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News of the Day ... In Perspective

4/5/2007

Purchase of human eggs creates ethical dilemma

A “Perspective” in the New England Journal of Medicine notes that women in the United States are permitted to “donate” their eggs for profit if used for reproduction, but are not allowed to receive payment beyond reasonable costs for donating oocytes for stem-cell research (Debora Spar, N Engl J Med 2007;357:1289-1291).

To forestall concerns about the commodification of human eggs, in the “heated environment” around embryonic stem-cell research, scientists were quick to promise never to purchase eggs. The April 2005 National Academy of Sciences Guidelines for Human Embryonic Stem Cell Research recommended that no payment be made for eggs used in research, and states permitting such research enacted the guidelines into law.

Potential complications of egg donation have received inadequate scientific scrutiny. More longitudinal studies are needed of the drugs used for ovarian hyperstimulation. Five women are known to have died in the UK as a result of egg donation, and between 0.5 and 5 percent have reportedly had side effects ranging from respiratory distress to renal failure.

A policy of allowing $20,000 payment for an egg used to create a child but nothing for the same egg used in research “would make sense only if we deemed assisted reproduction more valuable than research.”

The only source of eggs for research in the U.S. is from women undergoing in vitro fertilization who agree to donate excess eggs for use by other infertile women. Eggs from women who are infertile and desperate for access to treatment are “arguably far less attractive” than those from healthy young women recruited to supply desirable reproductive material.

Some argue that “if men can sell their sperm, why can’t women sell their eggs?” Others say: “We don’t allow people to sell their kidneys. Why should they sell eggs?”

In contrast to egg donors, live organ donors must undergo a formal process of informed consent overseen by the Organ Procurement and Transplantation Network.

Spar concludes: “We have not thought deeply about what makes sense for science, for women, and for society. Instead, we are only fighting about the price.”

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