Correspondence

Compensating Egg Donors: Equal Pay for Equal Time?

N Engl J Med 1993; 328:737March 11, 1993

Article

To the Editor:

The ability to achieve pregnancy after egg donation represents an important recent medical advance, not only because of its scientific merit, but also because of the way in which it benefits society. A woman with ovarian failure or known genetic disease can have a normal child if a healthy egg is available through egg donation.

However, the word “donation” is creating a stumbling block. The American Fertility Society (AFS) clearly stated in its 1990 ethical advisory committee report that “there should be no compensation to the donor for the egg.” Yet the next sentence states, “This does not exclude reimbursement for expenses, time, risk and associated inconvenience.”

In most states in which insurance coverage for the treatment of infertility is not mandated, egg donors are so compensated. In Massachusetts, where coverage for the treatment of infertility is mandated, one major insurance company's provider contract acknowledges only the first sentence of the AFS report. The insurers will not compensate donors for the time, risk, inconvenience, or mental health screening involved in the process of donation. More important, they do not allow the insured recipient to cover these expenses out of pocket. This entire stance is puzzling, since the same insurance company does compensate for sperm donation. Sperm donors are generally paid a minimum of $25 as compensation for approximately one hour of time and any inconvenience and travel involved. Using this scale, we calculated the time involved in egg donation (Table 1Table 1An Analysis of the Time Involved in Egg Donation.). According to our calculations, an egg donor could expect to receive $1,400 for her time alone, exclusive of any compensation for travel, risk, or inconvenience.

Although some women are fortunate enough to have a sister or friend who will go through mental health screening, days of injections, blood tests, ultrasonography, and a minor surgical procedure to provide them with an egg, many women are less fortunate. Luckily, some young women are willing to brave the risks and inconvenience to help someone they do not know. Most donor programs across the United States compensate anonymous egg donors in amounts ranging from $1,000 to $2,000. By neither providing nor allowing compensation for the donors' time, risk, inconvenience, or mental health screening, insurance companies negatively influence egg-donor selection and standards of care. In February 1993 the AFS guidelines for oocyte donation were changed to the following: “Donors should be compensated for direct and indirect expenses associated with their participation, inconvenience, time, risk and discomfort.” Since it is standard to compensate men for sperm donation, shouldn't the policy be equal pay for equal time?

Machelle M. Seibel, M.D.
Ann Kiessling, Ph.D.
Faulkner Centre for Reproductive Medicine, Boston, MA 02130

Citing Articles (7)

Citing Articles

1. 1

   Heidi Mertes, Guido Pennings. (2011) The force of dissimilar analogies in bioethics. Theoretical Medicine and Bioethics 32:2, 117-128
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2. 2

   Robert Klitzman, Mark V Sauer. (2009) Payment of egg donors in stem cell research in the USA. Reproductive BioMedicine Online 18:5, 603-608
   CrossRef

3. 3

   Sharon N. Covington, William E. Gibbons. (2007) What is happening to the price of eggs?. Fertility and Sterility 87:5, 1001-1004
   CrossRef

4. 4

   (2004) Financial incentives in recruitment of oocyte donors. Fertility and Sterility 82, 240-244
   CrossRef

5. 5

   Ken R. Daniels, Gillian M. Lewis. (1996) Donor insemination: The gifting and selling of semen. Social Science & Medicine 42:11, 1521-1536
   CrossRef

6. 6

   Seibel, Machelle M., . (1994) Cadaveric Ovary Donation. New England Journal of Medicine 330:11, 796-796
   Full Text

7. 7

   (1993) More on Compensating Egg Donors. New England Journal of Medicine 329:4, 278-279
   Full Text

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