← Return to search results
Back to Prindle Institute

Commodification and Exploitation in Egg Donation

image of ovarian follicles

Egg donation is a form of assisted reproductive technology (ART) in which a woman donates eggs to equip another woman to conceive a child. The process of egg donation usually involves in vitro fertilization technology, as the eggs undergo fertilization in a laboratory, or alternatively, the unfertilized egg can be frozen and stored to be used at a later time. Regulated according to guidelines set by the American Society for Reproductive Medicine, this form of ART has gained momentum in the US and around the world since the first child was born from egg donation in Australia in 1983. In the US today, egg donation accounts for about 18% of IVF births.

While the allowance of compensation for egg donors varies by the country, egg donors in the US are compensated up to $8,000 on average for the retrieval of eggs. While egg donation is a sought-after fix for those unable to conceive and stands to provide real benefits to donors and recipients alike, this form of IVF can be a sensitive subject as it raises a number of medical ethics questions.

A common concern raised by medical ethicists regarding egg donation is the type of consent obtained in the process of donating eggs. Although most donor recruiting agencies cite altruism and reliability as the most desirable qualities in a donor, the incentive of monetary compensation could hinder a donor’s capacity to make coherent and informed decisions. Studies have shown that donors motivated by financial incentives suffer more emotional trauma from the process and have a higher probability of regretting their decision than women who express altruistic motivations. In part to avoid risking the commodification of motherhood, nations such as the UK and Australia have ruled any form of monetary compensation to the egg donor to be illegal.

However, Lori Andrews (1992) notes that more often than not, “when society suggests that a certain activity should be done for altruism rather than money, it is generally a woman’s activity.” In agreement with Andrews, sociologist Anna Curtis argues, in her 2010 article Giving ‘Til It Hurts: Egg Donation and the Costs of Altruism, that women should be sufficiently compensated if egg donation is to remain legal in the US, due to the health risks the procedure poses, the emotional strain a donor is subjected to by donating an egg, and the time spent going through and recovering from the procedure.

Due to the technical and invasive nature of egg donation, donors may lack a complete understanding of all the potential short-term as well as long-term risks associated with donating eggs. Curtis also argues that the donors’ emotional investment can cause them to downplay the risks of the procedure. Curtis’ research suggests that not only did donors experience joy over a successful donation, but they also felt guilty when the procedure failed. When Curtis questioned donors regarding their knowledge of health risks associated with egg donation, she found that the women claimed to give “little or no thought to the possible short- or long-term risks involved in donating, despite their ability to list many of these very risks,” demonstrating that even if the donors are aware of the risks, they may not seriously consider the likelihood of these risks affecting them in the future, possibly because of their emotional investment in the egg donation process.

Furthermore, egg donation is a costly process — not only in terms of the emotional and physical strain put on the donor, but also in terms of the financial expenses for the recipient. The inequality of access to ART means that reproductive technology is a viable option exclusively to the wealthy. The feasibility of egg donation must therefore be analyzed recognizing that there may be a large demographic of infertile individuals who would choose ART to conceive a child had they the financial means, but are not able to so due to the high cost of reproductive technology.

The eugenic commodification of egg donors is an additional ethical concern regarding egg donation. Advertisements directed towards egg donors usually depict specific racial, physical, and intellectual characteristics as desirable, making it clear that the agencies are recruiting a certain type of woman whether it be based on ethnicity, height, or even scores obtained on standardized tests. This emphasis on eugenics perpetuates the commodification and exploitation of women’s bodies, reducing the female body to a product with reproductive value.

With these ethical concerns in mind, infertility specialists, agencies that recruit egg donors, as well as recipients of the donated egg must consider the multifaceted implications of egg donation when assessing regulations regarding egg donation. By doing so, individuals and agencies alike can make equitable and informed decisions concerning the emotional, physical, and monetary costs of egg donation to both the donors and the recipients.

Surrogacy in New York

photograph of pregnant torso

There are many ways to make a family. The intimate bonds of commitment and affection that make a family unit are grounded in a wide variety of ways: in biological relation, in choice, in shared experience, etc. Family bonds across generations are manifested between parent and child, but even these bonds vary in how they are grounded. Societies and our medical technology has developed in ways to support the variety of ways that parents can have children – currently there are ways to have a child through adoption, in vitro fertilization, and surrogacy, and advancements are being made in artificial wombs that would open up further methods of bringing children into the world. The diversity of methods for having children benefit potential parents for whom cis-hetero fertilization is not possible or desirable. Single parents, LGBT couples, and cis-hetero couples with fertility concerns are all aided by this variety of methods. 

So, the medical technologies and social policies that support individuals’ decisions to become parents, and thereby positively respect autonomy of these people. However, as with many developments and advancements that can be costly, there are justice considerations that arise: who is benefitting from the development, and who is placed at risk? Gestational surrogacy has recently been debated along these lines, for while the opportunity to have a child via surrogate benefits many potential parents, the risk and burden of gestation is adopted by someone else. To be a surrogate, a person agrees to take on the responsibilities of pregnancy and gestation for a potential parent with the understanding that parental rights and responsibilities after the birth of the child will belong to the person seeking the surrogate, not the person who gestates the child. The morality of compensating someone to take on this burden with their time and body raises questions for feminists and economic ethicists alike. 

Recently, New York State failed to pass a bill that would make compensated gestational surrogacy legal. Currently, in New York, only altruistic surrogacy is legal and surrogacy contracts are unenforceable. Surrogates cannot receive a fee or compensation, and the success of the arrangement is due solely to the integrity of the parties involved. 

New York is one of two states that currently ban compensated gestational surrogacy outright. In 1992, a gestational surrogate in New Jersey sued to keep parental rights over her biological child. In the wake of that suit, New Jersey, Michigan and New York passed bills banning gestational surrogacy. New Jersey reversed the ban last year, leaving New York and Michigan remaining. (Though it is important to note the variety of restrictions and protections that exist across America, sometimes at the county-by-county level.) 

However, the proposed bill — allowing gestational surrogates to be compensated for bearing a child without intending to bear the rights and responsibilities of parenthood — did not succeed during this legislative session. Democratic representatives were concerned that compensated surrogacy presents a slippery slope to commodifying women’s bodies and the bill did not garner sufficient support. “We must ensure that the health and welfare of women who enter into these arrangements are protected, and that reproductive surrogacy does not become commercialized,” said Assembly Speaker Carl Heastie.

Some feminists, such as Gloria Steinem, have been vocal opponents of gestational surrogacy. These opponents are concerned about the exploitation of people from marginalized and vulnerable groups and putting the bodies of individuals from such group to use for gestation. The monetary incentive to put one’s body through pregnancy presses on the economically vulnerable in an unjust way, they claim, and their case is strengthened by the state of surrogacy in Cambodia, Thailand, and India. In India, for example, some surrogates are forced to live in special homes and have no health insurance beyond the pregnancy, and no guarantee of payment.

Other feminists, as well as infertility advocates and LGBT groups, have been advocating in favor of changing the New York law. Governor Cuomo criticized the failure of support behind the bill, emphasizing the protections for the surrogates included that were meant to safeguard against exploitation. With all of these safeguards, Cuomo questioned how much the lawmakers were respecting the autonomy of those that would choose to be surrogates: “I say, how about a woman’s right to choose, which we just argued for Roe v. Wade?” Cuomo said. “But in this state we say the woman must have an attorney, the woman must have a health counselor, the transaction will be supervised under the Department of Health, the woman can’t be in dire economic conditions, but you still believe the woman is not competent to make that decision.” 

Thus the division between protecting vulnerable groups (economically disadvantaged and individuals with uteruses) and advocating for individuals to be able to take on risks consensually came down in favor of protection in New York this month. Both sides emphasized that this will be an ongoing conversation.