Egg Raffles and Shadow Markets: The Fertility Industry Goes Global - and Skirts Laws
The baby business has become a transnational enterprise.
Posted Mar 23, 2010
The Times' article noted that the raffle "circumvents" British law, which limits payments for eggs to reimbursement for expenses, and which does not allow "baby profiling." By contrast, it said, the winner of the raffle "will be able to pick the egg donor by racial background, upbringing and education."
The Human Fertilization and Embryology Agency, the UK agency that regulates IVF treatment and embryo research, issued a brief but strongly worded statement asserting that the raffle "trivialises altruistic donation" and "runs contrary to the ethos that, in this country, underpins the regulations that... protect the dignity of donors and recipients."
The story was picked up a few days later by the Washington Post, which focused on the "international ethical controversy" the raffle sparked:
The seminar, designed to entice infertile British women to seek donor eggs in the United States, drew intense criticism from infertility experts, bioethicists and others in Britain and the United States, who likened the event to a crass, commercial come-on similar to a lottery, with the prize being a human body part.
If you commodify body parts, including reproductive materials, who's going to be selling them? It's going to be the poor. And who's going to be buying them? It's going to be rich people.
You're gradually going down a slippery slope that not only undermines respect for certain body parts but eventually whole bodies of, say, people who are very old or very sick or very poor.
Unsurprisingly, the egg raffle was defended by Sean Tipton of the American Society for Reproductive Medicine, the fertility industry's professional organization:
If [patients] can win a contest that is going to allow them to build their families, and a physician is going to offer a service that can help them do that, then we applaud them.
The Bridge Centre, the London fertility clinic behind the give-away, claimed that it was the media that was guilty of sensationalism and trivialization. It also pointed out that its partner, the Virginia-based Genetics and IVF Institute, raffles off eggs and IVF cycles as part of "its regular practice in the USA." This is true: GIVF has been offering a lottery for a "free donor egg cycle" to attract prospective customers to its seminars since at least February 2009.
It is precisely the fertility industry's "regular practice in the USA" that a number of other countries have decided is wrong. In the US, fertility clinics and egg brokers recruit young women who have desirable looks and other traits by offering them thousands or even tens of thousands of dollars, while often significantly downplaying the risks of egg retrieval and typically failing to follow up on the health of those who undergo it. In addition to the UK, some two dozen countries including Belgium, the Netherlands, Finland, Australia, Japan, Singapore, and South Korea do not allow payments beyond reimbursement of direct expenses.
Canada enacted limits on compensation for eggs in its 2004 Assisted Human Reproduction Act, reflecting concerns about the potential for exploitation that an unrestricted egg market poses. But six years later, the details that would regulate reimbursing expenses for third-party eggs have not been worked out.
The results of that lapse are not pretty. A thoroughly reported story in the April 2010 issue of The Walrus, a Canadian magazine, observes that Canada now finds itself "in the uncomfortable position of banning the purchase of gametes in principle but not in practice." In "The Human Egg Trade: How Canada's fertility laws are failing donors, doctors, and parents," journalist Alison Motluk documents a thriving shadow market in eggs that relies on "grey areas" in the Canadian law. Her interviews with egg providers, fertility patients, IVF doctors and policy makers reveal that the Canadian Assisted Human Reproduction Act has
simply forced [commerce in human eggs] underground, with unintended and undesirable consequences. Fertility specialists, lacking official guidance from the government, began drawing their own boundaries. Patients had only doctors to rely on for advice. Worst of all, donors became part of a shadow economy, aware they were part of something vaguely illicit and therefore reluctant to come forward when something went wrong.
Motluk spoke to Canadian women who received sums for their eggs similar to those that are typical in the US. The money was paid under the guise of reimbursement for expenses, although the amount was negotiated up front and no receipts were requested. Alternatively, Canadian fertility patients are routinely sent to US companies that connect them with American egg providers.
Assisted reproduction brings babies and joy to people who long for a biologically related child. But it also constitutes what Barnard College president Debora Spar calls a "baby business." And it is fast becoming a thriving transnational enterprise, with companies, workers, consumers and body tissues traveling across borders. As in other aspects of global commerce, the lowest level of labor and consumer protection tends to prevail. In seeking the human eggs that are a key component of its product, the fertility industry thus targets jurisdictions with minimal regulatory oversight - like American college campuses.
Isn't it time to reverse this race to the bottom, and move instead toward effective national and international policies to protect all those affected by the global fertility industry?