The most recent issue of a leading bioethics journal, The Hastings Center Report, contains a study of advertisements for egg donation targeted at young women at top universities and colleges in the US. The study is the latest instalment in a long-standing debate over how much egg donors should be paid – if they should be paid at all.

Dr Aaron Levine, an assistant professor of public policy at the Georgia Institute for Technology, scrutinised over 100 ads for egg donation from 63 college newspapers. He found that many of them offered far above the guidelines offered by American Society for Reproductive Medicine (ASRM). The association’s guidelines suggest a maximum of US$10,000, and that compensations exceeding this are “not appropriate”. Also, according to the guidelines, payments over $5,000 “require justification”.

Students at high-achieving universities have long been a target for those seeking egg donations. Dr Levine found that average SAT scores at the university where the advertisements were published had a strong correlation with compensation. Some ads in the Harvard, Princeton and Yale newspapers offered a tantalising $35,000, and an advertisement at Brown University offered $50,000.

Donation of eggs is illegal in many countries, and strictly regulated in many others. US fertility clinics, however, are self-regulating. This has led to concerns of exploitation. “The concern is that some young women may choose to donate against their own best interests,” Dr Levine told the New York Times. “They’ll look at the money on offer and will overlook some of the risks.”

The egg donation process takes weeks, starting with a series of hormone injections to stimulate the ovaries to produce 10 ova in a cycle, and the ova are then removed surgically under a local anaesthetic.

The procedure can result in abdominal swelling, hot flashes and mood swings. More significant, however, is the risk of ovarian hyperstimulation syndrome, which can result in abdominal pain, bloating, and in some cases blood clots, kidney failure, and other life-threatening conditions.

The self-regulation system has its limitations. Violation of guidelines provided by associations like the ASRM invites no penalty, meaning that compensation for egg donation is effectively unrestricted. Dr Levine argues that “A legal cap on compensation would eliminate the worst of the abuses.” He also suggests that associations such as the ASRM take steps to increase compliance with their own guidelines. ~ The Hastings Center Report, Mar 2010, New York Times Mar 11