriage.typepad.com/
    A remarkably large number of egg donors describe their decision to donate in terms similar to those of blood donors. These donors describe their decision to donate in altruistic terms, and express a lack of connection to the eggs themselves (in other words, they don’t feel that a gamete makes a parent, or that the genetic connection requires them to feel like mothers to any of the resulting chidlren). Quite a few egg donors apparently know/are related to people who have struggled with infertility. Far MORE sperm donors talk in terms of money (to the extent that it was actually a jokey subplot on Friends once–Joey was making money “hand over fist,” I believe was the phrase) than egg donors, who tend to talk in atruistic terms. Now, maybe that’s all just cover and a false front of femininity, but on the other hand, aren’t we supposed to respect the terms by which women describe their own experiences and choices?
    Is it only the lack of invasiveness, medical complications, and low level of renumeration per donation that exempts sperm donors from this type of examination/analysis? Because at first blush, this tendency to question egg donors more than sperm donors looks to harbor some unexamined assumptions about maternal vs. paternal connections to gametes, as well as female vs. male medical knowledge/responsibility. In other words, why the inequality here?

  12. WayCurious
    Posted January 28, 2006 at 12:15 pm | Permalink

    Is it OK to pay bums to fight each other? If not, then one can easily see what’s wrong with paying women to risk their lives donating eggs.
    This issue will become even more important with the increase demand due to embryonic stem cell research.
    A recent issue of SCIENCE states, “A major challenge facing hESC [human embryonic stem cell] research will be procurement of oocytes from ‘non-medical’ donors, meaning those who are donating oocytes neither for reproductive nor medical purposes”
    Imagine the numbers needed if therapies develop. Heart disease patients alone equals the donating pool (women 20-30 yrs.)
    As acknowledged here, egg donation requires drugs and surgery. “Between 0.3 and 5% or up to 10% of women who undergo ovarian stimulation to procure oocytes experience severe ovarian hyperstimulation syndrome, which can cause pain, and occasionally leads to hospitalization, renal failure, potential future infertility, and even death ” . The risk “is incurred not in the actual research but in the procurement of materials for the research” “their physician’s fiduciary obligations would seem to require council against undergoing such a procedure”. It is different than organ donation because “organ donation has fairly clearly established benefits to the recipient”
    Canada has banned altruistic egg donations since the 1980s. Denmark and Israel have too. Frankly, we need greater legislation to protect young women – who as neither patients nor research subjects are at real and significant risk only to supply materials for research.
    So what is ethical?
    Should non-patient volunteers donate eggs?
    (Reprod Biomed Online. 2003 Apr-May;6(3):277-80)
    Egg donation is associated with medical and surgical risks regardless of the source of eggs, be it through commercial, altruistic or more recent egg-share donors. Egg sharing is the only system that does not turn a healthy woman (the donor) into a patient. … We propose that anonymous egg sharing, as licensed by the Human Fertilisation and Embryology Authority (HFEA), minimizes risk, is ethically sound and should be considered as the only acceptable form of anonymous egg donation.
    (Entrez PubMed http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12735857&dopt=Abstract )
    Note: Unless otherwise noted, quotes from SCIENCE MAG, “Issues in Oocyte Donation for Stem Cell Research”, Vol 308 p. 1747-1748 (17 June 2005).

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